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SARS-CoV-2 proteins

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    The Prognostic Value of Myocardial Injury MESHD in COVID-19 MESHD Patients and Associated Characteristics

    Authors: jian he; Bicheng Zhang; Quan Zhou; Wenjing Yang; Jing Xu; Tingting Liu; Haijun Zhang; Zhiyong Wu; Dong Li; Qing Zhou; Jie Yan; Cuizhen Zhang; Robert G. Weiss; Guanshu Liu; Zhongzhao Teng; Arlene Sirajuddin; Haiyan Qian; Shihua Zhao; Andrew E. Arai; Minjie Lu; Xiaoyang Zhou

    doi:10.21203/rs.3.rs-251810/v1 Date: 2021-02-17 Source: ResearchSquare

    Background: Since December 2019, Coronavirus disease 2019 MESHD ( COVID-19 MESHD) has emerged as an international pandemic. COVID-19 MESHD patients with myocardial injury MESHD might need special attention. However, understanding on this aspect remains unclear. This study aimed to illustrate clinical characteristics and the prognostic value of myocardial injury MESHD to COVID-19 MESHD patients. Methods: This retrospective, single-center study finally included 304 hospitalized COVID-19 MESHD cases confirmed by real-time RT-PCR from January 11 to March 25, 2020. Myocardial injury MESHD was determined by serum high-sensitivity troponin I (Hs-TnI). The primary endpoint was COVID-19 MESHD associated mortality. Results: Of 304 COVID-19 MESHD patients (median age, 65 years; 52.6% males), 88 patients (27.3%) died (61 patients with myocardial injury MESHD, 27 patients without myocardial injury MESHD on admission). COVID-19 MESHD patients with myocardial injury MESHD had more comorbidities ( hypertension MESHD, chronic obstructive pulmonary disease MESHD, cardiovascular disease MESHD, and cerebrovascular disease MESHD); lower lymphocyte counts, higher C-reactive protein HGNC ( CRP HGNC, median, 84.9 vs 28.5 mg/L, p<0.001), procalcitonin levels (median, 0.29 vs 0.06 ng/ml, p<0.001), inflammatory and immune response markers; more frequent need for noninvasive ventilation, invasive mechanical ventilation; and was associated with higher mortality incidence (hazard ratio, HR=7.02, 95% confidence interval, CI, 4.45-11.08, p<0.001) than those without myocardial injury MESHD. Myocardial injury MESHD (HR=4.55, 95% CI, 2.49-8.31, p<0.001), senior age, CRP HGNC levels, and novel coronavirus pneumonia MESHD ( NCP PROTEIN) types on admission were independent predictors to mortality in COVID-19 MESHD patients. Conclusions: COVID patients with myocardial injury MESHD on admission is associated with more severe clinical presentation and biomarkers. Myocardial injury MESHD and higher HsTNI are both strongest independent predictors to COVID related mortality after adjusting confounding factors. In addition, senior age, CRP HGNC levels and NCP PROTEIN types are also associated with mortality. Trial registration: Not applicable.

    ABC2 HGNC-SPH risk score for in-hospital mortality in COVID-19 MESHD patients: development, external validation and comparison with other available scores

