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MeSH Disease

Pneumonia (98)

COVID-19 (97)

Fever (30)

Death (19)

Lymphopenia (18)


HGNC Genes

SARS-CoV-2 proteins

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    Maternal and neonatal outcomes of pregnant women with COVID-19 MESHD pneumonia: a case-control study

    Authors: Na Li; Lefei Han; Min Peng; Yuxia Lv; Yin Ouyang; Kui Liu; Linli Yue; Qiannan Li; Guoqiang Sun; Lin Chen; Lin Yang

    doi:10.1101/2020.03.10.20033605 Date: 2020-03-13 Source: medRxiv

    Background The ongoing epidemics of coronavirus disease 2019 MESHD ( COVID-19 MESHD) have caused serious concerns about its potential adverse effects on pregnancy. There are limited data on maternal and neonatal outcomes of pregnant women with COVID-19 MESHD pneumonia MESHD. Methods We conducted a case-control study to compare clinical characteristics, maternal and neonatal outcomes of pregnant women with and without COVID-19 MESHD pneumonia MESHD. Results During January 24 to February 29, 2020, there were sixteen pregnant women with confirmed COVID-19 MESHD pneumonia MESHD and eighteen suspected cases who were admitted to labor in the third trimester. Two had vaginal delivery and the rest took cesarean section. Few patients presented respiratory symptoms ( fever MESHD and cough MESHD) on admission, but most had typical chest CT images of COVID-19 MESHD pneumonia MESHD. Compared to the controls, COVID-19 MESHD pneumonia MESHD patients had lower counts of white blood cells (WBC), neutrophils, C-reactive protein HGNC ( CRP HGNC), and alanine aminotransferase HGNC (ALT) on admission. Increased levels of WBC, neutrophils, eosinophils, and CRP HGNC were found in postpartum blood tests of pneumonia MESHD patients. There were three (18.8%) and two (10.5%) of the mothers with confirmed or suspected COVID-19 MESHD pneumonia MESHD had preterm delivery due to maternal complications, which were significantly higher than the control group. None experienced respiratory failure MESHD during hospital stay. COVID-19 MESHD infection was not found in the newborns and none developed severe neonatal complications. Conclusion Severe maternal and neonatal complications were not observed in pregnant women with COVID-19 MESHD pneumonia MESHD who had vaginal delivery or caesarean section. Mild respiratory symptoms of pregnant women with COVID-19 MESHD pneumonia MESHD highlight the need of effective screening on admission.

    Epidemiological and clinical features of 201 COVID-19 MESHD patients in Changsha, China

    Authors: Jian Zhou; Jing-jing Sun; Zi-qin Cao; Wan-chun Wang; Kang Huang; Fang Zheng; Yuan-lin Xie; Di-xuan Jiang; Zhi-guo Zhou

