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SARS-CoV-2 proteins

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    The Association Between Biomarkers and Clinical Outcomes in Novel Coronavirus ( COVID-19 MESHD) Pneumonia in a U.S. Cohort

    Authors: Shant Ayanian; Juan A Reyes; Lei Lynn; Karolyn Teufel

    doi:10.1101/2020.05.27.20115105 Date: 2020-05-29 Source: medRxiv

    Background: The global pandemic caused by COVID-19 MESHD remains poorly understood by clinicians. Identifying biologic markers associated with prognosis can help clinicians recognize disease severity. Objective: To describe the association between D-dimer, CRP HGNC, IL-6 HGNC, ferritin, LDH, and clinical outcomes in a cohort of COVID-19 MESHD patients treated on the inpatient medical service at a university hospital in Washington, DC. Design: In this retrospective study, we included all adults admitted to the inpatient medicine service at George Washington University Hospital between March 12, 2020 and May 9, 2020 with laboratory confirmed COVID-19 MESHD. Clinical and laboratory data were extracted from electronic medical records and compared between survivors not requiring ICU transfer, survivors requiring ICU transfer, survivors requiring intubation, and non-survivors. Key Results: 299 patients were included in our study, of whom 69 required transfer to the ICU, 39 required intubation, and 71 died. Threshold values for IL-6 HGNC (>50 pg/mL), D-dimer (>3 mcg/mL), ferritin (>450 ng/mL), CRP HGNC (>100 mg/L), and LDH (1,200 u/L) were found to be statistically significant and independently associated with higher odd of clinical deterioration and death. Hypertension MESHD, CVA and heart disease MESHD independently had an increased risk of all three outcomes, while CKD had only an increased risk of death MESHD. Patient co-morbidities had no effect on the different biomarkers' significant association with poor patient clinical outcomes, except cancer MESHD. Conclusion: Laboratory markers of inflammation MESHD and coagulopathy MESHD can help clinicians identify patients who are at high risk for clinical deterioration, independent of clinically significant medical comorbidities

    Clinical Features of Hypertensive Patients With Covid-19 MESHD Compared With a Normotensive Group

    Authors: shuang wang; qiang zhang; zhao bin zheng; peng wang; hua hong ye; xiao qing jing; jun hua zhang; da yu fan; ping jia; zhong dan zhang; ting ting luo; shi sheng zhu

    doi:10.21203/rs.3.rs-31685/v1 Date: 2020-05-26 Source: ResearchSquare

    Background: The novel coronavirus ( COVID-19 MESHD), which began in Wuhan, China, in December 2019, has spread worldwide and poses a great threat to human health. Among COVID-19 MESHD patients, those with hypertension MESHD have been reported to have higher morbidity and mortality. This study was conducted to provide the international community with a deeper understanding of COVID-19 MESHD with hypertension MESHD.Methods: A total of 188 COVID-19 MESHD patients were studied from January to March 2020. The epidemiology, clinical features, and laboratory data of hypertensive MESHD patients with COVID-19 MESHD were collected, retrospectively analyzed, and compared with a normotensive group. The use of anti- hypertensive MESHD drugs, general treatment, and clinical outcomes of hypertensive MESHD patients were also analyzed.Results: The median ages in hypertensive MESHD patients with mild and severe COVID-19 MESHD were both significantly greater than the median age in the normotensive group. But there was no significant gender difference between the hypertensive MESHD and normotensive groups. All patients had lived in the Wuhan area. Common symptoms of all of the patients included fever MESHD, cough MESHD, and fatigue MESHD. Chest CT scans showed bilateral patchy shadows or ground glass opacity in the lungs of all of the patients. All (98 [100%]) of the hypertensive MESHD patients received antiviral therapy (Arbidol was used alone or in combination with Ribavirin), antibiotic therapy (85 [86.7%]), and corticosteroids (31 [31.6%]). It has been suggested that the combination of Arbidol and Ribavirin as initial therapy for hypertensive MESHD patients with COVID-19 MESHD is effective and safe. There were no significant differences in laboratory data between the mild cases in the hypertensive MESHD and the normotensive groups. In the severe cases, the hypertensive MESHD patients had higher plasma levels of D-dimer, C-reactive protein HGNC ( CRP HGNC), and Interleukin-6 HGNC ( IL-6 HGNC) (P < 0.05). Furthermore, the hypertensive MESHD patients who were treated with angiotensin-converting enzyme inhibitors/angiotensin receptor blockers (ACEI/ARB) had no statistically significant differences between the mild and severe groups (p > 0.05).Conclusion: In this study, we demonstrated that the hypertensive MESHD patients who were treated with ACEI/ARB did not have an increased risk of developing severe COVID-19 MESHD. Arbidol and Ribavirin played an important role in the treatment of the viral pneumonia MESHD. Hypertensive MESHD patients with severe viral pneumonia MESHD had stronger inflammatory responses than non- hypertensive MESHD patients.

