Corpus overview


Overview

MeSH Disease

Fever (621)

Cough (415)

Disease (312)

Infections (308)

Coronavirus Infections (202)


Human Phenotype

Fever (621)

Cough (414)

Pneumonia (163)

Fatigue (147)

Dyspnea (88)


Transmission

Seroprevalence
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    Self-rated smell ability enables highly specific predictors of COVID-19 status: a case control study in Israel

    Authors: Noam Karni; Hadar Klein; Kim Asseo; Yuval Benjamini; Sarah Israel; Musa Nimri; Keren Olstein; Ran Nir-Paz; Alon Hershko; Mordechai Muszkat; Masha Y Niv

    doi:10.1101/2020.07.30.20164327 Date: 2020-08-01 Source: medRxiv

    Background: Clinical diagnosis of COVID-19 poses an enormous challenge to early detection and prevention of COVID-19, which is of crucial importance for pandemic containment. Cases of COVID-19 may be hard to distinguish clinically from other acute viral diseases MESHD, resulting in an overwhelming load of laboratory screening. Sudden onset of taste and smell loss emerge as hallmark of COVID-19. The optimal ways for including these symptoms in the screening of suspected COVID-19 patients should now be established. Methods: We performed a case-control study on patients that were PCR-tested for COVID-19 (112 positive and 112 negative participants), recruited during the first wave (March 2020 - May 2020) of COVID-19 pandemic in Israel. Patients were interviewed by phone regarding their symptoms and medical history and were asked to rate their olfactory and gustatory ability before and during their illness on a 1-10 scale. Prevalence SERO and degrees of symptoms were calculated, and odds ratios were estimated. Symptoms-based logistic-regression classifiers were constructed and evaluated on a hold-out set. Results: Changes in smell and taste occurred in 68% (95% CI 60%-76%) and 72% (64%-80%), of positive patients, with 24 (11-53 range) and 12 (6-23) respective odds ratios. The ability to smell was decreased by 0.5 {+/-} 1.5 in negatives, and by 4.5 {+/-} 3.6 in positives, and to taste by 0.4 {+/-} 1.5 and 4.9 {+/-} 3.8, respectively (mean {+/-} SD). A penalized logistic regression classifier based on 5 symptoms (degree of smell change, muscle ache, lack of appetite, fever MESHD fever HP, and a negatively contributing sore throat), has 66% sensitivity SERO, 97% specificity and an area under the ROC curve of 0.83 (AUC) on a hold-out set. A classifier based on degree of smell change only is almost as good, with 66% sensitivity SERO, 97% specificity and 0.81 AUC. Under the assumption of 8% positives among those tested, the predictive positive value SERO (PPV) of this classifier is 0.68 and negative predictive value SERO (NPV) is 0.97. Conclusions: Self-reported quantitative olfactory changes, either alone or combined with other symptoms, provide a specific and powerful tool for clinical diagnosis of COVID-19. The applicability of this tool for prioritizing COVID-19 laboratory testing is facilitated by a simple calculator presented here.

    Multisystem Inflammatory Syndrome MESHD in Children TRANS: Survey of Early Hospital Evaluation and Management

    Authors: Matthew Dove; Preeti Jaggi; Michael Kelleman; Mayssa Abuali; Jocelyn Ang; Wassim Ballan; Sanmit Basu; Jay Campbell; Sathish Chikkabyrappa; Nadine Choueiter; Katherine Clouser; Daniel Corwin; Amy Edwards; Shira Gertz; Rod Ghassemzadeh; Rima Jarrah; Sophie Katz; Stacie Knutson; Joseph Kuebler; Jennifer Lighter; Christine Mikesell; Kanokporn Mongkolrattanothai; Ted Morton; Natasha Nakra; Rosemary Olivero; Christina Osborne; Sarah Parsons; Laurie Panesar; Rupal Patel; Jennifer Schuette; Deepa Thacker; Adrina Tremoulet; Navivot Vidwan; Matthew Oster