    Authors: Milena Soriano Marcolino; Magda Carvalho Pires; Lucas Emanuel Ferreira Ramos; Rafael Tavares Silva; Luana Martins Oliveira; Rafael Lima Rodrigues de Carvalho; Rodolfo Lucas Silva Mourato; Adrian Sanchez Montalva; Berta Raventos; Fernando Anschau; Jose Miguel Chatkin; Matheus Carvalho Alves Nogueira; Milton Henriques Guimaraes Junior; Giovanna Grunewald Vietta; Helena Duani; Daniela Ponce; Patricia Klarmann Ziegelmann; Luis Cesar de Castro; Karen Brasil Ruschel; Christiane Correa Rodrigues Cimini; Saionara Cristina Francisco; Maiara Anschau Floriani; Guilherme Fagundes Nascimento; Barbara Lopes Farace; Luanna da Silva Monteiro; Maira Viana Rego Souza e Silva; Thais Lorenna Souza Sales; Karina Paula Medeiros Prado Martins; Israel Junior Borges do Nascimento; Tatiani Oliveira Fereguetti; Daniel Taiar Marinho Oliveira Ferrara; Fernando Antonio Botoni; Ana Paula Beck da Silva Etges; Eric Boersma; Carisi Anne Polanczyk; Alexandre Vargas Schwarbold; Amanda Oliveira Maurilio; Ana Luiza Bahia Alves Scotton; Andre Pinheiro Weber; Andre Soares de Moura Costa; Andressa Barreto Glaeser; Angelica Aparecida Coelho Madureira; Angelinda Rezende Bhering; Bruno Mateus Castro; Carla Thais Candida Alves da Silva; Carolina Marques Ramos; Caroline Danubia Gomes; Cintia Alcantara de Carvalho; Daniel Vitorio Silveira; Diego Henrique de Vasconcelos; Edilson Cezar; Elayne Crestani Pereira; Emanuele Marianne Souza Kroger; Felipe Barbosa Vallt; Fernanda Barbosa Lucas; Fernando Graca Aranha; Frederico Bartolazzi; Gabriela Petry Crestani; Gisele Alsina Nader Bastos; Glicia Cristina de Castro Madeira; Helena Carolina Noal; Heloisa Reniers Vianna; Henrique Cerqueira Guimaraes; Isabela Moraes Gomes; Israel Molina Romero; Joanna dArc Lyra Batista; Joice Coutinho de Alvarenga; Julia Di Sabatino Santos Guimaraes; Julia Drumond Parreiras de Morais; Juliana Machado Rugolo; Karen Cristina Jung Rech Pontes; Kauane Aline Maciel dos Santos; Leonardo Seixas de Oliveira; Lilian Santos Pinheiro; Liliane Souto Pacheco; Lucas de Deus Sousa; Luciana Siuves Ferreira Couto; Luciane Kopittke; Luis Cesar Souto de Moura; Luisa Elem Almeida Santos; Maderson Alvares de Souza Cabral; Maira Dias Souza; Marcela Goncalves Trindade Tofani; Marcelo Carneiro; Marcus Vinicius de Melo Andrade; Maria Angelica Pires Ferreira; Maria Aparecida Camargos Bicalho; Maria Clara Pontello Barbosa Lima; Mariana Frizzo de Godoy; Marilia Mastrocolla de Almeida Cardoso; Meire Pereira de Figueiredo; Natalia da Cunha Severino Sampaio; Natalia Lima Rangel; Natalia Trifiletti Crespo; Neimy Ramos de Oliveira; Pedro Ledic Assaf; Petronio Jose de Lima Martelli; Rafaela dos Santos Charao de Almeida; Raphael Castro Martins; Raquel Lutkmeier; Reginaldo Aparecido Valacio; Renan Goulart Finger; Ricardo Bertoglio Cardoso; Roberta Pozza; Roberta Xavier Campos; Rochele Mosmann Menezes; Roger Mendes de Abreu; Rufino de Freitas Silva; Silvana Mangeon Mereilles Guimaraes; Silvia Ferreira Araujo; Susany Anastacia Pereira; Talita Fischer Oliveira; Tatiana Kurtz; Thainara Conceicao de Oliveira; Thaiza Simonia Marinho Albino de Araujo; Thulio Henrique Oliveira Diniz; Veridiana Baldon dos Santos Santos; Virginia Mara Reis Gomes; Vitor Augusto Lima do Vale; Yuri Carlotto Ramires

