Corpus overview


MeSH Disease

Human Phenotype


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    Self-Reported Taste and Smell Disorders in Patients with COVID-19: Distinct Features in China

    Authors: Jia Song; Yi-Ke Deng; Hai Wang; Zhi-Chao Wang; Bo Liao; Jin Ma; Chao He; Li Pan; Yang Liu; Isam Alobid; De-Yun Wang; Ming Zeng; Joaquim Mullol; Zheng Liu

    doi:10.21203/ Date: 2020-08-03 Source: ResearchSquare

    Background: Last December 2019, a cluster of viral pneumonia MESHD pneumonia HP cases identified as coronavirus disease MESHD 2019 (COVID-19), was reported in Wuhan, China. We aimed to explore the frequencies of nasal symptoms in patients with COVID-19, including loss of smell and taste, as well as their presentation as the first symptom of the disease MESHD and their association with the severity of COVID-19.Methods: In this retrospective study, 1,206 laboratory-confirmed COVID-19 patients were included and followed-up by telephone call one month after discharged from Tongji Hospital, Wuhan. Demographic data, laboratory values, comorbidities, symptoms, and numerical rating scale scores (0-10) of nasal symptoms were extracted from the hospital medical records, and confirmed or reevaluated by the telephone follow-up. Results: From COVID-19 patients (N = 1,172) completing follow-up, 199 (17%) subjects had severe COVID-19 and 342 (29.2%) reported nasal symptoms. The most common nasal symptom was loss of taste (20.6%, median score = 6), while 11.4% had loss of smell (median score = 5). The incidence of nasal symptom including loss of smell and loss of taste as the first onset symptom TRANS was <1% in COVID-19 patients. Loss of smell or taste scores showed no correlation with the scores of other nasal symptoms. Loss of taste scores, but not loss of smell scores, were significantly increased in severe vs. non-severe COVID-19 patients. Interleukin (IL)-6 and lactose dehydrogenase (LDH) serum SERO levels positively correlated with loss of taste scores. About 80% of COVID-19 patients recovered from smell and taste dysfunction in 2 weeks.Conclusions: In the Wuhan COVID-19 cohort, only 1 out of 10 hospital admitted patients had loss of smell while 1 out 5 reported loss of taste which was associated to severity of COVID-19. Most patients recovered smell and taste dysfunctions in 2 weeks.

    COVID-19: Role of the Interferons

    Authors: Claudio G. Gallo; Sirio Fiorino; Giovanni Posabella; Donato Antonacci; Antonio Tropeano; Emanuele Pausini; Carlotta Pausini; Tommaso Guarniero; Marco Zancanaro

    id:202008.0018/v1 Date: 2020-08-02 Source:

    COVID-19 disease MESHD, caused by the SARS-CoV2 virus, is a potentially fatal disease MESHD that represents a serious public health and economic problem worldwide. The SARS-CoV2 virus infects the lower respiratory tract and can cause pneumonia MESHD pneumonia HP in humans. ARDS is the leading cause of death MESHD in COVID-19 disease MESHD. One of the main characteristics of ARDS is the cytokine storm, an uncontrolled systemic inflammatory response resulting from the release of pro-inflammatory cytokines and chemokines and growth factors, by immune cells. The other important aspect of the disease MESHD is represented by the involvement of the vascular organ that undergoes endothelitis. Hyperinflammation and endothelitis contribute in various ways to trigger coagulation disorders with diffuse micro thrombotic and thromboembolic phenomena. Lastly, multiple organ failure MESHD may occur (MOF). Since so far there is no approved treatment, there is an urgent need to reposition known treatments, considered safe, to be included in trials. Naturally produced interferons represent the body's first line of defense against viruses. Pharmacological forms, obtained by means of genetic recombination techniques, have long been approved and used to treat numerous pathologies. Interferons are divided into three families, within which some subfamilies are distinguishable. Only IFN-II comprises a single isoform which has completely different aspects and functions. The IFN I and III, however, each comprise different subfamilies (17 subfamilies the IFN-I and 4 subfamilies the IFN-III), share many aspects, representing the body's first antiviral response, but play different roles. The use of IFNs has been studied in two severe hCoV (Human Coronavirus) diseases MESHD, closely related to COVID-19 disease MESHD, such as SARS and MERS. Numerous in vitro and in vivo studies have been conducted, often in combination with other antivirals. The results have been controversial. The positive results in vitro and in experimental animals were often not replicable in humans. The possible positioning of these molecules in the right window of therapeutic opportunity requires that the complex dialogue between IFN, inflammasome, cytokines, pro-inflammatory chemokines, growth factors and barrier function be shed light.

