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SARS-CoV-2 proteins

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    Clinical features of COVID-19 MESHD patients with comorbid coronary heart disease MESHD

    Authors: Hang Yang; RUI GUO; Lincheng Yang; Ruitao Zhang; Yunpeng Ling; Qinggang Ge

    doi:10.21203/rs.3.rs-129449/v1 Date: 2020-12-15 Source: ResearchSquare

    Background: In addition to the lungs, the coronavirus disease 2019 MESHD ( COVID-19 MESHD) also affects multiple organs throughout the body. The relationship between COVID-19 MESHD infection and cardiovascular disease MESHD, and the mechanisms by which this disease causes damage to the cardiovascular system are unclear. Coronary heart disease MESHD ( CHD MESHD) is one of the common comorbidities of COVID-19 MESHD, but there is insufficient evidence for its clinical features and impact on clinical outcomes. The aim of this study was to analyze the clinical characteristics of COVID-19 MESHD patients with comorbid CHD MESHD and the possible risk factors for the occurrence of critical illness. Methods: A single-center, retrospective study was conducted to analyze COVID-19 MESHD patients admitted to the Sino-French New City Campus of Tongji Hospital in Wuhan, Hubei Province and treated by the Peking University National Medical Assistance Team between January 29 and March 10 HGNC, 2020. Patients testing positive for SARS-CoV-2 viral nucleic acid in nasopharyngeal swab specimens and who had comorbid CHD MESHD, were included in the study. Clinical data and laboratory test results of eligible patients were collected, and the factors associated with the occurrence of critical illness among these patients were evaluated. Results: A total of 205 patients were enrolled in this study, including 20 CHD MESHD patients and 185 non- CHD MESHD patients. The mean age was 66.7 years. Compared to non- CHD MESHD patients, more CHD MESHD patients had comorbid hypertension MESHD and diabetes MESHD (P < 0.05). In terms of laboratory tests, the CHD MESHD group did not differ significantly from the non- CHD MESHD group in blood routine, blood chemistry, and various inflammatory cytokines. More CHD MESHD patients experienced myocardial injury MESHD (25% vs 8.1% P < 0.031) and CHD MESHD patients were more likely to progress to critical illness MESHD (40% vs 16.8%P = 0.012). Univariate logistic regression analysis indicated that a history of CHD MESHD, occurrence of myocardial injury MESHD, high white blood cell (WBC) count, low lymphocyte count, and elevated levels of Cr, ferritin, IL-2R HGNC, IL-8 HGNC at admission were factors associated with the occurrence of critical illness. Multivariate regression analysis found that a history of CHD MESHD(OR=3.529, 95% CI =1.032-12.075, P =0.044),high WBC count(OR=1.289, 95% CI =1.136-1.463, P<0.001) and low lymphocyte count(OR=0.215, 95% CI =0.075-0.616, P =0.004)were independent factors for the occurrence of critical illness among COVID-19 MESHD patients. Conclusion: COVID-19 MESHD patients with comorbid CHD MESHD commonly exhibited myocardial injury MESHD and were prone to developing critical illness. Among COVID-19 MESHD patients, a history of CHD MESHD,high WBC count and low lymphocyte count were independent risk factors for the occurrence of critical illness. Greater attention and vigilance are needed in this regard during clinical practice.

    Outcomes and risk factors for the survival of COVID-19 MESHD related ARDS patients treated with extracorporeal membrane oxygenation

    Authors: Luyun Wang; Kengquan Chen; Peng Chen; Li Ni; Jiangang Jiang; Daowen Wang

    doi:10.21203/rs.3.rs-58688/v1 Date: 2020-08-13 Source: ResearchSquare

    Background: In current pandemic of COVID-19 MESHD, approximately 15% to 30% of critically ill COVID-19 MESHD patients developed acute respiratory distress syndrome MESHD ( ARDS MESHD) with a high mortality. Extracorporeal membrane of oxygenation (ECMO) provides direct support for both lung and heart in ARDS MESHD. However, the role of ECMO in COVID-19 MESHD related ARDS MESHD was still controversial. The aim of this study was to provide insights into the mortality, intensive care unit (ICU) management, risk factors for mortality, 180-day short term prognosis of the COVID-19 MESHD related severe ARDS MESHD patients receiving ECMO treatment. Methods: From Feb 2nd, 2020 to April 27th, 2020, we included adult COVID-19 MESHD related ARDS MESHD patients admitted to intensive care unit in Tongji Hospital. Totally, 53 patients were retrospectively analyzed. They were divided into ECMO (mechanical ventilation with ECMO, n=16) and non-ECMO group (mechanical ventilation, n=37). The primary outcome was all-cause 60-day mortality. The secondary outcomes were complications on ECMO, successful weaning from ECMO, and all-cause 180-day mortality. Results: The all-cause 60-day mortality was 37.5% (6/16) in ECMO group and 86.5% (32/37) in non-ECMO group (HR, 0.196; 95% CI, 0.053-0.721; p=0.014). 10 (62.5%) patients were successfully weaned from ECMO. The all-cause 180-day mortality was 56.3% (9/16) in ECMO group and 33 (89.2%, 33/37) in non-ECMO group (HR, 0.298; 95% CI, 0.130-0.680; p=0.004). All the patients in ECMO group suffered from at least one device-related complication with coagulopathy MESHD (81.3%) being most frequently seen. Up to 180-day follow up after disease onset, the ECMO-treated survivors maintained good quality of life without severe complications or disabilities. Hypercapnia MESHD, thrombopenia MESHD, myocardial injury MESHD and elevation of IL-8 HGNC and IL-10 HGNC during ECMO treatment were strongly associated with death MESHD.Conclusion: This study showed the COVID-19 MESHD patients significantly benefited from ECMO treatment during severe ARDS MESHD, which supported the application of ECMO as an indicated strategy in the management of COVID-19 MESHD related ARDS MESHD.

    Immunophenotyping of Circulating Leukocytes Reveal Non-specific Activation of Innate and Adaptive Immune Systems in Multi-System Inflammatory Syndrome of Childhood Temporally Associated with SARS-Cov-2 Infection MESHD: Descriptive Cohort Study

    Authors: Michael J. Carter; Matthew Fish; Aislinn Jennings; Katie J. Doores; Paul Wellman; Jeffrey Seow; Sam Acors; Emma Timms; Julia Kenny; Stuart Neil; Michael H. Malim; Shane M. Tibby; Manu Shankar-Hari

    id:10.20944/preprints202007.0252.v1 Date: 2020-07-12 Source: Preprints.org

    We describe the innate and adaptive immune system trajectory in Multi-system inflammatory syndrome MESHD of childhood (MIS-C), at acute(within 72 hours of hospitalization), resolution (at clinical improvement) and convalescent phase. In our cohort, in the acute phase, 68% of the children were SARS-CoV-2 seropositive, with hypercytokinenemia (high interleukin(IL)-1beta HGNC, IL-6 HGNC, IL-8 HGNC, IL-10 HGNC, IL-17 HGNC, interferon gamma HGNC), procoagulant state, myocardial dysfunction MESHD, activated neutrophils and monocytes; differential T and B cell subset lymphopenia MESHD; activated chemokine receptor type-7 positive and gamma-delta T cell subsets; antigen presenting cells had reduced HLA-DR expression; and B-cell class-switch responses occurred with illness resolution. MIS-C is an immunopathogenic illness associated with SARS-CoV-2 infections MESHD in children.

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