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SARS-CoV-2 proteins

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    Risk Factors Associated with Disease Severity and Clinical Outcomes for COVID-19 MESHD in Wuhan, China

    Authors: Yun Liu; Hao Wu; Bei Zhu; Yi Yang; Peng Cheng; Chaolin Huang; Wenjuan Wu; Weihong Zhao; Jinsong Zhang

    doi:10.21203/rs.3.rs-143695/v1 Date: 2021-01-08 Source: ResearchSquare

    Background: A new type of pneumonia MESHD caused by severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) appeared in Wuhan, China. However, the risk factors and characteristics related to the severity of the disease and its outcomes need to be further explored.Methods: In this retrospective study, we evaluated COVID-19 MESHD patients with severe disease and those who were critically ill, as diagnosed at Jinyintan Hospital (Wuhan, China). The demographic information, clinical characteristics, complications, and laboratory results for the patients were evaluated. Multivariate logistic regression methods were used to analyze risk factors related to hospital deaths.Results: The 235 COVID-19 MESHD patients included were divided into a severe group of 183 (78%) and a critical group of 52 (22%). Of these patients, 185 (79%) were discharged, and 50 (21%) died during hospitalization. In multivariate logistic analyses, age (OR=1.07, 95% CI 1.02-1.14, P=0.009), critical disease MESHD (OR=48.23, 95% CI 10.91-323.13, P<0.001), low lymphocyte counts (OR=15.48, 95% CI 1.98-176.49, P=0.015), elevated interleukin 6 HGNC ( IL-6 HGNC) (OR=9.11, 95% CI 1.69-67.75, P=0.017), and elevated aspartate aminotransferase ( AST HGNC) (OR=8.46, 95% CI 2.16-42.60, P=0.004) were independent risk factors for adverse outcomes.Conclusions: The results show that advanced age (> 64 years), critical illness, low lymphocyte levels, and elevated IL-6 HGNC and AST HGNC were factors for the risk of death for COVID-19 MESHD patients who had severe disease and those who were critically ill.

    Beneficial effect of Indigo Naturalis on acute lung injury MESHD induced by influenza A virus

    Authors: Peng Tu; Rong Tian; Yan Lu; Yunyi Zhang; Haiyan Zhu; Lijun Ling; Hong Li; Daofeng Chen

    doi:10.21203/rs.3.rs-73166/v3 Date: 2020-09-06 Source: ResearchSquare

    Background: Infections induced by influenza viruses, as well as coronavirus disease MESHD 19 ( COVID-19 MESHD) pandemic induced by severe acute respiratory coronavirus MESHD 2 (SARS-CoV-2) led to acute lung injury MESHD ( ALI MESHD) and multi organ failure MESHD, during which traditional Chinese medicine (TCM) played an important role in treatment of the pandemic. The study aimed to investigate the effect of Indigo Naturalis on ALI MESHD induced by influenza A virus (IAV) in mice.Method: The anti-influenza and anti-inflammatory properties of aqueous extract of Indigo Naturalis (INAE) were evaluated in vitro. BALB/c mice inoculated intranasally with IAV (H1N1) were treated intragastrically with INAE (40, 80 and 160 mg·kg-1/d) 2 h later for 4 or 7 days. Animal lifespan and mortality were recorded. Expression of high mobility group box-1 HGNC protein ( HMGB-1) and toll-like receptor 4 HGNC ( TLR4 HGNC) were evaluated through immunohistological staining. Inflammatory cytokines were also monitored by ELISA.Result: INAE inhibited virus replication on Madin-Darby canine kidney (MDCK) cells and decreased nitric oxide (NO) production from lipopolysaccharide (LPS)-stimulated peritoneal macrophages in vitro. The results showed that oral administration of 160 mg/kg of INAE significantly improved the lifespan (P < 0.01) and survival rate of IAV infected MESHD mice, improved lung injury MESHD and lowered viral replication in lung tissue (P < 0.01). Treatment with INAE (40, 80 and 160 mg/kg) significantly increased liver weight and liver index (P < 0.05), as well as weight and organ index of thymus and spleen at 160 mg/kg (P < 0.05). Serum alanine transaminase (ALT) and aspartate aminotransferase ( AST HGNC) levels were reduced by INAE administration (P < 0.05). The expression of HMGB-1 HGNC and TLR4 HGNC in lung tissue were also suppressed. The increased production of myeloperoxidase HGNC ( MPO HGNC) and methylene dioxyamphetamine (MDA) in lung tissue were inhibited by INAE treatment (P < 0.05). Treatment with INAE reduced the high levels of interferon α (IFN-α), interferon β (IFN-β), monocyte chemoattractant protein-1 (MCP-1), regulated upon activation normal T cell expressed and secreted factor (RANTES), interferon induced protein-10 (IP-10), tumor MESHD necrosis MESHD factor-α (TNF-α), interleukin-6 (IL-6) (P < 0.05), with increased production of interferon γ (IFN-γ) and interleukin-10 (IL-10) (P < 0.05).Conclusion: The results showed that INAE alleviated IAV induced ALI MESHD in mice. The mechanisms of INAE were associated with its anti-influenza, anti-inflammatory and anti-oxidation properties. Indigo Naturalis might have clinical potential to treat ALI MESHD induced by IAV.

