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MeSH Disease

HGNC Genes

SARS-CoV-2 proteins

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    Patients’ treatment limitations as predictive factor for mortality in COVID-19 MESHD: Results from hospitalized patients of a hotspot region for SARS-CoV-2 infection MESHDs

    Authors: Stephan Budweiser; Sevki Bas; Rudolf Jörres; Sebastian Engelhardt; Stefan von Delius; Jens Deerberg; Andreas Bauer; Katharina Lenherr

    doi:10.21203/rs.3.rs-113642/v1 Date: 2020-11-22 Source: ResearchSquare

    Background: In hospitalized patients with SARS-CoV-2 infection MESHD, outcomes markedly differ between locations, regions and countries. For this, patients’ treatment limitations (PTL) could be of major relevance. We thus studied their role as predictor for mortality in a population of hospitalized patients with COVID-19 MESHD.Methods: In a region with high incidence of SARS-CoV-2 infection MESHD, adult hospitalized patients with PCR-confirmed SARS-CoV-2 infection MESHD were prospectively registered and characterized regarding sex, age, vital signs, symptoms, comorbidities (including Charlson Comorbidity Index (CCI)), transcutaneous pulse oximetry (SpO2) and laboratory values upon admission, as well as ICU-stay including respiratory support, discharge, transfer to another hospital and death. PTL assessed by routine clinical procedures comprised the acceptance of ICU-therapy, orotracheal intubation and/or cardiopulmonary resuscitation.Results: Among 526 patients included (median [quartiles] age 73 [57; 82] years, 47% female), 226 (43%) had at least one treatment limitation. Each limitation was associated with age, dementia MESHD and eGFR HGNC (p<0.05 each), that regarding resuscitation additionally with Charlson comorbidity index (CCI) and cardiac disease MESHD. Overall mortality was 27% and lower (p<0.001) in patients without treatment limitation (12%) compared to those with any limitation (47%). In univariate analyses, age and comorbidities ( diabetes MESHD, cardiac, cerebrovascular, renal, hepatic, malignant disease MESHD, dementia MESHD), SpO2, hemoglobin, leucocyte numbers, estimated glomerular filtration rate ( eGFR HGNC), C-reactive protein HGNC ( CRP HGNC), Interleukin-6 HGNC and LDH were predictive for death (p<0.05 each). In multivariate analyses, the presence of any treatment limitation was an independent predictor of death MESHD (OR 4.34, 95%-CI 2.10-12.30; p=0.001), in addition to CCI, eGFR HGNC <55 ml/min, neutrophil number >5 G/l, CRP >7 mg/l and SpO2 <93% (p<0.05 each).Conclusion: In hospitalized patients with SARS-CoV-2, the percentage of patients with treatment limitations was high. PTL were linked to age, comorbidities and eGFR HGNC assessed upon admission and strong, independent risk factors for mortality. These findings might be useful for further understanding of COVID-19 MESHD mortality and its regional variations.

    Covid-19 MESHD fatality prediction in people with diabetes and prediabetes using a simple score at hospital admission

    Authors: Harald Sourij; Faisal Aziz; Alexander Braeuer; Christian Ciardi; Martin Clodi; Peter Fasching; Mario Karolyi; Alexandra Kautzky-Willer; Carmen Klammer; Oliver Malle; Abderrahim Oulhaj; Erich Pawelka; Slobodan Peric; Claudia Ress; Caren Sourij; Lars Stechemesser; Harald Stingl; Thomas Stulnig; Norbert Tripolt; Michael Wagner; Peter Wolf; Andreas Zitterl; Susanne Kaser

    doi:10.1101/2020.11.02.20224311 Date: 2020-11-04 Source: medRxiv

    AIM We assessed predictors of inhospital mortality in people with prediabetes MESHD and diabetes MESHD hospitalized for COVID19 MESHD infection and developed a risk score for identifying those at the highest risk of a fatal outcome. MATERIALS AND METHODS A combined prospective and retrospective multicenter cohort study was conducted in 10 sites in Austria on 247 people with diabetes MESHD or newly diagnosed prediabetes MESHD, who were hospitalised for COVID19 MESHD. The primary outcome was inhospital mortality and predictor variables at the time of admission included clinical data, comorbidities of diabetes MESHD or laboratory data. Logistic regression analyses were performed to identify significant predictors and develop a risk score for inhospital mortality. RESULTS The mean age of people hospitalized (n=238) for COVID-19 MESHD was 71.1{+/-}12.9 years, 63.6% were males, 75.6% had type 2 diabetes MESHD, 4.6% had type 1 diabetes MESHD, and 19.8% had prediabetes MESHD. The mean duration of hospital stay was 18{+/-}16 days, 23.9% required ventilation therapy, and 24.4% died in the hospital. Mortality rate in people with diabetes MESHD was numerically higher (26.7%) as compared to those with prediabetes MESHD (14.9%) but without statistical significance (p=0.128). A score including age, arterial occlusive disease MESHD, CRP HGNC, eGFR HGNC and AST HGNC levels at admission predicted inhospital mortality with a Cstatistics of 0.889 (95%CI: 0.837-0.941) and calibration of 1.000 (p=0.909). CONCLUSIONS The inhospital mortality for COVID-19 MESHD was high in people with diabetes MESHD and not significantly different to the risk in people with prediabetes MESHD. A risk score using five routinely available patient parameters demonstrated excellent predictive performance for assessing inhospital mortality.

