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SARS-CoV-2 proteins

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    Clinical characteristics of COVID-19 MESHD patients in Latvia under low incidence in Spring 2020

    Authors: Ludmila Viksna; Oksana Kolesova; Aleksandrs Kolesovs; Ieva Vanaga; Seda Arutjunana; Sniedze Laivacuma; Jelena Storozenko; Ieva Tolmane; Ilze Berzina; Baiba Rozentale

    doi:10.1101/2020.12.22.20239392 Date: 2020-12-24 Source: medRxiv

    Background: COVID-19 MESHD is a new infectious disease MESHD with severe disease course and high mortality in some groups. Blood tests on admission to the hospital can be useful for stratification of patients and timely correction. Our study investigated the clinical features of COVID-19 MESHD patients in Latvia and differences in blood tests in groups with different disease severity. Methods: The retrospective study included 100 patients hospitalized in Riga East Clinical University Hospital in Spring 2020. The severity of the disease course was classified by the presence of pneumonia MESHD and its combination with respiratory failure MESHD. We have assessed blood cells' count, hemoglobin, hematocrit, erythrocyte sedimentation rate (ESR), C-reactive protein HGNC ( CRP HGNC), alanine aminotransferase HGNC, lactate dehydrogenase (LDH), troponin T, electrolytes, creatinine, glomerular filtration rate (GFR), D-dimer, prothrombin time, prothrombin index, oxygen saturation, and temperature on admission to the hospital. Results: Patients were from 18 to 99, 57% males. Comorbidities were found in 74% of patients. The mild, moderate, and severe groups included 35, 44, and 16 patients, respectively. In the severe group, the mortality rate was 50%. The progression to severe COVID-19 MESHD was associated positively with temperature, ESR, CRP HGNC, creatinine, LDH, and troponin T and negatively associated with oxygen saturation, eosinophils, and GFR on admission to the hospital. Conclusions: COVID-19 MESHD severity associates with lower renal function and a higher level of inflammation MESHD and tissue damage. Eosinophils, CRP HGNC, ESR, LDH, troponin T, creatinine, and GFR are blood indicators for monitoring patients' condition.

    Association Between Cystatin C HGNC, Cystatin C HGNC Rangeability and Mortality of COVID-19 MESHD Patients With or Without Type 2 Diabetes Mellitus: An Opportunistic Retrospective Analysis

    Authors: Lei Yang; Dou Xu; Yiqing Tan; Bolin Li; Dan Zhu; Jingbo Wang; Hui Sun; Xinglong Liu; Xiao-Pu Zheng; Ling Zhu; Zhongyu Li

    doi:10.21203/rs.3.rs-112220/v1 Date: 2020-11-19 Source: ResearchSquare

    Background: Since December of 2019, novel coronavirus (SARS-CoV-2)-induced pneumonia MESHD ( COVID-19 MESHD) exploded in Wuhan, and rapidly spread throughout China. Patients with COVID-19 MESHD demonstrated quite different appearances and outcomes in clinical manifestations. We aimed to figure out whether risk factors of the cystatin C HGNC (CysC) and the CysC rangeability are influencing the prognosis of COVID-19 MESHD patients with or without type 2 diabetes mellitus MESHD ( T2DM MESHD).Methods: 675 T2DM MESHD patients and 602 non- T2DM MESHD patients were divided into low CysC group, high CysC group and low CysC rangeability group, high CysC rangeability group according to the serum CysC level and the change range of CysC. Demographic characteristics, clinical data and laboratory results of the four groups were collected and analyzed.Results: Our data showed that COVID-19 MESHD patients with high CysC level and CysC rangeability had more organic damage MESHD and higher mortality rate compared to those with low level or low rangeability of CysC. Furthermore, patients with higher CysC level and CysC rangeability also demonstrated higher blood lymphocytes (lymph), C-reactive protein HGNC (CRP), alanine aminotransferase HGNC (ALT), aspartate aminotransferase ( AST HGNC) which may greatly influence disease progression and poor prognosis of COVID-19 MESHD. After adjusting for possible confounders, multivariate analysis revealed that CysC≤0.93mg/dl as a reference, CysC>0.93mg/dl were significantly associated with the risk of heart failure MESHD (OR=2.401, 95% CI: 1.118–5.156) and all-cause death MESHD (OR=2.734, 95% CI: 1.098-6.811); referring to CysC rangeability≤0, CysC rangeability>0 significantly associated with all-cause death MESHD (OR=4.029, 95% CI: 1.864-8.706). Further grouped by T2DM MESHD, these associations were stronger in T2DM MESHD than in non- T2DM MESHD.Conclusions: It suggests that CysC level and CysC rangeability contribute to clinical manifestations and may influence the prognosis of COVID-19 MESHD. The CysC is considered as a potential risk factor of the prognosis of COVID-19 MESHD. Special medical care and appropriate intervention should be performed in COVID-19 MESHD patients with elevated CysC during hospitalization and later clinical follow-up, especially for those with T2DM MESHD.