    doi:10.21203/rs.3.rs-17313/v1 Date: 2020-03-11 Source: ResearchSquare

    Background In December 2019, a cluster of coronavirus Disease MESHD coronavirus Disease 2019 MESHD ( COVID-19 MESHD) occurred in Wuhan, Hubei Province, China. With the advent of the Chinese Spring Festival, this disease spread rapidly throughout the country. The information about the clinical characteristics of COVID-19 MESHD patients outside of Wuhan is limited. Methods All of the patients with confirmed COVID-19 MESHD were admitted to the First Hospital of Changsha City, the designated hospital for COVID-19 MESHD assigned by the Changsha City Government. The clinical and epidemiological characteristics, data of laboratory, radiological picture, treatment, and outcomes records of 201 COVID-19 MESHD patients were collected using electronic medical records. Results This study population consisted of 201 hospitalized patients with laboratory-confirmed COVID-19 MESHD in Changsha by February 15, 2020. The median age of the patients was 45 years (IQR 34–59). About half (50.7%) of the patients were male, and most of the infected MESHD patients were staff (96 [47.8%]). Concerning the epidemiologic history, the number of patients linked to Wuhan was 92 (45.8%). The most common symptoms were fever MESHD (125 [62.2%]), dry cough MESHD (118 [58.7%]), fatigue MESHD (65 [32.3%]), and pharyngalgia (31 [15.4%]). One hundred and forty-four (71.6%) enrolled patients showed bilateral pneumonia MESHD. Fifty-four (26.9%) patients showed unilateral involvement, and three (1.5%) patients showed no abnormal signs or symptoms. The laboratory findings differed significantly between the Intensive Care Unit (ICU) and non-ICU groups. Compared with non-ICU patients, ICU MESHD patients had depressed MESHD white blood cell (WBC), neutrocytes, lymphocytes, and prolonged prothrombin time (PT). Moreover, higher plasma levels of erythrocyte sedimentation rate (ESR), C-reactive protein HGNC ( CRP HGNC), procalcitonin (PCT), alanine aminotransferase (ALA), aspartate aminotransferase ( AST HGNC), creatine kinase (CK), creatine kinase-MB (CK-MB), creatinine (CREA), and lactate dehydrogenase (LDH) were detected in the ICU group. Conclusions In this single-center study of 201 COVID-19 MESHD patients in Changsha, China, 22.4% of patients were admitted to ICU. Based on our findings, we propose that the risk of cellular immune deficiency MESHD, hepatic injury MESHD, and kidney injury MESHD should be monitored. Previous reports focused on the clinical features of patients from Wuhan, China. With the global epidemic of COVID-19 MESHD, we should pay more attention to the clinical and epidemiological characteristics of patients outside of Wuhan.

    Prediction of survival for severe Covid-19 MESHD patients with three clinical features: development of a machine learning-based prognostic model with clinical data in Wuhan

    Authors:

    doi:10.1101/2020.02.27.20028027 Date: 2020-03-01 Source: medRxiv

    The sudden increase of COVID-19 MESHD cases is putting a high pressure on healthcare services worldwide. At the current stage, fast, accurate and early clinical assessment of the disease severity is vital. To support decision making and logistical planning in healthcare systems, this study leverages a database of blood samples from 404 infected patients in the region of Wuhan, China to identify crucial predictive biomarkers of disease severity. For this purpose, machine learning tools selected three biomarkers that predict the survival of individual patients with more than 90% accuracy: lactic dehydrogenase (LDH), lymphocyte and high-sensitivity C-reactive protein HGNC (hs-CRP). In particular, relatively high levels of LDH alone seem to play a crucial role in distinguishing the vast majority of cases that require immediate medical attention. This finding is consistent with current medical knowledge that high LDH levels are associated with tissue breakdown occurring in various diseases, including pulmonary disorders MESHD such as pneumonia MESHD. Overall, this paper suggests a simple and operable formula to quickly predict patients at the highest risk, allowing them to be prioritised and potentially reducing the mortality rate.

    Clinical characteristics of 25 death cases infected with COVID-19 MESHD pneumonia: a retrospective review of medical records in a single medical center, Wuhan, China

    Authors: Xun Li; Luwen Wang; Shaonan Yan; Fan Yang; Longkui Xiang; Jiling Zhu; Bo Shen; Zuojiong Gong

