Corpus overview


MeSH Disease

Human Phenotype


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    A Comprehensive Evaluation of Early Predictors of Disease Progression MESHD in Patients with COVID-19: A Case Control Study

    Authors: Qiang Tang; Yanwei Liu; Yingfeng Fu; Ziyang Di; Kailiang Xu; Bo Tang; Hui Wu; Maojun Di

    doi:10.21203/ Date: 2020-07-29 Source: ResearchSquare

    Background: The 2019 coronavirus disease MESHD (COVID-19) has become an unprecedented public health crisis with nearly 16 million confirmed cases TRANS and 630,000 deaths MESHD worldwide. Methods: We retrospectively investigated the demographic, clinical, laboratory, radiological and treatment data of COVID-19 patients consecutively enrolled from January 18 to May 15, 2020, in Taihe and Jinzhou central hospital. Results: Of all 197 patients, the median age TRANS was 66.5 years (IQR 7-76), and 120 (60.9%) patients were males TRANS. We identified 88 (44.7%) of 197 COVID-19 patients as the disease progression MESHD (aggravation) cases. The aggravation cases tend to have more medical comorbidity: hypertension MESHD hypertension HP (34.1%), diabetes (30.7%), and presented with dyspnea MESHD dyspnea HP (34.1%), neutrophilia HP (60.2%), and lymphocytopenia (73.9%), compared with those without. And the patients with disease progression MESHD showed significantly higher level of Fibrinogen (Fbg), D-dimer, IL-6, C-reactive protein (CRP), procalcitonin (PCT), and serum SERO ferritin, and were more prone to develop organ damage in the liver, kidney, and heart (P<0.05). Multivariable regression showed that advanced age TRANS, comorbidities, lymphopenia MESHD lymphopenia HP, and elevated level of Fbg, lactate dehydrogenase (LDH), Cardiac troponin (CTnI), IL-6, serum SERO ferritin were the significant predictors of disease progression MESHD. Further, we investigated antibody SERO responses to SARS-CoV-2 and found that the levels of IgM and IgG were significantly higher in the disease progression MESHD cases compared to non-progression cases from 3 weeks after symptom onset TRANS. In addition, the disease progression MESHD group tended to peak later and has a more vigorous IgM/IgG response against SARS-CoV-2. Further, we performed Kaplan-Meier analysis and found that 61.6% of patients had not experienced ICU transfer or survival from hospital within 25 days from admission.Conclusions: Investigating the potential factors of advanced age TRANS, comorbidities and elevated level of IL-6, serum SERO ferritin and Kaplan-Meier analysis enables early identification and management of patients with poor prognosis. Detection of the dynamic antibody SERO may offer vital clinical information during the course of SARS-CoV-2 and provide prognostic value for patients infection MESHD.  

    Placental SARS-CoV-2 in a patient with mild COVID-19 disease MESHD

    Authors: Albert L. Hsu; Minhui Guan; Eric Johannesen; Amanda J. Stephens; Nabila Khaleel; Nikki Kagan; Breanna C. Tuhlei; Xiu-Feng Wan