    Estimating Risk of Mechanical Ventilation and Mortality Among Adult COVID-19 MESHD patients Admitted to Mass General Brigham: The VICE and DICE Scores

    Authors: Christopher J Nicholson; Luke Wooster; Haakon H Sigurslid; Rebecca F Li; Wanlin Jiang; Wenjie Tian; Christian Lino Cardenas; Rajeev Malhotra

    doi:10.1101/2020.09.14.20194670 Date: 2020-09-17 Source: medRxiv

    Background: Risk stratification of COVID-19 MESHD patients upon hospital admission is key for their successful treatment and efficient utilization of hospital resources. Objective: To evaluate the risk factors associated with ventilation need and mortality. Design, setting and participants: We established a retrospective cohort of COVID-19 MESHD patients from Mass General Brigham hospitals. Demographic, clinical, and admission laboratory data were obtained from electronic medical records of patients admitted to hospital with laboratory-confirmed COVID-19 MESHD before May 19th, 2020. Using patients admitted to Massachusetts General Hospital (MGH, derivation cohort), multivariable logistic regression analyses were used to construct the Ventilation in COVID Estimator (VICE) and Death MESHD in COVID Estimator (DICE) risk scores. Measurements: The primary outcomes were ventilation status and death MESHD. Results: The entire cohort included 1042 patients (median age, 64 years; 56.8% male). The derivation and validation cohorts for the risk scores included 578 and 464 patients, respectively. We found seven factors to be independently predictive for ventilation requirement ( diabetes mellitus MESHD, dyspnea MESHD, alanine aminotransferase HGNC, troponin, C-reactive protein, neutrophil-lymphocyte ratio, and lactate dehydrogenase), and 10 factors to be predictors of in-hospital mortality (age, sex, diabetes mellitus MESHD, chronic statin use, albumin, C-reactive protein HGNC, neutrophil-lymphocyte ratio, mean corpuscular volume, platelet count, and procalcitonin). Using these factors, we constructed the VICE and DICE risk scores, which performed with C-statistics of at least 0.8 in our cohorts. Importantly, the chronic use of a statin was associated with protection against death MESHD due to COVID-19 MESHD. The VICE and DICE score calculators have been placed on an interactive website freely available to the public (https://covid-calculator.com/). Limitations: One potential limitation is the modest sample sizes in both our derivation and validation cohorts. Conclusion: The risk scores developed in this study may help clinicians more appropriately determine which COVID-19 MESHD patients will need to be managed with greater intensity.

    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.

    Serum S100B HGNC protein as a marker of severity in Covid-19 MESHD patients

    Authors: Antonio Aceti; Lory Marika Margarucci; Elena Scaramucci; Massimiliano Orsini; Gerardo Salerno; Gabriele Di Sante; Gianluca Gianfranceschi; Rosa Di Liddo; Federica Valeriani; Francesco Ria; Maurizio Simmaco; Pier Paolo Parnigotto; Matteo Vitali; Vincenzo Romano Spica; Fabrizio Michetti

