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MeSH Disease


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    Recombinant ACE2 Expression is Required for SARS-CoV-2 to Infect Primary Human Endothelial Cells and Induce Inflammatory and Procoagulative Responses

    Authors: Jonas Nascimento Conde; William R. Schutt; Elena Gorbunova; Erich R. Mackow; Suprabhat Mukherjee; Kianna M. Nguyen; Ming H. Ho; Jung-Eun Shin; Jared Feldman; Blake M. Hauser; Timothy M. Caradonna; Laura M. Wingler; Aaron G. Schmidt; Debora S. Marks; Jonathan Abraham; Andrew C. Kruse; Chang C. Liu

    doi:10.1101/2020.11.10.377606 Date: 2020-11-11 Source: bioRxiv

    SARS-CoV-2 causes COVID-19 MESHD, an acute respiratory distress HP respiratory distress MESHD syndrome ( ARDS MESHD) characterized by pulmonary edema HP pulmonary edema MESHD, viral pneumonia MESHD pneumonia HP, multiorgan dysfunction, coagulopathy and inflammation MESHD. SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE2) receptors to infect and damage ciliated epithelial cells in the upper respiratory tract. In alveoli, gas exchange occurs across an epithelial-endothelial barrier that ties respiration to endothelial cell (EC) regulation of edema HP edema MESHD, coagulation MESHD and inflammation MESHD. How SARS-CoV-2 dysregulates MESHD vascular functions to cause ARDS MESHD in COVID-19 MESHD patients remains an enigma focused on dysregulated EC responses. Whether SARS-CoV-2 directly or indirectly affects functions of the endothelium remains to be resolved and critical to understanding SARS-CoV-2 pathogenesis and therapeutic targets. We demonstrate that primary human ECs lack ACE2 receptors at protein and RNA levels, and that SARS-CoV-2 is incapable of directly infecting ECs derived from pulmonary, cardiac, brain, umbilical vein or kidney tissues. In contrast, pulmonary ECs transduced with recombinant ACE2 receptors are infected by SARS-CoV-2 and result in high viral titers (~1x107/ml), multinucleate syncytia MESHD and EC lysis. SARS-CoV-2 infection MESHD of ACE2-expressing ECs elicits procoagulative and inflammatory responses observed in COVID-19 MESHD patients. The inability of SARS-CoV-2 to directly infect and lyse ECs without ACE2 expression explains the lack of vascular hemorrhage MESHD in COVID-19 MESHD patients and indicates that the endothelium is not a primary target of SARS-CoV-2 infection MESHD. These findings are consistent with SARS-CoV-2 indirectly activating EC programs that regulate thrombosis MESHD and endotheliitis MESHD in COVID-19 MESHD patients, and focus strategies on therapeutically targeting epithelial and inflammatory responses that activate the endothelium or initiate limited ACE2 independent EC infection MESHD.

    Human Identical Sequences of SARS-CoV-2 Promote Clinical Progression of COVID-19 MESHD by Upregulating Hyaluronan via NamiRNA-Enhancer Network

    Authors: Wei Li; Shuai Yang; Peng Xu; Dapeng Zhang; Ying Tong; Lu Chen; Ben Jia; Ang Li; Daoping Ru; Baolong Zhang; Mengxing Liu; Cheng Lian; Cancan Chen; Weihui Fu; Songhua Yuan; Xiaoguang Ren; Ying Liang; Zhicong Yang; Wenxuan Li; Shaoxuan Wang; Xiaoyan Zhang; Hongzhou Lu; Jianqing Xu; Hailing Wang; Wenqiang Yu; Vattipally B Sreenu; Jay Nix; Ruth F Jarrett; Martina Beltramello; Kyriaki Nomikou; Matteo Pizzuto; Lily Tong; Elisabetta Cameroni; Natasha Johnson; Arthur Wickenhagen; Alessandro Ceschi; Daniel Mair; Paolo Ferrari; Katherine Smollett; Federica Sallusto; Stephen Carmichael; Christian Garzoni; Jenna Nichols; Massimo Galli; Joseph Hughes; Agostino Riva; Antonia Ho; Peter JM Openshaw; Kenneth Baillie; - The ISARIC4C Investigators; - COVID-19 Genomics UK (COG-UK) consortium; Suzannah J Rihn; Samantha J Lycett; Herbert W Virgin; Amalio Telenti; Davide Corti; David L Robertson; Gyorgy Snell; Lingxiao Wang; Lisa White; Pan Xu; Yupeng Yang; Osman N Yogurtcu; Weitong Zhang; Yanting Zhao; Difan Zou; Matthew Ferrari; David Pannell; Michael Tildesley; Jack Seifarth; Elyse Johnson; Matthew Biggerstaff; Michael Johansson; Rachel B Slayton; John Levander; Jeff Stazer; Jessica Salermo; Michael C Runge