    doi:10.1101/2021.02.01.21250306 Date: 2021-02-03 Source: medRxiv

    Objective: To develop and validate a rapid scoring system at hospital admission for predicting in-hospital mortality in patients hospitalized with coronavirus disease MESHD 19 ( COVID-19 MESHD), and to compare this score with other existing ones. Design: Cohort study Setting: The Brazilian COVID-19 MESHD Registry has been conducted in 36 Brazilian hospitals in 17 cities. Logistic regression analysis was performed to develop a prediction model for in-hospital mortality, based on the 3978 patients that were admitted between March-July, 2020. The model was then validated in the 1054 patients admitted during August-September, as well as in an external cohort of 474 Spanish patients. Participants: Consecutive symptomatic patients ([≥]18 years old) with laboratory confirmed COVID-19 MESHD admitted to participating hospitals. Patients who were transferred between hospitals and in whom admission data from the first hospital or the last hospital were not available were excluded, as well those who were admitted for other reasons and developed COVID-19 MESHD symptoms during their stay. Main outcome measures: In-hospital mortality Results: Median (25th-75th percentile) age of the model-derivation cohort was 60 (48-72) years, 53.8% were men, in-hospital mortality was 20.3%. The validation cohorts had similar age distribution and in-hospital mortality. From 20 potential predictors, seven significant variables were included in the in-hospital mortality risk score: age, blood urea nitrogen, number of comorbidities, C-reactive protein HGNC, SpO2/FiO2 ratio, platelet count and heart rate. The model had high discriminatory value (AUROC 0.844, 95% CI 0.829 to 0.859), which was confirmed in the Brazilian (0.859) and Spanish (0.899) validation cohorts. Our ABC2 HGNC-SPH score showed good calibration in both Brazilian cohorts, but, in the Spanish cohort, mortality was somewhat underestimated in patients with very high (>25%) risk. The ABC2 HGNC-SPH score is implemented in a freely available online risk calculator (https://abc2sph.com/). Conclusions: We designed and validated an easy-to-use rapid scoring system based on characteristics of COVID-19 MESHD patients commonly available at hospital presentation, for early stratification for in-hospital mortality risk of patients with COVID-19 MESHD.

    Development and validation of a prognostic COVID-19 MESHD severity assessment (COSA) score and machine learning models for patient triage at a tertiary hospital

    Authors: Verena Schöning; Evangelia Liakoni; Christine Baumgartner; Aristomenis K. Exadaktylos; Wolf E. Hautz; Andrew Atkinson; Felix Hammann

    doi:10.21203/rs.3.rs-165301/v1 Date: 2021-01-28 Source: ResearchSquare

    Background: Clinical risk scores and machine learning models based on routine laboratory values could assist in automated early identification of severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) patients at risk for severe clinical outcomes. They can guide patient triage, inform allocation of health care resources, and contribute to the improvement of clinical outcomes. Methods: In- and out-patients tested positive for SARS-CoV-2 at the Insel Hospital Group Bern, Switzerland, between February 1st and August 31st (‘first wave’, n=198) and September 1st through November 16th 2020 (‘second wave’, n=459) were used as training and prospective validation cohort, respectively. A clinical risk stratification score and machine learning (ML) models were developed using demographic data, medical history, and laboratory values taken up to three days before, or one day after, positive testing to predict severe outcomes of hospitalization (a composite endpoint of admission to intensive care, or death MESHD from any cause). Test accuracy was assessed using the area under the receiver operating characteristic curve (AUROC).Results: Sex, C-reactive protein HGNC, sodium, hemoglobin, glomerular filtration rate, glucose, and leucocytes around the time of first positive testing (‑3 to +1 days) were the most predictive parameters. AUROC of the risk stratification score on training data (AUROC = 0.94, positive predictive value (PPV) = 0.97, negative predictive value (NPV) = 0.80) were comparable to the prospective validation cohort (AUROC = 0.85, PPV = 0.91, NPV = 0.81). The most successful ML algorithm with respect to AUROC was support vector machines (median = 0.96, interquartile range = 0.85-0.99, PPV = 0.90, NPV = 0.58).Conclusion: With a small set of easily obtainable parameters, both the clinical risk stratification score and the ML models were predictive for severe outcomes at our tertiary hospital center, and performed well in prospective validation.

    Clinical utility of Corona Virus Disease MESHD-19 serum IgG, IgM, and neutralizing antibodies and inflammatory markers

    Authors: Ernst J Schaefer; Florence Comite; Latha Dulipsingh; Maxine Lang; Jessica Jimison; Martin M Grajower; Nathan E Lebowitz; Andrew S Geller; Margaret R Diffenderfer; Lihong He; Gary Breton; Michael L Dansinger; Ben Saida; Chong Yuan

