Corpus overview


Overview

MeSH Disease

Human Phenotype

Hypertension (161)

Fever (49)

Cough (40)

Obesity (26)

Pneumonia (25)


Transmission

Seroprevalence
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    Clinical course and severity outcome indicators among COVID 19 hospitalized patients in relation to comorbidities distribution Mexican cohort

    Authors: Genny Carrillo; Nina Mendez Dominguez; Kassandra D Santos Zaldivar; Andrea Rochel Perez; Mario Azuela Morales; Osman Cuevas Koh; Alberto Alvarez Baeza

    doi:10.1101/2020.07.31.20165480 Date: 2020-08-04 Source: medRxiv

    Introduction: COVID-19 affected worldwide, causing to date, around 500,000 deaths MESHD. In Mexico, by April 29, the general case fatality was 6.52%, with 11.1% confirmed case TRANS mortality and hospital recovery rate around 72%. Once hospitalized, the odds for recovery and hospital death MESHD rates depend mainly on the patients' comorbidities and age TRANS. In Mexico, triage guidelines use algorithms and risk estimation tools for severity assessment and decision-making. The study's objective is to analyze the underlying conditions of patients hospitalized for COVID-19 in Mexico concerning four severity outcomes. Materials and Methods: Retrospective cohort based on registries of all laboratory-confirmed patients with the COVID-19 infection MESHD that required hospitalization in Mexico. Independent variables were comorbidities and clinical manifestations. Dependent variables were four possible severity outcomes: (a) pneumonia MESHD pneumonia HP, (b) mechanical ventilation (c) intensive care unit, and (d) death MESHD; all of them were coded as binary Results: We included 69,334 hospitalizations of laboratory-confirmed and hospitalized patients to June 30, 2020. Patients were 55.29 years, and 62.61% were male TRANS. Hospital mortality among patients aged TRANS<15 was 9.11%, 51.99% of those aged TRANS >65 died. Male TRANS gender TRANS and increasing age TRANS predicted every severity outcome. Diabetes and hypertension MESHD hypertension HP predicted every severity outcome significantly. Obesity MESHD Obesity HP did not predict mortality, but CKD, respiratory diseases MESHD, cardiopathies were significant predictors. Conclusion: Obesity MESHD Obesity HP increased the risk for pneumonia MESHD pneumonia HP, mechanical ventilation, and intensive care admittance, but it was not a predictor of in-hospital death MESHD. Patients with respiratory diseases MESHD were less prone to develop pneumonia MESHD pneumonia HP, to receive mechanical ventilation and intensive care unit assistance, but they were at higher risk of in-hospital death MESHD.

    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.

    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.

    Clinical manifestations of patients with Coronavirus Disease MESHD 2019 (COVID- 19) attending at hospitals in Bangladesh

    Authors: Md. Shahed Morshed; Abdullah Al Mosabbir; Prodipta Chowdhury; Sheikh Mohammad Ashadullah; Mohammad Sorowar Hossain

    doi:10.1101/2020.07.30.20165100 Date: 2020-08-01 Source: medRxiv

    Bangladesh is in the rising phase of the ongoing pandemic of the coronavirus disease MESHD 2019 (COVID-19), caused by severe acute respiratory syndrome MESHD coronavirus-2 (SARS-CoV-2). The scientific literature on clinical manifestations of COVID-19 patients from Bangladesh is scarce. This study aimed to report the sociodemographic and clinical characteristics of patients with COVID-19 in Bangladesh. We conducted a cross-sectional study at three dedicated COVID-19 hospitals. The severity of the COVID-19 cases was assessed based on the WHO interim guidance. Data were collected only from non-critical COVID-19 patients as critical patients required immediate intensive care admission making them unable to respond to the questions. A total of 103 RT-PCR confirmed non-critical COVID-19 patients were enrolled. Most of the patients (71.8%) were male TRANS. Mild, moderate and severe illness were assessed in 74.76%, 9.71% and 15.53% of patients respectively. Nearly 52.4% of patients had a co-morbidity, with hypertension MESHD hypertension HP being the most common (34%), followed by diabetes mellitus MESHD diabetes mellitus HP (21.4%) and ischemic heart disease MESHD (9.7%). Fever MESHD Fever HP (78.6%), weakness (68%) and cough MESHD cough HP (44.7%) were the most common clinical manifestations. Other common symptoms included loss of appetite (37.9%), difficulty in breathing (37.9%), altered sensation of taste or smell (35.0%), headache MESHD headache HP (32%) and body ache (32%). The median time from onset of symptom TRANS to attending hospitals was 7 days (IQR 4-10). This study will help both the clinicians and epidemiologists to understand the magnitude and clinical spectrum of COVID-19 patients in Bangladesh.

    Echocardiographic patterns in critically ill COVID-19 patients.

