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MeSH Disease

Pneumonia (97)

COVID-19 (96)

Fever (29)

Death (19)

Lymphopenia (18)


HGNC Genes

SARS-CoV-2 proteins

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    Prognostic and predictive biomarkers in patients with COVID-19 MESHD treated with tocilizumab in a randomised controlled trial

    Authors: Jennifer Tom; Min Bao; Larry Tsai; Aditi Qamra; David Summers; Montserrat Carrasco-Triguero; Jacqueline McBride; Carrie M Rosenberger; Celia J F Lin; William Stubbings; Kevin G Blyth; Jordi Carratala; Bruno Francois; Thomas Benfield; Derrick Haslem; Paolo Bonfanti; Cor H van der Leest; Nidhi Rohatgi; Lothar Wiese; Charles Edouard Luyt; Farrah Kheradmand; Ivan O Rosas; Fang Cai

    doi:10.1101/2020.12.23.20247379 Date: 2020-12-26 Source: medRxiv

    Background Retrospective observational studies suggest that interleukin-6 HGNC ( IL-6 HGNC), C-reactive protein HGNC ( CRP HGNC), lactate dehydrogenase (LDH), ferritin, lymphocytes, monocytes, neutrophils, D-dimer, and platelets are associated with disease progression, treatment outcomes, or both, in patients with COVID-19 MESHD pneumonia MESHD. We explored these candidate prognostic and predictive biomarkers with efficacy outcomes after treatment with tocilizumab, an anti- IL-6 HGNC receptor antibody using data from the COVACTA trial for patients hospitalised with severe COVID-19 MESHD pneumonia MESHD. Methods Candidate biomarkers were measured in 295 patients in the tocilizumab arm and 142 patients in the placebo arm. Efficacy outcomes assessed were clinical status on a seven-category ordinal scale (1, discharge; 7, death), mortality, time to hospital discharge, and mechanical ventilation (if not receiving it at randomisation) through day 28. Prognostic and predictive biomarkers were evaluated continuously with proportional odds, binomial or Fine-Gray models, and additional sensitivity analyses. Findings Modelling in the placebo arm showed all candidate biomarkers except LDH and D-dimer were strongly prognostic for day 28 clinical outcomes of mortality, mechanical ventilation, clinical status, and time to hospital discharge. Modelling in the tocilizumab arm showed a predictive value of ferritin for day 28 clinical outcomes of mortality (predictive interaction p=0.03), mechanical ventilation (predictive interaction p=0.01), and clinical status (predictive interaction p=0.02) compared with placebo. Interpretation Multiple biomarkers prognostic for clinical outcomes were confirmed in COVACTA. Ferritin was identified as a predictive biomarker for the effects of tocilizumab in the COVACTA patient population; high ferritin levels were associated with better clinical outcomes for tocilizumab compared with placebo at day 28.

    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.

    Effects of obesity on serum levels of SARS-CoV-2-specific antibodies in COVID-19 MESHD patients

    Authors: Daniela Frasca; Lisa Reidy; Carolyn Cray; Alain Diaz; Maria Romero; Kristin Kahl; Bonnie B Blomberg

    doi:10.1101/2020.12.18.20248483 Date: 2020-12-20 Source: medRxiv

    SARS-CoV-2 (Severe Acute Respiratory Syndrome Corona Virus-2 MESHD), cause of COVID-19 MESHD (Coronavirus Disease of 2019), represents a significant risk to people living with pre-existing conditions associated with exacerbated inflammatory responses and consequent dysfunctional immunity. In this paper, we have evaluated the effects of obesity MESHD, a condition associated with chronic systemic inflammation MESHD, on the secretion of SARS-CoV-2-specific IgG antibodies in the blood of COVID-19 MESHD patients. Results have shown that SARS-CoV-2 IgG antibodies are negatively associated with Body Mass Index (BMI) in COVID-19 MESHD obese MESHD patients, as expected based on the known effects of obesity MESHD on humoral immunity. Antibodies in COVID-19 MESHD obese MESHD patients are also negatively associated with serum levels of pro-inflammatory and metabolic markers of inflammaging and pulmonary inflammation MESHD, such as SAA ( serum amyloid A protein HGNC), CRP HGNC ( C-reactive protein HGNC) and ferritin, but positively associated with NEFA (nonesterified fatty acids). These results altogether could help to identify an inflammatory signature with strong predictive value for immune dysfunction MESHD that could be targeted to improve humoral immunity in individuals with obesity MESHD as well as with other chronic inflammatory conditions.

