Corpus overview


Overview

MeSH Disease

Human Phenotype

Hypertension (190)

Fever (57)

Cough (48)

Pneumonia (36)

Obesity (27)


Transmission

Seroprevalence
    displaying 151 - 160 records in total 190
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    Clinical and historical features associated with severe COVID-19 infection MESHD: a systematic review

    Authors: Jennifer L Pigoga; Alexandra Friedman; Morgan Broccoli; Sarah Hirner; Antoinette Vanessa Naidoo; Swasthi Singh; Kalin Werner; Lee A Wallis

    doi:10.1101/2020.04.23.20076653 Date: 2020-04-27 Source: medRxiv

    Background: There is an urgent need for rapid assessment methods to guide pathways of care for COVID-19 patients, as frontline providers need to make challenging decisions surrounding rationing of resources. This study aimed to evaluate existing literature for factors associated with COVID-19 illness severity. Methods: A systematic review identified all studies published between 1/12/19 and 19/4/20 that used primary data and inferential statistics to assess associations between the outcome of interest - disease severity - and historical or clinical variables. PubMed, Scopus, Web of Science, and the WHO Database of Publications on Coronavirus Disease MESHD were searched. Data were independently extracted and cross-checked independently by two reviewers using PRISMA guidelines, after which they were descriptively analysed. Quality and risk of bias in available evidence were assessed using the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) framework. This review was registered with PROSPERO, registration number CRD42020178098. Results: Of the 6202 relevant articles found, 63 were eligible for inclusion; these studies analysed data from 17648 COVID-19 patients. The majority (n=57, 90.5%) were from China and nearly all (n=51, 90.5%) focussed on admitted adult TRANS patients. Patients had a median age TRANS of 52.5 years and 52.8% were male TRANS. The predictors most frequently associated with COVID-19 disease severity were age TRANS, absolute lymphocyte count, hypertension HP hypertension MESHD, lactate dehydrogenase (LDH), C-reactive protein (CRP), and history of any pre-existing medical condition. Conclusion: This study identified multiple variables likely to be predictive of severe COVID-19 illness. Due to the novelty of SARS-CoV-2 infection MESHD, there is currently no severity prediction tool designed to, or validated for, COVID-19 illness severity. Findings may inform such a tool that can offer guidance on clinical treatment and disposition, and ultimately reduce morbidity and mortality due to the pandemic.

    Lack of association between genetic variants at ACE2 and TMPRSS2 genes involved in SARS-CoV-2 infection MESHD and human quantitative phenotypes

    Authors: Esteban Lopera; Adriaan van der Graaf; Pauline Lanting; Marije van der Geest; - Lifelines Cohort Study; Jingyuan Fu; Morris Swertz; Lude Franke; Cisca Wijmenga; Patrick Deelen; Alexandra Zhernakova; Serena Sanna

    doi:10.1101/2020.04.22.20074963 Date: 2020-04-25 Source: medRxiv

    Coronavirus disease 2019 (COVID-19) shows a wide variation in expression and severity of symptoms, from very mild or no symptomes, to flu-like symptoms, and in more severe cases, to pneumonia HP pneumonia MESHD, acute respiratory distress syndrome MESHD respiratory distress HP syndrome and even death. Large differences in outcome have also been observed between males TRANS and females TRANS. The causes for this variability are likely to be multifactorial, and to include genetics. The SARS-CoV-2 virus responsible for the infection uses the human receptor angiotensin converting enzyme 2 (ACE2) for cell invasion, and the serine protease TMPRSS2 for S protein priming. Genetic variation in these two genes may thus modulate an individual's genetic predisposition to infection MESHD and virus clearance. While genetic data on COVID-19 patients is being gathered, we carried out a phenome-wide association scan (PheWAS) to investigate the role of these genes in other human phenotypes in the general population. We examined 178 quantitative phenotypes including cytokines and cardio-metabolic biomarkers, as well as 58 medications in 36,339 volunteers from the Lifelines population biobank, in relation to 1,273 genetic variants located in or near ACE2 and TMPRSS2. While none reached our threshold for significance, we observed a suggestive association of polymorphisms within the ACE2 gene with (1) the use of ARBs combination therapies (p=5.7x10-4), an association that is significantly stronger in females TRANS (pdiff=0.01), and (2) with the use of non-steroid anti-inflammatory and antirheumatic products (p=5.5x10-4). While these associations need to be confirmed in larger sample sizes, they suggest that these variants play a role in diseases such as hypertension HP hypertension MESHD and chronic inflammation MESHD that are often observed in the more severe COVID-19 cases. Further investigation of these genetic variants in the context of COVID-19 is thus promising for better understanding of disease variability. Full results are available at https://covid19research.nl.

