Corpus overview


Overview

MeSH Disease

Human Phenotype

Hypertension (127)

Pneumonia (27)

Obesity (26)

Fever (25)

Cough (22)


Transmission

Seroprevalence
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    Impact of tocilizumab administration on mortality in severe COVID-19

    Authors: Andrew Tsai; Oumou Diawara; Ronald G Nahass; Luigi Brunetti

    doi:10.1101/2020.07.30.20114959 Date: 2020-08-02 Source: medRxiv

    Background The novel coronavirus disease MESHD 2019 (COVID-19) worldwide pandemic has placed a significant burden on hospitals and healthcare providers. The immune response to this disease MESHD is thought to lead to a cytokine storm, which contributes to the severity of illness. There is an urgent need to confirm whether the use of tocilizumab provides a benefit in individuals with COVID-19. Methods A single-center propensity-score matched cohort study, including all consecutive COVID-19 patients, admitted to the medical center who were either discharged from the medical center or expired between March 1, 2020, and May 5, 2020, was performed. Patients were stratified according to the receipt of tocilizumab for cytokine storm and matched to controls using propensity scores. The primary outcome was in-hospital mortality. Results A total of 132 patients were included in the matched dataset (tocilizumab=66; standard of care=66). Approximately 73% of the patients were male TRANS. Hypertension MESHD Hypertension HP (55%), diabetes mellitus MESHD diabetes mellitus HP (31%), and chronic pulmonary disease MESHD (15%) were the most common comorbidities present. There were 18 deaths MESHD (27.3%) in the tocilizumab group and 18 deaths MESHD (27.3%) in the standard of care group (odds ratio, 1.0; 95% confidence interval, 0.465 - 2.151; p=1.00). Advanced age TRANS, history of myocardial infarction MESHD myocardial infarction HP, dementia MESHD dementia HP, chronic pulmonary disease, heart MESHD failure, and malignancy were significantly more common in patients who died. Interpretation The current analysis does not support the use of tocilizumab for the management of cytokine storm in patients with COVID-19. Use of this therapeutic agent should be limited to the context of a clinical trial until more evidence is available.

    Quantification of the association between predisposing health conditions, demographic, and behavioural factors with hospitalisation, intensive care unit admission, and death MESHD from COVID-19: a systematic review and meta-analysis

    Authors: Nathalie Veronica Fernandez Villalobos; Joerdis Jennifer Ott; Carolina Judith Klett-Tammen; Annabelle Bockey; Patrizio Vanella; Gerard Krause; Berit Lange

    doi:10.1101/2020.07.30.20165050 Date: 2020-08-01 Source: medRxiv

    Background Comprehensive evidence synthesis on the associations between comorbidities and behavioural factors with hospitalisation, Intensive Care Unit (ICU) admission, and death MESHD due to COVID-19 is lacking leading to inconsistent national and international recommendations on who should be targeted for non-pharmaceutical interventions and vaccination strategies. Methods We performed a systematic review and meta-analysis on studies and publicly available data to quantify the association between predisposing health conditions, demographics, and behavioural factors with hospitalisation, ICU admission, and death MESHD from COVID-19. We provided ranges of reported and calculated effect estimates and pooled relative risks derived from a meta-analysis and meta-regression. Results 75 studies were included into qualitative and 74 into quantitative synthesis, with study populations ranging from 19 - 44,672 COVID-19 cases. The risk of dying from COVID-19 was significantly associated with cerebrovascular [pooled RR 2.7 (95% CI 1.7-4.1)] and cardiovascular [RR 3.2 (CI 2.3-4.5)] diseases MESHD, hypertension MESHD hypertension HP [RR 2.6 (CI 2.0-3.4)], and renal disease MESHD [RR 2.5 (CI 1.8-3.4)]. Health care workers had lower risk for death MESHD and severe outcomes of disease MESHD (RR 0.1 (CI 0.1-0.3). Our meta-regression showed a decrease of the effect of some comorbidities on severity of disease MESHD with higher median age TRANS of study populations. Associations between comorbidities and hospitalisation and ICU admission were less strong than for death MESHD. Conclusions We obtained robust estimates on the magnitude of risk for COVID-19 hospitalisation, ICU admission, and death MESHD associated with comorbidities, demographic, and behavioural risk factors. We identified and confirmed population groups that are vulnerable and that require targeted prevention approaches.