    Correlation Study of Chest CT Features of Severe/Critical type COVID-19 MESHD with Early Renal Damage and Clinical Prognosis

    Authors: Guan Li; Yongchun Ge; Zhiyuan Sun; Song Luo; Wen Wang; Changsheng Zhou; Fan zhou; Xin Zhang; Jie Dong; Zhiqiang Cao; Longjiang Zhang; Guangming Lu

    doi:10.21203/rs.3.rs-75596/v1 Date: 2020-09-10 Source: ResearchSquare

    Background: Among patients with confirmed severe/critical type COVID-19 MESHD, we found that although the seurm creatinine (Cr) value is in normal range, patients might have occured early renal damage MESHD. For severe/critical type COVID-19 MESHD patients, whether some chest CT features can be used to predict the early renal damage MESHD or clinical prognosis.Methods: 162 patients with severe/critical type COVID-19 MESHD were reviewed retrospectively in 13 medical centers from China. According to the level of eGFR HGNC, 162 patients were divided into three groups, group A (eGFR < 60 ml/min/1.73m2), group B (60 ml/min/1.73m2 ≤ eGFR HGNC < 90 ml/min/1.73m2 group) and group C (eGFR ≥ 90 ml/min/1.73m2). All patients’ baseline clinical characteristics, laboratory data, CT features and clinical outcomes were collected and compared. The eGFR HGNC and CT features was assessed using univariate and multivariate Cox regression.Results: Baseline clinical characteristics showed that there were significant differences in age, hypertension MESHD, cough MESHD and fatigue MESHD among groups A, B and C. Laboratory data analysis revealed significant differences between the three groups of leukocyte count, platelet count, C-reactive protein HGNC, aspartate aminotransferase, creatine kinase. Chest CT features analysis indicated that crazy-paving pattern has significant statistical difference in groups A and B compared with group C. The eGFR HGNC of patients with crazy-paving pattern was significant lower than those without crazy-paving pattern (76.73 ± 30.50 vs. 101.69 ± 18.24 ml/min/1.73m2, p < 0.001), and eGFR HGNC (OR = 0.962, 95% CI = 0.940-0.985) was the independent risk factor of crazy-paving pattern. The eGFR HGNC (HR = 0.549, 95% CI = 0.331-0.909, p = 0.020) and crazy-paving pattern (HR = 2.996, 95% CI = 1.010-8.714, p = 0.048) were independent risk factors of mortality.Conclusions: In patients with severe/critical type COVID-19 MESHD, the presence of crazy-paving pattern on chest CT are more likely occured the decline of eGFR HGNC and poor clinical prognosis. The crazy-paving pattern appeared could be used as an early warning indicator of renal damage MESHD and to guide clinicians to use drugs reasonably.

    The Application of Lactate Dehydrogenase in Coronavirus Disease 2019 MESHD as the Best Indicator for the Progression and Clinical Status: A Case-Control Study

    Authors: Yang Li; Xian Zhou; Jing-wen Ai; Hongyu Wang; Taoping Weng; Haocheng Zhang; Yuxian Huang; Wenhong Zhang