    Characterization and Clinical Course of 1000 Patients with COVID-19 in New York: retrospective case series

    Authors: Michael G Argenziano; Samuel L Bruce; Cody L Slater; Jonathan R Tiao; Matthew R Baldwin; R Graham Barr; Bernard P Chang; Katherine H Chau; Justin J Choi; Nicholas Gavin; Parag Goyal; Angela M Mills; Ashmi A Patel; Marie-Laure S Romney; Monika M Safford; Neil W Schluger; Soumitra Sengupta; Magdalena E Sobieszczyk; Jason E Zucker; Paul A Asadourian; Fletcher M Bell; Rebekah Boyd; Matthew F Cohen; MacAlistair I Colquhoun; Lucy A Colville; Joseph H de Jonge; Lyle B Dershowitz; Shirin A Dey; Katherine A Eiseman; Zachary P Girvin; Daniella T Goni; Amro A Harb; Nicholas Herzik; Sarah Householder; Lara E Karaaslan; Heather Lee; Evan Lieberman; Andrew Ling; Ree Lu; Arthur Y Shou; Alexander C Sisti; Zachary E Snow; Colin P Sperring; Yuqing Xiong; Henry W Zhou; Karthik Natarajan; George Hripcsak; Ruijun Chen

    doi:10.1101/2020.04.20.20072116 Date: 2020-04-22 Source: medRxiv

    Objective: To characterize patients with coronavirus disease MESHD 2019 (COVID-19) in a large New York City (NYC) medical center and describe their clinical course across the emergency department (ED), inpatient wards, and intensive care units (ICUs). Design: Retrospective manual medical record review. Setting: NewYork-Presbyterian/Columbia University Irving Medical Center (NYP/CUIMC), a quaternary care academic medical center in NYC. Participants: The first 1000 consecutive patients with laboratory-confirmed COVID-19. Methods: We identified the first 1000 consecutive patients with a positive RT-SARS-CoV-2 PCR test who first presented to the ED or were hospitalized at NYP/CUIMC between March 1 and April 5, 2020. Patient data was manually abstracted from the electronic medical record. Main outcome measures: We describe patient characteristics including demographics, presenting symptoms, comorbidities on presentation, hospital course, time to intubation, complications, mortality, and disposition. Results: Among the first 1000 patients, 150 were ED patients, 614 were admitted without requiring ICU-level care, and 236 were admitted or transferred to the ICU. The most common presenting symptoms were cough HP (73.2%), fever HP fever MESHD (72.8%), and dyspnea HP dyspnea MESHD (63.1%). Hospitalized patients, and ICU patients in particular, most commonly had baseline comorbidities including of hypertension HP hypertension MESHD, diabetes MESHD, and obesity HP obesity MESHD. ICU patients were older, predominantly male TRANS (66.9%), and long lengths of stay (median 23 days; IQR 12 to 32 days); 78.0% developed AKI and 35.2% required dialysis. Notably, for patients who required mechanical ventilation, only 4.4% were first intubated more than 14 days after symptom onset TRANS. Time to intubation from symptom onset TRANS had a bimodal distribution, with modes at 3-4 and 9 days. As of April 30, 90 patients remained hospitalized and 211 had died in the hospital. Conclusions: Hospitalized patients with COVID-19 illness at this medical center faced significant morbidity and mortality, with high rates of AKI, dialysis, and a bimodal distribution in time to intubation from symptom onset TRANS.