    Sex-specificity of mortality risk factors among hospitalized COVID-19 patients in New York City: prospective cohort study

    Authors: Tomi Jun; Sharon Nirenberg; Patricia Kovatch; Kuan-lin Huang

    doi:10.1101/2020.07.29.20164640 Date: 2020-08-01 Source: medRxiv

    Objective: To identify sex-specific effects of risk factors for in-hospital mortality among COVID-19 patients admitted to a hospital system in New York City. Design: Prospective observational cohort study with in-hospital mortality as the primary outcome. Setting: Five acute care hospitals within a single academic medical system in New York City. Participants: 3,086 hospital inpatients with COVID-19 admitted on or before April 13, 2020 and followed through June 2, 2020. Follow-up till discharge or death MESHD was complete for 99.3% of the cohort. Results: The majority of the cohort was male TRANS (59.6%). Men were younger (median 64 vs. 70, p<0.001) and less likely to have comorbidities such as hypertension MESHD hypertension HP (32.5% vs. 39.9%, p<0.001), diabetes (22.6% vs. 26%, p=0.03), and obesity MESHD obesity HP (6.9% vs. 9.8%, p=0.004) compared to women. Women had lower median values of laboratory markers associated with inflammation MESHD compared to men: white blood SERO cells (5.95 vs. 6.8 K/uL, p<0.001), procalcitonin (0.14 vs 0.21 ng/mL, p<0.001), lactate dehydrogenase (375 vs. 428 U/L, p<0.001), C-reactive protein (87.7 vs. 123.2 mg/L, p<0.001). Unadjusted mortality was similar between men and women (28.8% vs. 28.5%, p=0.84), but more men required intensive care than women (25.2% vs. 19%, p<0.001). Male TRANS sex was an independent risk factor for mortality (OR 1.26, 95% 1.04-1.51) after adjustment for demographics, comorbidities, and baseline hypoxia MESHD. There were significant interactions between sex and coronary artery disease MESHD (p=0.038), obesity MESHD obesity HP (p=0.01), baseline hypoxia MESHD (p<0.001), ferritin (p=0.002), lactate dehydrogenase (p=0.003), and procalcitonin (p=0.03). Except for procalcitonin, which had the opposite association, each of these factors was associated with disproportionately higher mortality among women. Conclusions: Male TRANS sex was an independent predictor of mortality, consistent with prior studies. Notably, there were significant sex-specific interactions which indicated a disproportionate increase in mortality among women with coronary artery disease MESHD, obesity MESHD obesity HP, and hypoxia MESHD. These new findings highlight patient subgroups for further study and help explain the recognized sex differences in COVID-19 outcomes.

    METFORMIN USE IS ASSOCIATED WITH REDUCED MORTALITY IN A DIVERSE POPULATION WITH COVID-19 AND DIABETES

    Authors: Andrew Crouse; Tiffany Grimes; Peng Li; Matthew Might; Fernando Ovalle; Anath Shalev