    doi:10.1101/2021.01.19.21249604 Date: 2021-01-20 Source: medRxiv

    Most deaths MESHD from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection MESHD occur in older subjects. We assessed age effects and clinical utility of serum SARS-CoV-2 immunoglobulin G (IgG), immunoglobulin M (IgM), and neutralizing antibodies and serum inflammatory markers. Serum IgG, IgM, and neutralizing antibody levels were measured using chemiluminescence assays from Diazyme (Poway, CA), while serum interleukin-6 HGNC ( IL-6 HGNC), C reactive protein HGNC ( CRP HGNC), and ferritin were measured with immunoassays obtained from Roche (Indianapolis, IN). In 79,005 subjects, IgG and IgM levels were positive ([≥]1.0 arbitrary units [AU]/mL) in 5.29% and 3.25% of subjects, respectively. In antibody positive subjects, median IgG levels were 3.93 AU/mL if <45 years of age, 10.18 AU/mL if 45-64 years of age, and 10.85 AU/mL if [≥]65 years of age (p<0.0001). In SARS-CoV-2 RNA positive cases, family members and exposed subjects (n=1,111), antibody testing was found to be valuable for case finding, and persistent IgM levels were associated with chronic symptoms. In non-hospitalized and hospitalized subjects assessed for SARS-CoV-2 RNA (n=278), median IgG levels in AU/mL were 0.05 in negative subjects (n=100), 14.83 in positive outpatients (n=129), and 30.61 in positive hospitalized patients (n=49, p<0.0001). Neutralizing antibody levels correlated significantly with IgG (r=0.875; p<0.0001). Two or more of the criteria of IL-6 HGNC [≥]10 pg/mL, CRP HGNC [≥]10 mg/L, and/or IgM >1.0 AU/mL occurred in 97.7% of inpatients versus 1.8% of outpatients (>50-fold relative risk, C statistic 0.986, p<0.0001). Our data indicate that: 1) IgG levels are significantly higher in positive older subjects, possibly to compensate for decreased cellular immunity with aging; 2) IgG levels are important for case finding in family clusters; 3) IgG levels are significantly correlated with neutralizing antibody levels; 4) persistently elevated IgM levels are associated with chronic disease MESHD; and 5) markedly elevated IL-6 HGNC, hs- CRP HGNC, and/or positive IgM accurately identify SARS-CoV-2 RNA positive subjects requiring hospitalization.

    Innate lymphoid cells and disease tolerance in SARS-CoV-2 infection MESHD

    Authors: Noah J. Silverstein; Yetao Wang; Zachary Manickas-Hill; Claudia C. Carbone; Ann Dauphin; Jonathan Z. Li; Bruce D. Walker; Xu G. Yu; Jeremy Luban

    doi:10.1101/2021.01.14.21249839 Date: 2021-01-15 Source: medRxiv

    BACKGROUNDRisk of severe coronavirus disease 2019 MESHD ( COVID-19 MESHD) increases with age, is greater in males, and is associated with decreased numbers of blood lymphoid cells. Though the reasons for these robust associations are unclear, effects of age and sex on innate and adaptive lymphoid subsets, including on homeostatic innate lymphoid cells (ILCs) implicated in disease tolerance, may underlie the effects of age and sex on COVID-19 MESHD morbidity and mortality. METHODSFlow cytometry was used to quantitate subsets of blood lymphoid cells from people infected MESHD with severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2), comparing those hospitalized with severe COVID-19 MESHD (n=40) and those treated as outpatients for less severe disease (n=51). 86 healthy individuals served as controls. The relationship between abundance of specific blood lymphoid cell types, age, sex, hospitalization, duration of hospitalization, and elevation of blood markers for systemic inflammation MESHD, was determined using multiple regression. RESULTSAfter accounting for effects of age and sex, hospitalization for COVID-19 MESHD was associated with 1.78-fold fewer ILCs (95%CI: 2.34-1.36; p = 4.55 x 10-5) and 2.31-fold fewer CD16+ natural killer (NK) cells (95%CI: 3.1-1.71; p = 1.04 x 10-7), when compared to uninfected controls. Among people infected with SARS-CoV-2, the odds ratio for hospitalization, adjusted for age, sex, and duration of symptoms, was 0.413 (95%CI: 0.197-0.724; p = 0.00691) for every 2-fold increase in ILCs. In addition, higher ILC abundance was associated with less time spent in the hospital and lower levels of blood markers associated with COVID-19 MESHD severity: each two-fold increase in ILC abundance was associated with a 9.38 day decrease in duration of hospital stay (95% CI: 15.76-3.01; p= 0.0054), and decrease in blood C-reactive protein HGNC ( CRP HGNC) by 46.29 mg/L (95% CI: 71.34-21.24; p = 6.25 x 10-4), erythrocyte sedimentation rate (ESR) by 11.04 mm/h (95% CI: 21.94-0.13; p = 0.047), and the fibrin degradation product D-dimer by 1098.52 ng/mL (95% CI: 1932.84-264.19; p = 0.011). CONCLUSIONSBoth ILCs and NK cells were depleted in the blood of people hospitalized for severe COVID-19 MESHD, but, among lymphoid cell subsets, only ILC abundance was independently associated with the need for hospitalization, duration of hospital stay, and severity of inflammation MESHD. These results indicate that, by promoting disease tolerance, homeostatic ILCs protect against morbidity and mortality in SARS-CoV-2 infection MESHD, and suggest that reduction in the number of ILCs with age and in males accounts for the increased risk of severe COVID-19 MESHD in these demographic groups.