    doi:10.21203/rs.3.rs-50341/v1 Date: 2020-07-28 Source: ResearchSquare

    SARS-CoV-2 infection MESHD shows a wide-ranging clinical severity, requiring prognostic markers. We focused on S100B HGNC, a calcium-binding protein present in biological fluids, being a reliable biomarker in disorders having inflammatory processes as common basis and RAGE HGNC as main receptor. Since Covid-19 MESHD is characterized by a potent inflammatory response also involving RAGE HGNC, we tested if S100B HGNC serum levels were related to disease severity.Serum samples (n=74) were collected from hospitalized SARS-CoV-2 positive patients admitted to Covid center. Illness severity was established by admission clinical criteria and Covid risk score. Treatment protocols followed WHO guidelines available at the time. Circulating S100B HGNC was determined by ELISA assay. Statistical analysis used Pearson’s χ2 test, t-Test, and ANOVA, ANCOVA, Linear Regression. S100B HGNC was detected in serum from Covid-19 MESHD patients, significantly correlating with disease severity as shown both by the level of intensity of care (p<0.006) as well by the value of Covid score (Multiple R-squared: 0.3751); the correlation between Covid-Score and S100B HGNC was 0.61 (p<0.01). S100B HGNC concentration was associated with inflammation MESHD markers (Ferritin, C-Reactive Protein HGNC, Procalcitonin), and organ damage markers ( Alanine Aminotransferase HGNC, Creatinine). Serum S100B HGNC plays a role in Covid-19 MESHD and can represent a prognostic marker in Sars- CoV-2 infected MESHD patients.

    Clinical Severity and CT Features of the COVID-19 MESHD Pneumonia: Focus on CT Score and Laboratory Parameters

    Authors: Jianghui Duan; Kunsong Su; Hongliang Sun; Yanyan Xu; Liangying Liu

    doi:10.21203/rs.3.rs-45453/v1 Date: 2020-07-18 Source: ResearchSquare

    Background: Although CT characteristics of Coronavirus Disease 2019 MESHD ( COVID-19 MESHD) pneumonia MESHD between patients with mild and severe forms of the disease have already been reported in the literature, there was little attention to the correlation of imaging features and laboratory testing. We aimed to compare the laboratory and chest CT imaging features in patients with COVID-19 MESHD pneumonia MESHD between non-severe cases and severe cases, and to analyze the correlation of CT score and laboratory testing.Methods: This study consecutively included 54 patients with COVID-19 MESHD pneumonia MESHD (26 males and 28 females, 26 to 92 years of age, 43 cases with non-severe and 11 cases with severe group). Clinical, laboratory and image data were collected between two subgroups. A CT score system was used to evaluate the extent of disease. Correlation between the CT score and laboratory data were estimated. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of CT score and laboratory tests.Results: Compared with non-severe patients, severe patients had showed increased white blood cell count, neutrophil count, neutrophil percentage, the neutrophil-to-lymphocyte ratio (NLR) and decreased lymphocyte percentage (all p < 0.05). Architectural distortion, pleural effusion MESHD, air bronchogram and consolidation-dominant pattern were more common in the severe group (all p < 0.05). CT score of the severe group was higher than the non-severe group (p < 0.001). For distribution characters of the lesions, diffuse pattern in the transverse distribution was more often seen in the severe group (p < 0.001). CT score was positively correlated with the white blood cell counts, neutrophil counts, the percent of neutrophil, NLR, alanine aminotransferase HGNC, lactate dehydrogenase and C-reactive protein HGNC, and was inversely related to the lymphocyte, the percent of lymphocyte. ROC analysis showed that when the optimal threshold of CT score was 13, the area under the curve was the largest, which was 0.855, and the sensitivity and specificity were 100% and 60% respectively for the diagnosis of the severe patients.Conclusion: CT score showed significant correlations with laboratory inflammatory markers, suggesting that chest CT and laboratory examination maybe provide a better reference for clinicians to judge the severity of diseases.

    Temporal Dynamics in Clinical and Laboratory Manifestations During COVID-19 MESHD Progression

    Authors: Lin-Lin Ye; Wen-Bei Peng; Xiao-Shan Wei; Xu Wang; Zi-Hao Wang; Xuan Xiang; Xiao-Rong Wang; Wei-Bing Yang; Xin-Liang He; Fei Xiang; Yuan Su; Qiong Zhou