    Development a quantitative segmentation model to assess the effect of comorbidity on patients with COVID-19

    Authors: Cui Zhang; Guangzhao Yang; Chunxian Cai; Zhihua Xu; Hai Wu; Youmin Guo; Zongyu Xie; Hengfeng Shi; Guohua Cheng; Jian Wang

    doi:10.21203/ Date: 2020-08-01 Source: ResearchSquare

    Background: The coronavirus disease MESHD 2019 (COVID-19) has brought a global disaster. Quantitative lesions may provide the radiological evidence of the severity of pneumonia MESHD pneumonia HP and further to assess the effect of comorbidity on patients with COVID-19.Methods: 294 patients with COVID-19 were enrolled from February, 24, 2020 to June, 1, 2020 from six centers. Multi-task Unet network was used to segment the whole lung and lesions from chest CT images. This deep learning method was pre-trained in 650 CT images (550 in primary dataset and 100 in test dataset) with COVID-19 or community acquired pneumonia MESHD pneumonia HP and Dice coefficients in test dataset were calculated. 50 CT scans of 50 patients (15 with comorbidity and 35 without comorbidity) were random selected to mark lesions manually. The results will be compared with the automatic segmentation model. Eight quantitative parameters were calculated based on the segmentation results to evaluate the effect of comorbidity on patients with COVID-19.Results: Quantitative segmentation model was proved to be effective and accurate with all Dice coefficients more than 0.85 and all accuracies more than 0.95. Of the 294 patients, 52 (17.7%) patients were reported having at least one comorbidity, 14 (4.8%) having more than one comorbidity. Patients with any comorbidity were older (P<0.001), had longer incubation period TRANS (P<0.001), were more likely to have abnormal laboratory findings (P<0.05) and be in severity status (P<0.001). More lesions (including larger volume of lesion, consolidation and ground-glass opacity) were shown in patients with any comorbidity than patients without comorbidity (all P<0.001). The more comorbidities patients have, the poorer CT manifestation is. The median volume of lesion, consolidation and ground-glass opacity in diabetes mellitus MESHD diabetes mellitus HP group was largest among the three prevalently single comorbidity groups.Conclusions: Multi-task Unet network can make quantitative CT analysis of lesions to assess the effect of comorbidity on patients with COVID-19, further to provide the radiological evidence of the severity of pneumonia MESHD pneumonia HP. More lesions were found in CT images of cases with comorbidity. The more comorbidities patients have, the poorer CT manifestation is. 

    Differential Diagnosis in Patients with HRCT Patterns Suspected for COVID-19 Pneumonia MESHD Pneumonia HP and RT-PCR Negative: A Multidisciplinary Approach for an Appropriate Management

    Authors: D'Onofrio Renato; D’Andreta Michela; Modolon Cecilia; Rimondi Maria Rita; Poggi Cristina; Di Scioscio Valerio; Trapani Filippo; Attard Luciano; Nava Stefano; Monteduro Francesco

    doi:10.21203/ Date: 2020-07-31 Source: ResearchSquare

    Since 11th March 2020, the World Health Organization has declared that coronavirus disease MESHD 2019 (COVID-19) caused by SARS-CoV-2 is a pandemic and a global public health emergency MESHD. One of the main problems related to the rapid spread of the pandemic was the low sensitivity SERO of the swabs that were used, resulting in high false negative rates, and the inability of HRCT to distinguish COVID-19 pneumonia MESHD pneumonia HP from other types of pneumonia MESHD pneumonia HP, resulting in diagnostic delays and increased infections MESHD in the hospital units. To deal with this problem, a multidisciplinary team has been created at the Sant'Orsola-Malpighi University Hospital in Bologna, with the aim of integrating the data of each patient framed as a "COVID suspect" and to get to a correct diagnosis. We analysed some exemplary cases of patients with negative swab but highly suggestive clinical and radiological characteristics for COVID-19 that, thanks to this multidisciplinary team, were then framed as other forms of pneumonia MESHD pneumonia HP and successfully treated.