    Early experience with COVD-19 patients at tertiary care teaching hospital in southwestern United states

    Authors: Rahul Shekhar; Shubhra Upadhyay; Abubaker Sheikh; Jeanette Atencio; Devika Kapuria

    doi:10.1101/2020.05.15.20094284 Date: 2020-05-18 Source: medRxiv

    Abstract Importance: There is limited information about presenting characteristics, treatment and outcomes of patients requiring hospitalization for coronavirus disease 2019 MESHD ( COVID-19 MESHD) serving underserved population in southwestern United states. Objective: To describe the clinical characteristics and outcomes of patients with COVID-19 MESHD, hospitalized in a tertiary care teaching hospital in southwestern United states serving Underserved population. Methods: Case series of first 50 adults admitted at the University of New Mexico (UNM) Health Science center, the only tertiary care teaching hospital in the state of New Mexico between Jan 19th to April 24th 2020 via retrospective and prospective chart review. Main outcomes and measures: Clinical outcomes during hospitalization, such as invasive mechanical ventilation, kidney replacement therapy and death MESHD. Demographics, baseline comorbidities, presenting vital signs, and test results were also collected. Results: A total of 50 patients were included (median age, 55.5; 20-85-year-old, 54% were female). Obesity was the most common comorbidity in 20/39 (51%), followed by diabetes MESHD in 18/50 (36%) and hypertension MESHD 17/50(34%). Mean onset of symptoms duration before admission 7.39 days (range 1-21days). Most common symptoms on presentation included subjective fevers 40/42 (95.2%), cough 43/46 (93%) 43/46 and shortness of breath 40/46(87%). At triage only 24% were febrile and 46% patient did not have a single febrile episode throughout hospitalization, 56% had respiratory rate > 20 and 66% had a heart rate > 90. 80% patients required oxygen and 20%required intubation on presentation. On differential analysis 46% had elevated neutrophil counts, and 48% had low lymphocytes counts. Median D dimer, Ferritin, CRP HGNC, LDH were all elevated at presentation. 10% of patients had a negative initial chest x ray. 19.3% patients have coinfection with another respiratory viral pathogen. 34 (68%) patient required ICU level of care at some point during hospitalization. More than 70% of patients were treated with antibiotics mainly directed towards community acquired pneumonia MESHD but 97.5% patient has negative blood culture and 93.3% has negative sputum cultures. Of admitted patients, 34% (17/50) were directly admitted to ICU and. Of these ICU patients 82.4% (28/34) required invasive mechanical ventilation. Patients spent a median of 2 days on the floor prior to ICU transfer, median length of stay in the ICU was 7 days. On comparing characteristics of patients, patients with diabetes MESHD, and higher lactate dehydrogenase on admission were more likely to require ICU level of care. No patient deaths were reported on the floor. Of 34 patients in the ICU 13 died while 6 are still receiving care in the hospital, with an overall mortality of 30.2% (13/43). Out of 13 patients who died, 2 were on HD MESHD, 11/13(84%) patients had acute kidney injury MESHD and required CRRT or HD MESHD. The median length of stay is 7 days (Range 1-31days), for floor patients 4 days and ICU patients 13 days. Out of 43 patients who completed their clinical course 24/43(58.1%) were discharged home, 5/43(11.6%) went to rehabilitation facilities and 30.2% died. 16/30(53.3%) required oxygen on discharge. Conclusion: This case series provides characteristics and early experience in treating patient admitted to tertiary care teaching hospital in state of NEW Mexico.