    Foistar(Camostat mesylate) associated with the significant decrease in CRP HGNC levels compared to Kaletra(Lopinavir/Ritonavir) treatment in Korean mild COVID-19 MESHD pneumonic patients.

    Authors: Jae-Phil Choi; Jae-Phil Choi; Hyoung-Jun Kim; Jumi Han; Sujung Park; JinJoo Han

    doi:10.1101/2020.12.10.20240689 Date: 2020-12-15 Source: medRxiv

    Background There is limited information due to absence of virus titer MESHD and symptom related changes. Nonetheless, this is the first comparative study between the use of Foistar (Camostat mesilate) and Kaletra (lopinavir/ritonavir) on COVID-19 MESHD infection. Methods Patients with confirmed SARS-CoV-2 infection MESHD by positive polymerase chain reaction (PCR) testing that were admitted to Seoul Medical Center (Seoul, South Korea) where is the largest public medical center in South Korea between August 1 and September 20, 2020 were included The data of the patients with pneumonia MESHD who received Foistar (Foistar group) during their hospitalization period were primarily collected, and the patients who received Kaletra (Kaletra group) during their hospitalization period were matched to have a similar age group to that of Foistar group so that three times the number of Foistar group patients were randomly selected into Kaletra group and their body temperature, CRP HGNC level, WBC count, and event of diarrhea MESHD were collected, accordingly. Results A total of 29 patients (7 Foistar group and 22 Kaletra group) was included. The median age was 69, and all had mild COVID-19 MESHD (WHO ordinal scale 3 or 4) on admission. 6 patients out of 7 patients (85.71%) from Foistar group who exhibited elevated CRP HGNC levels ( CRP HGNC >0.4mg/dL) on admission have controlled their CRP HGNC levels to the normal range. In Kaletra group, 11 out of 18 patients (61.11%) have controlled their CRP HGNC levels to the normal range, and only 1 of 2 patients (50.00%) who had normal CRP HGNC level has maintained his or her normal CRP HGNC level. The difference in the white blood cell counts was not significant between two groups. None of the patients in the study had hyperkalemia MESHD. Conclusion This study has found a probable association of controlling inflammatory reactions and fever MESHD in COVID-19 MESHD patients with Foistar (camostat mesilate) use. In addition, there was no significant adverse drug event found from this study upon the Foistar use. These results may encourage the use of Foistar as a treatment option for the patients with mild to moderate COVID-19 MESHD.

    Clinical, Laboratory, and Chest CT Features of Severe Versus Non-Severe Pediatric Patients with COVID‐19 Infection Among Different Age Groups

    Authors: Meisam Hoseinyazdi; Saeid Esmaeilian; Reza Jahankhah; Arash Teimouri; Farzaneh ghazi sherbaf; Faranak Rafiee; Reza Jalli; Sedighe Hooshmandi