    doi:10.1101/2020.07.29.20164020 Date: 2020-07-31 Source: medRxiv

    BACKGROUND: Coronavirus disease MESHD-2019 (COVID-19) is a growing pandemic with an increasing death MESHD toll that has been linked to various comorbidities as well as racial disparity. However, the specific characteristics of these at-risk populations are still not known and approaches to lower mortality are lacking. METHODS: We conducted a retrospective electronic health record data analysis of 25,326 subjects tested for COVID-19 between 2/25/20 and 6/22/20 at the University of Alabama at Birmingham Hospital, a tertiary health care center in the racially diverse Southern U.S. The primary outcome was mortality in COVID-19-positive subjects and the association with subject characteristics and comorbidities was analyzed using simple and multiple linear logistic regression. RESULTS: The odds ratio of contracting COVID-19 was disproportionately high in Blacks/African-Americans (OR 2.6; 95%CI 2.19-3.10; p<0.0001) and in subjects with obesity MESHD obesity HP (OR 1.93; 95%CI 1.64-2.28; p<0.0001), hypertension MESHD hypertension HP (OR 2.46; 95%CI 2.07-2.93; p<0.0001), and diabetes (OR 2.11; 95%CI 1.78-2.48; p<0.0001). Diabetes was also associated with a dramatic increase in mortality (OR 3.62; 95%CI 2.11-6.2; p<0.0001) and emerged as an independent risk factor in this diverse population even after correcting for age TRANS, race, sex, obesity MESHD obesity HP and hypertension MESHD hypertension HP. Interestingly, we found that metformin treatment was independently associated with a significant reduction in mortality in subjects with diabetes and COVID-19 (OR 0.33; 95%CI 0.13-0.84; p=0.0210). CONCLUSION: Thus, these results suggest that while diabetes is an independent risk factor for COVID-19-related mortality, this risk is dramatically reduced in subjects taking metformin, raising the possibility that metformin may provide a protective approach in this high risk population.

    Patient characteristics and predictors of mortality in 470 adults TRANS admitted to a district general hospital in England with Covid-19

    Authors: Joseph V Thompson; Nevan Meghani; Bethan M Powell; Ian Newell; Roanna Craven; Gemma Skilton; Lydia J Bagg; Irha Yaqoob; Michael J Dixon; Eleanor J Evans; Belina Kambele; Asif Rehman; Georges Ng Man Kwong

    doi:10.1101/2020.07.21.20153650 Date: 2020-07-27 Source: medRxiv

    Background Understanding risk factors for death MESHD in Covid 19 is key to providing good quality clinical care. Due to a paucity of robust evidence, we sought to assess the presenting characteristics of patients with Covid 19 and investigate factors associated with death MESHD. Methods Retrospective analysis of adults TRANS admitted with Covid 19 to Royal Oldham Hospital, UK. Logistic regression modelling was utilised to explore factors predicting death MESHD. Results 470 patients were admitted, of whom 169 (36%) died. The median age TRANS was 71 years (IQR 57 to 82), and 255 (54.3%) were men. The most common comorbidities were hypertension MESHD hypertension HP (n=218, 46.4%), diabetes (n=143, 30.4%) and chronic neurological disease MESHD (n=123, 26.1%). The most frequent complications were acute kidney injury MESHD acute kidney injury HP (n=157, 33.4%) and myocardial injury (n=21, 4.5%). Forty three (9.1%) patients required intubation and ventilation, and 39 (8.3%) received non-invasive ventilation Independent risk factors for death MESHD were increasing age TRANS (OR per 10 year increase above 40 years 1.87, 95% CI 1.57 to 2.27), hypertension MESHD hypertension HP (OR 1.72, 1.10 to 2.70), cancer (OR 2.20, 1.27 to 3.81), platelets <150x103/microlitre (OR 1.93, 1.13 to 3.30), C-reactive protein >100 micrograms/mL (OR 1.68, 1.05 to 2.68), >50% chest radiograph infiltrates, (OR 2.09, 1.16 to 3.77) and acute kidney injury MESHD acute kidney injury HP (OR 2.60, 1.64 to 4.13). There was no independent association between death MESHD and gender TRANS, ethnicity, deprivation level, fever MESHD fever HP, SpO2/FiO2 (oxygen saturation index), lymphopenia MESHD lymphopenia HP or other comorbidities. Conclusions We characterised the first wave of patients with Covid 19 in one of Englands highest incidence areas, determining which factors predict death MESHD. These findings will inform clinical and shared decision making, including the use of respiratory support and therapeutic agents.