    Dynamic Prognosis Model for Predicting Survival in Severe and Critically Ill COVID-19 MESHD Patients Using Machine Learning

    Authors: Yongyue Wei; Jieyu He; Jiao Chen; Ying Zhu; Jiajin Chen; Jingjing Ding; Hao Wang; Yahua Hu; Yingzi Huang; Yue Jiang; Zoucheng Pan; Sipeng Shen; Wei Zhao; Wei Gao; Feng Chen; Xiang Lu

    doi:10.21203/rs.3.rs-64083/v1 Date: 2020-08-22 Source: ResearchSquare

    Background Novel coronavirus disease MESHD ( COVID-19 MESHD) is an emerging, rapidly evolving situation. At present, the prognosis of severe and critically ill MESHD patients has become an important focus of attention. We strived to develop a prognostic prediction model for severe and critically ill COVID-19 MESHD patients.MethodsTo assess the factors associated with the prognosis of those patients, we retrospectively investigated the clinical, laboratory characteristics of confirmed 112 cases of COVID-19 MESHD admitted between 21 January to 6 March 2020 from Huangshi Central Hospital, Huangshi Hospital of Traditional Chinese Medicine, and Daye People’s Hospital. We applied machine learning method (survival random forest) to select predictors for 28-day survival and taken into account the dynamic trajectory of laboratory indicators. Results Fifteen candidate prognostic features, including 11 baseline measures (including platelet count (PLT), urea, creatine kinase (CK), fibrinogen HGNC, creatine kinase isoenzyme activity, aspartate aminotransferase ( AST HGNC), activation of partial thromboplastin time (APTT), albumin, standard deviation of erythrocyte distribution width (RBC-SD), neutrophils (%) and red blood cell count (RBC)) and 4 trajectory clusters (changes during hospitalization in the white blood cell (WBC), PLT large cell ratio (P-LCR), PLT distribution width (PDW) and AST HGNC), combined with covariates achieved 100% (95%CI: 99%-100%) AUC and reached 87% (95%CI: 84%-91%) AUC in an external validation set. Conclusions Taking advantage of random forest technique and laboratory dynamic measures, we developed a forest model to predict survival outcome of COVID-19 MESHD patients, which achieved 87% AUC in the external validation set. Our online tool will help to facilitate the early recognition of patients with high risk. 