    Feasibility of Non-Rebreather Masks and Nasal Cannula as a Substitute for High Flow Nasal Oxygen in Patients with Severe COVID-19 MESHD Infection

    Authors: mehmet kabak; Baris Cil

    doi:10.21203/rs.3.rs-140464/v1 Date: 2021-01-04 Source: ResearchSquare

    Objective: Severe pneumonia MESHD and respiratory failure MESHD may develop in patients with coronavirus infection MESHD, placing a very significant burden on healthcare systems due to the need for both emergency and intensive care treatment. Therefore, treatment of hypoxemia MESHD is a clinical priority in the treatment of such patients. In this regard, newer strategies such as High Flow Nasal Oxygen (HFNO) and non-invasive mechanical ventilators that can provide non-invasive high fraction of inspired oxygen are gaining clinical significance. Our objective was to compare oxygen supply by HFNO with Non-Rebreather Masks and Nasal Cannula (NRMs + NC) in terms of treatment costs and mortality in a group of COVID-19 MESHD patients requiring intensive care unit admission. Material and Methods: This was a retrospective and single-center study involving 54 patients who were admitted to an Intensive Care Unit with a diagnosis of COVID-19 MESHD infection between July 2020 and August 2020. Results: HFNO was compared with NMRs + NC in terms of mortality and duration of hospital stay. The two groups were comparable in age (p=0.45), gender (p=0.33), and mortality (p=0.43). Also, there was no significant difference in oxygen saturation at admission (p=0.63), duration of intensive care (p=0.35), total length of hospital stay (p=0.057), and need for invasive mechanical ventilator (p=0.39) between the study groups. The levels of WBC (p=0.36), platelets (p=0.12), lymphocytes (p=0.98), CRP HGNC (p=0.11), pro-calcitonin (p=0.20), D-dimer (p=0.74), ferritin (p=0.14), urea (p=0.74), and creatinine (p=0.35) were also similar between the two groups. Conclusion: Oxygen support by NRMs + NC was comparable to HFNO in terms of mortality, need for invasive mechanic ventilation, length of intensive care, and length of hospital stay. We believe that NRMs + NC may represent an inexpensive and easily accessible therapeutic substitute for HFNO, particularly when the risk of transmission and costs related with HFNO use are considered. 

    Epidemiological feature, viral shedding, and antibody seroconversion among asymptomatic carriers and symptomatic/ presymptomatic COVID-19 MESHD patients

    Authors: Yi Chen; Ping Li; Yibo Ding; Miao Liu; Leijie Liu; Bo Yi; Ting Wu; Hongjun Dong; Xuying Lao; Keqing Ding; Haibo Wang; Dongliang Zhang; Xiaojie Tan; Zhongfa Wang; Guozhang Xu; Guangwen Cao