    doi:10.1101/2020.07.11.20149344 Date: 2020-07-14 Source: medRxiv

    Background: The full impact of COVID-19 on pregnancy remains uncharacterized. Current literature suggests minimal maternal, fetal, and neonatal morbidity and mortality,1 and COVID-19 manifestations appear similar between pregnant and non-pregnant women.2 We present a case of placental SARS-CoV-2 virus in a woman with an uncomplicated pregnancy and mild COVID-19 disease MESHD. Methods: A pregnant woman was evaluated at University of Missouri Women and Childrens Hospital. Institutional review board approval was obtained; information was obtained from medical records. Reverse transcriptase-polymerase chain reaction (RT-PCR) was performed to detect SARS-CoV-2. A gynecological pathologist examined the placenta and performed histolopathology. Sections were formalin-fixed and paraffin-embedded; slides were cut and subjected to hematoxylin-and-eosin or immunohistochemistry (IHC) staining. IHC was performed with specific monoclonal antibodies SERO to detect SARS-CoV-2 antigen or to identify trophoblasts. Findings: A 29 year-old multigravida presented at 40-4/7 weeks for labor induction. With myalgias MESHD myalgias HP two days prior, she tested positive for SARS-CoV-2. Her parents TRANS were in self-isolation for COVID-19 positivity; husband was asymptomatic TRANS and tested negative for COVID-19, but exposed to a workplace (meatpacking facility) outbreak. Prenatal course was uncomplicated, with no gestational hypertension MESHD hypertension HP. She was afebrile and asymptomatic TRANS with normal vital signs throughout hospitalization. Her myalgias MESHD myalgias HP improved prior to admission. A liveborn male TRANS infant was delivered vaginally. Newborn course was uneventful; he was appropriate for gestational age TRANS, physical was unremarkable, and he was discharged home at 36 hours. COVID-19 RT-PCR test was negative at 24 hours. At one-week follow-up, newborn was breastfeeding well, with no fevers MESHD fevers HP or respiratory distress HP. Overall placental histology is consistent with acute uterine hypoxia MESHD (subchorionic laminar necrosis MESHD) superimposed on chronic uterine hypoxia MESHD (extra-villous trophoblasts and focal chronic villitis). IHC using SARS-CoV-2 nucleocapsid-specific monoclonal antibody SERO demonstrated SARS-CoV-2 antigens throughout the placenta in chorionic villi endothelial cells, and rarely in CK7-expressing trophoblasts. Negative control placenta (November 2019 delivery) and ferret nasal turbinate tissues (not shown) were negative for SARS-CoV-2. Interpretation: In this report, SARS-CoV-2 was found in the placenta, but newborn was COVID-19 negative. Our case shows maternal vascular malperfusion, with no features of fetal vascular malperfusion. To our knowledge, this is the first report of placental COVID-19 despite mild COVID-19 disease MESHD in pregnancy (with no symptoms of COVID-19 aside from myalgias MESHD myalgias HP); specifically, this patient had no fever MESHD fever HP, cough MESHD cough HP, or shortness of breath, but only myalgias MESHD myalgias HP and sick contacts. Despite her having mild COVID-19 disease MESHD in pregnancy, we demonstrate placental vasculopathy and presence of SARS-CoV-2 virus across the placenta. Evidence of placental COVID-19 raises concern for possible placental vasculopathy (potentially leading to fetal growth restriction, pre-eclampsia MESHD eclampsia HP, and other pregnancy complications MESHD) as well as for potential vertical transmission TRANS -- especially for pregnant women who may be exposed to COVID-19 in early pregnancy. Further studies are urgently needed, to determine whether women with mild, pre-symptomatic, or asymptomatic TRANS COVID-19 may have SARS-CoV-2 virus that can cross the placenta, cause fetal vascular malperfusion, and possibly affect the fetus. This raises important public health and public policy questions of whether future pregnancy guidance should include stricter pandemic precautions, such as screening for a wider array of COVID-19 symptoms, increased antenatal surveillance, and possibly routine COVID-19 testing on a regular basis throughout pregnancy.

    Clinical characteristics of 134 convalescent patients with COVID-19 in Guizhou, China

    Authors: Siqin Zhang; Lin Liu; Bin Yang; Rou Li; Jianhua Luo; Jing Huang; Yanjun Long; Ying Huang; Jianping Zhou; Yan Zha; Xiangyan Zhang