    Coronavirus Disease ( COVID-19 MESHD) and the Liver: A comprehensive systematic review and meta-analysis

    Authors: Praveen Kumar-M; Shubhra Mishra; Daya Krishna Jha; Jayendra Shukla; Arup Choudhury; Ritin Mohindra; Harshal S Mandavdhare; Usha Dutta; Vishal Sharma

    doi:10.21203/rs.3.rs-37723/v1 Date: 2020-06-24 Source: ResearchSquare

    Background: Liver function derangements have been reported in coronavirus disease MESHD ( COVID-19 MESHD) but reported rates are variable. Methods: We searched Pubmed and Embase with terms COVID and SARS-COV-2 from December 1, 2019 till April 5, 2020. We estimated overall prevalence, stratified prevalence based on severity, estimated risk ratio (RR) and estimated standardized mean difference (SMD) of liver function parameters in severe as compared to nonsevere COVID. Random effect method utilizing inverse variance approach was used for pooling the data. Results: In all, 128 studies were included. The most frequent abnormalities were hypoalbuminemia MESHD [61.27% (48.24 - 72.87)], elevations of gamma-glutamyl transferase ( GGT HGNC) [27.94%(18.22 -40.27)], alanine aminotransferase HGNC (ALT) [23.28%(19.92 - 27.01)] and aspartate aminotransferase ( AST HGNC) [23.41%(18.84 - 28.70)]. Further the relative risk of these abnormalities was higher in the patients with severe COVID-19 MESHD when compared to non-severe disease [ Hypoalbuminemia MESHD - 2.65(1.38 - 5.07); GGT HGNC - 2.31(1.6 - 3.33); ALT - 1.76(1.44 - 2.15); AST HGNC 2.30(1.82 - 2.90)]. The SMD of hypoalbuminemia MESHD, GGT HGNC, ALT and AST HGNC elevation in severe as compared to nonsevere were -1.05(-1.27 - -0.83), 0.76(0.40 - 1.12), 0.42(0.27 - 0.56) and 0.69 (0.52 - 0.86) respectively. The pooled prevalence and RR of chronic liver disease MESHD as a comorbidity was 2.64% (1.73- 4) and 1.69(1.05-2.73) respectively. Conclusion: The most frequent abnormality in liver functions was hypoalbuminemia MESHD followed by derangements in gamma-glutamyl transferase and aminotransferases and these abnormalities were more frequent in severe disease.  The systematic review was, however, limited by heterogeneity in definitions of severity and liver function derangements.  

    Lung and Kidney Perfusion Deficits Diagnosed by Dual-Energy Computed Tomography in COVID–19 Patients: Evidence Supporting Systemic Microangiopathy

    Authors: Ilkay S. Idilman; Gulcin Telli Dizman; Selin Ardali Duzgun; Ilim Irmak; Musturay Karcaaltincaba; Ahmet Cagkan Inkaya; Figen Basaran Demirkazik; Gamze Durhan; Meltem Gulsun Akpinar; Orhan Macit Ariyurek; Erhan Akpinar; Jordi Rello; Murat Akova; Deniz Akata