    doi:10.1101/2020.02.19.20025239 Date: 2020-02-25 Source: medRxiv

    Summary Background The pneumonia MESHD caused by the 2019 novel coronavirus (SARS-CoV-2) is a highly infectious disease MESHD, which was occurred in Wuhan, Hubei Province, China in December 2019. As of February 13, 2020, a total of 59883 cases of COVID-19 MESHD in China have been confirmed and 1368 patients have died from the disease. However, the clinical characteristics of the dyed patients were still not clearly clarified. This study aims to summarize the clinical characteristics of death cases with COVID-19 MESHD and to identify critically ill patients of COVID-19 MESHD early and reduce their mortality. Methods The clinical records, laboratory findings and radiologic assessments included chest X-ray or computed tomography were extracted from electronic medical records of 25 died patients with COVID-19 MESHD in Renmin Hospital of Wuhan University from Jan 14 to Feb 13, 2020. Two experienced clinicians reviewed and abstracted the data. Findings The mean age of the dead was 71.48 years, the average course of the disease was 10.56 days, all patients eventually died of respiratory failure MESHD. All of those who died had underlying diseases, the most common of which was hypertension MESHD (16/25, 64%), followed by diabetes MESHD (10/25, 40%), heart diseases MESHD (8/25, 32%), kidney diseases MESHD (5/25, 20%), cerebral infarction MESHD (4/25, 16%), chronic obstructive pulmonary disease MESHD ( COPD MESHD, 2/25, 8%), malignant tumors MESHD (2/25, 8%) and acute pancreatitis MESHD (1/25, 4%). The most common organ damage outside the lungs was the heart, followed by kidney and liver. In the patients' last examination before death MESHD, white blood cell and neutrophil counts were elevated in 17 patients (17/25, 68%) and 18 patients (18/25, 72%), lymphocyte counts were decreased in 22 patients (22/25, 88%). Most patients' PCT HGNC, CRP HGNC and SAA levels were elevated, the percentages were 90.5% (19/21), 85% (19/20) and 100% (21/21) respectively. The levels of the last test of neutrophils (15/16, 93.8%), PCT HGNC (11/11, 100%), CRP HGNC (11/13, 84.6%), cTnI HGNC (8/9, 88.9%), D-Dimer (11/12, 91.6%) and LDH (9/9, 100%) were increased as compared to the first test, while the levels of lymphocytes were decreased (14/16, 87.5%). Interpretation The age and underlying diseases ( hypertension MESHD, diabetes MESHD, etc.) were the most important risk factors for death of COVID-19 MESHD pneumonia MESHD. Bacterial infections may play an important role in promoting the death of patients. Malnutrition MESHD was common to severe patients. Multiple organ dysfunction can be observed, the most common organ damage was lung, followed by heart, kidney and liver. The rising of neutrophils, SAA, PCT HGNC, CRP HGNC, cTnI HGNC, D-Dimer and LDH levels can be used as indicators of disease progression, as well as the decline of lymphocytes counts.

    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.

    Clinical characteristics of 51 patients discharged from hospital with COVID-19 MESHD in Chongqing,China

    Authors: liu lei; Gao Jian-ya

    doi:10.1101/2020.02.20.20025536 Date: 2020-02-23 Source: medRxiv

    Abstract BackgroundSince December 2019, Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)-infected disease MESHD ( Coronavirus Disease 2019 MESHD COVID-19 MESHD) emerged in Wuhan , Chinaand rapidly spread throughout Chinaeven throughout the world. We try to describe the epidemiological and clinical characteristics of COVID-19 MESHD in non-Wuhan areaand explore its effective treatment. MethodsRetrospective, single-center case series of the 51 hospitalized patients with confirmed COVID-19 MESHD at Chongqing University Three Gorges Hospital in Chongqing, China, from January 20 to February 3, 2020The discharge time was from January 29 to February 11, 2020. The main results and indicators of epidemiology, demography, clinical manifestation, laboratory examination, imaging data and treatment data of 51 patients with covid-19 MESHD were collected and analyzed. The changes of blood routine and biochemical indexes at discharge and admission were compared. Compare the clinical characteristics of severe patients (including severe and critical patients) and non- severe patients (general patients). Results Of 51 hospitalized patients with COVID-19 MESHD, the median age was 45 years (interquartile range, 34-51; range, 16-68 years) and 32 (62.7%) were men.43(84.3%)patients had been to Wuhan or Other Hubei areas outside Wuhanand 4(7.7%) patients had a clear contact history of COVID-19 MESHD patients before the onset of the disease, and 4(7.7%) patients had no clear epidemiological history of COVID-19 MESHD.Common symptoms included fever MESHD (43 [84.3%]), cough (38 [74.5%]) and fatigue MESHD (22 [43.1%]). Lymphopenia MESHD was observed in 26 patients (51.0%), and elevated C-reactive protein HGNC level in 32 patients (62.7%). Ground-glass opacity was the typical radiological finding on chest computed tomography (41 [80.4%])Local consolidation of pneumonia MESHD in some patients(17 [33.3%]).Most of the patients were treated with traditional Chinese medicine decoction (28 [54.9%])all of them received aerosol inhalation of recombinant human interferon a-1b for injection and oral antiviral therapy with Lopinavir and Ritonavir tablets (51 [100%]); Most of the patients were given Bacillus licheniformis capsules regulated intestinal flora treatment (44 [86.3%]). 10 patients (19.6%) received short-term (3-5 days) glucocorticoid treatment. Compared with non-severe patients (n = 44), severe patients (n = 7) were older (median age, 52 years vs 44 years), had a higher proportion of diabetes mellitus (4 [57.1%] vs 0 [0.0%]), most of them needed antibiotic treatment (7 [100%] vs 4 [9.1%], most of them needed nutritional diet (6 [85.7%) vs 0 [0.0%], and were more likely to have dyspnea (6 [85.7%] vs 5 [11.4%])most of them needed noninvasive mechanical ventilation (6 [85.7%] vs 0 [0.0%]). Except one patient died, the remaining 50 patients were discharged according to the discharge standard, the common clinical symptoms disappeared basically, the lymphocyte increased significantly (P=0.008), CRP HGNC decreased significantly (P <0.001). The median length of stay was 12 days (IQR, 9-13). ConclusionIn 51 single center cases confirmed as COVID-19 MESHD and discharged from the hospital, 13.7% of the patients were severe. The main clinical symptoms of patients with COVID-19 MESHD were fever, cough and astheniaSome patients had obvious dyspnea. They had clinical laboratory and radiologic characteristics. There is no specific drug treatment for the disease. For the treatment of COVID-19 MESHD, in addition to oxygen inhalation and antiviral treatment, attention should be paid to the dialectical treatment of traditional Chinese medicine, regulation of intestinal flora, nutritional support treatment and other comprehensive treatment.