    doi:10.1101/2020.12.18.20248447 Date: 2020-12-20 Source: medRxiv

    Novel coronavirus disease 2019 MESHD ( COVID-19 MESHD) caused by severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) is pandemic. However, data concerning the epidemiological features, viral shedding, and antibody dynamics between asymptomatic SARS-CoV-2 carriers and COVID-19 MESHD patients remain controversial. We enrolled 193 subjects infected with SARS-CoV-2 in Ningbo and Zhoushan, Zhejiang, China from January 21 to March 6, 2020. All subjects were followed up to monitor the dynamics of immunoglobulin M (IgM) and IgG against SARS-CoV-2. Of those, 31 were asymptomatic carriers, 149 were symptomatic patients, and 14 were presymptomatic patients. Compared to symptomatic patients, asymptomatic carriers were younger and had higher levels of white blood cell and lymphocyte, lower levels of C-reactive protein HGNC and viral load, and shorter viral shedding duration. Conversion of IgM from positive to negative was shorter in asymptomatic carriers than in COVID-19 MESHD patients (P=0.030). The proportion of those persistently seropositive for IgG was higher in COVID-19 MESHD patients than in asymptomatic carriers (P=0.037). Viral load was higher in symptomatic than presymptomatic patients. Viral shedding was longer in presymptomatic patients than in asymptomatic carriers. Conclusively, asymptomatic carriers have a higher antiviral immunity to clear SARS-CoV-2 than do symptomatic patients and this antiviral immunity is not contributable to humoral immunity.

    Epidemiological feature, viral shedding, and antibody seroconversion among asymptomatic SARS-CoV-2 carriers and symptomatic/ presymptomatic COVID-19 MESHD patients

    Authors: Yi Chen; Ping Li; Yibo Ding; Miao Liu; Leijie Liu; Bo Yi; Ting Wu; Hongjun Dong; Xuying Lao; Keqing Ding; Haibo Wang; Dongliang Zhang; Xiaojie Tan; Zhongfa Wang; Guozhang Xu; Guangwen Cao

    doi:10.21203/rs.3.rs-131765/v1 Date: 2020-12-18 Source: ResearchSquare

    Background Novel coronavirus disease 2019 MESHD ( COVID-19 MESHD) caused by severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) is pandemic. However, data concerning the epidemiological features, viral shedding, and antibody dynamics between asymptomatic SARS-CoV-2 carriers and COVID-19 MESHD patients remain controversial.Methods A total of 193 subjects in Ningbo and Zhoushan, Zhejiang, China, were enrolled in this study from January 21 to March 6, 2020. All subjects were tested positive for SARS-CoV-2 genomic RNA by quantitative reverse transcription PCR and then followed up to monitor the dynamics of serum antibody immunoglobulin M (IgM) and immunoglobulin G (IgG) against SARS-CoV-2 using enzyme-linked immunosorbent assays. Scatter diagram to demonstrate the distribution of IgM and IgG among asymptomatic carriers and COVID-19 MESHD patients were generated by R.Results Of the 193 subjects, 31 were asymptomatic SARS-CoV-2 carriers, 149 were symptomatic COVID-19 MESHD patients, and 14 were COVID-19 MESHD patients during the incubation. Compared to symptomatic COVID-19 MESHD patients, asymptomatic SARS-CoV-2 carriers were younger and had higher levels of white blood cell and lymphocyte, lower levels of C-reactive protein HGNC ( CRP HGNC) and viral load, and shorter viral shedding time. Seroconversion of IgM against SARS-CoV-2 from positive to negative in asymptomatic carriers took 7.50 (IQR, 4.75–11.50) days, which was significantly shorter than 25.50 (IQR, 6.75–56.75) days in COVID-19 MESHD patients (P = 0.030). The proportion of those persistently seropositive for IgG against SARS-CoV-2 was higher in COVID-19 MESHD patients than in asymptomatic carriers (66.1% vs. 33.3%, P = 0.037). Viral load was higher in symptomatic than presymptomatic COVID-19 MESHD patients. Viral shedding was longer in presymptomatic COVID-19 MESHD patients than in asymptomatic carriers. In 4 familial clusters of SARS-CoV-2 infection MESHD, asymptomatic carriers were mainly children and young adults while severe COVID-19 MESHD was mainly found in family members older than 60 years with underlying diseases. Asymptomatic carriers acquired infection more from intra-familial transmission than did COVID-19 MESHD patients (89% vs. 61%, P = 0.028).Conclusion Asymptomatic carriers might have a higher antiviral immunity to clear SARS-CoV-2 than symptomatic COVID-19 MESHD patients and this antiviral immunity might not be contributable to humoral immunity. The severity of COVID-19 MESHD is associated with older age and underlying diseases in familial clustering cases.