    doi:10.21203/rs.3.rs-126200/v1 Date: 2020-12-10 Source: ResearchSquare

    Background: The aim of this study was to compare the clinical, laboratory, and chest computed tomography (CT) findings between severe and non-severe patients as well as between different age groups of pediatric patients with confirmed COVID-19 MESHD.Method: This study was performed on 55 pediatric patients with confirmed COVID-19 MESHD hospitalized in Namazi and Ali Asghar Hospitals, Shiraz, Iran. Patients were divided into severe (n=27) and non-severe (n=28) groups. Also, they were categorized into three age groups: aged less than two years, 3-12 years and 13-17 years.  CT scans, laboratory, and clinical features were taken from all patients at the admission time. Abnormal chest CT in COVID-19 MESHD pneumonia MESHD was found to show one of the following findings: ground-glass opacities (GGO), bilateral involvement, peripheral and diffuse distribution.Result:  Fever MESHD (79.2%) and dry cough MESHD (75.5%) were the most common clinical symptoms. Severe COVID-19 MESHD patients showed lymphocytosis MESHD compared to non-severe ones (P = 0.028). C-reactive protein HGNC ( CRP HGNC) was shown to be significantly lower in patients aged less than two years than those aged 3-12 and 13-17 years old (P = 0.009). It was also shown that O2 saturation was significantly increased, as age increased (P = 0.015). Also, severe patients had significantly higher CT abnormalities compared to non-severe ones (48.0% compared to 17.9%, respectively) (P = 0.019).Conclusion: Lymphocytosis and abnormal CT findings are among the factors most associated with COVID-19 MESHD severity. It was, moreover, showed that the severity of the COVID-19 MESHD, O2 saturation, and respiratory distress MESHD were improved as the age of confirmed COVID-19 MESHD pediatric patients increased.

    Predictive modeling of morbidity and mortality in COVID-19 MESHD hospitalized patients and its clinical implications.

    Authors: Joshua M. Wang; Wenke Liu; Xiaoshan Chen; Michael P. McRae; John T. McDevitt; David Fenyo

    doi:10.1101/2020.12.02.20235879 Date: 2020-12-04 Source: medRxiv

    ObjectiveRetrospective study of COVID-19 MESHD positive patients treated at NYU Langone Health (NYULH) to identify clinical markers predictive of disease severity to assist in clinical decision triage and provide additional biological insights into disease progression. Materials and MethodsClinical activity of 3740 de-identified patients at NYULH between January and August 2020. Models were trained on clinical data during different parts of their hospital stay to predict three clinical outcomes: deceased, ventilated, or admitted to ICU. ResultsXGBoost model trained on clinical data from the final 24 hours excelled at predicting mortality (AUC=0.92, specificity=86% and sensitivity=85%). Respiration rate was the most important feature, followed by SpO2 and age 75+. Performance of this model to predict the deceased outcome extended 5 days prior with AUC=0.81, specificity=70%, sensitivity=75%. When only using clinical data from the first 24 hours, AUCs of 0.79, 0.80, and 0.77 were obtained for deceased, ventilated, or ICU admitted, respectively. Although respiration rate and SpO2 levels offered the highest feature importance, other canonical markers including diabetic MESHD history, age and temperature offered minimal gain. When lab values were incorporated, prediction of mortality benefited the most from blood urea nitrogen (BUN) and lactate dehydrogenase (LDH). Features predictive of morbidity included LDH, calcium, glucose, and C-reactive protein HGNC ( CRP HGNC). ConclusionTogether this work summarizes efforts to systematically examine the importance of a wide range of features across different endpoint outcomes and at different hospitalization time points. BACKGROUND AND SIGNIFICANCEThe first cluster of SARS-CoV-2 was reported in Wuhan, Hubei Province on December 31, 2019. Inciting symptoms remarkably similar to pneumonia MESHD, the disease quickly traveled around the world, earning its pandemic status by the World Health Organization on March 11, 2020. Although the first wave has since passed for hardest-hit regions such as New York City (NYC) and most of Asia, a resurgence of cases has already been reported in Europe and record new cases tallied in the Midwest and rural United States (US). As of November 12th, the US alone logged its highest tally to date with a 317% growth over the preceding 30 days1. The coronavirus disease MESHD ( COVID-19 MESHD) is far from seeing the end of its days and there remains a compelling need to prioritize care and resources for patients at elevated risk of morbidity and mortality. Previous work building machine learning models used patient data from Tongji Hospital2,3 (Wuhan, China), Zhongnan Hospital4 (Wuhan China), Mount Sinai Hospital5 (NYC, US), and NYU Family Health Center6 (NYC, US). Surprisingly, clinical features selected varied widely across studies. For example, while McRae et al.s 2-tiered model6 trained on 701 NYC patients to predict mortality was based on actual age, C-reactive protein HGNC ( CRP HGNC), procalcitonin, and D-dimer, Yan et al.s model2 trained on 485 patients from Wuhan selected lactate dehydrogenase (LDH), lymphocyte count, and CRP HGNC as the most predictive for mortality. Variations MESHD in selected features differed greatly even when trained to predict similar outcomes on data from patients of the same city. Yao et al.s model3 was trained on 137 patients from Wuhan and relied on 28 biomarkers in their final model to predict morbidity. Given the differences among prior models, some of which were driven by domain-specific knowledge, we decided to systematically examine the importance of a wide range of features across different endpoint outcomes and at different hospitalization time points. This study analyzes retrospective PCR-confirmed COVID-19 MESHD inpatient data collected at NYU Langone Hospital spanning 1/1/2020 to 8/7/2020 to predict three sets of clinical outcomes: alive vs deceased, ventilated vs not ventilated, or ICU admitted vs not ICU admitted. The clinical information of 3740 patient encounters included demographic data (age, sex, insurance, past diagnosis of diabetes MESHD, presence of cardiovascular comorbidities), vital signs (SpO2, pulse, respiration rate, temperature, blood pressure), and the 50 most frequently ordered lab tests in our dataset. Models were developed using two methods: logistic regression with feature selection using Least Absolute Shrinkage and Selection Operator7 (LASSO) and gradient tree boosting with XGBoost8. An explainable algorithm, such as logistic regression, provides easy to interpret insights into the features of importance. Conversely, the larger model capacity of XGBoost better handles data complexities to explore the extent that predictive performance can be optimized. Together, these methods ensure a holistic survey that explores the clinical underpinnings of disease etiology and the prospects of building models that are sufficiently competent to be effective decision support tools.