    doi:10.21203/rs.3.rs-42499/v1 Date: 2020-07-13 Source: ResearchSquare

    BAckground Severe COVID-19 MESHD patients account for most of the mortality of this disease. Early detection of severe cases of the disease remains a major challenge. Here, we performed clinical and laboratory profiling of COVID-19 MESHD to explore the early warning indicators of severe cases.Methods An analysis of the evolution during the hospitalization of clinical and laboratory findings from 78 confirmed COVID-19 MESHD patients and the associated risk factors.Results Of the 78 patients who were classified as un-severe at admission, 60 patients(stable group) were stable as mild cases until discharge, and the remaining 18 patients progressed to severe cases(exacerbated group) during hospitalization. Compared with stable patients, exacerbated patients exhibited older, higher BMI values and higher proportion of smokers. In the exacerbated patients, the median time from onset to deterioration was 7.5 days. Before the time point(days 0–7 from onset), we observed higher-levels of White blood cells(WBC), neutrophil, Neutrophi-Lymphocyte-Ratio(NLR), Lactose-dehydrogenase(LDH), D-dimer, and lower-levels of albumin in the exacerbated group, compared with the stable group. In the second week after the time point, the exacerbated patients displayed lower numbers of lymphocytes, CD3+, and CD8+T-cells, and higher-levels of C-reactive protein HGNC( CRP HGNC), erythrocyte-sedimentation-rate(ESR), Alanine-aminotransferase HGNC(ALT),Aspartate-aminotransferase( AST HGNC), and Interleukin-6 HGNC. In the third week, the highest temperature and the proportion of febrile patients declined. All of the laboratory indicators gradually improved.Conclusions Advanced age and smoking history could be risk factors for COVID-19 MESHD progression. In the early stage, high-levels of WBC and neutrophils, with noticeably increased LDH and D-dimer, could be early indicators of the disease’s conversion from mild to severe, followed by elevated inflammatory markers, liver enzymes, and decreased T-lymphocytes in the next week.

    Low high-density lipoprotein level is correlated with the severity of COVID-19 MESHD patients

    Authors: Guyi Wang; Quan Zhang; Haiyun Dong; Chenfang Wu; Fang Wu; Bo Yu; Jianlei Lv; Siye Zhang; Ying Wu; Guobao Wu; Shangjie Wu; yanjun Zhong

    doi:10.21203/rs.3.rs-34659/v1 Date: 2020-06-11 Source: ResearchSquare

    Background The aim of the present study was to describe the clinical characteristics of patients with different levels of high-density lipoproteins (HDLs) and analyze the correlation between HDL levels and prognosis of coronavirus disease 2019 MESHD ( COVID-19 MESHD) patients.Methods In the clinical retrospective analysis, a total of 228 adult COVID-19 MESHD patients admitted to Public Health Treatment Center of Changsha, China from January 17 to March 14, 2020 were enrolled. Median with interquartile range and Mann-Whitney test were used to depict and analyze the clinical characteristics of patients. The Kaplan-Meier (KM) curve and cox regression were adopted to analyze the association between HDLs and severe events of COVID-19 MESHD patients.Results Median levels of high-density lipoprotein cholesterol (HDL-C) in adult COVID-19 MESHD patients were below normal range. Compared with patients with high HDL-C, patients with low HDL-C showed higher proportion of male (69.6% vs 45.6%, P = 0.004), higher levels of C-reactive protein HGNC ( CRP HGNC) (median, 27.83 vs 12.56 mg/L, P = 0.000) and alanine aminotransferase HGNC (ALT) (median, 21.49 vs 18.81 U/L, P = 0.044), as well as higher proportion of severe events (37.0% vs 14.8%, P = 0.001). Moreover, they presented a higher risk of developing severe events compared with those with high HDL-C (Log Rank P < 0.001, Fig. 1). After adjusting for age, gender and underlying diseases, patients with low HDL-C still had elevated possibility of developing to severe cases than those with high HDL-C (HR 2.852, 95% CI 1.505–5.407, P = 0.001).Conclusions HDL-C level decreased in COVID-19 MESHD adult patients, and low HDL-C in COVID-19 MESHD patients was correlated with a higher risk of developing severe events.

    Liver Function in Novel Coronavirus Disease ( COVID-19 MESHD): A Systematic Review and Meta-Analysis