    Analysis of the Clinical Characteristics of 77 COVID-19 Deaths

    Authors: Kaige Wang; Zhixin Qiu; Dan Liu; Jianfei Luo; Jiasheng Liu; Tao Fan; Chunrong Liu; Panwen Tian; Ye Wang; Zhong Ni; Shumin Zhang; Weimin Li

    doi:10.21203/rs.3.rs-23960/v1 Date: 2020-04-20 Source: ResearchSquare

    Purpose: For the emerging pandemic Coronavirus Disease MESHD 2019 (COVID-19), no clear description on its deaths’ clinical characteristics and causes of death MESHD is available. Hence, this study analyzed clinical characteristics of 77 COVID-19 deaths, providing data support to further understand this disease.Method: A retrospective analysis of 77 COVID-19 deaths in East Branch, Renmin Hospital of Wuhan University from February 1 to March 7, 2020 was performed in clinical characteristics, laboratory results, causes of death MESHD, and subgroup comparison. Results: Totally 72.7% of the deaths ( male TRANS- female TRANS ratio: 51:26, average age TRANS at death: 71, mean survival time: 17.4 days) had hypertension HP hypertension MESHD, heart disease MESHD, diabetes MESHD, chronic lung disease HP chronic lung disease MESHD, and other comorbidities. Acute respiratory distress HP respiratory distress MESHD syndrome ( ARDS MESHD) and sepsis HP sepsis MESHD were the main causes of death MESHD. Increases in C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer and lactic acid (LAC), and decreases in lymphocyte, cluster of differentiation (CD) 4+ and CD8+ cells were common in laboratory results. Subgroup analysis showed: 1) Most female TRANS deaths had cough HP cough MESHD and diabetes MESHD. 2) The male TRANS proportion in young and middle- aged TRANS deaths was higher; while elderly TRANS deaths were more prone to myocardial injury MESHD and elevated CRP. 3) There was no statistical difference between short-term and non-short-term survival subgroups. 4) CRP and LDH increased and CD4+ and CD8+ cells decreased significantly in patients with hypertension HP hypertension MESHD.Conclusions: The majority of COVID-19 deaths are males TRANS, especially the elderly TRANS with underlying diseases. The main causes of death include ARDS MESHD and sepsis HP sepsis MESHD. Most female TRANS deaths have cough HP cough MESHD and diabetes MESHD. Myocardial injury MESHD is common in elderly TRANS deaths. Patients with hypertension HP hypertension MESHD are prone to increased inflammatory index, tissue hypoxia MESHD and cellular immune injury.Authors Kaige Wang and Zhixin Qiu contributed equally to this work.

    SARS-COV-2 comorbidity network and outcome in hospitalized patients in Crema, Italy

    Authors: Gianpaolo Benelli; Elisabetta Buscarini; Ciro Canetta; Giuseppe La Piana; Guido Merli; Alessandro Scartabellati; Giovanni Vigano; Roberto Sfogliarini; Giovanni Melilli; Roberto Assandri; Daniele Cazzato; Davide Sebastiano Rossi; Susanna Usai; Guido Caldarelli; Tommaso Gili; Irene Tramacere; Germano Pellegata; Giuseppe Lauria