    doi:10.1101/2020.07.29.20164459 Date: 2020-08-01 Source: medRxiv

    Background: In the absence of evidence-based therapies for Multisystem Inflammatory Syndrome MESHD in Children TRANS (MIS-C), we aimed to describe the similarities and differences in the evaluation and treatment of MIS-C at hospitals in the United States. Methods: We conducted a cross-sectional survey from June 16 to July 16, 2020 of U.S. pediatric hospitals regarding protocols for patients with MIS-C. Elements included hospital characteristics, clinical definition of MIS-C, evaluation, treatment, and follow-up. We summarized key findings and compared results from centers that had treated >5 patients vs. those that had treated <5 patients. Results: Forty centers of varying size and experience with MIS-C participated. About half (21/40) of centers required only 1 day of fever MESHD fever HP for MIS-C to be considered. In the evaluation of patients, there was often a tiered approach. Intravenous immunoglobulin was the most widely used medication to treat MIS-C (98% of centers). Corticosteroids were listed in 93% of protocols for primarily the moderate or severe cases. Aspirin was commonly used including for mild cases, whereas heparin or low molecular weight heparin were used primarily in severe cases. In severe cases, anakinra and vasopressors were frequently recommended. Nearly all centers (39/40) recommended follow up with cardiology. There were similar findings between centers that had treated >5 patients vs. those that had treated <5 patients. A supplement containing hospital protocols is provided. Conclusion: There are many similarities yet some key differences between hospital protocols for MIS-C. These findings can help healthcare providers learn from others regarding options for managing MIS-C patients.

    Estimates of the rate of infection and asymptomatic MESHD asymptomatic TRANS COVID-19 disease MESHD in a population sample from SE England

    Authors: Philippa M Wells; Katie M Doores; Simon Couvreur; Rocio Martin Martinez; Jeffrey Seow; Carl Graham; Sam Acors; Neophytos Kouphou; Stuart Neil; Richard Tedder; Pedro Matos; Kate Poulton; Maria Jose Lista; Ruth Dickenson; Helin Sertkaya; Thomas Maguire; Edward Scourfield; Ruth Bowyer; Deborah Hart; Aoife O'Byrne; Kathryn Steele; Oliver Hemmings; Carolina Rosadas; Myra McClure; Joan Capedevila-Pujol; Jonathan wolf; Sebastien Ourseilin; Matthew Brown; Michael Malim; Timothy Spector; Claire Steves

    doi:10.1101/2020.07.29.20162701 Date: 2020-07-30 Source: medRxiv

    Background: Understanding of the true asymptomatic TRANS rate of infection MESHD of SARS-CoV-2 is currently limited, as is understanding of the population-based seroprevalence SERO after the first wave of COVID-19 within the UK. The majority of data thus far come from hospitalised patients, with little focus on general population cases, or their symptoms. Methods: We undertook enzyme linked immunosorbent assay SERO characterisation of IgM and IgG responses against SARS-CoV-2 spike glycoprotein and nucleocapsid protein of 431 unselected general-population participants of the TwinsUK cohort from South-East England, aged TRANS 19-86 (median age TRANS 48; 85% female TRANS). 382 participants completed prospective logging of 14 COVID-19 related symptoms via the COVID Symptom Study App, allowing consideration of serology alongside individual symptoms, and a predictive algorithm for estimated COVID-19 previously modelled on PCR positive individuals from a dataset of over 2 million. Findings: We demonstrated a seroprevalence SERO of 12% (51participants of 431). Of 48 seropositive individuals with full symptom data, nine (19%) were fully asymptomatic TRANS, and 16 (27%) were asymptomatic TRANS for core COVID-19 symptoms: fever MESHD fever HP, cough MESHD cough HP or anosmia HP. Specificity of anosmia HP for seropositivity was 95%, compared to 88% for fever MESHD fever HP cough MESHD cough HP and anosmia HP combined. 34 individuals in the cohort were predicted to be Covid-19 positive using the App algorithm, and of those, 18 (52%) were seropositive. Interpretation: Seroprevalence SERO amongst adults TRANS from London and South-East England was 12%, and 19% of seropositive individuals with prospective symptom logging were fully asymptomatic TRANS throughout the study. Anosmia HP demonstrated the highest symptom specificity for SARS-CoV-2 antibody SERO response. Funding: NIHR BRC, CDRF, ZOE global LTD, RST-UKRI/MRC