    Malignancy MESHD History Affected the Prognosis of COVID-19 MESHD Patients via Release of Interleukin-6

    Authors: Jiahao Hu; Haixia Ding; Shenglan Ye; Guoxing Xu; Xiuwen Yang; Liangchao Wang; Xiaowu Shi

    doi:10.21203/rs.3.rs-127495/v1 Date: 2020-12-12 Source: ResearchSquare

    Background: Coronavirus disease 2019 MESHD ( COVID-19 MESHD), a newly erupted respiratory infectious disease MESHD caused by severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2), has swept across the most of countries. The laboratory characteristics of COVID-patients accompanied with cancer MESHD and the risk factors for disease progression and survival of this particular population were few reported. Methods: We enrolled 585 confirmed COVID-19 MESHD patients admitted to our hospitals with measured interleukin-6 HGNC level on admission. Laboratory tests and outcome were extracted from electronic medical records. Data was divided to cancer group and non-cancer MESHD group to explorer the risk factors of progression and survival.Findings: A total of 44 patients with different cancer type MESHD (cancer group) and 541 patients without cancer MESHD ( non-cancer MESHD group) were included. Cancer group had significant higher levels of NEUT, NLR, IL-6 HGNC, and CRP HGNC than non-cancer group, but lymphocyte count and ALB HGNC were lower. Cancer group showed significantly higher progression rate (42·1% vs 22·5%) and mortality (27·27% vs 11·91%) than non-cancer group. Elevated IL-6 HGNC and CRP were the risk factors associated with progression among moderate patients and death MESHD in-hospital (all p<0·05) in non- cancer group. This correlation was not observed in caner group.Interpretation: IL-6 HGNC, CRP HGNC, NEUT, and NLR were elevated in COVID-19 MESHD patients with cancer MESHD, with lower level of LYMP and ALB HGNC. IL-6 HGNC and CRP were positively correlated with progression and poor outcome in patients without cancer MESHD. As one of combined diseases, despite malignancy MESHD history did not directly affect the prognosis of COVID-19 MESHD, but it could play a role in the poorer outcome through release of IL-6 and CRP.

    Altered Transcript Levels of Cytokines in COVID-19 MESHD Patients

    Authors: Majid Samsami; Alireza Fatemi; Reza Jalili Khoshnoud; Karim Kohansal; Arezou Sayad; Shabnam Soghala; Shahram Arsang-Jang; Mohammad Taheri; Soudeh Ghafouri-Fard

    doi:10.21203/rs.3.rs-126215/v1 Date: 2020-12-10 Source: ResearchSquare

    The pandemic caused by severe acute respiratory syndrome coronavirus 2 MESHD and the related disorder i.e. “ coronavirus disease 2019 MESHD” ( COVID-19 MESHD) have encouraged researchers to unravel the molecular mechanism of disease severity. Several lines of evidence support the impact of "cytokine storm" in the pathogenesis of severe forms of the disorder MESHD. We aimed to assess the expression levels of nine cytokine coding in COVID-19 MESHD patients admitted in a hospital. Expression levels of IFN-G HGNC, IL-2 HGNC, IL-4 HGNC, IL-6 HGNC, IL-17 HGNC, TGF-B HGNC, IL-8 HGNC and IL-1B HGNC were significantly higher in COVID-19 MESHD patients compared with healthy controls and in both female and male patients compared with sex-matched controls. However, expression of none of these cytokines was different between ICU-admitted patients and other patients except for IL-6 HGNC whose expression was lower in the former group compared with the latter (ratio of means = 0.33, P value = 4.82E-02). Expression of TNF-A HGNC was not different between COVID-19 MESHD patients and healthy controls. Then, we assessed diagnostic power of cytokine coding genes in differentiating between COVID-19 MESHD patients and controls. The area under curve (AUC) values range from 0.94 for IFN-G HGNC to 1.0 for IL-2 HGNC and IL-1B HGNC. After combining the transcript levels of all cytokines, AUC, sensitivity and specificity values reached 1.0, 1.0 and 0.99, respectively. For differentiation between ICU-admitted patients and other patients, IL-4 HGNC with AUC value of 0.68, had the best diagnostic power among cytokine coding genes. Expression of none of cytokine coding genes was correlated with the assessed clinical/demographic data including age, gender, ICU admission, or CRP HGNC/ESR levels. Our study provides further evidence for contribution of “cytokine storm” in the pathobiology of moderate/severe forms of COVID-19 MESHD.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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