    Authors: Mohammad Zahedi; Mohammad Yousefi; Mahdi Abounoori; Mohammad Malekan; Fatemeh Tajik; Keyvan Heydari; Parham Mortazavi; Monireh Ghazaeian; Fateme Sheydaee; Amirreza Nasirzadeh; Reza Alizadeh-Navaei

    doi:10.1101/2020.05.20.20108357 Date: 2020-05-23 Source: medRxiv

    Introduction:The outbreak of new coronavirus has become a global public health challenge. Given a consequential liver function, and the high risk of death MESHD coming from liver disorders MESHD, the assessment of Novel Coronavirus Disease MESHD on liver function is importance. Hence, we carried out this meta-analysis to heightening insight into the occult features of COVID 19, which is likely to affect liver function. Method:This study was performed using databases of Web of Science, Scopus, and PubMed. We considered English cross-sectional and case-series papers, which reported available findings on the association between liver injury MESHD and COVID-19 MESHD infection. We used the STATA v.11 and random effect model for data analysis. Result:In this present meta-analysis, 52 papers, including 8,463 COVID-19 MESHD patients, were studied. The prevalence of increased liver enzymes among the patients, including Alanine aminotransferase HGNC, Aspartate aminotransferase, were 30% and 21% in non-severe patients, respectively, which were 38% and 48% in severe patients. The prevalence of increasing C-reactive protein HGNC, Lactate dehydrogenase, D-dimer, and Bilirubin were 55%, 39%, 28%, and 10% in non-severe patients respectively, which were 78%, 75%, 79% and 17% in sever patients.The prevalence of liver toxicity MESHD as a complication of COVID-19 MESHD was 20%.Also patients who have severe condition are 5.54, 4.22, 4.96, 4.13 and 4.34 times more likely to have elevated CRP, ALT, AST HGNC, LDH, D-dimer enzymes retrospectively. Conclusion:Elevation of some liver markers were higher in patients with severe COVID-19 MESHD infection. All to gather, we assumed that abnormal liver markers could act as a prognostic factor for a better survey of COVID-19 MESHD.

    Laboratory features in severe vs. non-severe COVID-19 MESHD patients, a systematic review and meta-analysis

    Authors: Sulmaz Ghahramani; Reza Tabrizi; Kamran B Lankarani; Seyyed mohammad amin Kashani; Shahla Rezaei; Nazanin Zeidi; Maryam Akbari; Seyed Taghi Heydari; Hamed Akbari; Peyman Nowrouzi-sohrabi; Fariba Ahmadizar

    doi:10.21203/rs.3.rs-29435/v1 Date: 2020-05-15 Source: ResearchSquare

    OBJECTIVE: Understanding the common laboratory features of COVID-19 MESHD in severe cases versus non-severe patients could be quite useful for clinicians and might help to predict the model of disease progression. MATERIALS AND METHODS: Electronic databases were systematically searched in PubMed, EMBASE, Scopus, Web of ‎Science, and Google Scholar from inception to 3rd of March 2020. Heterogeneity across included ‎studies was determined using Cochrane’s Q test and the I2 statistic. We used the fixed or random-effect models to pool ‎the weighted mean differences (WMDs) or standardized mean differences and 95% confidence ‎intervals (CIs).‎RESULTS:‎ Out of a total of 3009 citations, 17 articles (22 studies, 21 from China and one study from Singapour) with 3396 ranging from 12-1099 patients, ‎were included. Our meta-analyses showed a significant decrease in ‎lymphocyte, monocyte, and eosinophil, hemoglobin, platelet, albumin, serum sodium, lymphocyte to C-reactive protein HGNC ratio (LCR), leukocyte to C-reactive protein HGNC ratio (LeCR), leukocyte to IL-6 HGNC ratio (LeIR), and an increase in the ‎neutrophil, alanine ‎aminotransferase HGNC (ALT), aspartate aminotransferase ( AST HGNC), total bilirubin, blood urea nitrogen (BUN), creatinine (Cr), erythrocyte sedimentation rate (ESR), C-reactive protein HGNC ( CRP HGNC), procalcitonin (PCT), lactate dehydrogenase (LDH), fibrinogen HGNC, prothrombin time (PT), D-dimer, glucose ‎level, and neutrophil to lymphocyte ratio (NLR) in the severe group compared with the non-severe group. However, no significant changes were observed in white blood cells (WBC), ‎ creatine kinase (CK), troponin I, myoglobin HGNC, interleukin-6 HGNC ( IL-6 HGNC), and potassium (K) between the two groups.‎CONCLUSIONS: This meta-analysis provides evidence for the differentiation of severe cases of COVID-19 MESHD based on laboratory test results at the time of hospital admission. Future well-methodologically designed studies from other populations are strongly recommended.

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MeSH Disease
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SARS-CoV-2 Proteins


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