    doi:10.21203/rs.3.rs-32474/v1 Date: 2020-05-29 Source: ResearchSquare

    Objectives: There is increasing evidence of thrombotic MESHD events occurring in patients with coronavirus disease MESHD ( COVID-19 MESHD). We evaluated dual-energy computed tomography (DECT) findings, particularly lung and kidney perfusion, in non-intubated COVID-19 MESHD patients. Methods: Thirty-one COVID-19 MESHD patients who underwent pulmonary DECT angiography between March 15 and April 30, 2020, and were suspected of having pulmonary thromboembolism MESHD were included. Pulmonary and kidney images were reviewed. Qualitative and quantitative analyses of the perfused blood volume and iodine maps were performed. Results: DECT images showed perfusion deficits (PDs) in eight patients (25.8%), which were not overlapping with areas of ground-glass opacity or consolidation. Two patients had pulmonary thromboembolism MESHD confirmed by CT angiography. Five of 10 patients who had been infected MESHD for more than 5 days had PDs documented. Patients with PDs had a longer hospital stay (12.25 ± 8.81 vs 6.83 ± 5.04 days, p= 0.14), higher intensive care unit admission rates (37.5% vs 4.3%, p=0.02), higher CT scores (13.3 ± 8.2 vs 5 ± 5.4, p= 0.02) and more severe disease (50% vs 4.3%, p=0.01). In the PD group, serum ferritin, aspartate aminotransferase ( AST HGNC), fibrinogen HGNC, D-dimer, C-reactive protein HGNC ( CRP HGNC), and troponin levels were significantly higher, whereas albumin level was lower (p<0.05). D-dimer levels ≥ 0.485 ug/L predicted PD with 100% specificity and 87% sensitivity (AUROC: 0.957). Renal iodine maps showed heterogeneous enhancement consistent with perfusion abnormality in 13 patients (50%). Sodium levels were significantly lower in this group (p=0.03). Conclusions: Pulmonary perfusion abnormalities in COVID 19 patients is associated with more severe disease and in most of the patients can occur without macroscopic pulmonary thromboembolism MESHD. High rate of kidney perfusion abnormalities MESHD suggests subclinical systemic microvascular obstruction MESHD.

    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.

    Improved survival outcome in SARs-CoV-2 ( COVID-19 MESHD) Acute Respiratory Distress Syndrome patients with Tocilizumab administration

    Authors: Nafisa Wadud; Naim Ahmed; Mannu Mannu Shergil; Maida Khan; Murali G Krishna; Aamir Gilani; Samer El Zarif; Jodi Galaydick; Karthika Linga; Shravan Koor; Julia Galea; Lauren Stuczynski; Maria B Osundele

    doi:10.1101/2020.05.13.20100081 Date: 2020-05-16 Source: medRxiv

    ABSTRACT Background: The novel human coronavirus, severe acute respiratory syndrome coronavirus-2 MESHD (SARs-CoV-2), was declared a global pandemic by the World Health Organization on March 11, 2020. Hence, there is an urgency to find effective treatment. Of those patients afflicted in the United States, many have required treatment with ventilator secondary to acute respiratory distress syndrome MESHD ( ARDS MESHD). Data are needed regarding the benefit of treatment and prevention of the cytokine storms in COVID-19 MESHD patients with Tocilizumab. Methods: Clinical outcomes data for patients admitted to Orange Regional Medical Center with confirmed COVID-19 MESHD from Mar 15, 2020 to Apr 20, 2020 were identified through electronic health record chart review. We conducted a retrospective case-control study in confirmed COVID 19 positive patients with ARDS MESHD requiring mechanical ventilation and compared outcome in terms of mortality and length of stay amongst those who received Tocilizumab as treatment modality opposed to those that did not. Results: A total of 94 patients with COVID-19 MESHD ARDS MESHD were analyzed. 44 were in the study group and 50 in the control group. We tried to match both group as close as possible in terms of age, sex, BMI and HS score- calculated using inflammatory markers- ferritin, triglycerides, AST HGNC and fibrinogen HGNC. The median age was 55.5 years in the study group and 66 in the control group, difference was not statistically significant. Average HS score was 114 in the Tocilizumab group and 92 in the control group, difference was statistically significant with P<0.0001. Also, the patients in the study group had elevated levels of IL-6 HGNC, triglycerides, AST HGNC, ferritin which were statistically significant with p < 0.0001 when compared to the control group. Length of stay was longer, average 17.9 days in the Tocilizumab. Survival rate was much lower at 48 % in the control group and 61.36 % in patients who received Tocilizumab with significant P value of < 0.00001. The number needed to treat (NNT) was 7.48, if we treat 8 patients with Tocilizumab, 1 will not die. Conclusions: Cytokine Release Syndrome ( CRS HGNC) occurs in a large number of patients with severe COVID-19 MESHD, which is also an important cause of death MESHD. IL- 6 HGNC is the key molecule of CRS HGNC, so IL-6R HGNC antagonist Tocilizumab may be of value in improving outcomes. In our study Tocilizumab group seemed to have improved survival outcome. Results have to be interpreted with caution since this is a retrospective study and mortality is affected by multiple, confounding factors. We await the results of ongoing randomized controlled trials to definitely answer the question of whether Tocilizumab improves survival in COVID-19 MESHD ARDS MESHD patients.