    Air pollution, sociodemographic and health conditions effects on COVID-19 mortality in Colombia: an ecological study

    Authors: Laura A Rodriguez-Villamizar; Luis Carlos Belalcazar-Ceron; Julian Alfredo Fernandez-Nino; Diana Marcela Marin-Pineda; Oscar Alberto Rojas-Sanchez; Lizbeth Alexandra Acuna-Merchan; Nathaly Ramirez-Garcia; Sonia Cecilia Mangones-Matos; Jorge Mario Vargas-Gonzalez; Julian Herrera-Torres; Dayana Milena Agudelo-Castaneda; Juan Gabriel Pineros-Jimenez; Nestor Y Rojas-Roa; Victor Mauricio Herrera-Galindo

    doi:10.1101/2020.07.22.20159293 Date: 2020-07-25 Source: medRxiv

    Objective: To determine the association between chronic exposure to fine particulate matter (PM2.5), sociodemographic aspects, and health conditions and COVID-19 mortality in Colombia. Methods: Ecological study using data at the municipality level, as units of analysis. COVID-19 data were obtained from official reports up to and including July 17th, 2020. PM2.5 long-term exposure was defined as the 2014-2018 average of the estimated concentrations at municipalities obtained from the Copernicus Atmospheric Monitoring Service Reanalysis (CAMSRA) model. We fit a logit-negative binomial hurdle model for the mortality rate adjusting for sociodemographic and health conditions. Results: Estimated mortality rate ratios (MRR) for long-term average PM2.5 were not statistically significant in either of the two components of the hurdle model (i.e., the likelihood of reporting at least one death MESHD or the count of fatal cases). We found that having 10% or more of the population over 65 years of age TRANS (MRR=3.91 95%CI 2.24-6.81), the poverty index (MRR=1.03 95%CI 1.01-1.05), and the prevalence SERO of hypertension MESHD hypertension HP over 6% (MRR=1.32 95%CI1.03-1.68) are the main factors associated with death MESHD rate at the municipality level. Having a higher hospital beds capacity is inversely correlated to mortality. Conclusions: There was no evidence of an association between long-term exposure to PM2.5 and mortality rate at the municipality level in Colombia. Demographics, health system capacity, and social conditions did have evidence of an ecological effect on COVID-19 mortality.

    The impact of previous history of bariatric surgery on outcome of Covid-19: A nationwide medico-administrative French study.

    Authors: Antonio Iannelli; Samir Bouam; Anne-Sophie Schneck; Sébastien Frey; Jean Gugenheim; Marco Alifano

    doi:10.21203/rs.3.rs-48313/v1 Date: 2020-07-24 Source: ResearchSquare

    Purpose: To determine the risk of invasive mechanical ventilation and death MESHD in obese individuals with history of bariatric surgery compared to standard ones admitted for Covid-19 infection MESHD.Methods: Nationwide retrospective observational study based on electronic health data. 4 248 253 individuals aged TRANS 15 to 75 years with a diagnosis of obesity MESHD obesity HP were included. All obese inpatients, undergoing bariatric surgery or not, recorded during a hospital stay by the French National Health Insurance were followed, during a mean observation time of 5.43 ± 2.93 years. This exposition was bariatric surgery (n=389,671) including adjustable gastric banding, sleeve gastrectomy, gastric bypass versus no bariatric surgery (n=3,858,582). The primary outcome was Covid-19 related death MESHD and the secondary outcome was the need for invasive mechanical ventilation.Results: 8 286 (0.2%) obese individuals were admitted for Covid-19 infection MESHD between January 1st and May 15th 2020 with a diagnosis of Covid-19 infection MESHD. 541 (0.14%) had a history of bariatric surgery and 7,745 (0.2%) did not. Invasive mechanical ventilation was necessary in 14.54% of patients and death MESHD occurred in 13.58% of cases. The need for an invasive mechanical ventilation and death MESHD occurred in 7% and 3.5% in the bariatric surgery group versus 15% and 14.2% in the non-bariatric surgery group, respectively (both p<0.0001). After a logistic regression, the risk of invasive mechanical ventilation significantly increased with age TRANS being higher in the age TRANS class 61-75, male TRANS gender TRANS, and hypertension MESHD hypertension HP, whereas bariatric surgery showed an independent protective effect. Mortality was independently associated with increasing age TRANS, male TRANS gender TRANS, known history of heart failure MESHD, cancer, and diabetes, whereas BS was in favor with a protective effect. Conclusion: This nationwide administrative study showed that bariatric surgery is independently associated with a reduced risk of death MESHD and invasive mechanical ventilation in obese individuals with Covid-19 infection MESHD.