    doi:10.1101/2020.11.04.361576 Date: 2020-11-05 Source: bioRxiv

    The COVID-19 MESHD pandemic is a widespread and deadly public health crisis. The pathogen SARS-CoV-2 replicates in the lower respiratory tract and causes fatal pneumonia MESHD pneumonia HP. Although tremendous efforts have been put into investigating the pathogeny of SARS-CoV-2, the underlying mechanism of how SARS-CoV-2 interacts with its host is largely unexplored. Here, by comparing the genomic sequences of SARS-CoV-2 and human, we identified five fully conserved elements in SARS-CoV-2 genome, which were termed as "human identical sequences ( HIS MESHD)". HIS MESHD are also recognized in both SARS-CoV MESHD and MERS-CoV genome. Meanwhile, HIS-SARS-CoV-2 are highly conserved in the primate. Mechanically, HIS-SARS-CoV-2 RNA directly binds to the targeted loci in human genome and further interacts with host enhancers to activate the expression of adjacent and distant genes, including cytokines gene and angiotensin converting enzyme II (ACE2), a well-known cell entry receptor of SARS-CoV-2, and hyaluronan synthase 2 (HAS2), which further increases hyaluronan formation. Noteworthily, hyaluronan level in plasma SERO of COVID-19 MESHD patients is tightly correlated with severity and high risk for acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD) and may act as a predictor for the progression of COVID-19 MESHD. HIS antagomirs, which downregulate hyaluronan level effectively, and 4-Methylumbelliferone (MU), an inhibitor of hyaluronan synthesis, are potential drugs to relieve the ARDS MESHD related ground-glass pattern in lung for COVID-19 MESHD treatment. Our results revealed that unprecedented HIS elements of SARS-CoV-2 contribute to the cytokine storm and ARDS MESHD in COVID-19 MESHD patients. Thus, blocking HIS-involved activating processes or hyaluronan synthesis directly by 4-MU may be effective strategies to alleviate COVID-19 MESHD progression.

    Baseline characteristics, management, and outcomes of 55,270 children TRANS and adolescents diagnosed with COVID-19 MESHD and 1,952,693 with influenza in France, Germany, Spain, South Korea and the United States: an international network cohort study

    Authors: Talita Duarte-Salles; David Vizcaya; Andrea Pistillo; Paula Casajust; Anthony G. Sena; Lana Yin Hui Lai; Albert Prats-Uribe; Waheed-Ul-Rahman Ahmed; Thamir M Alshammari; Heba Alghoul; Osaid Alser; Edward Burn; Seng Chan You; Carlos Areia; Clair Blacketer; Scott DuVall; Thomas Falconer; Sergio Fernandez-Bertolin; Stephen Fortin; Asieh Golozar; Mengchun Gong; Eng Hooi Tan; Vojtech Huser; Pablo Iveli; Daniel R Morales; Fredrik Nyberg; Jose D. Posada; Martina Recalde; Elena Roel; Lisa M. Schilling; Nigam H. Shah; Karishma Shah; Marc A. Suchard; Lin Zhang; Andrew E. Williams; Christian G. Reich; Kristin Kostka; Daniel Prieto-Alhambra