    doi:10.21203/ Date: 2020-07-13 Source: ResearchSquare

    Background: Previous studies have focused on the clinical characteristics of hospitalized patients with the novel 2019 coronavirus disease MESHD (COVID-19). Limited data are available for convalescent patients. This study aimed to evaluate the clinical characteristics of discharged COVID-19 patients.Methods: In this retrospective study, we extracted data for 134 convalescent patients with COVID-19 in Guizhou Provincial Staff Hospital from February 15 to March 31, 2020. Cases were analyzed on the basis of demographic, clinical, and laboratory data as well as radiological features. Results: Of 134 convalescent patients with COVID-19, 19 (14.2%) were severe cases, while 115 (85.8%) were non-severe cases. The median patient age TRANS was 33 years (IQR, 21.8 to 46.3), and the cohort included 69 men and 65 women. Compared with non-severe cases, severe patients were older and had more chronic comorbidities, especially hypertension MESHD hypertension HP, diabetes, and thyroid disease MESHD (P<0.05). Leukopenia MESHD Leukopenia HP was present in 32.1% of the convalescent patients and lymphocytopenia was present in 6.7%, both of which were more common in severe patients. 48 (35.8%) of discharged patients had elevated levels of alanine aminotransferase, which was more common in adults TRANS than in children TRANS (40.2% vs 13.6%, P=0.018). A normal chest CT was found in 61 (45.5%) patients during rehabilitation. Severe patients had more ground-glass opacity, bilateral patchy shadowing, and fibrosis MESHD. No significant differences were observed in the positive rate of IgG and/or IgM antibodies SERO between severe and non-severe patients.Conclusion: Leukopenia MESHD Leukopenia HP, lymphopenia MESHD lymphopenia HP, ground-glass opacity, and fibrosis MESHD are common in discharged severe COVID-19 patients, and liver injury is common in discharged adult TRANS patients. We suggest physicians develop follow-up treatment plans based on the different clinical characteristics of convalescent patients. 

    Possible COVID-19 recurrence MESHD in an older patient: a case report

    Authors: Antoine Garnier-Crussard; Marine Haution ; Mathilde Gueret-Du-Manoir ; Quitterie Reynaud ; Nathalie Freymond ; Maude Bouscambert-Duchamp ; Anne Conrad ; Claire Falandry

    doi:10.21203/ Date: 2020-06-11 Source: ResearchSquare

    Background: Novel coronavirus (COVID-19) pandemic cause by Severe Acute Respiratory Syndrome MESHD Coronavirus-2 (SARS-CoV-2) threatens the world for few months. Few cases of prolonged positivity of viral tests and clinical recurrence MESHD of COVID-19 have been described. We report the case of a 78-year-old woman with metastatic breast cancer who developed possible COVID-19 recurrence MESHD in a post-acute and rehabilitation unit. Case presentation: A 78-year-old woman with metastatic breast cancer and hypertension MESHD hypertension HP developed COVID-19. After symptom improvement and RT-PCR negativation, she regained symptom ( fever MESHD fever HP, fall HP) and lymphopenia MESHD lymphopenia HP on Day 26 and we note a turned positive RT-PCR even though she was tested positive for antibody SERO against SARS-CoV-2. After the diagnosis of possible COVID-19 recurrence MESHD, she was transferred back to an acute “COVID-19” unit and she then quickly clinically recovered. Conclusions: This clinical case allows us to discuss the risk of recurrence MESHD and possible specific causes in older patients. Moreover, prolonged symptoms and lymphopenia MESHD lymphopenia HP could be associated to worse outcomes in older patients. Finally, at a collective level, even if traces TRANS of virus detected by RT-PCR were not necessarily correlated with the contagiousness, the importance of possible COVID-19 recurrence MESHD in the care pathway for older adults TRANS must be taken into account, since they are often surrounded by frail older people.

    A tertiary center experience of multiple myeloma MESHD multiple myeloma HP patients with COVID-19: lessons learned and the path forward

    Authors: Bo Wang; Oliver Van Oekelen; Tarek Mouhieddine; Diane Marie Del Valle; Joshua Richter; Hearn Jay Cho; Shambavi Richard; Ajai Chari; Sacha Gnjatic; Miriam Merad; Sundar Jagannath; Samir Parekh; Deepu Madduri

