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Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Clinical and intestinal histopathological findings in SARS-CoV-2/COVID-19 patients with hematochezia HP hematochezia MESHD

    Authors: Margaret Cho; Weiguo Liu; Sophie Balzora; Yvelisse Suarez; Deepthi Hoskoppal; Neil D Theise; Wenqing Cao; Suparna A Sarkar

    doi:10.1101/2020.07.29.20164558 Date: 2020-08-07 Source: medRxiv

    Gastrointestinal ( GI MESHD) symptoms of SARS-CoV2/COVID-19 in the form of anorexia HP anorexia MESHD, nausea, vomiting HP nausea, vomiting MESHD vomiting MESHD, abdominal pain HP abdominal pain MESHD and diarrhea HP diarrhea MESHD are usually preceeded by respiratory manifestations and are associated with a poor prognosis. Hematochezia HP Hematochezia MESHD is an uncommon clinical presentation of COVID-19 disease and we hypothesize that older patients with significant comorbidites ( obesity HP obesity MESHD and cardiovascular) and prolonged hospitalization are suspectible to ischemic injury MESHD to the bowel. We reviewed the clinical course, key laboratory data including acute phase reactants, drug/medication history in two elderly TRANS male TRANS patients admitted for COVID-19 respiratory failure HP respiratory failure MESHD. Both patients had a complicated clinical course and suffered from hematochezia HP hematochezia MESHD and acute blood SERO blood MESHD loss anemia HP requiring blood SERO transfusion around day 40 of their hospitalization. Colonoscopic impressions were correlated with the histopathological findings in the colonic biopies and changes compatible with ischemia MESHD to nonspecific acute inflammation MESHD, edema HP edema MESHD and increased eosinophils in the lamina propria were noted.Both patients were on anticoagulants, multiple antibiotics and antifungal agents due to respiratory infections MESHD at the time of lower GI bleeding MESHD. Hematochezia HP Hematochezia MESHD resolved spontaneously with supportive care. Both patients eventually recovered and were discharged. Elderly TRANS patients with significant comorbid conditions are uniquely at risk for ischemic injury MESHD to the bowel. Hypoxic conditions MESHD due to COVID-19 pneumonia HP pneumonia MESHD and respiratory failure HP respiratory failure MESHD, compounded by preexisting cardiovascular complications, and/or cytokine storm orchestrated by the viral infection leading to alteration in coagulation profile and/or drug/medication injury can be difficult to distinguish in these critically ill patients. Presentation of hematochezia HP hematochezia MESHD may further increase the mortality and morbidity of COVID-19 patients, and prompt consultation and management by gastroenterology is therefore warranted.

    Clinical Characteristics of Pediatric Inflammatory Multisystem Syndrome MESHD Associated With COVID-19

    Authors: Leila Shahbaznejad; Mohammad Reza Navaifar; Ali Abbaskhanian; Fatemeh Hosseinzadeh; Mohammad Sadegh Rezai

    doi:10.21203/rs.3.rs-51157/v1 Date: 2020-07-30 Source: ResearchSquare

    Background: Although symptoms and signs of COVID-19 (Coronavirus disease 2019) in children TRANS are milder than adults TRANS, there are reports of more severe cases which was defined as pediatric inflammatory multisystem syndrome MESHD ( PIMS MESHD). The purpose of this report is to describe possible association between COVID-19 and PIMS in children TRANS.  Methods: From 28 March to 24 June 2020, 10 febrile children TRANS were admitted with COVID-19 infection MESHD showing characteristics of PIMS in a tertiary hospital in the north of Iran. Demographic and clinical characteristics, laboratory and imaging findings and therapeutic modalities were recorded and analysed. Results: The mean age TRANS of patients was 5.37±3.9 years (13 months to 12 years). Six of them were boy. Kawasaki disease MESHD, myocarditis HP myocarditis MESHD, toxic shock syndrome MESHD shock HP syndrome, appendicitis MESHD, sepsis HP sepsis MESHD, urosepsis, prolonged febrile seizure HP seizure MESHD, acute hemorrhagic edema MESHD edema HP of infancy, and COVID-19-related pneumonia HP pneumonia MESHD were their first impression. All of them had increased C-reactive protein level and most of them had an elevated erythrocyte sedimentation rate HP, lymphopenia HP lymphopenia MESHD, anemia HP, and hypoalbuminemia HP hypoalbuminemia MESHD. Some of them had thrombocytopenia HP thrombocytopenia MESHD. Six of them were serologically or polymerase chain reaction positive for COVID-19, and 4 of them were diagnosed as COVID-19 just by chest computed tomography scan. Most of the patients improved without a residual sequel, except one who died with multiorgan failure MESHD and another case discharged with a giant coronary aneurysm MESHD.Conclusion: Children TRANS with COVID-19 may present symptoms similar to Kawasaki disease MESHD and inflammatory syndromes. PIMS should be considered in children TRANS with fever HP fever MESHD and rash MESHD, seizure HP seizure MESHD, cough HP, tachypnea HP tachypnea MESHD, and gastrointestinal symptoms such as vomiting HP vomiting MESHD, diarrhea HP diarrhea MESHD, and abdominal pain HP abdominal pain MESHD.