    doi:10.1101/2020.10.29.20222083 Date: 2020-10-30 Source: medRxiv

    Objectives To characterize the demographics, comorbidities, symptoms, in-hospital treatments, and health outcomes among children TRANS/adolescents diagnosed or hospitalized with COVID-19 MESHD. Secondly, to describe health outcomes amongst children TRANS/adolescents diagnosed with previous seasonal influenza. Design International network cohort. Setting Real-world data from European primary care records (France/Germany/Spain), South Korean claims and US claims and hospital databases. Participants Diagnosed and/or hospitalized children TRANS/adolescents with COVID-19 MESHD at age TRANS <18 between January and June 2020; diagnosed with influenza in 2017-2018. Main outcome measures Baseline demographics and comorbidities, symptoms, 30-day in-hospital treatments and outcomes including hospitalization, pneumonia HP pneumonia MESHD, acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD), multi-system inflammatory syndrome MESHD (MIS-C), and death MESHD. Results A total of 55,270 children TRANS/adolescents diagnosed and 3,693 hospitalized with COVID-19 MESHD and 1,952,693 diagnosed with influenza were studied. Comorbidities including neurodevelopmental disorders MESHD, heart disease MESHD, and cancer MESHD were all more common among those hospitalized vs diagnosed with COVID-19 MESHD. The most common COVID-19 MESHD symptom was fever HP fever MESHD. Dyspnea HP Dyspnea MESHD, bronchiolitis MESHD bronchiolitis HP, anosmia and gastrointestinal symptoms MESHD anosmia and gastrointestinal symptoms HP were more common in COVID-19 MESHD than influenza. In-hospital treatments for COVID-19 MESHD included repurposed medications (<10%), and adjunctive therapies: systemic corticosteroids (6.8% to 37.6%), famotidine (9.0% to 28.1%), and antithrombotics such as aspirin (2.0% to 21.4%), heparin (2.2% to 18.1%), and enoxaparin (2.8% to 14.8%). Hospitalization was observed in 0.3% to 1.3% of the COVID-19 MESHD diagnosed cohort, with undetectable (N<5 per database) 30-day fatality. Thirty-day outcomes including pneumonia MESHD pneumonia HP, ARDS MESHD, and MIS-C were more frequent in COVID-19 MESHD than influenza. Conclusions Despite negligible fatality, complications including pneumonia HP pneumonia MESHD, ARDS MESHD and MIS-C were more frequent in children TRANS/adolescents with COVID-19 MESHD than with influenza. Dyspnea HP Dyspnea MESHD, anosmia and gastrointestinal symptoms MESHD anosmia and gastrointestinal symptoms HP could help differential diagnosis. A wide range of medications were used for the inpatient management of pediatric COVID-19 MESHD.

    Lung transplantation for pulmonary fibrosis MESHD pulmonary fibrosis HP secondary to severe COVID-19 MESHD

    Authors: Ankit Bharat; Melissa Querrey; Nikolay S Markov; Samuel S Kim; Chitaru Kurihara; Rafael Garza-Castillon Jr.; Adwaiy Manerikar; Ali Shilatifard; Rade Tomic; Yuliya Politanska; Hiam Abdala-Valencia; Anjana V Yeldandi; Jon W Lomasney; Alexander V Misharin; GR Scott Budinger; Sarah Platt; Eve Hamilton; Andrew Barr; Lucy Venyo; Peter Wilson; Tom Bewick; Priya Daniel; Paul Dark; Adam R Jeans; Jamie McCanny; Jonathan D Edgeworth; Martin J Llewelyn; Matthias L Schmid; Tricia M McKeever; Martin Beed; Wei Shen Lim

    doi:10.1101/2020.10.26.20218636 Date: 2020-10-27 Source: medRxiv

    Lung transplantation can potentially be a life-saving treatment for patients with non-resolving COVID-19 MESHD acute respiratory distress syndrome MESHD respiratory distress HP syndrome. Concerns limiting transplant include recurrence of SARS-CoV-2 infection MESHD in the allograft, technical challenges imposed by viral-mediated injury to the native lung, and potential risk for allograft infection MESHD by pathogens associated with ventilator-induced pneumonia MESHD pneumonia HP in the native lung. Additionally, the native lung might recover, resulting in long-term outcomes preferable to transplant. Here, we report the results of the first two successful lung transplantation procedures in patients with non-resolving COVID-19 MESHD associated acute respiratory distress HP respiratory distress MESHD syndrome in the United States. We performed smFISH to detect both positive and negative strands of SARS-CoV-2 RNA in the explanted lung tissue, extracellular matrix imaging using SHIELD tissue clearance, and single cell RNA-Seq on explant and warm post-mortem lung biopsies from patients who died from severe COVID-19 MESHD pneumonia HP pneumonia MESHD. Lungs from patients with prolonged COVID-19 MESHD were free of virus but pathology showed extensive evidence of injury MESHD and fibrosis MESHD which resembled end-stage pulmonary fibrosis MESHD pulmonary fibrosis HP. Single cell RNA-Seq of the explanted native lungs from transplant and paired warm post-mortem autopsies showed similarities between late SARS-CoV-2 acute respiratory distress syndrome MESHD respiratory distress HP syndrome and irreversible end-stage pulmonary fibrosis HP pulmonary fibrosis MESHD requiring lung transplantation. There was no recurrence of SARS-CoV-2 or pathogens associated with pre-transplant ventilator-associated pneumonias HP pneumonias MESHD following transplantation in either patient. Our findings suggest that some patients with severe COVID-19 MESHD develop fibrotic lung disease MESHD for which lung transplantation is the only option for survival.