    doi:10.1101/2020.06.04.20122846 Date: 2020-06-05 Source: medRxiv

    Background: The COVID-19 pandemic, caused by SARS-CoV-2 virus, has resulted in over 100,000 deaths MESHD in the United States. Our institution has treated over 2,000 COVID-19 patients during the pandemic in New York City. The pandemic directly impacted cancer patients and the organization of cancer care. Mount Sinai Hospital has a large and diverse multiple myeloma MESHD multiple myeloma HP (MM) population. Herein, we report the characteristics of COVID-19 infection MESHD and serological response in MM patients in a large tertiary care institution in New York. Methods: We performed a retrospective study on a cohort of 58 patients with a plasma SERO-cell disorder (54 MM, 4 smoldering MM) who developed COVID-19 between March 1, 2020 and April 30, 2020. We report epidemiological, clinical and laboratory characteristics including persistence of viral detection by polymerase chain reaction (PCR) and anti- SARS-CoV-2 antibody SERO testing, treatments initiated, and outcomes. Results: Of the 58 patients diagnosed with COVID-19, 36 were hospitalized and 22 were managed at home. The median age TRANS was 67 years; 52% of patients were male TRANS and 63% were non-white. Hypertension MESHD Hypertension HP (64%), hyperlipidemia MESHD hyperlipidemia HP (62%), obesity MESHD obesity HP (37%), diabetes mellitus MESHD diabetes mellitus HP (28%), chronic kidney disease HP kidney disease MESHD (24%) and lung disease MESHD (21%) were the most common comorbidities. In the total cohort, 14 patients (24%) died. Older age TRANS (>70 years), male TRANS sex, cardiovascular risk, and patients not in complete remission (CR) or stringent CR were significantly (p<0.05) associated with hospitalization. Among hospitalized patients, laboratory findings demonstrated elevation of traditional inflammatory markers (CRP, ferritin, D-dimer) and a significant (p<0.05) association between elevated inflammatory markers, severe hypogammaglobulinemia, non-white race, and mortality. Ninety-six percent (22/23) of patients developed antibodies to SARS-CoV-2 SERO at a median of 32 days after initial diagnosis. Median time to PCR negativity was 43 (range 19-68) days from initial positive PCR. Conclusions: Drug exposure and MM disease MESHD status at the time of contracting COVID-19 had no bearing on mortality. Mounting a severe inflammatory response to SARS-CoV-2 and severe hypogammaglobulinemia were associated with higher mortality. The majority of patients mounted an antibody SERO response to SARS-CoV-2. These findings pave a path to identification of vulnerable MM patients who need early intervention to improve outcome in future outbreaks of COVID-19.

    Susceptibility of the Elderly TRANS to SARS-CoV-2 Infection MESHD: ACE-2 Overexpression, Shedding and Antibody SERO-dependent Enhancement (ADE)

    Authors: Jean Pierre Schatzmann Peron; Helder Nakaya

    id:10.20944/preprints202003.0400.v1 Date: 2020-03-27 Source:

    The world is currently going through a serious pandemic of viral infection MESHD with SARS-CoV-2, a new isolate of coronavirus, resembling and surpassing the crisis that occurred in 2002 and 2013 with SARS and MERS, respectively. SARS-CoV-2 has currently infected more than 142,000 people, causing 5,000 deaths MESHD and reaching more than 130 countries worldwide. The very large spreading capacity of the virus clearly demonstrates the potential threat of respiratory viruses to human health, alarming governments around the world that preventive health policies and scientific research are pivotal to overcoming the crisis. Coronavirus disease MESHD 2019 (COVID-19) causes flu-like symptoms in most cases. However, approximately 15% of patients will need hospitalization, and 5% require assisted ventilation, depending on the cohorts studied. What is intriguing, however, is the higher susceptibility of elderly TRANS individuals, especially those who are more than 60 years old and have comorbidities, including hypertension MESHD hypertension HP, diabetes and heart disease MESHD. In fact, the death MESHD rate in this group may be up to 10-12%. Interestingly, children TRANS are somehow protected and not included as a risk group.Thus, here, we discuss some possibilities of molecular and cellular mechanisms by which elderly TRANS subjects may be more susceptible to severe COVID-19. In this sense, we raise two main points: i) increased ACE-2 expression in pulmonary and heart tissue of chronic angiotensin 1 receptor (AT1R) blocker users and hypertensive individuals and ii) antibody SERO-dependent enhancement (ADE) after previous exposure to other circulating coronaviruses. We believe these are pivotal points for a better understanding of the pathogenesis of severe COVID-19 and must be addressed with attention by physicians and scientists in the field.

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MeSH Disease
Human Phenotype

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