    doi:10.1101/2020.04.14.20053090 Date: 2020-04-20 Source: medRxiv

    No systematic data on hospitalized SARS-COV-2 patients from Western countries are available. We report onset, course, correlations with comorbidities, and diagnostic accuracy of nasopharyngeal swab in 539 individuals suspected to carry SARS-COV-2 admitted to the hospital of Crema, Italy. All individuals underwent clinical and laboratory exams, SARS-COV-2 reverse transcriptase-polymerase chain reaction on nasopharyngeal swab, and chest X-ray and/or computed tomography (CT). Data on onset, course, comorbidities, number of drugs including angiotensin converting enzyme (ACE) inhibitors and angiotensin-II-receptor antagonists (sartans), follow-up swab, pharmacological treatments, non-invasive respiratory support, ICU admission, and deaths MESHD were recorded. Among 411 SARS-COV-2 patients (66.6% males TRANS) median age TRANS was 70.5 years (range 1-99). Chest CT was performed in 317 (77.2%) and showed interstitial pneumonia MESHD pneumonia HP in 304 (96%). Fatality rate was 17.5% (74% males TRANS), with 6.6% in 60-69 years old, 21.1% in 70-79 years old, 38.8% in 80-89 years old, and 83.3% above 90 years. No death occurred below 60 years. Non-invasive respiratory support rate was 27.2% and ICU admission 6.8%. Older age TRANS, cough HP and dyspnea HP dyspnea MESHD at onset, hypertension HP hypertension MESHD, cardiovascular diseases MESHD, diabetes MESHD, renal insufficiency HP renal insufficiency MESHD, >7 drugs intake and positive X-ray, low lymphocyte count, high C-reactive protein, aspartate aminotransferase and lactate dehydrogenase values, and low PO2 partial pressure with high lactate at arterial blood SERO gas analysis at admission were significantly associated with death MESHD. Use of ACE inhibitors or sartans was not associated with outcomes. Comorbidity network analysis revealed homogenous distribution of deceased and 60-80 aged TRANS SARS-COV-2 patients across diseases. Among 128 swab negative patients at admission (63.3% males TRANS) median age TRANS was 67.7 years (range 1-98). Chest CT was performed in 87 (68%) and showed interstitial pneumonia MESHD pneumonia HP in 76 (87.3%). Follow-up swab turned positive in 13 of 32 patients. Using chest CT at admission as gold standard on the entire study population of 539 patients, nasopharyngeal swab had 80% sensitivity SERO. SARS-CoV-2 caused high mortality among patients older than 60 years and correlated with pre-existing multiorgan impairment. ACE inhibitors and sartans did not influence patients' outcome.

    Epidemiology, clinical course, and outcomes of critically ill adults TRANS with COVID-19 in New York City: a prospective cohort study

    Authors: Matthew J Cummings; Matthew R Baldwin; Darryl Abrams; Samuel D Jacobson; Benjamin J Meyer; Elizabeth M Balough; Justin G Aaron; Jan Claassen; LeRoy E Rabbani; Jonathan Hastie; Beth R Hochman; John Salazar-Schicchi; Natalie H Yip; Daniel Brodie; Max R O'Donnell

    doi:10.1101/2020.04.15.20067157 Date: 2020-04-20 Source: medRxiv

    Background: Nearly 30,000 patients with coronavirus disease MESHD-2019 (COVID-19) have been hospitalized in New York City as of April 14th, 2020. Data on the epidemiology, clinical course, and outcomes of critically ill MESHD patients with COVID-19 in this setting are needed. Methods: We prospectively collected clinical, biomarker, and treatment data on critically ill adults TRANS with laboratory-confirmed-COVID-19 admitted to two hospitals in northern Manhattan between March 2nd and April 1st, 2020. The primary outcome was in-hospital mortality. Secondary outcomes included frequency and duration of invasive mechanical ventilation, frequency of vasopressor use and renal-replacement-therapy, and time to clinical deterioration following hospital admission. The relationship between clinical risk factors, biomarkers, and in-hospital mortality was modeled using Cox-proportional-hazards regression. Each patient had at least 14 days of observation. Results: Of 1,150 adults TRANS hospitalized with COVID-19 during the study period, 257 (22%) were critically ill. The median age TRANS was 62 years (interquartile range [IQR] 51-72); 170 (66%) were male TRANS. Two-hundred twelve (82%) had at least one chronic illness, the most common of which were hypertension HP hypertension MESHD (63%; 162/257) and diabetes mellitus HP diabetes mellitus MESHD (36%; 92/257). One-hundred-thirty-eight patients (54%) were obese MESHD, and 13 (5%) were healthcare workers. As of April 14th, 2020, in-hospital mortality was 33% (86/257); 47% (122/257) of patients remained hospitalized. Two-hundred-one (79%) patients received invasive mechanical ventilation (median 13 days [IQR 9-17]), and 54% (138/257) and 29% (75/257) required vasopressors and renal-replacement-therapy, respectively. The median time to clinical deterioration following hospital admission was 3 days (IQR 1-6). Older age TRANS, hypertension HP hypertension MESHD, chronic lung disease HP lung disease MESHD, and higher concentrations of interleukin-6 and d-dimer at admission were independently associated with in-hospital mortality. Conclusions: Critical illness MESHD among patients hospitalized with COVID-19 in New York City is common and associated with a high frequency of invasive mechanical ventilation, extra-pulmonary organ dysfunction, and substantial in-hospital mortality.