    Intravenous Mesenchymal Stem Cells in Extracorporeal Oxygenation Patients with Severe COVID-19 MESHD Acute Respiratory Distress Syndrome MESHD Respiratory Distress HP Syndrome

    Authors: Sunjay Kaushal; Aisha Khan; Kristopher Deatrick; Derek K Ng; Abigail Snyder; Aakash Shah; Lina V Caceres; Ketty Bacallao; Melania Bembea; Allen Everett; Jie Zhu; David Kaczorowski; Ronson Madathil; Ali Tabatabai; Geoffrey Rosenthal; Adriana Brooks; Bangon Longsomboon; Rachana Mishra; Progyaparamita Saha; Yvenie Desire; Russell Saltzman; Kim G Hankey; Sixto A Arias; Folusakin Ayoade; Jairo A. Tovar; Rejane Lamazares; Hayley B Gershengorn; Fontaine J Magali; Matthias Loebe; Kristin Mullins; Muthukumar Gunasekaran; Vela Karakeshishyan; Dushyantha T Jayaweera; Anthony Atala; Ali Ghodsizad; Joshua M Hare

    doi:10.1101/2020.10.15.20122523 Date: 2020-10-20 Source: medRxiv

    Background: There is an ongoing critical need to improve therapeutic strategies for COVID-19 MESHD pneumonia MESHD pneumonia HP, particularly in the most severely affected patients. Adult TRANS mesenchymal stem cell (MSC) infusions have the potential to benefit critically ill MESHD patients with acute respiratory syndrome SARS-COV-2 infection MESHD SARS-COV-2 infection MESHD, but clinical data supporting efficacy are lacking. Methods: We conducted a case-control study of critically ill MESHD patients with laboratory-confirmed COVID-19 MESHD, severe acute respiratory distress syndrome MESHD respiratory distress syndrome HP ( ARDS MESHD). To evaluate clinical responsiveness in the most critically ill patient we examined outcomes in a sub-group of those requiring extracorporeal membrane oxygenation (ECMO) support. Patients (n=9) were administered with up to 3 infusions of intravenous (IV) MSCs and compared to a local ECMO control group (n=31). The primary outcome was safety, and the secondary outcomes were all-cause mortality (or rate of hospital discharge), cytokine levels, and viral clearance. Findings: MSC infusions (12 patients) were well tolerated and no side effects occurred. Of ECMO patients receiving MSC infusions, 2 out of 9 died (22.2%; 95%CI: 2.8%, 60.0%) compared with a mortality of 15 of 31 (48.4%; 95%CI: 30.2%, 66.9%; p = 0.25) in the ECMO control group. Isolated plasma SERO exosomes containing the SARS-COV-2 Spike protein decreased after MSC infusions between day 14 or 21 after administration (p=0.003 and p=0.005, respectively) and was associated with a decrease in COVID-19 MESHD IgG Spike protein titer at same time points (p = 0.006 and p=0.007, respectively). Control ECMO patients receiving convalescent plasma SERO did not clear COVID-19 MESHD IgG over the same time frame. Interpretation: Together these findings suggest that MSC IV infusion is well tolerated in patients with a broad range of severity including the most severe COVID-19 MESHD ARDS requiring ECMO. These data also raise the possibility that MSCs, in addition to exerting an immunomodulatory effect, contribute to viral clearance and strongly support the conduct of randomized placebo-controlled trial.