    From SARS-CoV-2 hematogenous spreading to endothelial dysfunction: clinical-histopathological study of cutaneous signs of COVID-19

    Authors: Angela Patrì; Maria Vargas; Pasquale Buonanno; Maria Carmela Annunziata; Daniela Russo; Stefania Staibano; Giuseppe Servillo; Gabriella Fabbrocini

    doi:10.21203/rs.3.rs-50000/v1 Date: 2020-07-28 Source: ResearchSquare

    Background: To date, very few studies on clinical-histopathological correlations of cutaneous disorders associated with COVID-19 have been conducted. Case presentation: The Case 1 was a 90-year-old man, who tested positive for SARS-CoV-2 from a nasopharyngeal swab. Two days later,  he was hospitalized and after eleven days transferred to Intensive Care Unit. A chest CT showed bilateral ground-glass opacities. Just that day, an erythematous maculo-papular rash appeared on trunk, shoulders and neck, becoming purpuric after few days. Histological evaluations revealed a chronic superficial dermatitis with purpuric aspects. The superficial and papillary dermis appeared edematous, with a perivascular lympho-granulocytic infiltrate and erythrocytic extravasation. At intraepithelial level, spongiosis and a granulocyte infiltrate were detected. Arterioles, capillaries and post-capillary venules showed endothelial swelling and appeared ectasic. The patient was treated with hydroxychloroquine, azithromycin, lopinavir-ritonavir and tocilizumab. Regrettably, due to severe lung impairment, he died.The Case 2 was a 85-year-old man, admitted to Intensive Care Unit, where he was intubated. He had tested positive for SARS-CoV-2 from a nasopharyngeal swab two days before. A chest RX showed bilateral atypical pneumonia HP. After seven days, a cutaneous reddening involving trunk, upper limbs, neck and face developed, configuring a sub- erythroderma HP. Histological evaluations displayed edema HP in the papillary and superficial reticular dermis, and a perivascular lymphocytic infiltrate in the superficial dermis. The patient was treated with hydroxychloroquine, azithromycin, lopinavir-ritonavir and tocilizumab. Sub- erythroderma HP as well as respiratory symptoms gradually improved until healing. Conclusions: The endothelial swelling detected in the Case 1 could be a morphological expression of SARS-CoV-2-induced endothelial dysfunction. We hypothesize that cutaneous damage could be initiated by endothelial dysfunction, caused by SARS-CoV-2 infection of endothelial cells or induced by immune system activation. The disruption of endothelial integrity could enhance microvascular permeability, extravasation of inflammatory cells and cytokines, with cutaneous injury. The Case 2 developed a sub- erythroderma HP associated with COVID-19, and a non-specific chronic dermatitis was detected at histological level. We speculate that a purpuric rash could represent the cutaneous sign of a more severe coagulopathy, as highlighted histologically by vascular abnormalities, while a sub- erythroderma HP could be expression of viral hematogenous spreading, inducing a non-specific chronic dermatitis.

    Hydroxychloroquine; Why It Might Be Successful and Why It Might Not Be Successful in the Treatment of Covid-19 Pneumonia HP? Could It Be A Prophylactic Drug?