    Identification of risk factors for the severity of coronavirus disease MESHD 2019: a retrospective study of 163 hospitalized patients

    Authors: Ye Tu; Ping Yang; Jingjing Wang; Xuebi Tian; Kai Wang; Chaolong Wang; Ailin Luo; Feng Gao

    doi:10.21203/rs.3.rs-23867/v1 Date: 2020-04-20 Source: ResearchSquare

    Background: To compare clinical features between moderate and severe cases with COVID-19, and screen factors associated with disease severity.Methods: Demographic and clinical data were compared between moderate and severe cases. Logistic regression was performed for prognostic factors.Results: 163 patients (median age TRANS 65.0 (56.8-71.0) years, 78 (47.9%) females TRANS) were enrolled, including 87 (53.4%) severe and 76 (46.6%) moderate cases. 79 (90.8%) severe and 59 (77.6%) moderate cases had comorbidities, with hypertension HP hypertension MESHD and diabetes MESHD commonly presented. The most common symptoms were fever HP fever MESHD. Severe cases had higher lactate dehydrogenase (LDH), inflammatory cytokines and lymphopenia HP lymphopenia MESHD, eosinopenia on admission, and lower eosinophil and higher neutrophil counts from admission to day 13 and 19. Multivariable regression showed that neutrophilia HP, eosinopenia, high LDH and D-dimer were associated with severe COVID-19. In receiver operating characteristic curve analysis, LDH, eosinophil and neutrophil + eosinophil + LDH + D-dimer combination, with area under curve of 0.86, 0.76 and 0.93, predicted severe illness with high sensitivity SERO (82.8%, 83.3%, 88.0%) and specificity (68.4%, 84.2%, 81.3%).Conclusions: Eosinopenia, higher LDH and neutrophil + eosinophil + LDH + D-dimer combination on admission were powerful indicators of severe COVID-19. Dynamic changes of neutrophils and eosinophils may be used to evaluate disease progression.

    Clinical Characteristics of 208 Patients with COVID-19 in a Surrounding City of Wuhan, China

    Authors: Xin Chen; Peng Chen; Dodji Kossi Djakpo; Yan Lin; Rong Zhang; Zhiquan Wang

    doi:10.21203/rs.3.rs-23842/v1 Date: 2020-04-19 Source: ResearchSquare

    Background: Since December 2019, a severe novel coronavirus ( SARS-CoV-2) infection (Coronavirus Disease MESHD 2019,COVID-19) has occurred in Wuhan, China, and has rapidly spread to the country and around the world. This study intends to investigate the epidemiological and clinical characteristics of patients with COVID-19 in a surrounding city of Wuhan.Methods: A retrospective study was conducted on 208 cases of COVID -19 patients from February 11, 2020 to February 29, 2020 in Xiaogan dongnan Hospital, collected basic information, history of exposure, medical history, clinical symptoms, laboratory indicators and pulmonary imaging Data, and analyzed the epidemiological and clinical characteristics of all patients. According to the clinical classification criteria, 208 patients were divided into light group and ordinary group, and the epidemiological and clinical characteristics of the two groups were compared.Results: Among 208 patients in this study, with a median age TRANS of 50.5 years (IQR,36-64.7,range,10-91 years), among which 107 (51.4%) were males TRANS and 101 (48.6%) were females TRANS. 51 (24.5%) had a clear exposure to COVID-19 infection within 2 weeks before admission, and 40 (19.2%) had a history of residence or exposure in Wuhan within 2 weeks before admission. Among all the patients, there were 16 (7.7%) with pulmonary diseases MESHD, 41 (19.7%) with hypertension HP hypertension MESHD, 11 (5.3%) with coronary heart disease MESHD, 13 (6.3%) with diabetes MESHD, 12(5.8%) with a history of alcohol consumption, and 12(5.8%) with a history of smoking. Among all clinical symptoms, 146 cases (70.2%) of fever HP fever MESHD, the highest temperature range was 37.3℃-41℃ before admission, 115 (55.3%) cases of cough HP, and 57 (27.4%) cases of chest tightness HP chest tightness MESHD, 47 (22.6%) cases of fatigue HP fatigue MESHD, 28 (13.5%) cases of inappetence, 9 (4.3%) cases of diarrhea HP diarrhea MESHD, 7 (3.4%) cases of nasal congestion or runny nose , and 5 ( 2.4%) cases of pharyngalgia. Analysis of the laboratory results of 208 patients showed that 42 (20.2%) cases had decreased white blood SERO cell count, and 61 (29.3%) cases had decreased lymphocyte count. There were 154 (74%) cases with elevated CRP, 50 (24%) cases with elevated fasting blood SERO glucose, and 23 (11.1%) cases with elevated LDH (>245U/L). The comparison of clinical characteristics between the light group and the common group showed that the median age TRANS of the light group was 44.8 years (IQR 30-58), the median age TRANS of the common group was 53.1 years (IQR 38.8-67) (P<0.01). The symptoms of fever HP fever MESHD [53(80.3%) vs 93(65.5%),P<0.05], fatigue HP fatigue MESHD [53(80.3%) vs 93(65.5%),P<0.05] and inappetence [4(6.1%) vs 24(16.9%),P<0.05] in the light group were less than those in the common group. The white blood SERO cell count (5.48 vs 6.37, P<0.05), lymphocyte count (1.40 vs 1.61, P<0.05) and HDL-C (1.5 vs 1.3, P<0.05) of the common group were lower than that of the light group, while CRP (26.5 vs 22.1, P<0.01), AST (22.9 vs 18.5, P<0.05), fasting blood SERO glucose (5.8 vs 5.6, P<0.05), LDH (196.8 vs 157.9, P<0.001) of the common group were higher than that of the light group.Conclusion: COVID-19 infection is mainly in middle- aged TRANS and elderly TRANS patients, patients with other diseases MESHD are more susceptible to infection. The main symptoms of COVID-19 infection MESHD were fever HP fever MESHD, cough HP cough MESHD, chest tightness HP chest tightness MESHD, fatigue HP fatigue MESHD, and inappetence. Decreased lymphocyte count, increased CRP concentration, increased LDH concentration and decreased HDL-C concentration were the laboratory features of COVID-19 infection MESHD, and were important indicators to assess the severity of COVID-19 disease.