    Accelerated repurposing and drug development of pulmonary hypertension MESHD hypertension HP therapies for COVID-19 treatment using an AI-integrated biosimulation platform

    Authors: Kaushik Chakravarty; Victor Antontsev; Aditya Jagarapu; Yogesh Bundey; Hypatia Hou; Neha Maharao; Jyotika Varshney

    doi:10.21203/rs.3.rs-48619/v1 Date: 2020-07-24 Source: ResearchSquare

    A World Health Organization-declared pandemic, COVID-19, has affected more than 4 million people worldwide with over 100,000 deaths MESHD and growing in the United States. Due to the fast-spreading and multi-targeted nature of the virus, it is clear that drugs and/or vaccines need to be developed at an accelerated rate, and a combinatorial approach may stand to be more successful than a single drug therapy. Among several targets and pathways that are under investigation, the renin-angiotensin system (RAS) and specifically Angiotensin converting enzyme (ACE), and Ca2+ -mediated SARS-CoV-2 cellular entry and replication are noteworthy. A combination of ACE inhibitors (e.g. benazepril) and calcium channel blockers (CCB, e.g. amlodipine), a critical line of therapy for pulmonary hypertension MESHD hypertension HP, has shown therapeutic relevance in COVID-19 when investigated independently. To that end, we conducted in silico modeling using BIOiSIM, an AI-integrated mechanistic modeling platform by utilizing known preclinical in vitro and in vivo datasets to accurately simulate systemic therapy disposition and site-of-action penetration of the CCB and ACEI compounds to tissues implicated in COVID-19 pathogenesis.

    SECOND WEEK METHYL-PREDNISOLONE PULSES IMPROVE PROGNOSIS IN PATIENTS WITH SEVERE CORONAVIRUS DISEASE MESHD 2019 PNEUMONIA MESHD PNEUMONIA HP: AN OBSERVATIONAL COMPARATIVE STUDY USING ROUTINE CARE DATA.

    Authors: Guillermo Ruiz-Irastorza; Jose-Ignacio Pijoan; Elena Bereciartua; Susanna Dunder; Jokin Dominguez; Paula Garcia-Escudero; Alejandro Rodrigo; Carlota Gomez-Carballo; Jimena Varona; Laura Guio; Marta Ibarrola; Amaia Ugarte; Agustin Martinez-Berriotxoa