    Elevated oxygen demand in a case of COVID-19 with severe ARDS: a point for optimal oxygenation therapy including ECMO management

    Authors: Taku Oshima; Takehiko Oami; Mana Yamashiro; Akiko Higashi; Yosuke Hayashi; Natsumi Suga; Shin Takayanagi; Seiichiro Sakao; Taka-aki Nakada

    doi:10.21203/ Date: 2020-07-30 Source: ResearchSquare

    Background: Coronavirus disease MESHD 2019 (COVID-19) caused by SARS-CoV-2 has become a global pandemic, and those developing critically ill conditions have been reported to have mortality in the range of 39% to 61%. Due to the lack of definitive treatments, mechanical ventilation and supportive oxygenation therapy are key management strategies for the survival of patients with acute respiratory distress HP syndrome MESHD (ARDS). Optimizing oxygenation therapy is mandatory to treat patients with severe respiratory failure HP, to sufficiently compensate for the oxygen (O2) demand. We experienced a case of severe ARDS due to COVID-19 successfully treated with extracorporeal membrane oxygenation (ECMO) after increasing oxygen delivery according to O2 consumption measurement by indirect calorimetryCase Presentation: A 29-year-old obese but otherwise healthy man was hospitalized for treatment of COVID-19 pneumonia MESHD pneumonia HP presenting with a 4-day history of persisting cough MESHD cough HP, high fever MESHD fever HP, and dyspnea MESHD dyspnea HP. Mechanical ventilation, nitric oxide inhalation, and prone positioning were initiated in the ICU against severe respiratory dysfunction. Indirect calorimetry on the 3rd and 6th ICU days revealed persistent elevation of oxygen consumption (VO2) of 380 mL/min. Veno-venous ECMO was initiated on the 7th ICU day after further deterioration of respiratory failure HP. Periodic events of SpO2 decline due to effortful breathing was not resolved by neuromuscular blockade in attempt to reduce O2 consumption. Increasing the ECMO flow induced hemolysis MESHD and hyperkalemia MESHD hyperkalemia HP despite the use of large bore cannulas and ECMO circuit free of clots and defects. The hemoglobin management level was elevated from 10 g/dL to 13 g/dL to increase blood SERO oxygen capacity, enabling the reduction of ECMO flow while attenuating respiratory effort and maintaining SpO2. Lung protective ventilation strategy and prone positioning were continued for successful weaning from ECMO on the 16th ICU day, and the ventilator on the 18th ICU day.Conclusion: The present case of severe ARDS due to COVID-19 was successfully treated with ECMO. Enhancing oxygen delivery was crucial to compensate for the elevated O2 demand. Measuring O2 consumption by indirect calorimetry can elucidate the oxygen demand for optimizing the oxygenation therapy for successful management and survival of critically ill COVID-19 patients. 

    Severity detection for the coronavirus disease MESHD 2019 (COVID-19) patients using a machine learning model based on the blood SERO and urine tests

    Authors: Haochen Yao; Nan Zhang; Ruochi Zhang; Meiyu Duan; Tianqi Xie; Jiahui Pan; Ejun Peng; Juanjuan Huang; Yingli Zhang; Xiaoming Xu; Hong Xu; Fengfeng Zhou; Guoqing Wang

    doi:10.1101/2020.07.27.20044990 Date: 2020-07-29 Source: medRxiv

    The recent outbreak of the coronavirus disease MESHD-2019 (COVID-19) caused serious challenges to the human society in China and across the world. COVID-19 induced pneumonia MESHD pneumonia HP in human hosts and carried a highly inter-person contagiousness. The COVID-19 patients may carry severe symptoms, and some of them may even die of major organ failures. This study utilized the machine learning algorithms to build the COVID-19 severeness detection model. Support vector machine (SVM) demonstrated a promising detection accuracy after 32 features were detected to be significantly associated with the COVID-19 severeness. These 32 features were further screened for inter-feature redundancies. The final SVM model was trained using 28 features and achieved the overall accuracy 0.8148. This work may facilitate the risk estimation of whether the COVID-19 patients would develop the severe symptoms. The 28 COVID-19 severeness associated biomarkers may also be investigated for their underlining mechanisms how they were involved in the COVID-19 infections MESHD.

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

    Authors: Yuan Hu; Jing Xiong; Yuan Shi

    doi:10.21203/ 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.