    Authors: Ali A El Solh; Gianfranco Umberto Meduri; Yolanda Lawson; MIchael Carter; Kari A Mergenhagen; Ce Cheng; Qin Zhou; Chenyu Sun; Manuel M Vicente; Angela Fernandes; Ana M Dias; Ivan-Christian Kurolt; Alemka Markotic; Dragan Primorac; Adriana Soares; Luis Malheiro; Irena Trbojevic-Akmacic; Miguel Abreu; Rui Sarmento e Castro; Silvia Bettinelli; Annapaola Callegaro; Marco Arosio; Lorena Sangiorgio; Luca Lorini; Xavier Castells; Juan P Horcajada; Salome Pinho; Massimo Allegri; Clara Barrios; Gordan Lauc

    doi:10.1101/2020.10.16.20214130 Date: 2020-10-20 Source: medRxiv

    Background: Mortality attributable to coronavirus disease-19 MESHD ( COVID-19 MESHD) 2 infection occurs mainly through the development of viral pneumonia HP pneumonia MESHD-induced acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD). Research Question: The objective of the study is to delineate the clinical profile, predictors of disease progression, and 30-day mortality from ARDS MESHD using the Veterans Affairs Corporate Data Warehouse. Study Design and Methods: Analysis of a historical cohort of 7,816 hospitalized patients with confirmed COVID-19 MESHD infection between January 1, 2020, and August 1, 2020. Main outcomes were progression to ARDS MESHD and 30-day mortality from ARDS MESHD, respectively. Results: The cohort was comprised predominantly of men (94.5%) with a median age TRANS of 69 years (interquartile range [IQR] 60-74 years). 2,184 (28%) were admitted to the intensive care unit and 643 (29.4%) were diagnosed with ARDS MESHD. The median Charlson Index was 3 (IQR 1-5). Independent predictors of progression to ARDS MESHD were body mass index (BMI)[≥] 40 kg/m2, diabetes MESHD, lymphocyte counts<700x109/L, LDH>450 U/L, ferritin >862 ng/ml, C-reactive protein >11 mg/dL, and D-dimer >1.5 ug/ml. In contrast, the use of an anticoagulant lowered the risk of developing ARDS (OR 0.66 [95% CI 0.49-0.89]. Crude 30-day mortality rate from ARDS was 41% (95% CI 38%-45%). Risk of death from ARDS was significantly higher in those who developed acute renal failure and septic shock HP. Use of an anticoagulant was associated with two-fold reduction in mortality. Survival benefit was observed in patients who received corticosteroids and/or remdesivir but there was no advantage of combination therapy over either agent alone. Conclusions: Among those hospitalized for COVID-19 MESHD, nearly one in ten progressed to ARDS. Septic shock HP, and acute renal failure are the leading causes of death in these patients. Treatment with either remdesivir and corticosteroids reduced the risk of mortality from ARDS. All hospitalized patients with COVID-19 MESHD should be placed at a minimum on prophylactic doses of anticoagulation.

    Clinical efficacy of corticosteroids in the early stage of worsening of COVID-19 MESHD pneumonia HP pneumonia MESHD

    Authors: Zheng Liu; Hui Wang; Jia-Qi Liu; Qian Wang; Jing Li; Cui-Jiao Jia; Chang-Lang Gao; Jian-Min Li; Dong-Fang Zhao

    doi:10.21203/ Date: 2020-10-12 Source: ResearchSquare

    Background: The World Health Organization (WHO) recommends using corticosteroids in patients with severe coronavirus disease 2019 MESHD ( COVID-19 MESHD) and acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD), and a large randomized controlled clinical trial in the UK found that dexamethasone was effective in reducing the number of deaths MESHD in patients with severe COVID-19 MESHD.Case presentation: Herein, we described a case of COVID-19 MESHD with the clinical characteristics of the mild-symptomatic stage deteriorating to a critically ill state, who showed dramatic improvement with corticosteroids in the early stage of worsening of COVID-19 MESHD pneumonia HP pneumonia MESHD.Discussion: This article further discusses the most suitable timing and dosage of corticosteroid to maximize its effect during the worsening of COVID-19 MESHD pneumonia HP pneumonia MESHD.Learning points:• One of the main pathophysiological hypotheses for severe COVID-19 MESHD pneumonia HP pneumonia MESHD is related to cytokine storm and viral load.• The clinical factors should be considered as the initial sign of a cytokine storm, and corticosteroid therapy may be useful in these patients. 