    Authors: Antoine Vieillard-Baron; Cyril Charron; Ségolène Tran; Matthieu Godement; Xavier Repessé; Pierre-Alexandre Haruel; Amélie Prigent; Samuel Castro; Lola Girodias; Emilie Charbit; Foucault Isnard; Mohamed Saleh; Koceila Bouferrache; Bernard Page; Romain Jouffroy; Guillaume Geri

    doi:10.21203/rs.3.rs-52431/v1 Date: 2020-08-01 Source: ResearchSquare

    Background: Need for catecholamines is frequent in COVID-19 patients, but the main echocardiographic patterns are unknown. The objective was to report the main echo patterns in critically-ill COVID-19 patients. Methods: Observational and descriptive study in consecutive COVID-19 patients admitted to the ICU between March 12 and May 8, 2020. Systematic critical care echocardiography (CCE) was performed and retrospectively analyzed off-line. Echo values are reported in the overall population and in patients who required catecholamine infusion during the first 2 days following admission (D1-2) or afterwards until day 7 (D3-7). Results: Of the 79 patients (78% male TRANS; median age TRANS 63 [56-71]; body mass index 29 [26-30]) included, 90% had at least 1 comorbidity. PaO2/FiO2 at admission was 85 [67-162] mmHg. 53% of patients were mechanically ventilated. ICU length of stay was 9 [5-16] days and mortality 34%. 134 echocardiographic studies were performed during the first week in 65 patients. Pulmonary artery acceleration time was decreased (77 [65-97] ms), suggesting pulmonary hypertension MESHD hypertension HP. All 39 patients (49%) who required catecholamine infusion underwent CCE and 25.6% had left ventricular (LV) systolic dysfunction, 28.2% acute cor pulmonale HP (ACP), 7.7% hypovolemia MESHD hypovolemia HP, and 38.5% vasoplegia MESHD. Modification of echo patterns was observed at D3-7, with less LV systolic dysfunction and more ACP, which was the most frequent pattern. Computed tomography pulmonary angiography in 6 patients with ACP indicated intrapulmonary thrombus in 4. Conclusion: Different echocardiographic patterns were observed during the first week following ICU admission in COVID-19 patients. ACP was frequent and often related to thrombus in the pulmonary circulation. 

    Association of Diabetes and Outcomes in Patients with COVID-19: A Propensity Score Matched Analyses from a French Retrospective Cohort

    Authors: Willy Sutter; Baptiste Duceau; Aurélie Carlier; Antonin Trimaille; Thibaut Pommier; Oriane Weizman; Joffrey Cellier; Laura Geneste; Vassili Panagides; Wassima Marsou; Antoine Deney; Sabir Attou; Thomas Delmotte; Sophie Ribeyrolles; Pascale Chemaly; Clément Karsenty; Gauthier Giordano; Alexandre Gautier; Corentin Chaumont; Pierre Guilleminot; Audrey Sagnard; Julie Pastier; maxime Vignac; delphine Mika; Charles Fauvel; Théo Pezel; Ariel Cohen; Guillaume Bonnet; Ronan Roussel; Louis POTIER

    doi:10.21203/rs.3.rs-51775/v1 Date: 2020-07-31 Source: ResearchSquare

    Background: To compare the clinical outcomes between patients with and without diabetes admitted to hospital with COVID-19.Methods: Retrospective multicentre cohort study from 24 academic tertiary medical centres in France including 2851 patients (675 with diabetes) hospitalised for COVID-19 between February 26 and April 20, 2020. A propensity score matching method (1:1 matching including patient characteristics, medical history, vital signs, and laboratory results) was used to compare patients with and without diabetes (n=603 in each group). The primary outcome was admission to intensive care unit (ICU) or in-hospital death MESHD. Results: Patients with diabetes were older (71 ± 13 vs. 65 ± 18 years; p<0.001), were less often female TRANS (38% vs. 44%; p<0.001) and more likely to have comorbidities: hypertension MESHD hypertension HP (79% vs 42%; p<0.001), coronary heart disease MESHD (23% vs 9%; p<0.001), stroke MESHD stroke HP (13% vs 8%; p<0.001), heart failure MESHD (17% vs 9%; p<0.001), chronic kidney disease HP kidney disease MESHD (26% vs 10%; p<0.001), and chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP (7% vs 5%; p<0.05). The primary outcome occurred in 584 (36.4%) patients with diabetes compared to 246 (26.8%) in those without diabetes (p<0.001). After propensity score matching, the risk of primary outcome was similar in patients with and without diabetes (hazard ratio [HR] 1.16, 95%CI 0.95-1.41, p=0.14) and was 1.29 (95%CI 0.97 – 1.69) for in-hospital mortality, 1.26 (95%CI 0.93 – 1.72) for mortality without transfer in ICU, and 1.14 (95%CI 0.88 – 1.47) for transfer to ICU.Conclusions: In this retrospective cohort of patients hospitalised for COVID-19, diabetes was not significantly associated with a higher risk of COVID-19 severe outcomes after propensity score matching.Trial registration NCT04344327

    Risk Factors for COVID-19-associated hospitalization: COVID-19-Associated Hospitalization Surveillance Network and Behavioral Risk Factor Surveillance System