    Characteristics and outcomes of a cohort of SARS-CoV-2 patients in the Province of Reggio Emilia, Italy

    Authors: Paolo Giorgi Rossi; Massimiliano Marino; Debora Formisano; Francesco Venturelli; Massimo Vicentini; Roberto Grilli; - The Reggio Emilia COVID-19 Working Group

    doi:10.1101/2020.04.13.20063545 Date: 2020-04-16 Source: medRxiv

    Objectives. To describe the age TRANS- and sex-specific prevalence SERO of SARS-CoV-2 disease MESHD (COVID-19) and its prognostic factors. Design. Population-based prospective cohort study on archive data. Setting. Preventive services and hospital care in the province of Reggio Emilia, Northern Italy. Participants. All 2653 symptomatic patients who tested positive for SARS-CoV-2 from February 27 to April 2, 2020 in the province of Reggio Emilia. Main outcome measures. Hospitalization and death up to April 2, 2020. Results. Females TRANS had higher prevalence SERO of infection MESHD than males TRANS below age TRANS 50 (2.61 vs. 1.84 per 1000), but lower in older ages TRANS (16.49 vs. 20.86 per 1000 over age TRANS 80). Case fatality rate reached 20.7% (22/106) in cases with more than 4 weeks follow up. After adjusting for age TRANS and comorbidities, men had a higher risk of hospitalization (hazard ratio (HR) 1.4 95% confidence interval (95% CI) 1.2 to 1.6) and of death (HR 1.6, 95% CI 1.2 to 2.1). Patients over age TRANS 80 compared to < age TRANS 50 had HR 7.1 (95% CI 5.4 to 9.3) and HR 27.8 (95% CI 12.5 to 61.7) for hospitalization and death MESHD, respectively. Immigrants had a higher risk of hospitalization (HR 1.3, 95% CI 0.99 to 1.81) than Italians and a similar risk of death MESHD. Risk of hospitalization and of death MESHD were higher in patients with heart failure MESHD (HR 1.6, 95% CI 1.2 to 2.1and HR 2.3, 95% CI 1.6 to 3.2, respectively), arrhythmia HP arrhythmia MESHD (HR 1.5, 95% CI 1.2 to 1.9 and HR 1.8, 95% CI 1.3 to 2.5, respectively), dementia HP dementia MESHD (HR 1.2, 95% CI 0.9 to 1.8 and HR 1.8, 95% CI 1.1 to 2.8, respectively), ischemic MESHD heart disease MESHD (HR 1.3, 95% CI 1.0 to 1.7 and HR 1.7, 95% CI 1.2 to 2.5, respectively), diabetes MESHD (HR 1.5, 95% CI 1.3 to 1.9 and HR 1.6, 95% CI 1.1 to 2.2, respectively), and hypertensions HP hypertensions MESHD(HR 1.4, 95% CI 1.2 to 2.6 and HR 1.6, 95% CI 1.2 to 2.1, respectively), while COPD increased the risk of hospitalization (HR 1.9, 95% CI 1.4 to 2.5) but not of death MESHD (HR 1.1, 95% CI 0.7 to 1.7). Previous use of ACE inhibitors has no effect on risk of death (HR 0.97, 95% CI 0.69 to 1.34) Conclusions. The mechanisms underlying these associations are mostly unknown. A deeper understanding of the causal chain from infection MESHD, disease onset, and immune response to outcomes may explain how these prognostic factors act.