    Automatic CT Quantification of Coronavirus Disease MESHD 2019 pneumonia MESHD pneumonia HP: An international collaborative development, validation, and clinical implication

    Authors: Seung-Jin Yoo; Xiaolong Qi; Shohei Inui; Sang Joon Park; Hyungjin Kim; Yeon Joo Jeong; Kyung Hee Lee; Young Kyung Lee; Bae Young Lee; Jin Yong Kim; Kwang Nam Jin; Jae-Kwang Lim; Yun-Hyeon Kim; Ki Beom Kim; Zicheng Jiang; Chuxiao Shao; Junqiang Lei; Shengqiang Zou; Hongqiu Pan; Ye Gu; Guo Zhang; Jin Mo Goo; Soon Ho Yoon

    doi:10.21203/ Date: 2020-07-24 Source: ResearchSquare

    Objectives    We aimed to develop and validate the automatic quantification of COVID-19 pneumonia MESHD pneumonia HP on CT images. Methods This retrospective study included 176 chest CT scans of 131 COVID-19 patients from 13 Korean and Chinese institutions. Two experienced radiologists semi-automatically drew pneumonia MESHD pneumonia HP, preparing 49,830 positive and negative CT slices to develop the 2D U-Net for segmenting pneumonia MESHD pneumonia HP. The 2D U-Net was distributed as downloadable software. External validation for quantifications’ accuracy was performed using Japanese, Italian, Radiopaedia, Chinese datasets. Primary measures for the accuracy of the network were correlation coefficients for extent (%) and weight (g) of pneumonia MESHD pneumonia HP. Logistic regression analyses were performed to evaluate the clinical implication of the extent and weight regarding the presence of symptoms in the Japanese dataset and the occurrence of composite outcome in the Spanish dataset. Results In the internal validation dataset, the intraclass correlation coefficients between the 2D U-Net and reference values for the extent and weight were 0.990 and 0.993, respectively. In the Japanese dataset, the Pearson correlation coefficients between the U-Net outcomes and visual CT severity scores were 0.908 and 0.899, respectively. In the other external validation datasets, the intraclass correlation coefficients between the U-Net and reference values were between 0.951-0.970 (extent) and between 0.970-0.995 (weight), respectively. In multivariate logistic regression analyses, the extent and weight of pneumonia MESHD pneumonia HP were independently associated with symptoms (OR, 4.142 and 4.434; p=.013 and .009, respectively), and poor prognosis (OR, 7.446 and 4.677; p=.004 and .029, respectively).Conclusions CT extent and weight of COVID-19 pneumonia MESHD pneumonia HP were automatically quantifiable and independently associated with symptoms and prognosis. 


    Authors: Guillermo Ruiz-Irastorza; Jose-Ignacio Pijoan; Elena Bereciartua; Susanna Dunder; Jokin Dominguez; Paula Garcia-Escudero; Alejandro Rodrigo; Carlota Gomez-Carballo; Jimena Varona; Laura Guio; Marta Ibarrola; Amaia Ugarte; Agustin Martinez-Berriotxoa

    doi:10.1101/2020.07.16.20152868 Date: 2020-07-23 Source: medRxiv

    OBJECTIVE: To analyze the effects of a short course of methyl-prednisolone pulses (MP) during the second week of disease MESHD (week-2) on the clinical course of patients with severe coronavirus disease MESHD 2019 (COVID-19) pneumonia MESHD pneumonia HP. DESIGN: Comparative observational study using data collected from routine care. SETTING: Hospital Universitario Cruces, a tertiary level University hospital at Barakaldo, Bizkaia, Spain. PARTICIPANTS: All patients with COVID-19 pneumonia MESHD pneumonia HP admitted between 1st March and 30th April 2020 to the services of Infectious Diseases MESHD and Internal Medicine. INTERVENTIONS: Treatment with week-2-MP (125-250 mg/d for 3 consecutive days with no subsequent tapering) vs. standard of care. MAIN OUTCOMES MEASURES: Time to death MESHD and time to death MESHD or endotracheal intubation. RESULTS: Two hundred and forty-two patients with confirmed COVID-19 pneumonia MESHD pneumonia HP and elevated inflammatory markers at admission were included in the study. Sixty-one patients (25%) received week-2-MP. Twenty-two patients (9%) died during the study period. Thirty-one patients (12.8%) suffered death MESHD or intubation. The adjusted HR for death MESHD was 0.35 (95%CI 0.11 to 1.06, p= 0.064) for patients in the week-2-MP group. The adjusted HR for death MESHD or intubation week-2-MP was 0.33 (95%CI 0.13 to 0.84, p=0.020) for patients in the week-2-MP group. These differences were seen in the subcohort of patients with a SaO2/FiO2 at day 7 lower than the median of the whole population: HR 0.31, 95% CI 0.08 to 1.12, p=0.073 and HR 0.34, 95%CI 0.12 to 0.94, p=0.038, respectively, but not in patients with higher SaO2/FiO2. Other predictors of the final outcomes were arterial hypertension MESHD hypertension HP, SaO2/FiO2, high-risk CURB65 scores and the use of non-pulse glucocorticoids. Non-pulse glucocorticoids were a predictor of infections MESHD (OR 4.72, 95%CI 1.90 to 11.80, p<0.001), while week-2-MP were not (OR 1.04, 95%CI 0.40 to 2.70, p=0.938). CONCLUSIONS: Week-2-MP are effective in improving the prognosis of patients with COVID-19 pneumonia MESHD pneumonia HP with features of inflammatory activity and respiratory deterioration entering the second week of disease MESHD. The recognition of this high-risk population should prompt early use of MP at this point. REGISTRATION: This study has been registered in the EU PAS Register with the number EUPAS36287.

