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HGNC Genes

SARS-CoV-2 proteins

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    Six-month pulmonary impairment MESHD after severe COVID-19 MESHD: a prospective, multicenter follow-up study

    Authors: Paola Faverio; Fabrizio Luppi; Paola Rebora; Sara Busnelli; Anna Stainer; Martina Catalano; Luca Parachini; Anna Monzani; Stefania Galimberti; Francesco Bini; Bruno Dino Bodini; Monia Betti; Federica De Giacomi; Paolo Scarpazza; Elisa Oggionni; Alessandro Scartabellati; Luca Bilucaglia; Paolo Ceruti; Denise Modina; Sergio Harari; Antonella Caminati; Maria Grazia Valsecchi; Giacomo Bellani; Giuseppe Foti; Alberto Pesci

    doi:10.1101/2021.03.29.21254151 Date: 2021-03-30 Source: medRxiv

    Background and objective. Long-term pulmonary sequelae following SARS-CoV-2 pneumonia MESHD are not yet confirmed, however preliminary observations suggests a possible relevant clinical, functional and radiological impairment. The aim of this study was to identify and characterise pulmonary sequelae caused by SARS-CoV-2 pneumonia MESHD at 6-month follow-up. Methods. In this multicenter, prospective, observational cohort study, patients hospitalised for SARS-CoV-2 pneumonia MESHD and without prior diagnosis of structural lung diseases MESHD were stratified by maximum ventilatory support (oxygen only, continuous positive airway pressure ( CPAP HGNC) and invasive mechanical ventilation (IMV)) and followed up at 6 months from discharge. Pulmonary function tests and diffusion capacity for carbon monoxide (DLCO), 6 minutes walking test, chest X-ray, physical exam and modified Medical Research Council (mMRC) dyspnoea MESHD score were collected. Results. Between March and June 2020, 312 patients were enrolled (83, 27% women; median [IQR] age 61.1 [53.4,69.3] years). The parameters that showed the highest rate of impairment were DLCO and chest-X-ray, in 46% and 25% of patients, respectively. However, only a minority of patients reported dyspnoea MESHD (31%), defined as mMRC [≥] 1, or showed a restrictive ventilatory defects (9%). In the logistic regression model, having asthma MESHD as comorbidity was associated with DLCO impairment at follow-up, while prophylactic heparin administration during hospitalisation appeared as a protective factor. Need for invasive ventilatory support during hospitalisation was associated with chest imaging abnormalities MESHD. Conclusion. DLCO and radiological assessment appear to be the most sensitive tools to monitor patients with COVID-19 MESHD during follow-up. Future studies with longer follow-up are warranted to better understand pulmonary sequelae.

    Evaluation of the ROX HGNC index in SARS-CoV-2 Acute Respiratory failure MESHD treated with both High-Flow Nasal Oxygen (HFNO) and Continuous Positive Airway Pressure ( CPAP HGNC)

    Authors: Hakim Ghani; Michael Shaw; Phyoe Pyae; Rigers Cama; Meghna Prabhakar; Alessio Navarra; Janice Yu Ji Lee; Felix Chua; Rahul Mogal; Andrew Barlow; Nazril Nordin; Rama Vancheeswaran