    Analysis of Risk Factors of Severe COVID-19 Patients

    Authors: Qin Yin; Zhen Fu; Jiao Xie; Jie Yang; Fengqin Li; Wangcai Zhu; Yihan Yu; Jixian Zhang

    doi:10.21203/rs.3.rs-23272/v1 Date: 2020-04-16 Source: ResearchSquare

    Objective: To explore relevant risk factors for severity of patients with novel coronavirus pneumonia MESHD pneumonia HP (COVID-19).Methods: The clinical data of 292 patients with COVID-19 admitted to Hubei Provincial Hospital of Integrated Chinese & Western Medicine from January 1, 2020 to February 29, 2020 were analyzed retrospectively. Patients were divided into mild or severe group according to the Guidance for Corona Virus Disease MESHD 2019 (7th version) released by the Chinese National Health Committee. The clinical data were collected at the time of admission, including demographics, clinicalcharacteristics, laboratory test results, imaging characteristics and outcome of treatment. We applied univariable and multivariable logistic regression methods to explore the risk factorsassociated with severity of the disease.Results: The median age TRANS of patients in the severe group((68.19 ± 12.51)years) was significantly older than mild group((54.14 ± 13.62)years). The male TRANS sex was more predominant in severe group (63.45%) than that of mild group (38.1%). There were more smokers (8.97% vs 1.36%) and drinkers (4.14% vs 0%) in severe group than that of mild group. Patients in the severe group had more underlying diseases. Hypertension HP Hypertension MESHD(48.97% vs 23.81%), coronary heart disease MESHD (22.07% vs 1.36%, P < 0.0001), chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD (6.21% vs 1.36%), malignant tumor MESHD (7.59% vs 2.04%) and chronic kidney disease HP chronic kidney disease MESHD (3.45% vs 0%) were more frequent in severe group than in mild group.The dyspnea HP dyspnea MESHD, chest tightness HP chest tightness MESHD and dry cough MESHD cough HP were more common in severe group (43.45%, 66.9% and 66.21%) than in mild group (23.13%, 44.22% and 53.74%). Abnormality of chest radiography were more frequent in the severe group, there were more ground glass opacities, consolidation of lung and white lung in the severe cases (88.97%, 44.07% and 46.21%) than in mild cases (78.91%, 19.05% and 2.04%). Patients in the severe group were more likely to receive methylprednisolone, oxygen therapy and mechanical ventilation. Lasso algorithm showed that age TRANS, C-reactive protein (CRP), creatine kinase (CK) and α-hydroxybutyrate dehydrogenase (α-HBDB) were the independent risk factors for severeCOVID-19, and CD4+T lymphocyte count was the protective factor.Conclusion: This large-scale retrospective study of 292 COVID-19 patients revealed that age TRANS, CRP, CK,α-HBDB and CD4+T lymphocyte were independent risk factors for severity of COVID-19. Identifying patients with risk factors at an early stage of the disease are helpful for outcome prediction and clinical management.

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Human Phenotype
Transmission
Seroprevalence


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