    doi:10.1101/2020.07.16.20152868 Date: 2020-07-23 Source: medRxiv

    OBJECTIVE: To analyze the effects of a short course of methyl-prednisolone pulses (MP) during the second week of disease MESHD (week-2) on the clinical course of patients with severe coronavirus disease MESHD 2019 (COVID-19) pneumonia MESHD pneumonia HP. DESIGN: Comparative observational study using data collected from routine care. SETTING: Hospital Universitario Cruces, a tertiary level University hospital at Barakaldo, Bizkaia, Spain. PARTICIPANTS: All patients with COVID-19 pneumonia MESHD pneumonia HP admitted between 1st March and 30th April 2020 to the services of Infectious Diseases MESHD and Internal Medicine. INTERVENTIONS: Treatment with week-2-MP (125-250 mg/d for 3 consecutive days with no subsequent tapering) vs. standard of care. MAIN OUTCOMES MEASURES: Time to death MESHD and time to death MESHD or endotracheal intubation. RESULTS: Two hundred and forty-two patients with confirmed COVID-19 pneumonia MESHD pneumonia HP and elevated inflammatory markers at admission were included in the study. Sixty-one patients (25%) received week-2-MP. Twenty-two patients (9%) died during the study period. Thirty-one patients (12.8%) suffered death MESHD or intubation. The adjusted HR for death MESHD was 0.35 (95%CI 0.11 to 1.06, p= 0.064) for patients in the week-2-MP group. The adjusted HR for death MESHD or intubation week-2-MP was 0.33 (95%CI 0.13 to 0.84, p=0.020) for patients in the week-2-MP group. These differences were seen in the subcohort of patients with a SaO2/FiO2 at day 7 lower than the median of the whole population: HR 0.31, 95% CI 0.08 to 1.12, p=0.073 and HR 0.34, 95%CI 0.12 to 0.94, p=0.038, respectively, but not in patients with higher SaO2/FiO2. Other predictors of the final outcomes were arterial hypertension MESHD hypertension HP, SaO2/FiO2, high-risk CURB65 scores and the use of non-pulse glucocorticoids. Non-pulse glucocorticoids were a predictor of infections MESHD (OR 4.72, 95%CI 1.90 to 11.80, p<0.001), while week-2-MP were not (OR 1.04, 95%CI 0.40 to 2.70, p=0.938). CONCLUSIONS: Week-2-MP are effective in improving the prognosis of patients with COVID-19 pneumonia MESHD pneumonia HP with features of inflammatory activity and respiratory deterioration entering the second week of disease MESHD. The recognition of this high-risk population should prompt early use of MP at this point. REGISTRATION: This study has been registered in the EU PAS Register with the number EUPAS36287.

    Clinical Characteristics of 107 Patients with COVID-19 in Ningbo, China: Single Center Experience Outside Hubei

    Authors: Boming Wu; Junjie Li; Hongping Xuan; Nanhong Zheng; Honghua Ye; Yaoren Hu; Tong’en Chen; Hao Ying; Lingyan Fan; Qing Xie; Zike Sheng; Yin Ying

    doi:10.21203/rs.3.rs-44830/v1 Date: 2020-07-17 Source: ResearchSquare

    Background Since December 2019, there has be an outbreak of coronavirus disease MESHD 2019 (COVID-19) caused by severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) in Wuhan, China. Nowadays, it rapidly spread across the country and then the worldwide. We aimed to investigate the clinical characteristics of patients with COVID-19.Methods The patients with confirmed COVID-19 admitted between January 25 and February 10, 2020, were enrolled. Epidemiological, demographic, clinical, laboratory, radiological data, and antivirus therapies, were retrospectively collected and analyzed. The 90-day follow-up of these patients was also performed.Results A total of 107 patients were included. The median age TRANS was 55.0 years (range from 18.0 to 85.0 years), and 72 (67.3%) were female TRANS. Ninety-three (86.9%) of the patients had a history of contacting with residents from Wuhan (n=31), or contacting with confirmed COVID-19 patients (n=62) within 2 weeks. Fifty-eight (54.2%) had a family cluster onset. Fever MESHD Fever HP and cough MESHD cough HP were the most common symptoms. Only two patients had diarrhea MESHD diarrhea HP. The most common underlying disease MESHD was hypertension MESHD hypertension HP. Lymphopenia MESHD Lymphopenia HP was observed in 26 patients. Fifty-two patients with an elevated level of IL-6. On admission, bilateral patchy shadowing and ground-glass opacity were the typical radiological findings on chest computed tomography. Six patients had an intensive care unit (ICU) stay. Antivirus therapy was performed to all patients. 105 patients discharged with an improved condition, and no death MESHD was occurred during our 90-day follow-up for these patients.Conclusions Patients with COVID-19 in our hospital had relatively mild symptoms, and good prognosis. This study also highlights the importance of human-to-human transmission TRANS in COVID-19.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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