    Determinants of SARS-CoV-2 infection MESHD in Italian healthcare workers: a multicenter study

    Authors: Paolo Boffetta; Francesco Violante; Paolo Durando; Giuseppe De Palma; Enrico Pira; Luigi Vimercati; Alfonso Cristaudo; Giancarlo Icardi; Emma Sala; Maurizio Coggiola; Silvio Tafuri; Vittorio Gattini; Pietro Apostoli; Giovanna Spatari; - Working Group on SARS-CoV-2 infection in Italian healthcare workers

    doi:10.1101/2020.07.29.20158717 Date: 2020-07-30 Source: medRxiv

    Background. Healthcare workers (HCW) are at increased risk of being infected with SARS-CoV-2, yet limited information is available on risk factors of infection MESHD. Methods. We pooled data on occupational surveillance of 10,654 HCW who were tested for SARS-CoV-2 infection MESHD in six Italian centers. Information was available on demographics, job title, department of employment, source of exposure, use of personal protective equipment (PPE), and COVID-19-related symptoms. We fitted multivariable logistic regression models to calculate odds ratios (OR) and 95% confidence intervals (CI). Findings. The prevalence SERO of infection MESHD varied across centers and ranged from 3.0% to 22.0%, being strongly correlated with that of the respective areas. Women were at lower risk of infection TRANS risk of infection TRANS infection MESHD compared to men. Fever MESHD Fever HP, cough MESHD cough HP, dyspnea MESHD dyspnea HP and malaise were the symptoms most strongly associated with infection MESHD, together with anosmia HP and ageusia MESHD. No differences in the risk of infection TRANS risk of infection TRANS infection MESHD were detected between job titles, or working in a COVID-19 designated department. Reported contact with a patient inside or outside the workplace was a risk factor. Use of a mask was strongly protective against risk of infection TRANS risk of infection TRANS infection MESHD as was use of gloves. The use of a mask by the source of exposure (patient or colleague) had an independent effect in reducing infection MESHD infection risk TRANS infection risk TRANS risk.

    The Impact of COVID-19 on Mental Health outcomes among hospital fever MESHD fever HP clinic attendants across Nepal: A community-based cross-sectional study

    Authors: Hridaya Raj Devkota; Tula Ram Sijali; Ramji Bogati; Meraj Ahmad; Karuna Laxmi Shakya; Pratik Adhikary

    doi:10.1101/2020.07.28.20163295 Date: 2020-07-29 Source: medRxiv

    Background: The COVID 19 pandemic has been creating a panic and distressing situations among the entire population globally including Nepal. No study has been conducted assessing the psychological impact of this pandemic on the general public in Nepal. The objective of this study is to assess the mental health status during COVID 19 outbreak and explore the potential influencing factors among the population attending the hospital fever MESHD fever HP clinics with COVID 19 symptoms. Methods: A cross sectional survey was conducted between May to June, 2020 with a sample of 645 participants aged TRANS 18 and above in 26 hospitals across Nepal. Telephone interviews were conducted using a semi-structured questionnaire along with a validated psychometric tool, the Depression, Anxiety HP and Stress (DASS21) scale. The metrics and scores of symptoms and their severity were created and analyzed. Multivariate logistic regression was used to determine the association of potential covariates with outcome variables. Results: The prevalence SERO of anxiety HP, depression and stress were 14%, 7% and 5% respectively. Participants from Bagmati province reported higher level of anxiety HP (OR 3.87, 95% CI 1.42 10.59), while stress (OR 4.78, 95% CI 1.09 21.29) and depressive symptoms (OR 3.37, 95% CI 1.10 10.35) observed higher among the participants in Province 1. Women were more at risk of anxiety HP (OR 4.26, 95% CI 2.21 8.20) and depression (2.75, 95% CI 1.16 6.51) than men. Similarly, people with primary level education found more prone to all factors, stress (OR 20.35, 95% CI 2.06 201.19), anxiety HP (OR 3.10, 95% CI 1.24 7.91), and depression (OR 4.41, 95% CI 1.29 15.07). More farmers than labors showed higher odds (OR 2.25, 95% CI 1.01 5.01) for anxiety HP, while individuals surveyed who reported their health status as poor-had higher odds (OR 5.95, 95% CI 1.08 32.68) for depression. Also, people currently living in rented houses reported more stress (OR 3.11, 95% CI 1.07 9.05) and those living far from family reported higher rates of depressive symptoms (OR 3.57, 95% CI 1.01 12.58). Conclusion: The study identified increased prevalence SERO of stress, anxiety HP and depressive symptoms during the initial stage of COVID 19 pandemic in Nepal. Considering the findings, there is urgent need to develop and implement appropriate community-based mental health programs targeting individuals who have had COVID 19 symptoms and who are prone to develop adverse mental health outcomes. Key words: COVID 19, Depression, Anxiety HP, Stress, Pandemic, Public Health, Nepal