    doi:10.1101/2021.03.23.21254203 Date: 2021-03-24 Source: medRxiv

    Background: Non-invasive respiratory support including high-flow nasal oxygen (HFNO), and continuous positive airway pressure ( CPAP HGNC) have been used to provide therapy in selected SARS-CoV-2 patients with acute respiratory failure MESHD ( ARF MESHD). The value of the ROX HGNC index, a validated benchmark for outcomes in HFNO is unknown in CPAP HGNC. Objective: Can the ROX HGNC, a validated benchmark in HFNO be used for measuring treatment outcomes of CPAP HGNC in SARS-COV-2 ARF MESHD? Study Design and Methods: A non-randomised prospective protocol driven observational non-intensive care unit study in 130 SARS-COV-2 patients with ARF MESHD treated with non-invasive therapy from March 2020 to January 2021. The primary end point was failure of therapy ( death MESHD or escalation). Secondary outcomes included time to failure including invasive mechanical ventilation (IMV) or death MESHD, the effect of escalation to CPAP HGNC from HFNO and the utility of ROX HGNC in ARF MESHD. Results: HFNO was better than CPAP HGNC in treating SARS-COV-2 ARF MESHD: 17/35 (48.5%) with successful HFNO therapy versus 24/95 (25.2%) with CPAP HGNC. The ROX HGNC index was more sensitive to outcomes with CPAP HGNC compared to HFNO and distinguished treatment failure early at 1, 4, 6, 12, and 24 hours with the highest sensitivity at 24 hours ( ROX HGNC-24h). The AUC for the ROX-24h was 0.77 for HFNO (P<0.0001), and 0.84 for CPAP HGNC (P<0.0001). The ROX HGNC-24h cut-points predicted failure with HFNO when < 3.9 (PPV 71%, NPV 75%) and CPAP HGNC < 4.3 (PPV 75%, NPV 91%). For success, ROX HGNC-24h cut-points of 7.6 for HFNO (PPV 85%, NPV 48%) and 6.1 for CPAP HGNC (PPV 88%, NPV 62%) were observed. Escalation from HFNO to CPAP HGNC was mostly not successful. Conclusion: ARF MESHD in SARS-COV-2 can be successfully managed by non-invasive support. The ROX HGNC index, validated for HFNO, provides a timely, low resource measure for both HFNO and CPAP HGNC avoiding delayed intubation. Trial registration: Study approved by NHS HRAREC (20/ HRA MESHD/2344;ethics 283888)

    COVID-19 MESHD and Multisystem Inflammatory Syndrome in Latin American children: a multinational study

    Authors: Omar Yassef Antunez-Montes; Maria Isabel Escamilla; Augusto Flavio Figueroa-Uribe; Erick Arteaga-Menchaca; Manuel Lavariega-Sarachaga; Perla Salcedo-Lozada; Priscilla Melchior; Rodrigo Berea de Oliveira; Juan Carlos Tirado Caballero; Hernando Pinzon Redondo; Laura Vanessa Montes Fontalvo; Roger Hernandez; Carolin Chavez; Francisco Eduardo Campos; Fadia Uribe; Olguita del Aguila; JORGE ALBERTO RIOS AIDA; Andrea Parra Buitrago; Lina Maria Betancur Londono; Leon Felipe Mendoza Vega; Carolina Almeida Hernandez; Michela Sali; JULIAN HIGUITA PALACIO; Jessica Gomez-Vargas; Adriana Yock Corrales; Danilo Buonsenso

    doi:10.1101/2020.08.29.20184242 Date: 2020-09-02 Source: medRxiv

    Background To date, there are no comprehensive data on pediatric COVID19 MESHD from Latin America. This study aims to assess COVID-19 MESHD and Multisystem Inflammatory Syndrome MESHD (MIS C) in Latin American children, in order to appropriately plan and allocate resources to face the pandemic on a local and International lever Methods Ambispective multicentre cohort study from five Latin American countries. Children aged 18 years or younger with microbiologically confirmed SARS CoV 2 infection MESHD were included. Findings 409 children were included, with a median age of 53.0 years (IQR 0.6 9.0). Of these, 95 191 (23.2%) were diagnosed with MIS C. 191 (46.7%) children were admitted to hospital and 52 (12.7%) required admission to a Pediatric Intensive Care Unite (PICU). 92 (22.5%) patients required oxygen support: 8 (2%) were started on continuous positive airway pressure ( CPAP HGNC) and 29 (7%) on mechanical ventilation. 35 (8.5%) patients required inotropic support. The following factors were associated with PICU admission: pre-existing medical condition (P < 0.0001), immunodeficiency MESHD (P = 0.01), lower respiratory tract infection MESHD (P< 0.0001), gastrointestinal symptoms MESHD (P = 0.006), radiological changes suggestive of pneumonia MESHD and acute respiratory distress syndrome MESHD (P< 0.0001), low socioeconomic conditions (P 0.009). Conclusions This study shows a generally more severe form of COVID 19 and a high number of MIS C in Latin American children, compared with studies from China, Europe and North America, and support current evidence of a more severe disease in Latin/Hyspanic children or in people of lower socioeconomic level. The findings highlight an urgent need of more data of COVID 19 in South America.