    doi:10.21203/rs.3.rs-55590/v1 Date: 2020-08-07 Source: ResearchSquare

    Introduction Coronavirus disease 2019 MESHD ( COVID-19 MESHD) is now officially a pandemic. Current studies observed extensive abnormal indexes in COVID-19 MESHD patients and significant differences between mild and severe patients. However, which index would perform better as the indicator of disease progression merits further investigation.Methods We enrolled COVID-19 MESHD patients who were admitted to Shanghai Public Health Clinical center. We closely monitored the following candidate indictors: white blood cell, lymphocyte, platelet, CD4 T cell, CD8 T cell, alanine aminotransferase HGNC, estimated glomerular filtration rate ( eGFR HGNC), fibrin degradation products (FDP), D-dimer, creatine kinase, myoglobin HGNC, troponin T ( TnT HGNC), N-terminal pro-B-type natriuretic peptide (NT-proBNP), lactase dehydrogenase (LDH), C-reactive protein HGNC ( CRP HGNC), and procalcitonin. The correlation with illness severity were assessed by Spearman analysis and the ability of differentiating the clinical statuses was quantified as the AUC value of the ROC curve. Results A total of 326 patients were enrolled, including 299 mild-ordinary and 27 severe-critical patients. At admission, D-dimer and CRP HGNC were elevated above normal range both in mild-ordinary and severe-critical patients. LDH, NT-proBNP, myoglobin HGNC, CD4 T cell, eGFR HGNC, FDP and PCT were beyond normal range in the mild-ordinary stages of severe-critical patients, but remained normal in the persistently mild-ordinary patients. Top 5 parameters with highest spearmen coefficient were LDH, procalcitonin, NT-proBNP, myoglobin HGNC and D-dimer (Spearman coefficient: 0.488, 0.453, 0.414, 0.412, 0.407). Comparing between mild-ordinary stage and severe/critical stage, LDH showed the highest receiver operating characteristics (ROC) area under the curve (AUC) of 0.951. PCT ranked second, with the ROC AUC of 0.905. Comparing between mild-ordinary and severe stages, only LDH had the ROC AUC of over 0.90 (0.927). Conclusions This study found LDH to be a superior indicator for COVID-19 MESHD status and had the potential to optimize the clinical management strategy.

    COVID-19 MESHD patients with hypertension under potential risk of worsened organ injuries

    Authors: Fei Xia; Mingwei Zhang; Bo Cui; Wei An; Min Chen; Ping Yang; Tao Qin; Xiaoyang Zhou; Yaling Liao; Xin Xu; Shiguo Liu; Kuangyu Li; Qin Zhou; Keke Wang; Guangxu Hu; Ming Du; Songrui Chen; Jianjun Zhang; Yafang Zhang; Wei Wei; Ming Xiang

    doi:10.21203/rs.3.rs-34615/v1 Date: 2020-06-11 Source: ResearchSquare

    COVID -19 has rapidly spread from Wuhan to worldwide, and now has become a global health concern. Hypertension MESHD is the most common chronic illness in COVID-19 MESHD, while the influence on those patients have not been well described. In this retrospective study, 82 confirmed patients with COVID-19 MESHD were enrolled, with epidemiological, demographic, clinical, laboratory, radiological, and therapies data analyzed and compared between COVID-19 MESHD patients with (29 cases) or without (53 cases) hypertension MESHD. Of all 82 patients with COVID-19 MESHD, the median age of all patients was 60.5 years, including 49 females (59.8%) and 33 (40.2%) males. Hypertension MESHD (31[28.2%]) was the most chronic illness, followed by diabetes MESHD (16 [19.5%]) and cardiovascular disease MESHD (15 [18.3%]). Common symptoms included fatigue (55[67.1%]), dry cough (46 [56.1%]) and fever (≥37.3℃ (46 [56.1%]). The median time from illness onset to positive outcomes of RT-PCR analysis were 13.0 days, ranging from 3-25 days. In hypertension group, 6 (20.7%) patients died compared to 5 (9.4%) died in non-hypertension group. More hypertension patients with COVID-19 MESHD (8 [27.6%]) had at least one coexisting disease than those of non-hypertension patients (2 [3.8%]) (P=0.002). Compared with non-hypertension patients, higher levels of neutrophil counts, serum amyloid A, C-reactive protein HGNC, and NT-proBNP were observed in hypertension group, whereas levels of lymphocyte count and eGFR HGNC were decreased. Dynamic observations displayed more significant and worsened outcomes in hypertension group after hospital admission. COVID-19 MESHD patients with hypertension take more risks of severe inflammatory reactions, worsened internal organ injuries, and deteriorated progress. 