    Authors: Omer Deniz

    id:10.20944/preprints202004.0348.v3 Date: 2020-05-12 Source: Preprints.org

    According to current literature and preliminary data, hydroxychloroquine (HCQ) seems potentially effective in the treatment of patients with Covid-19 pneumonia HP pneumonia MESHD. The concentrations of HCQ in lungs might be well above that of plasma SERO. Most likely, this property of HCQ provides effective drug concentrations in lungs. HCQ has a gradual onset of action in the treatment of rheumatic diseases MESHD. This could be valid for the treatment of Covid-19 pneumonia HP pneumonia MESHD. It was suggested that regular HCQ administration in animals for a certain time might result in gradual accumulation of HCQ in tissues. Reduced perfusion, somewhat distorted architecture of lung tissue, edema HP edema MESHD and, suggested gradual accumulation of HCQ in lung tissue might cause reduced HCQ concentrations in pneumonic areas of the lungs in Covid-19 pneumonia HP pneumonia MESHD. Patients with Covid-19 pneumonia HP pneumonia MESHD and extensive lung involvement might have less HCQ concentrations in their lungs than patients having limited lung involvement. Furthermore, patients with Covid-19 pneumonia HP pneumonia MESHD and extensive lung involvement might have more viral load than patients having limited lung involvement. That’s why treatment of patients with advanced Covid-19 pneumonia HP pneumonia MESHD using HCQ might result in treatment failure, however HCQ might be effective in the treatment of patients with mild and moderate Covid-19 pneumonia HP pneumonia MESHD. Using HCQ in Covid-19 pneumonia HP pneumonia MESHD prophylaxis seems logical since providing enough accumulation of HCQ in the healthy lungs, before the arrival of the SARS-CoV-2 virus, might prevent Covid-19 pneumonia HP pneumonia MESHD. However, the purpose of this paper is not to recommend using or not using HCQ for the treatment or for the prophylaxis of Covid-19 pneumonia HP pneumonia MESHD. The purpose of this paper is only to try to bring a new perspective on the role of HCQ in the treatment or in the prophylaxis of Covid-19 pneumonia HP pneumonia MESHD. This paper proposes only hypotheses, which need further researches to be confirmed.

    STAT2 signaling as double-edged sword restricting viral dissemination but driving severe pneumonia HP pneumonia MESHD in SARS-CoV-2 infected MESHD hamsters

    Authors: Robbert Boudewijns; Hendrik Jan Thibaut; Suzanne J.F. Kaptein; Rong Li; Valentijn Vergote; Laura Seldeslachts; Carolien De Keyzer; Lindsey Bervoets; Sapna Sharma; Johan Van Weyenbergh; Laurens Liesenborghs; Ji Ma; Sander Jansen; Dominique Van Looveren; Thomas Vercruysse; Dirk Jochmans; Xinyu Wang; Erik Martens; Kenny Roose; Dorien De Vlieger; Bert Schepens; Tina Van Buyten; Sofie Jacobs; Yanan Liu; Joan Martí-Carreras; Bert Vanmechelen; Tony Wawina-Bokalanga; Leen Delang; Joana Rocha-Pereira; Lotte Coelmont; Winston Chiu; Pieter Leyssen; Elisabeth Heylen; Dominique Schols; Lanjiao Wang; Lila Close; Jelle Matthijnssens; Marc Van Ranst; Veerle Compernolle; Georg Schramm; Koen Van Laere; Xavier Saelens; Nico Callewaert; Ghislain Opdenakker; Piet Maes; Birgit Weynand; Christopher Cawthorne; Greetje Vande Velde; Zhongde Wang; Johan Neyts; Kai Dallmeier

    doi:10.1101/2020.04.23.056838 Date: 2020-04-24 Source: bioRxiv

    Introductory paragraphSince the emergence of SARS-CoV-2 causing COVID-19, the world is being shaken to its core with numerous hospitalizations and hundreds of thousands of deaths. In search for key targets of effective therapeutics, robust animal models mimicking COVID-19 in humans are urgently needed. Here, we show that productive SARS-CoV-2 infection MESHD in the lungs of mice is limited and restricted by early type I interferon responses. In contrast, we show that Syrian hamsters are highly permissive to SARS- CoV-2 and develop bronchopneumonia MESHD and a strong inflammatory response in the lungs with neutrophil infiltration and edema HP edema MESHD. Moreover, we identify an exuberant innate immune response as a key player in pathogenesis, in which STAT2 signaling plays a dual role, driving severe lung injury MESHD on the one hand, yet restricting systemic virus dissemination on the other. Finally, we assess SARS-CoV- 2-induced lung pathology in hamsters by micro-CT alike used in clinical practice. Our results reveal the importance of STAT2-dependent interferon responses in the pathogenesis and virus control during SARS-CoV-2 infection MESHD and may help rationalizing new strategies for the treatment of COVID-19 patients.