    Comparison of clinical characteristics and risk factors in hospitalized patients with SARS-CoV-2, MERS-CoV, and SARS-CoV infection

    Authors: Zhengtu Li; Xidong Wang; Guansheng Su; Zeguang Zheng; Shaoqiang Li; Yuwei Ye; Qiuxue Deng; Jinchuang Li; Xiaoyu Xiong; Xinguang Wei; Zeqiang Lin; Zichen Jie; Feng Ye

    doi:10.21203/rs.3.rs-28847/v1 Date: 2020-05-14 Source: ResearchSquare

    Herein, we compared the risk factors, clinical presentation of patients hospitalized with SARS-CoV-2, SARS-CoV MESHD, or MERS-CoV infection MESHD. Our data sources include PubMed, Embase, CNKI, and Ovid/Medline. The proportion of male patients with COVID-19 MESHD was higher than who with SARS but lower than who with MERS (p<0.001). More patients with COVID-19 MESHD had coexisting chronic medical conditions than those with SARS (p<0.001) but fewer than those with MERS (p<0.001), and the prevalence of hypertension MESHD (17%) and smoking history (14%) was higher than in patients with SARS (p<0.001). Furthermore, the symptom of fever MESHD (53%), hemoptysis (1%), diarrhea MESHD (4%) and vomiting MESHD (3%) of COVID-19 MESHD were significantly lower than that in patients with SARS or MERS. The level of ALT and AST HGNC in COVID-19 MESHD was significantly lower (p<0.001), however, thrombocytopenia MESHD, high LDH were common. Summary, male, smoking history and hypertension MESHD were the most common risk factors for hospitalization with COVID-19 MESHD; and the clinical feature was less severe in COVID-19 MESHD.

    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

    The Impact of Coronavirus Disease 2019 MESHD ( COVID-19 MESHD) on Liver Injury in China: A Systematic Review and Meta-analysis

    Authors: Xin Zhao; Zehua Lei

    doi:10.1101/2020.05.03.20089557 Date: 2020-05-08 Source: medRxiv

    Abstract Background: The evidence for the incidence and severity of liver injury MESHD in Chinese patients with COVID-19 MESHD is still controversial. Aims: The purpose of this study was to summarize the incidence of liver injury MESHD and the differences between liver injury MESHD markers among different patients with COVID-19 MESHD in China. Methods: Computer searches of PubMed, Embase, CNKI and medRxiv were used to obtain reports on the incidence and markers of liver injury MESHD in Chinese patients with COVID-19 MESHD, from January 1, 2020 to April 10, 2020. (No. CRD42020181350) Results: A total of 57 reports from China were included, including 9889 confirmed cases of COVID-19 MESHD infection. The results of the meta-analysis showed that among the patients with early COVID-19 MESHD infection in China, the incidence of liver injury MESHD events was 24.7% (95% CI, 23.4%-26.4%). Liver injury MESHD in severe patients was more common than that in non-severe patients, with a risk ratio of 2.07 (95% CI, 1.77 to 2.43). Quantitative analysis showed that the severe the coronavirus infection MESHD, the higher the level of AST HGNC, ALT, TB, ALP MESHD, GGT and the lower the level of ALB HGNC. The changing trend of the appeal index was similar in ICU patients and dead patients. Conclusion: There is a certain risk of liver injury MESHD in Chinese patients with COVID-19 MESHD, and the risk and degree of liver injury MESHD are related to the severity of COVID-19 MESHD.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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