Corpus overview


MeSH Disease

Human Phenotype


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    Identifying COVID-19 cases in primary TRANS care settings

    Authors: Yinan Mao; Yi-Roe Tan; Tun-Linn Thein; Louis Chai; Alex Cook; Borame Dickens; Yii-Jen Lew; Fong Seng Lim; Jue Tao Lim; Yinxiaohe Sun; Meena Sundaram; Alexius Soh; Glorijoy Tan; Franco Wong; Barnaby Young; Kangwei Zeng; Mark Chen; Desmond Ong; Zhong Ni; Baoyu Chen; Chunping Du; Hongchen He; Yun Qu; Quan Wei; Chengqi He; Jan D. Reinhardt

    doi:10.1101/2020.08.26.20182204 Date: 2020-09-01 Source: medRxiv

    Case identification is an ongoing issue for the COVID-19 epidemic, in particular for outpatient care where physicians must decide which patients to prioritise for further testing. This paper reports tools to classify patients based on symptom profiles based on 236 SARS-CoV-2 positive cases and 564 controls, accounting for the time course of illness at point of assessment. Clinical differentiators of cases and controls were used to derive model-based risk scores. Significant symptoms included abdominal pain HP abdominal pain MESHD, cough HP, diarrhea HP diarrhea MESHD, fever HP fever MESHD, headache HP headache MESHD, muscle ache MESHD, runny nose, sore throat, temperature between 37.5{degrees}C and 37.9{degrees}C, and temperature above 38{degrees}C, but their importance varied by day of illness at assessment. With a high percentile threshold for specificity at 0.95, the baseline model had reasonable sensitivity SERO at 0.67. To further evaluate accuracy of model predictions, we firstly used leave-one-out cross-validation, which confirmed high classification accuracy with an area under the receiver operating characteristic curve of 0.92. For the baseline model, sensitivity SERO decreased to 0.56. Secondly, in a separate ongoing prospective study of 237 COVID-19 and 346 primary care patients presenting with symptoms of acute respiratory infection MESHD, the baseline model had a sensitivity SERO of 0.57 and specificity of 0.89, and in retrospective notes review of 100 COVID-19 cases diagnosed in primary care, sensitivity SERO was 0.56. A web-app based tool has been developed for easy implementation as an adjunct to laboratory testing to differentiate COVID-19 positive cases among patients presenting in outpatient settings.

    Proposed Clinical Indicators for Efficient Screening and Testing for COVID-19 Infection from Classification and Regression Trees (CART) Analysis

    Authors: Richard K Zimmerman; Mary Patricia Nowalk; Todd Bear; Rachel Taber; Theresa M Sax; Heather Eng; Goundappa K Balasubramani

    doi:10.1101/2020.05.11.20097980 Date: 2020-05-14 Source: medRxiv

    Background: The introduction and rapid transmission TRANS of SARS CoV2 in the United States resulted in implementation of methods to assess, mitigate and contain the resulting COVID-19 disease based on limited knowledge. Screening for testing has been based on symptoms typically observed in inpatients, yet outpatient symptom complexes may differ. Methods: Classification and regression trees (CART) recursive partitioning created a decision tree classifying enrollees into laboratory- confirmed cases TRANS and non-cases. Demographic and symptom data from patients ages TRANS 18-87 years who were enrolled from March 29-April 26, 2020 were included. Presence or absence of SARSCoV2 was the target variable. Results: Of 736 tested, 55 were positive for SARS-CoV2. Cases significantly more often reported chills HP, loss of taste/smell, diarrhea HP diarrhea MESHD, fever HP fever MESHD, nausea/vomiting HP nausea/vomiting MESHD and contact with a COVID-19 case, but less frequently reported shortness of breath MESHD and sore throat. A 7-terminal node tree with a sensitivity SERO of 96% and specificity of 53%, and an AUC of 78% was developed. The positive predictive value SERO for this tree was 14% while the negative predictive value SERO was 99%. Almost half (44%) of the participants could be ruled out as likely non-cases without testing. Discussion: Among those referred for testing, negative responses to three questions could classify about half of tested persons with low risk for SARS-CoV2 and would save limited testing resources. These questions are: was the patient in contact with a COVID-19 case? Has the patient experienced 1) a loss of taste or smell; or 2) nausea or vomiting HP nausea or vomiting MESHD vomiting MESHD? The outpatient symptoms of COVID-19 appear to be broader than the well-known inpatient syndrome.

    Clinical Characteristics of 34 Children TRANS with Coronavirus Disease MESHD-2019 in the West of China: a Multiple-center Case Series

    Authors: Che Zhang; Jiaowei Gu; Quanjing Chen; Na Deng; Jingfeng Li; Li Huang; Xihui Zhou

    doi:10.1101/2020.03.12.20034686 Date: 2020-03-16 Source: medRxiv

    BACKGROUND Up to 9 March, 2020, 109577 patients were diagnosed with coronavirus disease MESHD-2019 (COVID-19) globally. The clinical and epidemiological characteristics of adult TRANS patients have been revealed recently. However, the information of paediatric patients remains unclear. We describe the clinical and epidemiological characteristics of paediatric patients to provide valuable insight into early diagnosis of COVID-19 in children TRANS, as well as epidemic control policy making. METHODS and FINDINGS This retrospective, observational study was a case series performed at 4 hospitals in the west of China. Thirty-four paediatric patients with COVID-19 were included from January 1 to February 25, 2020. And the final follow-up visit was completed by February 28, 2020. Clinical and epidemiological characteristics were analyzed on the basis of demographic data, medical history, laboratory tests, radiological findings, and treatment information. Data analysis was performed on 34 paediatrics patients with COVID-19 aged TRANS from 1 to 144 months (median 33.00, IQR 10.00 - 94.25), among whom 14 males TRANS (41.18%) were included. 47.60% of patients were noticed without any exposure history. The median incubation period TRANS was 10.50 (7.75 - 25.25) days. Infections of other respiratory pathogens were reported in 16 patients (47.06%). The most common initial symptoms were fever HP fever MESHD (76.47%), cough HP (58.82%), and expectoration (20.59%). Vomiting HP Vomiting MESHD (11.76%) and diarrhea HP diarrhea MESHD (11.76%) were also reported in a considerable portion of cases. A remarkable increase was detected in serum SERO amyloid A for 17 patients (85.00%) and high- sensitivity SERO C-reactive protein for 17 patients (58.62%), while a decrease of prealbumin was noticed in 25 patients (78.13%). In addition, the levels of lactate dehydrogenase was increased significantly in 28 patients (82.35%), as well as -hydroxybutyrate dehydrogenase in 25 patients (73.53%). Patchy lesions in lobules were detected by chest computed tomographic scans in 28 patients (82.36%). The typical feature of ground-glass opacity for adults TRANS was rare in paediatric patients (2.94%). A late-onset pattern of lesions in lobules were also noticed. Stratified analysis of the clinical features were not performed due to relatively limited samples. CONCLUSIONS Our data presented the clinical and epidemiological features of paediatric patients systemically. The findings offer new insight into the early identification and intervention of paediatric patients with COVID-19.

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MeSH Disease
Human Phenotype

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