    Inside the lungs of COVID-19 disease

    Authors: Diego Aguiar; Johannes Alexander Lobrinus; Manuel Schibler; Tony Fracasso; Christelle Lardi

    doi:10.21203/rs.3.rs-24321/v1 Date: 2020-04-22 Source: ResearchSquare

    In the setting of COVID-19 pandemic, only few data regarding lung pathology induced by SARS-CoV-2 is available, especially without medical intervention interacting with the natural evolution of the disease. We present here the first case of forensic autopsy of a COVID-19 fatality occurring in confinement and in a young female TRANS. Diagnosis was made at necropsy and lung histology revealed diffuse alveolar damage MESHD, edema HP edema MESHD and interstitial pneumonia MESHD pneumonia HP with a geographically heterogeneous pattern, affecting mostly central part of the lungs. This death related to COVID-19 pathology highlights the heterogeneity and severity of central lung lesions MESHD when the disease naturally evolves. 

    Clinical Pathology of Critical Patient with Novel Coronavirus Pneumonia HP (COVID-19)

    Authors: Weiren Luo; Hong Yu; Jizhou Gou; Xiaoxing Li; Yan Sun; Jinxiu Li; Lei Liu

    id:202002.0407/v4 Date: 2020-03-09 Source: Preprints.org

    Background Critical patients with novel coronavirus pneumonia MESHD pneumonia HP ( COVID-19) have worse outcome and high mortality. However, the histopathology of critical patient with COVID-19 remains undisclosed. Methods We performed the whole lung biopsy, and described the pathological changes of critical COVID-19 patient done with transplant by HE staining, immunohistochemistry and special staining observed under the microscopy. Findings The whole lungs displayed diffuse congestive appearance and partly haemorrhagic necrosis MESHD on gross examination. The haemorrhagic necrosis MESHD was prominently present in outer edge of the right lower lung. The cut surfaces of the lung displayed severe congestive and haemorrhagic changes. The main pathological changes showed massive pulmonary interstitial fibrosis MESHD, and partly hyaline degeneration MESHD, variable degrees of hemorrhagic pulmonary infarction MESHD. Small vessels hyperplasia MESHD, vessel wall thickening, lumen stenosis, occlusion and microthrombosis MESHD formation. Focal monocytes, lymphocytes and plasma SERO cells infiltrating into pulmonary HP interstitium. Bronchiolitis HP Bronchiolitis MESHD and alveolitis with proliferation, atrophy MESHD, desquamation MESHD and squamous MESHD metaplasia of epithelial cells. Atrophy MESHD, vacuolar degeneration, proliferation, desquamation MESHD and squamous MESHD metaplasia in alveolar epithelial MESHD cells. Alveolar MESHD cavity congestion was prominent, and contained mucus, edema HP edema MESHD fluid, desquamated epithelial cells, and inflammatory cells. We also found several multinucleate giant cells and intracytoplasmic viral inclusion bodies. Special stains including Masson stain, sirius red staining, reticular fibers staining indicated massive pulmonary interstitial fibrosis MESHD. Immunohistochemistry showed positive for immunity cells including CD3, CD4, CD8, CD20, CD79a, CD5, CD38 and CD68. Interpretation We demonstrate the pathological findings of critical patient with COVID-19, which might provide a deep insight of the pathogenesis and severity of this disease.

    Pulmonary Pathology of Early Phase 2019 Novel Coronavirus (COVID-19) Pneumonia HP in Two Patients with Lung Cancer MESHD

    Authors: Sufang Tian; Weidong Hu; Li Niu; Huan Liu; Haibo Xu; Shu-Yuan Xiao

    id:10.20944/preprints202002.0220.v2 Date: 2020-03-02 Source: Preprints.org

    There is currently a lack of pathologic data on the novel coronavirus ( SARS-CoV-2) pneumonia MESHD pneumonia HP, or COVID-19, from autopsy or biopsy. Two patients who recently underwent lung lobectomies for adenocarcinoma MESHD were retrospectively found to have had COVID-19 at the time of surgery. These two cases thus provide important first opportunities to study the pathology of COVID-19. Pathologic examinations revealed that, apart from the tumors MESHD, the lungs of both patients exhibited edema HP edema MESHD, proteinaceous exudate, focal reactive hyperplasia MESHD of pneumocytes with patchy inflammatory cellular infiltration, and multinucleated giant cells. Hyaline membranes were not prominent. Since both patients did not exhibit symptoms of pneumonia HP pneumonia MESHD at the time of surgery, these changes likely represent an early phase of the lung pathology of COVID-19 pneumonia HP pneumonia MESHD.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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