    Higher Body Mass Index is an Important Risk factor in COVID-19 MESHD patients: A Systematic Review

    Authors: Vivek Singh Malik; Ravindra Khaiwal; Savita Verma Attri; Sanjay Kumar Bhadada; Meenu Singh

    doi:10.1101/2020.05.11.20098806 Date: 2020-05-18 Source: medRxiv

    Background: Globally, both obesity MESHD and underweight are severe health risks for various diseases. The current study systematically examines the emerging evidence to identify an association between Body Mass Index (BMI) and COVID-19 MESHD disease outcome. Methods: Online literature databases (e.g., Google Scholar, PubMed, MEDLINE, EMBASE, Scopus, Medrixv and BioRixv) were screened following standard search strategy having the appropriate keyword such as Obesity, Underweight, BMI, Body Mass Index, 2019-nCov, COVID-19 MESHD, novel coronavirus, coronavirus disease MESHD. Studies published till 20th April 2020 were included without language restriction. These studies include case reports, case series, cohort, and any other which reported BMI, overweight/ obesity MESHD or underweight, and its complication with COVID-19 MESHD disease. Findings: Obesity plays a significant part in the pathogenesis of COVID-19 MESHD patients, though the role of BMI in the COVID-19 pandemic MESHD must not be ignored. Interpretation: Consequences of inflammation of adipose MESHD tissue has been reported as a leading cause of insulin HGNC resistance and hypertension MESHD due to metabolic dysfunction MESHD. The results of the current study show that BMI plays a significant role in COVID-19 MESHD severity in all ages, especially the elderly population. A panel should review COVID-19 MESHD patients with higher BMI and other co-morbidities, and they should be given increased vigilance, testing priority, and therapy. Further, the COVID-19 MESHD patients whose illness entered 7-10 days, age >50 yrs, and elevated CRP HGNC levels should have additional medical considerations. Recommendation: Population and patients with high BMI have moderate to high risk of medical complications with COVID-19 MESHD, and hence their health status should be monitored more frequently. Keywords: Age, BMI, COVID-19 MESHD, Obesity.

    COVID-19 MESHD in Spain: age, Interleukin-6 HGNC, C Reactive Protein HGNC and lymphocytes as key clues from a multicentre retrospective study

    Authors: Aurora Jurado; M Carmen Martin; Cristina Abad-Molina; Antonio Orduna; Alba Martinez; Esther Ocana; Oscar Yarce; Ana M Navas; Antonio Trujillo; Luis Fernandez-Pereira; Esther Vergara; Beatriz Rodriguez; Bibiana Quirant; Eva Martinez-Caceres; Manuel Hernandez; Janire Perurena; Juana Gil; Sergi Cantenys; Gema Gonzalez-Martinez; Maria Teresa Martinez-Saavedra; Ricardo Rojo; Francisco M Marco; Sergio Mora; Jesus Ontanon; Marcos Lopez-Hoyos; Gonzalo Ocejo-Vinyals; Josefa Melero; Marta Aguilar; Delia Almeida; Silvia Medina; Maria Carmen Vegas; Yesenia Jimenez; Alvaro Prada; David Monzon; Francisco Boix; Vanesa Cunil; Juan Molina