    Adjunctive Corticosteroids for COVID-19: A Retrospective Cohort Study

    Authors: Say Tat Ooi; Purnima Parthasarathy; Yi Lin; Valliammai Nallakaruppan; Shereen Ng; Teck Choon Tan; Serena Low; Terence Tang

    doi:10.1101/2020.07.18.20157008 Date: 2020-07-21 Source: medRxiv

    Background: Coronavirus disease MESHD 2019 (COVID-19) is associated with severe pneumonia MESHD pneumonia HP, respiratory failure HP and death MESHD. We aim to evaluate the efficacy of adjunctive corticosteroids in the management of COVID-19. Methods: This is a retrospective cohort study of hospitalized adults TRANS ([≥]18 years) who were diagnosed with COVID-19 and were given treatment. Treatment included hydroxycholoroquine and lopinavir-ritonavir. Corticosteroids were included as adjunctive therapy in mid-April, 2020. We compared composite outcomes of clinical progression and invasive mechanical ventilation (MV) or death MESHD between group that received treatment only (Group A) versus group that received adjunctive corticosteroids (Group B). Entropy balancing was used to generate stabilized weight for covariates between treatment groups. Unweighted Kaplan-Meir curves, weighted and adjusted Cox regression analysis were used to estimate effect of adjunctive corticosteroids on composite outcomes. Subgroup analysis was performed on those with pneumonia MESHD pneumonia HP. Results: Of 1046 patients with COVID-19, 57 received treatment alone (Group A) and 35 received adjunctive corticosteroids in addition to treatment (Group B). Median day of illness at treatment initiation was 5 day. There were 44 patients with pneumonia MESHD pneumonia HP; 68.9% of them were not requiring supplemental oxygen at treatment initiation. Overall, 17 (18.5%) of 92 patients had clinical progression including 13 (22.8%) of 57 patients in Group A versus 4 (11.4%) of 35 patients in Group B (p=0.172). Unweighted Kaplan-Meier estimates showed no significant difference in the proportion of patients who had clinical progression or invasive MV or death MESHD between the 2 treatment groups. However in those with pneumonia MESHD pneumonia HP, there were lower proportions of patients in Group B with clinical progression (11.1% , 95% CI 0.0 - 22.2 versus 58.8%, 95% CI 27.3 - 76.7, log rank p<0.001 ); and invasive MV or death MESHD (11.3%, 95% CI 0.0 - 22.5 versus 41.2%, 95% CI 12.4. - 60.5, log rank p=0.016). In weighted and adjusted cox regression analysis, patients in Group B were less likely to have clinical progression, (adjusted HR [aHR] 0.08, 95% CI 0.01-0.99, p=0.049) but there was no statistical significant difference in risk of requiring invasive MV or death MESHD (aHR 0.22, 95%CI 0.02 - 2.54, p=0.22). In subgroup with pneumonia MESHD pneumonia HP, patients in Group B were significantly at lower risk of clinical progression (aHR 0.15, 95% CI 0.06 - 0.39, p<0.001) and requiring invasive MV compared to Group A (aHR 0.30, 0.10-0.87, p=0.029). Conclusions: Use of adjunctive corticosteroids is associated with lower risk of clinical progression and invasive MV or death MESHD, especially in those with pneumonia MESHD pneumonia HP. Concurrent use of antivirals and corticosteroids should be considered in the management of COVID-19 related pneumonia MESHD pneumonia HP.

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MeSH Disease
Human Phenotype

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