    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.

    Corticosteroids are associated with increased survival in elderly presenting severe SARS-Cov2 infection

    Authors: Laure Gallay; Viet-Thi Tran; Elodie Perrodeau; Nicolas Vignier; Matthieu Mahevas; Francesca Bisio; Emmanuel Forestier; Xavier Lescure

    doi:10.1101/2020.11.10.20226886 Date: 2020-11-13 Source: medRxiv

    To assess the effectiveness of corticosteroids among elderly patients with COVID-19 MESHD pneumonia MESHD requiring oxygen. Design Comparative observational study based on routine care data. Baseline characteristics of patients were balanced using propensity-score inverse probability of treatment weighting. Setting Geriatric and infectious diseases wards from 36 hospitals in France and Luxembourg. Participants Adults [≥] 80 years old PCR confirmed SARS-CoV-2 infection MESHD or typical CT-scan images, requiring oxygen [≥] 3L/min and with an inflammatory syndrome MESHD ( C-reactive protein HGNC [≥] 40mg/L). Measurements The primary outcome was overall survival at day 14. The secondary outcome was the proportion of patients discharged from hospital to home/rehabilitation on day 14. Adverse events were abstracted from electronic health records. Results Among the 267 patients included in the analysis, 96 were assigned to the treatment group. Median age was 86, interquartile range 83 to 90 and 95% had a SARS-CoV-2 PCR-confirmed diagnosis. Use of corticosteroids was significantly associated with an increased survival (weighted hazard ratio [wHR] 0.66, 95% CI 0.44 to 0.97). There was no significant difference between the treatment and control groups regarding the proportion of patients discharged to home/rehabilitation at day 14 (wRR 1.11, 95% CI 0.68 to 1.81). Twenty-two (16.7%) patients receiving corticosteroids developed adverse events while only 11 (6.4%) from the control group did. Conclusions Corticosteroids were associated with a significant increase the day-14 overall survival of patients over 80 years old hospitalized for severe COVID-19 MESHD.