    doi:10.1101/2020.05.13.20101345 Date: 2020-05-16 Source: medRxiv

    Background. SARS-CoV-2 infection MESHD has widely spread to the hugest public health challenge to date, COVID-19 MESHD COVID-19 MESHD pandemic. Different fatality rates among countries are probably due to non-standardized records being carried out by local health authorities. Spanish case-fatality rate is 11.94%, far higher to those reported in Asia or by other European countries. A multicenter retrospective study was performed of demographic, clinical, laboratory and immunological features of 574 Spanish COVID-19 MESHD hospitalized patients and their outcomes. The use of use of renin HGNC-angiotensin system blockers was also analyzed as a risk factor. Results. In this study, 27.7% of cases presented a mild curse, 42% a moderate one and for 30.3% of cases, the course was severe. Ages ranged from 18 to 98 (average 63.2). Fifty eight percent (58.9%) of patients were male. Interleukin 6 HGNC was higher as severity increased. On the other hand, CD8 HGNC lymphocyte count was significantly lower as severity grew and subpopulations CD4 HGNC, CD8 HGNC, CD19 HGNC and NK showed concordant lowering trends. Severity-related natural killer percent descents were evidenced just within aged cases. A significant severity-related decrease of CD4 HGNC lymphocytes was found in males. The use of renin HGNC-angiotensin system blockers was associated with moderate or mild disease courses. Conclusions. Age and age-related comorbidities, such as dyslipidaemia, hypertension MESHD or diabetes MESHD, determined more frequent severe forms of the disease in this study than in previous literature cohorts. Our cases are older than those so far reported and clinical course of the disease is found to be impaired by age. Immunosenescence might be therefore a suitable explanation for immune system effectors severity-related hampering. Adaptive immunity would go exhausted and a huge ineffective and almost deleterious innate response would account for COVID-19 MESHD severity. Renin HGNC-angiotensin system blockers treatment in hypertensive MESHD patients has a protective effect as regarding COVID-19 MESHD severity.

    Early effect of SARS-COV-2 on renal tubule: a pilot study

    Authors: Mengyan Wang; Xiaotian Dong; Jun Yan; Zhongdong Zhang; Jinchuan Shi; Shourong Liu

    doi:10.21203/rs.3.rs-28591/v1 Date: 2020-05-12 Source: ResearchSquare

    Objective: To explore the early clinical characteristics of coronavirus disease 2019 MESHD ( COVID-19 MESHD) and provide a reference for the early prevention and treatment of the disease.Methods: We collected and analyzed demographic data, medical history, exposure history, underline diseases MESHD, symptoms, signs, laboratory data, chest computed tomographic (CT) scans, and treatment measures of COVID-19 MESHD patients admitted to the Sixth People's Hospital of Hangzhou from January 20 to February 23, 2020.Results: Among 51 confirmed COVID-19 MESHD patients included in this study, 7.8% (4/51) patients were severe and 45.1% (23/51) were male. Median age was 43 years (IQR, 23). Fever MESHD (54.9%, 28/51) and cough (52.9%, 27/51) were the main symptoms. 74.5% (38/51) patients had a history of exposure and 17.6% (9/51) patients had a history of hypertension MESHD. Importantly, most (60.8%, 31/51) patients had an increase of urine β2 microglobulin HGNC. In addition, the inflammation MESHD indexes ( C-reactive protein HGNC and serum amyloid A) of patients with elevated urine β2 microglobulin HGNC were significantly increased (p = 0.017 and p = 0.049) and lymphocytes count was significantly reduced (p = 0.012), compared with patients with normal urine β2 microglobulin HGNC. Correlation analysis showed that urine β2 microglobulin HGNC was positively correlated with C-reactive protein HGNC and serum amyloid A; but negatively correlated with lymphocytes count.Conclusions: COVID-19 MESHD patients have obvious symptoms of lung injury MESHD, but the occurrence of early renal tubular injuries MESHD has to be monitored vigilantly.