    The role of Intermediate Respiratory Care Units in preventing ICU collapse during the COVID pandemic.

    Authors: Sarah Heili; María del Pilar Carballosa de Miguel; Alba Naya Prieto; Itziar Fernández Ormaechea; Farah Ezzine de blas; Pablo López Yeste; Francisco Jos Laso del Hierro; Ainhoa Izquierdo Pérez; Marwan Mohamed Choukri; Herminia Ortiz Mayoral; Abdulkader El Hachem Debek; Andrés Giménez Velando; Marcel José Rodriguez Guzmán; Elena Cabezas Pastor; Pablo Minguez; Ignacio Mahillo Fernández; Antonio Herrero González; Lorena De La Fuente; Luis Jiménez Hiscock; Sandra Pelícano Vizuete; Rebeca Armenta Fernández; María José Checa Venegas; Germán Peces-Barba Romero

    doi:10.21203/rs.3.rs-52228/v1 Date: 2020-08-01 Source: ResearchSquare

    Introduction : There is limited information describing features and outcomes of patients requiring Intermediate Respiratory Care Unit (IRCU) hospitalization for COVID19 MESHD disease and as of yet, no mechanical or medical treatments have clearly demonstrated efficacy in IRCU. Methods : Demographics and clinical variables on admission, as well as medical and mechanical therapeutic interventions, were extracted from Electronic Clinical Records in 274 SARS-CoV-2 infected MESHD patients attending a third level hospital IRCU. Using multivariate logistic regression analysis, variables that best discriminated mortality were obtained. Principal components analysis and a neural network (NN) algorithm were applied. Results : In relation to respiratory support, high-flow oxygen therapy and weaning procedures were associated with survival as were CPAP HGNC and non-invasive ventilation with low levels of support among the most severely affected. The IRCU achieved a survival rate of 87.6%, avoided 178 ICU admissions, successfully referred 35% to the ICU, and of these, 94% later survived the weaning phase. Higher mortality incidence was associated with cardiac and respiratory diseases MESHD and fever MESHD, heart rhythm and blood pressure disturbances MESHD. Following analysis of specific therapeutic options Corticoids and Anticoagulants were associated with better outcomes. Conclusions : The IRCU prevented the collapse of the ICU, allowed for recovered ICU patients to be quickly released from their unit, thus freeing up critical care beds and permitting them to function more effectively and in terms of mortality, achieved good results, that did not worsen due to a possible delay in intubation. In addition, we have generated an open-access NN capable of identifying severity predictors of SARS-CoV-2.

    Continuous positive airway pressure face-mask ventilation to manage massive influx of patients requiring respiratory support during the SARS-CoV-2 outbreak

    Authors: Sophie Alviset; Quentin Riller; Jerome Aboab; Kelly Dilworth; Pierre Alain Billy; Yannis Lombardi; Mathilde Azzi; Luis Ferreira Vargas; Laurent Laine; Mathilde Lermuzeaux; Nathalie Memain; Daniel Silva; Tona Tchoubou; Daria Ushmorova; Hanane Dabbagh; Simon Escoda; Remi Lefrancois; Annelyse Nardi; Armand Ngima; Vincent Ioos