    ACP risk grade: a simple mortality index for patients with confirmed or suspected severe acute respiratory syndrome coronavirus 2 disease ( COVID-19 MESHD) during the early stage of outbreak in Wuhan, China

    Authors: Jiatao Lu; Shufang Hu; Rong Fan; Zhihong Liu; Xueru Yin; Qiongya Wang; Qingquan Lv; Zhifang Cai; Haijun Li; Yuhai Hu; Ying Han; Hongping Hu; Wenyong Gao; Shibo Feng; Qiongfang Liu; Hui Li; Jian Sun; Jie Peng; Xuefeng Yi; Zixiao Zhou; Yabing Guo; Jinlin Hou

    doi:10.1101/2020.02.20.20025510 Date: 2020-02-23 Source: medRxiv

    Background: Since the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease MESHD ( COVID-19 MESHD) outbreaks in Wuhan, China, healthcare systems capacities in highly endemic areas have been overwhelmed. Approaches to efficient management are urgently needed and key to a quicker control of the outbreaks and casualties. We aimed to characterize the clinical features of hospitalized patients with confirmed or suspected COVID-19 MESHD, and develop a mortality risk index for COVID-19 MESHD patients. Methods: In this retrospective one-centre cohort study, we included all the confirmed or suspected COVID-19 MESHD patients hospitalized in a COVID-19 MESHD-designated hospital from January 21 to February 5, 2020. Demographic, clinical, laboratory, radiological and clinical outcome data were collected from the hospital information system, nursing records and laboratory reports. Results: Of 577 patients with at least one post-admission evaluation, the median age was 55 years (interquartile range [IQR], 39 - 66); 254 (44.0%) were men; 22.8% (100/438) were severe pneumonia MESHD on admission, and 37.7% (75/199) patients were SARS-CoV-2 positive. The clinical, laboratory and radiological data were comparable between positive and negative SARS-CoV-2 patients. During a median follow-up of 8.4 days (IQR, 5.8 - 12.0), 39 patients died with a 12-day cumulative mortality of 8.7% (95% CI, 5.9% to 11.5%). A simple mortality risk index (called ACP index), composed of Age and C-reactive Protein HGNC, was developed. By applying the ACP index, patients were categorized into three grades. The 12-day cumulative mortality in grade three (age [≥] 60 years and CRP [≥] 34 mg/L) was 33.2% (95% CI, 19.8% to 44.3%), which was significantly higher than those of grade two (age [≥] 60 years and CRP < 34 mg/L; age < 60 years and CRP [≥] 34 mg/L; 5.6% [95% CI, 0 to 11.3%]) and grade one (age < 60 years and CRP < 34 mg/L, 0%) (P <0.001), respectively. Conclusion: The ACP index can predict COVID-19 MESHD related short-term mortality, which may be a useful and convenient tool for quickly establishing a COVID-19 MESHD hierarchical management system that can greatly reduce the medical burden and therefore mortality in highly endemic areas.