    The characteristics and death risk factors of 132 COVID-19 MESHD pneumonia patients with comorbidities: a retrospective single center analysis in Wuhan, China

    Authors: Chen Chen; Zhang Jing Yi; Li Chang; Hu Zhi Shuo; Zhang Ming; Tu Pei; Liu Lei; Zong Wen Xia

    doi:10.1101/2020.05.07.20092882 Date: 2020-05-12 Source: medRxiv

    Background: The new coronavirus pneumonia MESHD ( COVID-19 MESHD) has evolved into a global pandemic disease, and the epidemiological characteristics of the disease have been reported in detail. However, many patients with new coronary pneumonia MESHD have comorbidities, and there are few researches reported in this special population. Methods: a retrospective analysis was performed on 132 consecutive COVID-19 MESHD patients with comorbidities from January 19, 2020 to March 7, 2020 in Hubei NO.3 People Hospital. Patients were divided into mild group and critical group and were followed up to the clinical endpoint. The observation biomarkers include the clinical feature, blood routine, blood biochemistry, inflammation MESHD biomarkers, and coagulation function. Univariate and multivariate logistic regression was used to analyze the risk factors associated with death MESHD. Results: 132 patients were enrolled in this study and divided into the mild group (n=109, 82.6%) and critical group (n=23, 17.4%), of whom 119 were discharged and 13 were died in hospital. The all-cause mortality rate was 9.8%, of which 7 patients died of respiratory failure MESHD, 5 patients died of heart failure MESHD, and 1 patient died of chronic renal failure MESHD. There was significant statistical difference of mortality rates between the mild group (5.5%) and the critical group (30.4%).The average time of hospitalization was 16.9 (9, 22) days. Hypertension MESHD was the most common comorbidity (n=90, 68.2%), followed by diabetes MESHD (n=45, 34.1%), coronary heart disease MESHD (31, 23.5%). Compared with the mild group, the patients were older in critical group (P <0.05), and neutrophils, neutrophil ratio, neutrophil-lymphocyte ratio (NLR), serum urea nitrogen (BUN), procalcitonin (PCT), C-reactive protein CRP), serum amyloid protein ( SSA HGNC), N-terminal brain natriuretic peptide precursor (NT-pro BNP) were significantly increased (P <0.05). However, lymphocytes lymphocyte ratio, albumin were lower than those in the critical group (P <0.05). The patients were further divided into the survivor group (n=119, 90.2%) and the non-survivor group (n=13, 9.8%). Compared with the survivor group, the death rate of patients with coronary heart disease MESHD was significantly increased (53.8% vs 20.2%), and The neutrophil ratio, aspartate aminotransferase ( AST HGNC), BUN, PCT, CRP HGNC, SAA, interleukin-6 HGNC( IL-6 HGNC) and D-dimer were significantly increased (P <0.05), while the lymphocytes and NLR reduced (P <0.05). Multivariate logistic stepwise regression analysis showed that the past medical history of coronary heart disease MESHD[OR:2.806 95%CI:0.971~16.795], decreased lymphocytes[OR:0.040, 95%CI:0.001~2.306], increased AST HGNC[OR:1.026, 95%CI:1.000~1.052], increased SSA HGNC[OR:1.021, 95%CI:1.001~1.025], and increased D-dimer[OR:1.231, 95%CI:1.042~1.456] are risk factors associated with death MESHD in COVID-19 MESHD patients pneumonia MESHD with comorbidities. Conclusion: The mortality rate of COVID-19 MESHD patients with coronary heart disease MESHD is relatively high. In all patients, the lower lymphocytes, and higher NLR, BUN, PCT, CRP HGNC, SSA HGNC, D-dimer are significant characteristics. The past medical history of coronary heart disease MESHD, decreased lymphocytes, increased AST HGNC, SSA HGNC and D-dimer are risk factors associated with death MESHD in COVID-19 MESHD pneumonia MESHD patients with comorbidities

    Development and External Validation of a Prognostic Tool for COVID-19 MESHD Critical Disease