    Randomized controlled trial of convalescent plasma therapy against standard therapy in patients with severe COVID-19 MESHD disease

    Authors: Manaf AlQahtani; Abdulkarim Abdulrahman; Abdulrahman AlMadani; Salman Yousif AlAli; Alaa Mahmood Al Zamrooni; Amal Hejab; Pearl Wasif; Ronan Conroy; Stephen Atkin; Sameer Otoom; Manal Abduljalil AlSayed

    doi:10.1101/2020.11.02.20224303 Date: 2020-11-04 Source: medRxiv

    Background. Convalescent plasma (CP) therapy in COVID-19 MESHD disease has been suggested to improve clinical outcome in severe disease. This pilot study was designed to inform the design of a definitive phase 3 clinical trial. Methods. This was a prospective, interventional and randomized open label pilot trial involving 40 patients with COVID-19 MESHD who were requiring oxygen therapy and who had radiological evidence of pneumonia MESHD. Twenty COVID-19 MESHD patients received two 200ml transfusions of convalescent patient CP over 24 hours were compared with 20 patients who received routine care alone. The primary outcome was the requirement for ventilation. The secondary outcomes were white blood cell count, lactate dehydrogenase (LDH), C-reactive protein (CRP) HGNC, Troponin, Ferritin, D-Dimer, procalcitonin, mortality rate at 28 days. Results. The CP group were a higher risk group with higher ferritin levels (p<0.05) though respiratory indices did not differ. The primary outcome measure (ventilation) was required in 6 controls and 4 patients on CP (risk ratio 0.67 95% CI 0.22 to 2.0, p=0.72); mean time on ventilation was 10.5 days in the control against 8.2 days in patients on CP (p=0.81). There were no differences in secondary measures at the end of the study. Two patients died in the control and one patient in the CP arm. Conclusion. There were no significant differences in the primary or secondary outcome measures between CP and standard therapy though fewer patients required ventilation and for a shorter period of time. The study showed that CP therapy appears to be safe and it is feasible to perform a definitive phase 3 clinical trial using this study protocol.

    Tocilizumab is associated with reduction in inflammation and improvement in P/F ratio in critically sick COVID19 MESHD patients

    Authors: Muhammad Asim Rana; Mubashar Sultan Hashmi; Muhammad Muneeb Ullah Saif; Muhammad Faisal Munir; Ahad Qayyum; Rizwan Pervaiz; Muhammad Mansoor Hafeez

    doi:10.1101/2020.10.20.20210195 Date: 2020-10-21 Source: medRxiv

    Introduction: Coronavirus disease 2019 MESHD was initially detected in China and has been declared a global pandemic by World Health Organization on March 11, 2020. In the majority of patients, SARS-CoV-2 causes a mild to moderate illness characterized by fever MESHD and respiratory symptoms MESHD, with or without evidence of pneumonia MESHD. The recent studies suggest that anti-cytokine targeted therapies might be associated with benefit for patients with severe COVID-19 MESHD especially in improving respiratory failure MESHD. Tocilizumab, a monoclonal antibody against interleukin 6 HGNC (IL6) receptor, is associated with clinical benefit for COVID-19 MESHD patients as it inhibits IL6 HGNC and decreases inflammation MESHD. Methods: As Tocilizumab has been an important part of our treatment and a strict criterion was followed to administer Tocilizumab, a retrospective study design used to assess the beneficial effects of Tocilizumab in improvement of ratio partial pressure of arterial Oxygen and fraction of inspired Oxygen (PaO2/FiO2 or P/F ratio) and C- reactive protein HGNC ( CRP HGNC) in COVID19 MESHD patients has been done. 60 patients were taken for this study by using convenient sampling technique the data of demographics, laboratory results, and clinical outcomes i.e. improvement of respiratory failure MESHD depicted in the form of PF Ratio were obtained from the medical records, Statistical analysis was done with SPSS, version 21.0. Results: Sixty patients (47 males and 13 females) with COVID-19 MESHD were included in this study, the mean age of patients was 53.83 (14-81) years. After administration of Tocilizumab the lab parameters were changed as CRP HGNC decreased down to .40 (9.6-73) mg/L but other parameters were not affected. The PF ratio improved in COVID-19 MESHD patients after administration of Tocilizumab the median of PF Ratio before treatment was 108 (52-362) and improved up to 128 (37-406) after Tocilizumab therapy. Conclusion: In summary, Tocilizumab appears to be associated with improvement in P/F Ratio and CRP HGNC in COVID19 MESHD patients but other markers did not improve in response to Tocilizumab therapy in severely ill COVID-19 MESHD patients.

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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