    Analysis of early renal injury in COVID-19 MESHD and diagnostic value of multi-index combined detection

    Authors: Xu-wei Hong; Ze-pai Chi; Guo-yuan Liu; Hong Huang; Shun-qi Guo; Jing-ru Fan; Xian-wei Lin; Liao-zhun Qu; Rui-lie Chen; Ling-jie Wu; Liang-yu Wang; Qi-chuan Zhang; Su-wu Wu; Ze-qun Pan; Hao Lin; Yu-hua Zhou; Yong-hai Zhang

    doi:10.1101/2020.03.07.20032599 Date: 2020-03-10 Source: medRxiv

    Objectives The aim of the study was to analyze the incidence of COVID-19 MESHD with early renal injury MESHD, and to explore the value of multi-index combined detection in diagnosis of early renal injury MESHD in COVID-19 MESHD. Design The study was an observational, descriptive study. Setting This study was carried out in a tertiary hospital in Guangdong, China. Participants 12 patients diagnosed with COVID-19 MESHD from January 20, 2020 to February 20, 2020. Primary and secondary outcome measures The primary outcome was to evaluate the incidence of early renal injury MESHD in COVID-19 MESHD. In this study, the estimated glomerular filtration rate ( eGFR HGNC), endogenous creatinine clearance (Ccr) and urine microalbumin / urinary creatinine ratio (UACR) were calculated to assess the incidence of early renal injury MESHD. Secondary outcomes were the diagnostic value of urine microalbumin (UMA), 1-microglobulin (A1M), urine immunoglobulin-G (IGU), urine transferring (TRU) alone and in combination in diagnosis of COVID-19 MESHD with early renal injury MESHD. Results While all patients had no significant abnormalities in serum creatinine (Scr) and blood urea nitrogen (BUN), the abnormal rates of eGFR HGNC, Ccr, and UACR were 66.7%, 41.7%, and 41.7%, respectively. Urinary microprotein detection indicated that the area under curve (AUC) of multi-index combined to diagnose early renal injury MESHD in COVID-19 MESHD was 0.875, which was higher than UMA (0,813), A1M (0.813), IGU (0.750) and TRU (0.750) alone. Spearman analysis showed that the degree of early renal injury MESHD was significantly related to C-reactive protein HGNC ( CRP HGNC) and neutrophil ratio (NER), suggesting that the more severe the infection, the more obvious the early renal injury MESHD. Hypokalemia MESHD and hyponatremia MESHD were common in patients with COVID-19 MESHD, and there was a correlation with the degree of renal injury MESHD. Conclusions Early renal injury MESHD was common in patients with COVID-19 MESHD. Combined detection of UMA, A1M, IGU, and TRU was helpful for the diagnosis of early renal injury MESHD in COVID-19 MESHD.

    Comparative study of the lymphocyte change between COVID-19 MESHD and non- COVID-19 MESHD pneumonia cases suggesting uncontrolled inflammation might not be the main reason of tissue injury

    Authors: Yishan Zheng; Zhen Huang; Guoping Ying; Xia Zhang; Wei Ye; Zhiliang Hu; Chunmei Hu; Hongxia Wei; Yi Zeng; Yun Chi; Cong Cheng; Feishen Lin; Hu Lu; Lingyan Xiao; Yan Song; Chunming Wang; Yongxiang Yi; Lei Dong

    doi:10.1101/2020.02.19.20024885 Date: 2020-02-23 Source: medRxiv

    Background: The corona virus disease 2019 ( COVID-19 MESHD) shows unusually high transmission rate and unique clinical characteristics, with key pathological mechanism remaining unclear. Here, we analysed the laboratory data based on clinical samples from COVID-19 MESHD patients, in parallel comparison with non- COVID-19 MESHD pneumonia MESHD cases, in an attempt to elucidate the key pathological features of COVID-19 MESHD during its infection of the human body. Methods: We analysed biochemical indices and lymphocyte subpopulation in COVID-19 MESHD patients, and compare these data from non- COVID-19 MESHD pneumonia MESHD cases. Correlation analysis was performed between leukocyte subgroups count and biochemical indexes in COVID-19 MESHD patients. Results: The study enrolled 110 patients, comprising 88 COVID-19 MESHD patients and 22 non- COVID-19 MESHD pneumonia MESHD cases. We observed significant differences, including abnormal biochemical indices ( CRP HGNC, LDH, AST HGNC, eGFR HGNC, and sodium ion concentration) and reduced lymphocyte subsets count, between the COVID-19 MESHD patients and non- COVID-19 MESHD-caused pneumonia MESHD cases. Correlation analysis indicates that the count for lymphocyte subsets-but not that for neutrophils and monocytes-exhibits a significant negative correlation with biochemical indices relating to organ injury, in the COVID-19 MESHD infected MESHD patients. Conclusions: The study indicates significantly different clinical features between 2019 novel coronavirus (2019-nCoV)-caused and non-2019-nCoV-caused pneumonia MESHD, especially in terms of lymphocytopenia MESHD and organ injury. Notably, correlation analysis demonstrates that tissue damage in COVID-19 MESHD patients is attributed to virus infection MESHD itself rather than uncontrolled inflammatory responses ("cytokine storm"). These findings provide new insights for developing efficient therapeutic strategies against COVID-19 MESHD infection.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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