    Clinical and immunologic features in severe and moderate forms of Coronavirus Disease 2019 MESHD

    Authors: Guang Chen; Di Wu; Wei Guo; Yong Cao; Da Huang; Hongwu Wang; Tao Wang; Xiaoyun Zhang; Huilong Chen; Haijing Yu; Xiaoping Zhang; Minxia Zhang; Shiji Wu; Jianxin Song; Tao Chen; Meifang Han; Shusheng Li; Xiaoping Luo; Jianping Zhao; Qin Ning

    doi:10.1101/2020.02.16.20023903 Date: 2020-02-19 Source: medRxiv

    Background Since late December, 2019, an outbreak of pneumonia MESHD cases caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, and continued to spread throughout China and across the globe. To date, few data on immunologic features of Coronavirus Disease 2019 MESHD ( COVID-19 MESHD) have been reported. Methods In this single-centre retrospective study, a total of 21 patients with pneumonia MESHD who were laboratory-confirmed to be infected with SARS-CoV-2 in Wuhan Tongji hospital were included from Dec 19, 2019 to Jan 27, 2020. The immunologic characteristics as well as their clinical, laboratory, radiological features were compared between 11 severe cases and 10 moderate cases. Results Of the 21 patients with COVID-19 MESHD, only 4 (19%) had a history of exposure to the Huanan seafood market. 7 (33.3%) patients had underlying conditions. The average age of severe and moderate cases was 63.9 and 51.4 years, 10 (90.9%) severe cases and 7 (70.0%) moderate cases were male. Common clinical manifestations including fever MESHD (100%, 100%), cough (70%, 90%), fatigue MESHD (100%, 70%) and myalgia MESHD (50%, 30%) in severe cases and moderate cases. PaO2/FiO2 ratio was significantly lower in severe cases (122.9) than moderate cases (366.2). Lymphocyte counts were significantly lower in severe cases (7000 million/L) than moderate cases (11000 million/L). Alanine aminotransferase HGNC, lactate dehydrogenase levels, high-sensitivity C-reactive protein HGNC and ferritin were significantly higher in severe cases (41.4 U/L, 567.2 U/L, 135.2 mg/L and 1734.4 ug/L) than moderate cases (17.6 U/L, 234.4 U/L, 51.4 mg/L and 880.2 ug /L). IL-2R HGNC, TNF HGNC- and IL-10 HGNC concentrations on admission were significantly higher in severe cases (1202.4 pg/mL, 10.9 pg/mL and 10.9 pg/mL) than moderate cases (441.7 pg/mL, 7.5 pg/mL and 6.6 pg/mL). Absolute number of total T lymphocytes, CD4+T cells and CD8+T cells decreased in nearly all the patients, and were significantly lower in severe cases (332.5, 185.6 and 124.3 million/L) than moderate cases (676.5, 359.2 and 272.0 million/L). The expressions of IFN-{gamma HGNC} by CD4+T cells tended to be lower in severe cases (14.6%) than moderate cases (23.6%). Conclusion The SARS-CoV-2 infection MESHD may affect primarily T lymphocytes, particularly CD4+T cells, resulting in significant decrease in number as well as IFN-{gamma HGNC} production, which may be associated with disease severity. Together with clinical characteristics, early immunologic indicators including diminished T lymphocytes and elevated cytokines may serve as potential markers for prognosis in COVID-19 MESHD.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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