    doi:10.1101/2020.06.01.20118018 Date: 2020-06-03 Source: medRxiv

    Background: Since December 2019, a global outbreak of coronavirus disease MESHD ( COVID-19 MESHD) is responsible for massive influx of patients with acute respiratory failure MESHD in hospitals. We describe the characteristics, clinical course, and outcomes of COVID-19 MESHD patients treated with continuous positive airway pressure ( CPAP HGNC) in a large public hospital in France. Method: It is a single centre retrospective observational cohort. From 27th March to 23rd April, consecutive patients who had signs of respiratory failure MESHD or were unable to maintain an SpO2 > 90%, despite receiving 10 to 15 l/min of oxygen with a non-rebreather mask, were treated by CPAP HGNC with a face-mask unless the ICU physician judged that immediate intubation was indicated. The main outcomes under study were reasons for CPAP HGNC discontinuation and mortality. Results: A total of 585 patients were admitted in Delafontaine hospital for severe COVID-19 MESHD. ICU was quickly overwhelmed. Fifty-nine out of 159 (37%) patients requiring ICU care had to be referred to other hospitals. CPAP HGNC therapy was initiated in 49 patients and performed out of ICU in 41 (84%). SARS-CoV2 pneumonia MESHD was confirmed by PCR from respiratory tract in 39 (79%) patients and by thoracic CT scan in the remaining patients. CPAP HGNC was performed out of ICU in 41 (84%) cases. Median age was 65 years (IQR=54-71). Median duration of CPAP HGNC treatment was 3 days (IQR=1-5). Reasons for discontinuation of CPAP HGNC were intubation for invasive ventilation in 25 (51%) patients, improvement in 16 (33%), poor tolerance in 6 (12%) and death MESHD in 2 (4%). A decision not to intubate had been taken for the 2 patients who died while on CPAP HGNC. Conclusions: Treatment with CPAP HGNC is feasible and safe in a non-ICU environment in the context of a massive influx of patients. One third of these patients with high oxygen requirements did not eventually need invasive ventilation.

    Lung ultrasound and neonatal COVID-19 MESHD pneumonia: A case report.

    Authors: Daniel Ibarra Ríos; Dina Villanueva García; Edna Patricia Vázquez Solano; Alfonso de Jesús Martínez García; María Yolotzin Valdespino-Vázquez; Addy Cecilia Helguera Repetto; Horacio Márquez González

    doi:10.21203/rs.3.rs-33182/v2 Date: 2020-06-02 Source: ResearchSquare

    Introduction: Severe Novel Coronavirus Disease 2019 MESHD ( COVID-19 MESHD) infection in neonates is possible but reports are scarce.  Lung ultrasound (LUS) has been reported useful for triaging, diagnosing, and monitoring of patients with COVID-19 MESHD.Material and methods: We describe SARS-CoV-2 confirmed infection MESHD on a term newborn that developed pneumonia MESHD and pulmonary hypertension MESHD requiring mechanical ventilation. Ultrasonographic follow up of COVID-19 MESHD pneumonia MESHD and pulmonary hypertension MESHD was carried out. Histopathological and genetic study of the placenta was performed. Results: A 3,140-g male infant born at 40.3 weeks’ gestation developed progressive respiratory distress MESHD ( pulmonary hypertension MESHD) requiring mechanical ventilation. Real time PCR respiratory tract swabs for SARS COV 2 sampled on day 3 were positive for the baby and both parents. Lung ultrasound showed an irregular pleural MESHD line (shred sign), multiple confluent B-lines and bilateral ≥ 0.5 cm subpleural consolidations. Improvement of the lung and cardiac conditions were documented by ultrasound. The newborn was supported 6 days with mechanical ventilation, 3 days on CPAP and 3 HGNC days on oxygen. No antibiotics were used. The placenta showed histological findings linked to SARS-CoV-2 infection MESHD. RT-PCR from placental tissue showed amplification of viral E gene PROTEIN.Conclusion: Our case represents a severe presentation of COVID-19 MESHD pneumonia MESHD with pulmonary hypertension MESHD requiring mechanical ventilation. LUS showed to be useful for diagnosis and follow up. Transversal infection was possible. 

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MeSH Disease
HGNC Genes
SARS-CoV-2 Proteins


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