    Authors: Jean Y. Ko; Melissa L. Danielson; Machell Town; Gordana Derado; Kurt J. Greenland; Pam Daily Kirley; Nisha B. Alden; Kimberly Yousey-Hindes; Evan J. Anderson; Patricia A. Ryan; Sue Kim; Ruth Lynfield; Salina M. Torres; Grant R. Barney; Nancy M. Bennett; Melissa Sutton; H. Keipp Talbot; Mary Hill; Aron J. Hall; Alicia M. Fry; Shikha Garg; Lindsay Kim; - COVID-NET Investigation Group

    doi:10.1101/2020.07.27.20161810 Date: 2020-07-29 Source: medRxiv

    Background: Identification of risk factors for COVID-19-associated hospitalization is needed to guide prevention and clinical care. Objective: To examine if age TRANS, sex, race/ethnicity, and underlying medical conditions is independently associated with COVID-19-associated hospitalizations. Design: Cross-sectional. Setting: 70 counties within 12 states participating in the Coronavirus Disease MESHD 2019-Associated Hospitalization Surveillance Network (COVID-NET) and a population-based sample of non-hospitalized adults TRANS residing in the COVID-NET catchment area from the Behavioral Risk Factor Surveillance System. Participants: U.S. community-dwelling adults TRANS ([≥]18 years) with laboratory-confirmed COVID-19-associated hospitalizations, March 1- June 23, 2020. Measurements: Adjusted rate ratios (aRR) of hospitalization by age TRANS, sex, race/ethnicity and underlying medical conditions ( hypertension MESHD hypertension HP, coronary artery disease MESHD, history of stroke MESHD stroke HP, diabetes, obesity MESHD obesity HP [BMI [≥]30 kg/m2], severe obesity MESHD obesity HP [BMI[≥]40 kg/m2], chronic kidney disease HP kidney disease MESHD, asthma MESHD asthma HP, and chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP). Results: Our sample included 5,416 adults TRANS with COVID-19-associated hospitalizations. Adults TRANS with (versus without) severe obesity MESHD obesity HP (aRR:4.4; 95%CI: 3.4, 5.7), chronic kidney disease HP kidney disease MESHD (aRR:4.0; 95%CI: 3.0, 5.2), diabetes (aRR:3.2; 95%CI: 2.5, 4.1), obesity MESHD obesity HP (aRR:2.9; 95%CI: 2.3, 3.5), hypertension MESHD hypertension HP (aRR:2.8; 95%CI: 2.3, 3.4), and asthma MESHD asthma HP (aRR:1.4; 95%CI: 1.1, 1.7) had higher rates of hospitalization, after adjusting for age TRANS, sex, and race/ethnicity. In models adjusting for the presence of an individual underlying medical condition, higher hospitalization rates were observed for adults TRANS [≥]65 years, 45-64 years (versus 18-44 years), males TRANS (versus females TRANS), and non-Hispanic black and other race/ethnicities (versus non-Hispanic whites). Limitations: Interim analysis limited to hospitalizations with underlying medical condition data. Conclusion: Our findings elucidate groups with higher hospitalization risk that may benefit from targeted preventive and therapeutic interventions.

    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/rs.3.rs-50527/v1 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.  

    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.

    Trends in Angiotensin Receptor Blocker Use Among those at Risk for COVID-19 Morbidity and Mortality in the United States

    Authors: Alexandra Perez; Robert Speth; Juan Saavedra

    doi:10.1101/2020.07.24.20161851 Date: 2020-07-27 Source: medRxiv

    Importance: Assessment of the use of angiotensin receptor blockers (ARBs) in the United States provides insight into prescribing practices, and may inform guidelines, policy measures and research during the COVID-19 pandemic. Objective: To evaluate trends in ARB use among adults TRANS in the United States who have preexisting conditions and sociodemographic risk factors that put them at a higher risk of SARS-CoV-2 infection MESHD and COVID-19-related complications and mortality. Design, setting and participants: This study uses the nationally representative cross-sectional data from the 2005-2018 National Health and Nutrition Examination Survey (NHANES). Participants included 39,749 non-institutionalized U.S. civilian adults TRANS who were 20 years and older and those with the most common preexisting conditions and risk factors reported among patients with COVID-19. Main outcomes and measures: Use of ARBs in the prior 30 days from survey interview. Results: ARB use ranged from 7.4% [95% CI, 6.5%-8.4%] to 26.2% [95% CI, 19.4%-34.4%] among those with one or two metabolic, renal, respiratory, and/or cardiovascular diseases MESHD. Among individuals with the three most common preexisting conditions in patients with COVID-19 including hypertension MESHD hypertension HP, diabetes and obesity MESHD obesity HP, ARB use was higher among the elderly TRANS, females TRANS, non-Hispanic whites, and those with health insurance coverage. Conclusions and relevance: In this nationally representative survey, ARB use was found to be widespread, but unevenly distributed among individuals with conditions and sociodemographic risk factors that place them at a higher risk of COVID-19 morbidity and mortality.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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