    Authors: Daniel S Chow; Justin Glabis-Bloom; Jennifer Soun; Brent Weinberg; Theresa Berens-Loveless; Xiaohui Xie; Simukayi Mutasa; Edwin Monuki; Jung In Park; Daniela Bota; Jie Wu; Leslie Thompson; Bernadette Boden-Albala; Saahir Khan; Alpesh Amin; Peter Chang

    doi:10.1101/2020.05.06.20093435 Date: 2020-05-11 Source: medRxiv

    Background: The rapid spread of coronavirus disease 2019 MESHD ( COVID-19 MESHD) revealed significant constraints in critical care capacity. In anticipation of subsequent waves, reliable prediction of disease severity is essential for critical care capacity management and may enable earlier targeted interventions to improve patient outcomes. The purpose of this study is to develop and externally validate a prognostic model/clinical tool for predicting COVID-19 MESHD critical disease at presentation to medical care. Methods: This is a retrospective study of a prognostic model for the prediction of COVID-19 MESHD critical disease where critical disease MESHD was defined as ICU admission, ventilation, and/or death. The derivation cohort was used to develop a multivariable logistic regression model. Covariates included patient comorbidities, presenting vital signs, and laboratory values. Model performance was assessed on the validation cohort by concordance statistics. The model was developed with consecutive patients with COVID-19 MESHD who presented to University of California Irvine Medical Center in Orange County, California. External validation was performed with a random sample of patients with COVID-19 MESHD at Emory Healthcare in Atlanta, Georgia. Results: Of a total 3208 patients tested in the derivation cohort, 9% (299/3028) were positive for COVID-19 MESHD. Clinical data including past medical history and presenting laboratory values were available for 29% (87/299) of patients (median age, 48 years [range, 21-88 years]; 64% [36/55] male). The most common comorbidities included obesity MESHD (37%, 31/87), hypertension MESHD (37%, 32/87), and diabetes MESHD (24%, 24/87). Critical disease MESHD was present in 24% (21/87). After backward stepwise selection, the following factors were associated with greatest increased risk of critical disease MESHD: number of comorbidities, body mass index, respiratory rate, white blood cell count, % lymphocytes, serum creatinine, lactate dehydrogenase, high sensitivity troponin I, ferritin, procalcitonin, and C-reactive protein HGNC. Of a total of 40 patients in the validation cohort (median age, 60 years [range, 27-88 years]; 55% [22/40] male), critical disease MESHD was present in 65% (26/40). Model discrimination in the validation cohort was high (concordance statistic: 0.94, 95% confidence interval 0.87-1.01). A web-based tool was developed to enable clinicians to input patient data and view likelihood of critical disease MESHD. Conclusions and Relevance: We present a model which accurately predicted COVID-19 MESHD critical disease risk using comorbidities and presenting vital signs and laboratory values, on derivation and validation cohorts from two different institutions. If further validated on additional cohorts of patients, this model/clinical tool may provide useful prognostication of critical care needs.

    Clinical course and features of critical patients with COVID-19 MESHD: a single- center, retrospective study from Wuhan Huoshenshan Hospital

    Authors: Huisi He; Zhichao Jin; Yibin Ren; Junxue Wang; Wen Wen; Yushan Miao; Xuewei Qi; Taiyu Shang; Chenxu Zhang; Hongyang Wang; Weiqin Li; Xijing Zhang; Hao Tang