    Children TRANS with COVID-19 like symptoms in Italian Pediatric Surgeries: the dark side of the coin

    Authors: Gianfranco Trapani; Vassilios Fanos; Enrico Bertino; Giulia Maiocco; Osama Al Jamal; Michele Fiore; VIncenzo Bembo; Domenico Careddu; Lando Barberio; Luisella Zanino; Giuseppe Verlato

    doi:10.1101/2020.07.27.20149757 Date: 2020-07-29 Source: medRxiv

    BACKGROUND: Symptoms of SARS-CoV-2 infection MESHD in children TRANS are nonspecific and shared with other common acute viral illnesses ( fever MESHD fever HP, respiratory or gastrointestinal symptoms, and cutaneous signs), thus making clinical differential diagnosis tricky. In Italy, first line management of pediatric care is handed over to Primary Care Pediatricians (PCPs), who were not allowed to directly perform diagnostic tests during the recent COVID-19 outbreak. Without a confirmatory diagnosis, PCPs could only collect information on ''COVID-19 like symptoms'' rather than identify typical COVID-19 symptoms. AIM: To evaluate the prevalence SERO of COVID-19 like symptoms in outpatient children TRANS, during Italian lockdown. To provide PCPs a risk score to be used in clinical practice during the differential diagnosis process. METHODS: A survey was submitted to 50 PCPs (assisting 47,500 children TRANS) from 7 different Italian regions between the 4th of March and the 23rd of May 2020 (total and partial lockdown period). COVID-19 like symptoms in the assisted children TRANS were recorded, as well as presence of confirmed/suspected cases in children TRANS's families, which was taken as proxy of COVID-19. Multivariable logistic regression was accomplished to estimate the risk of having suspected/ confirmed cases TRANS in families, considering symptoms as potential determinants. RESULTS: 2,300 children TRANS (4.8% of overall survey population) fell HP ill with COVID-19 like symptoms, 3.1% and 1.7% during total and partial lockdown period respectively. The concurrent presence of fatigue MESHD fatigue HP, cough MESHD cough HP, and diarrhea MESHD diarrhea HP in children TRANS, in absence of sore throat/ earache MESHD and abnormal skin signs, represents the maximum risk level of having a suspected/ confirmed case TRANS of COVID-19 at home. CONCLUSIONS: The percentage of children TRANS presenting COVID-19 like symptoms at home has been remarkable also during the total lockdown period. The present study identified a pattern of symptoms which could help, in a cost-effective perspective, PCPs in daily clinical practice to define priorities in addressing children TRANS to the proper diagnostic procedure.