    Severity scores in COVID-19 MESHD pneumonia MESHD pneumonia HP: a multicenter, retrospective, cohort study

    Authors: Arturo Artero; Manuel Madrazo; Mar Fernández-Garcés; Antonio Muñoz Miguez; Andrés González García; Anxela Crestelo Vieitez; Elena García Guijarro; Eva María Fonseca Aizpuru; Miriam García Gómez; María Areses Manrique; Carmen Martinez Cilleros; María del Pilar Fidalgo Moreno; Jose Loureiro Amigo; Ricardo Gil Sánchez; Elisa Rabadán Pejenaute; Lucy Abella Vázquez; Ruth Cañizares Navarro; Marta Nataya Solís Marquínez; Francisco Javier Carrasco Sánchez; Julio González Moraleja; Lorena Montero Rivas; Joaquin Escobar Sevilla; María Dolores Martín Escalante; Ricardo Gómez-Huelgas; Jose-Manuel Ramos-Rincon

    doi:10.21203/ Date: 2020-09-25 Source: ResearchSquare

    BackgroundIdentification of patients on admission to hospital with Coronavirus infectious disease MESHD 2019 ( COVID-19 MESHD) pneumonia HP pneumonia MESHD who can develop poor outcomes have not yet ben comprehensively assessed.ObjectiveTo compare severity scores used for community acquired pneumonia MESHD pneumonia HP to identify high-risk patients.DesignPSI, CURB-65, qSOFA and MuLBSTA, a new score for viral pneumonia MESHD pneumonia HP, were calculated on admission to hospital to identify high-risk patients for in-hospital mortality. Area under receiver operating characteristics curve (AUROC), sensitivity SERO and specificity for each score were determined and AUROC were compared among them.ParticipantsPatients with COVID-19 MESHD pneumonia HP pneumonia MESHD included in the SEMI- COVID-19 MESHD Network.Key resultsWe examined 10,238 patients with COVID-19 MESHD. Mean age TRANS of patients was 66.6 years and 57.9% were males TRANS. The most common comorbidities were: hypertension HP hypertension MESHD (49.2%), diabetes MESHD (18.8%) and chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP (12.8%). Acute respiratory distress HP respiratory distress MESHD syndrome (34.7%) and acute kidney injury HP acute kidney injury MESHD (13.9%) were the most common complications. In-hospital mortality was 20.9%.  PSI and CURB-65 showed the highest AUROC (0.835 and0.825, respectively). qSOFA and MuLBSTA had a lower AUROC (0.728 and 0.715, respectively). qSOFA was the most specific score (specificity 95.7%) albeit its sensitivity SERO was only 26.2%. PSI had the highest sensitivity SERO (84.1%) and a specificity of 72.2%.ConclusionsPSI and CURB-65, specific severity scores for pneumonia MESHD pneumonia HP, were the best scores for COVID-19 MESHD pneumonia MESHD pneumonia HP and were better than qSOFA and MuLBSTA. Additionally, qSOFA, the simplest score to perform, was the most specific albeit the least sensitive.

    Epidemiological and Clinical Characteristics and Risk Factors for Mortality of Inpatients with COVID-19 MESHD in Golestan Province, Iran: A Retrospective Cohort Study

    Authors: Mohammad Reza Honarvar; Gholamreza Roshandel; Hesamaddin Shirzad-Aski; Alijan Tabarraei; Alireza Tahamtan; Mousa Ghelichi-Ghojogh; Abdolreza Fazel; Serajeddin Arefnia; Nahid Jafari; Mohsen Mansoury; Abdolhalim Rajabi

    doi:10.21203/ Date: 2020-09-20 Source: ResearchSquare

    Background: Coronavirus disease 2019 MESHD ( COVID-19 MESHD) is an emerging infectious disease MESHD that was first reported in Wuhan, China, and has subsequently spread worldwide. We aimed to further clarify the epidemiological and clinical characteristics of 2019-nCoV pneumonia MESHD pneumonia HP and risk factors associated for mortality. Methods: In this retrospective cohort study, we included inpatient with acute respiratory distress syndrome MESHD respiratory distress HP syndrome at Golestan University of Medical Sciences Hospitals (Golestan province, Iran) who had been discharged or had died in 2020. Epidemiological, clinical, and laboratory data, including samples for viral RNA detection, were extracted from electronic medical records and compared between recovered and died cases. We used multiple logistic regression methods to explore the risk factors associated with in-hospital death MESHD.Results: In overall 2,835 acute respiratory distress syndrome MESHD respiratory distress syndrome HP patients were included in this study, of these patients, 874 (30.83.9%) were positive for 2019­nCoV, and 1,046 (36.90%) were negative and 915 (32.28%) were not available for PCR result. Five hundred and sixty-three patients (19.86%) died, 1,687 patients (59.51%) were recovered, and 585 (20.63%) under treatment. Of the total deaths, only 288 (10.15%) were attributed to COVID-19 MESHD. The most common symptoms at onset TRANS of illness were respiratory distress HP (1,795 [63.32%]), fever MESHD fever HP (1,601 [56.47%]), dry cough MESHD cough HP (1,595 [56.26%]), Sore throat (445 [15.70%]), and myalgia MESHD myalgia HP (342 [12.06%]).One thousand and twelve (35.7%) had 1 or more coexisting medical conditions. In multiple logistic regression analysis, risk factors associated with the death included older age TRANS (OR (Odds Ratio), 1.03; 95% CI; 1.02-1.04), blood SERO oxygen level (SpO2<93%) (OR, 2.44; 95% CI; 1.79-3.31), comorbidities (OR, 2.15; 95% CI; 1.62-2.84), respiratory distress HP (OR, 1.74; 95% CI; 1.28-2.37), and headache HP headache MESHD (OR, 0.44 95% CI; 0.21-0.92). Conclusions: The 2019-nCoV infection MESHD caused collections of severe respiratory illness MESHD and was associated high ratio of hospitalization in ICU and high mortality. Older age TRANS and comorbidities were associated with more risk of death MESHD among patients with 2019­nCoV. 