    doi:10.21203/rs.3.rs-27487/v1 Date: 2020-05-08 Source: ResearchSquare

    Background : The coronavirus pandemic has become a growing public health concern worldwide, and there are insufficient epidemiological data on critical illness. Objective: To investigate the clinical course and features of critical patients with Corona Virus Disease MESHD 2019 ( COVID-19 MESHD ). Methods: The data on 94 consecutive critical patients from 8 th February through 16 th March 2020, including demographic and clinical information, were obtained from the intensive care unit (ICU) of Wuhan Huoshenshan Hospital. A cross-sectional survey and comparisons of key biomarkers between survivors and nonsurvivors were performed. Results: Over the study period, 42 nonsurvivors and 52 survivors were included. The overall case fatality rate for critical patients with COVID-19 MESHD was approximately 45%. The average age was 69.17±9.55 years, and the majority had underlying health problems such as hypertension MESHD (56[60%]) and diabetes MESHD (18[19%]). The median length of ICU stay was 8 days (IQR 4, 13). Compared with survivors, nonsurvivors were more likely to develop sepsis MESHD (42[100%] vs. 34[65%]), acute respiratory distress syndrome MESHD (40[95%] vs. 28[54%]) and organ dysfunction. In addition, the dynamic changes in some biomarkers were significantly different between the two groups. The trajectories of temperature revealed that the group with a high temperature on admission that steadily declined had the highest percentage of deaths (93.33%). Conclusions: Patients aged 60 years or older with many concomitant diseases were at highest risk, and the fatality rate started to increase with age. Lymphocyte, platelet, C-reactive protein HGNC and hypersensitivity MESHD troponin I were revealed to have potential as prognostic factors, whereas some other biomarkers, such as hepatic enzymes, may not offer additional information. Moreover, patients with high temperatures on admission should receive extra care.

    Single-cell Transcriptome Analysis Indicates New Potential Regulation Mechanism of ACE2 HGNC and NPs signaling among heart failure patients infected with SARS-CoV-2

    Authors: Xiaojiang Xu; Dachun Xu; Hong Li; Mengqiu Ma; Yanhua Xu; Yang Su; Sang-Bing Ong; Xindong Hu; Min Cai; Maojun Zhao; Yingjie Chen

    doi:10.1101/2020.04.30.20081257 Date: 2020-05-05 Source: medRxiv

    Background: COVID-19 MESHD patients with comorbidities such as hypertension MESHD or heart failure MESHD ( HF MESHD) are associated with poor clinical outcomes. Angiotensin-converting enzyme 2 HGNC ( ACE2 HGNC), the critical enzyme for SARS-CoV-2 infection MESHD, is broadly expressed in many organs including heart. However, the cellular distribution of ACE2 HGNC in the human heart, particularly the failing heart is unknown. Methods: We analyzed single-cell RNA sequencing (scRNA-seq) data in both normal and failing hearts, and characterized the ACE2 HGNC gene expression profile in various cell subsets, especially in cardiomyocyte subsets, as well as its interaction with gene networks relating to various defense and immune responses at the single cell level. Results: The results demonstrated that ACE2 HGNC is present in cardiomyocytes (CMs), endothelial cells, fibroblasts and smooth muscle cells in the heart, while the number of ACE2 HGNC-postive ( ACE2 HGNC+) CMs and ACE2 HGNC gene expression in these CMs are significantly increased in the failing hearts. Interestingly, both brain natriuretic peptides ( BNP HGNC) and atrial natriuretic peptide (ANP) are significantly up-regulated in the ACE2 HGNC+ CMs. Further analysis shows that ANP, BNP HGNC and ACE2 HGNC may form a negative feedback loop with a group of genes associated with the development of heart failure MESHD. To our surprise, we found that genes related to virus entry, virus replication and suppression of interferon-gamma HGNC signaling are all up-regulated in CMs in failing hearts, and the increases were significantly higher in ACE2 HGNC+ CMs as compared with ACE2 HGNC negative ( ACE2 HGNC-) CMs, suggesting that these ACE2 HGNC+ CMs may be more vulnerable to virus infection MESHD. Since ACE2 HGNC expression is correlated with BNP HGNC expression, we further performed retrospective analysis of the plasma BNP HGNC levels and clinic outcome of 91 COVID-19 MESHD patients from a single-center. Patients with higher plasma BNP HGNC were associated with significantly higher mortality rate and expression levels of inflammatory and infective markers such as procalcitonin and C-reactive protein HGNC. Conclusion: In the failing heart, the upregulation of ACE2 HGNC and virus infection MESHD associated genes, as well as the increased expression of ANP and BNP HGNC could facilitate SARS-CoV-2 virus entry and replication in these vulnerable cardiomyocyte subsets. These findings may advance our understanding of the underlying molecular mechanisms of myocarditis MESHD associated with COVID-19 MESHD.

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HGNC Genes
SARS-CoV-2 Proteins


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