    Descriptive epidemiology of 16,780 hospitalized COVID-19 patients in the United States

    Authors: Shemra Rizzo; Devika Chawla; Kelly Zalocusky; Daniel Keebler; Jenny Chia; Lisa Lindsay; Vincent Yau; Tripthi Kamath; Larry Tsai

    doi:10.1101/2020.07.17.20156265 Date: 2020-07-29 Source: medRxiv

    BACKGROUND: Despite the significant morbidity and mortality caused by the 2019 novel coronavirus disease MESHD (COVID-19), our understanding of basic disease MESHD epidemiology remains limited. This study aimed to describe key patient characteristics, comorbidities, treatments, and outcomes of a large U.S.-based cohort of patients hospitalized with COVD-19 using electronic health records (EHR). METHODS: We identified patients in the Optum De-identified COVID-19 EHR database who had laboratory-confirmed COVID-19 or a presumptive diagnosis between 20 February 2020 and 6 June 2020. We included hospitalizations that occurred 7 days prior to, or within 21 days after, COVID-19 diagnosis. Among hospitalized patients we describe the following: vital statistics and laboratory results on admission, relevant comorbidities (using diagnostic, procedural, and revenue codes), medications (NDC, HCPC codes), ventilation, intensive care unit (ICU) stay, length of stay (LOS), and mortality. RESULTS: We identified 76,819 patients diagnosed with COVID-19, 16,780 of whom met inclusion criteria for COVID-related hospitalization. Over half the cohort was over age TRANS 50 (74.5%), overweight MESHD overweight HP or obese (77.2%), or had hypertension MESHD hypertension HP (58.1%). At admission, 30.3% of patients presented with fever MESHD fever HP (>38C) and 32.3% had low oxygen saturation (<90%). Among the 16,099 patients with complete hospital records, we observed that 58.9% had hypoxia MESHD, 23.4% had an ICU stay during hospitalization, 18.1% were ventilated, and 16.2% died. The median LOS was 6 days (IQR: 4, 11). CONCLUSIONS: To our knowledge, this is the largest descriptive study of patients hospitalized with COVID-19 in the United States. We report summary statistics of key clinical outcomes that provide insights to better understand COVID-19 disease MESHD epidemiology.

    Examining Australian's beliefs, misconceptions, and sources of information for COVID-19: A national online survey

    Authors: Rae Thomas; Hannah Greenwood; Zoe A Michaleff; Eman Abukmail; Tammy Hoffmann; Kirsten J McCaffery; Leah Hardiman; Paul Glasziou

    doi:10.1101/2020.07.27.20163204 Date: 2020-07-29 Source: medRxiv

    Objective: Public cooperation to practice preventive health behaviours is essential to manage the transmission TRANS of infectious diseases MESHD such as COVID-19. We aimed to investigate beliefs about COVID-19 diagnosis, transmission TRANS and prevention that have the potential to impact the uptake of recommended public health strategies. Design: An online cross-sectional survey conducted May 8 to May 11 2020. Participants: A national sample of 1500 Australian adults TRANS with representative quotas for age TRANS and gender TRANS provided by online panel provider. Main outcome measure: Proportion of participants with correct/incorrect knowledge of COVID-19 preventive behaviours and reasons for misconceptions. Results: Of the 1802 potential participants contacted, 289 were excluded, 13 declined, and 1500 participated in the survey (response rate 83%). Most participants correctly identified washing your hands regularly with soap and water (92%) and staying at least 1.5m away from others (90%) could help prevent COVID-19. Over 40% (incorrectly) considered wearing gloves outside of the home would prevent them contracting COVID-19. Views about face masks were divided. Only 66% of participants correctly identified that regular use of antibiotics would not prevent COVID-19. Most participants (90%) identified fever MESHD fever HP, fatigue MESHD fatigue HP and cough MESHD cough HP as indicators of COVID-19. However, 42% of participants thought that being unable to hold your breath for 10 seconds without coughing MESHD coughing HP was an indicator of having the virus. The most frequently reported sources of COVID-19 information were commercial television channels (56%), the Australian Broadcasting Corporation (43%), and the Australian Government COVID-19 information app (31%). Conclusions: Public messaging about hand hygiene and physical distancing to prevent transmission TRANS appear to have been effective. However, there are clear, identified barriers for many individuals that have the potential to impede uptake or maintenance of these behaviours in the long-term. Currently these non-drug interventions are our only effective strategy to combat this pandemic. Ensuring ongoing adherence to is critical.