    Association of Initial Symptoms or Comorbidities With Pneumonia Lesions MESHD Pneumonia Lesions HP in COVID-19 MESHD Patients: Based on Artificial Intelligence-Enabled CT Quantitation

    Authors: Fangzhengyuan Yuan; Chuan Liu; Jie Yang; Hu Tan; Shizhu Bian; Xubin Gao; Jihang Zhang; Mingdong Hu; Renzheng Chen; Yang Shen; Jingbin Ke; Yuanqi Yang; Chunyan He; Ran Cheng; Lan Huang

    doi:10.21203/ Date: 2020-09-15 Source: ResearchSquare

    Background: Coronavirus disease 2019 MESHD ( COVID-19 MESHD) patients with a larger ratio of pneumonia HP pneumonia MESHD lesions are more likely to progress to acute respiratory distress syndrome MESHD respiratory distress HP syndrome and death MESHD. This study aimed to investigate the relationship of baseline parameters with pneumonia lesions MESHD pneumonia lesions HP on admission, as quantified by an artificial intelligence (AI) algorithm using computed tomography (CT) images. Methods: This retrospective study quantitatively assessed lung lesions on CT using an AI algorithm in 1630 consecutive patients confirmed with COVID-19 MESHD on admission and classified the patients into none (0%), mild (>0–25%), intermediate (>25–50%), and severe (>50%) groups, according to the lesion ratio of the whole lung. A multivariate linear regression model was established to explore the relationship between the lesion ratio and laboratory parameters. The baseline parameters associated with lung lesions MESHD, including demographics, initial symptoms, and comorbidities, were determined using a multivariate ordinal regression model. Results: The 1630 patients confirmed with COVID-19 MESHD had a median whole lung lesion ratio of 4.1%, and the right lower lung lobe had the most lesions among the five lung lobes based on the evaluation of CT using AI algorithm. The whole lung lesion ratio was associated with the levels of plasma SERO fibrinogen (r=0.280, p<0.001), plasma SERO D-dimer (r=0.248, p<0.001), serum SERO α-hydroxybutyrate dehydrogenase (r=0.363, p<0.001), serum SERO albumin (r=-0.300, p<0.001), and peripheral blood SERO leukocyte count (r=0.194, p<0.001). Among the four patients groups categorised by whole lung lesion ratio, the highest frequency of cough HP (p<0.001) and shortness of breath MESHD (p<0.001) were found in the severe group, and the highest frequency of hypertension MESHD hypertension HP (p<0.001), diabetes MESHD (p<0.001) and anemia HP anemia MESHD (p=0.039) were observed in the intermediate group. Based on baseline ordinal regression analysis, cough HP (p=0.009), shortness of breath MESHD (p<0.001), hypertension MESHD hypertension HP (p=0.002), diabetes MESHD (p=0.005), and anemia MESHD anemia HP (p=0.006) were independent risk factors for more severe lung lesions MESHD. Conclusions: Based on AI-enabled CT quantitation, patients with initial symptoms of cough MESHD cough HP/ shortness of breath MESHD, or with comorbidities of hypertension HP hypertension MESHD, diabetes MESHD, or anemia MESHD anemia HP, had a higher risk for more severe lung lesions on admission in COVID-19 MESHD patients.

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