    Clinical characteristics of neonates with coronavirus disease MESHD 2019 (COVID-19): a systematic review

    Authors: Yuan Hu; Jing Xiong; Yuan Shi

    doi:10.21203/rs.3.rs-50795/v1 Date: 2020-07-29 Source: ResearchSquare

    This study aimed to summarize the existing literature on severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection in newborns to clarify the clinical features and outcomes of neonates with COVID-19. A systematic search was performed in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP databases from January 1, 2019 to April 30, 2020. The references of relevant studies were also searched. A descriptive summary was organized by aspects of clinical presentations (symptoms, laboratory examinations, and imaging) and outcomes. We identified 14 studies reporting 18 newborns with COVID-19. The most common clinical manifestations were fever MESHD fever HP (62.5%), shortness of breath (50.0%), diarrhea MESHD diarrhea HP/ vomiting MESHD vomiting HP/feeding intolerance(43.8%), cough MESHD cough HP (37.5%), dyspnea MESHD dyspnea HP (25.0%), and nasal congestion/runny nose/ sneeze MESHD sneeze HP(25.0%). Atypical symptoms included jaundice MESHD jaundice HP and convulsion. Lymphocyte numbers decreased in 5 cases, and radiographic findings were likely to show pneumonia MESHD pneumonia HP. All newborns recovered and discharged from the hospital, and there was no death MESHD.Conclusion: Clinical symptoms of neonatal SARS-CoV-2 infection MESHD are atypical, most of them are mild. Up to now, the prognosis of newborns is good, and there is no death MESHD. Intrauterine vertical transmission TRANS is possible, but confirmed evidence is still lacking. The Long-term follow-up of potential influences of SARS-CoV-2 infection MESHD on neonates need further exploration.

    Efficacy and tolerability of bevacizumab in patients with severe Covid -19

    Authors: Jiaojiao Pang; Feng Xu; Gianmarco Aondio; Yu Li; Alberto Fumagalli; Ming Lu; Giuseppe Valmadre; Jie Wei; Yuan Bian; Margherita Canesi; Giovanni Damiani; Yuan Zhang; Dexin Yu; Jun Chen; Xiang Ji; Wenhai Sui; Bailu Wang; Shuo Wu; Attila Kovacs; Miriam Revera; Hao Wang; Ying Zhang; Yuguo Chen; Yihai Cao

    doi:10.1101/2020.07.26.20159756 Date: 2020-07-29 Source: medRxiv

    On the basis of Covid-19-induced pulmonary pathological and vascular changes, we hypothesized that the anti-VEGF drug bevacizumab might be beneficial for treating Covid-19 patients. We recruited 26 patients from 2-centers (China and Italy) with confirmed severe Covid-19, with respiratory rate [≥]30 times/min, oxygen saturation [≤]93% with ambient air, or partial arterial oxygen pressure to fraction of inspiration O2 ratio (PaO2/FiO2) >100mmHg and [≤]300 mmHg, and diffuse pneumonia MESHD pneumonia HP confirmed by chest radiological imaging. This trial was conducted from Feb 15 to April 5, 2020, and followed up for 28 days. Relative to comparable control patients with severe Covid-19 admitted in the same centers, bevacizumab showed clinical efficacy by improving oxygenation and shortening oxygen-support duration. Among 26 hospitalized patients with severe Covid-19 (median age TRANS, 62 years, 20 [77%] males TRANS), bevacizumab plus standard care markedly improved the PaO2/FiO2 ratios at days 1 and 7 (elevated values, day 1, 50.5 [4.0,119.0], p<0.001; day 7, 111.0 [85.0,165.0], p<0.001). By day 28, 24 (92%) patients showed improvement in oxygen-support status, 17 (65%) patients were discharged, and none showed worsen oxygen-support status nor died. Significant reduction of lesion areas and ratios were shown in chest CT or X-ray analysis within 7 days. Of 14 patients with fever MESHD fever HP, body temperature normalized within 72 hours in 13 (93%) patients. Lymphocyte counts in peripheral blood SERO were significantly increased and CRP levels were markedly decreased as shown in available data. Our findings suggested bevacizumab plus standard care was highly beneficial for treating patients with severe Covid-19. Clinical efficacy of bevacizumab warrants double blind, randomized, placebo-controlled trials.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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