Corpus overview


MeSH Disease

Pneumonia (34)

Infections (22)

Disease (17)

Fever (9)

Death (9)

Human Phenotype

Pneumonia (38)

Fever (9)

Cough (7)

Fatigue (5)

Dyspnea (4)


    displaying 1 - 10 records in total 38
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    The Lebanese Cohort for COVID-19; A Challenge for the ABO Blood SERO Group System

    Authors: Athar Khalil; Mahmoud Hassoun; Rita Feghali

    doi:10.1101/2020.08.02.20166785 Date: 2020-08-04 Source: medRxiv

    A sudden outbreak of pneumonia MESHD pneumonia HP caused by the Severe Acute Respiratory Syndrome MESHD Coronavirus 2 (SARS-CoV-2) has rapidly spread all over the world facilitating the declaration of the resultant disease MESHD as a pandemic in March,2020. In Lebanon, the fast action of announcing a state of emergency MESHD with strict measures was among the factors that helped in achieving a successful containment of the disease MESHD in the country. Predisposing factors for acquiring COVID-19 and for developing a severe form of this disease MESHD were postulated to be related to epidemiological and clinical characteristics as well as the genomics signature of a given population or its environment. Biological markers such as the ABO blood SERO group system was amongst those factors that were proposed to be linked to the variability in the disease MESHD course and/or the prevalence SERO of this infection MESHD among different groups. We therefore conducted the first retrospective case-control study in the Middle-East and North Africa that tackles the association between the blood SERO group types and the susceptibility as well as the severity of SARS-CoV2 infection MESHD. Opposing to the current acknowledged hypothesis, our results have challenged the association significance of this system with COVID-19. Herein, we highlighted the importance of studying larger cohorts using more rigorous approaches to diminish the potential confounding effect of some underlying comorbidities and genetic variants that are known to be associated with the ABO blood SERO group system.

    Older adults TRANS hospitalized with Covid-19: Clinical characteristics and early outcomes from a single center in Istanbul, Turkey 

    Authors: Alpay Medetalibeyoğlu; Naci Senkal; Murat Kose; Yunus Catma; Emine Bilge Caparali; Mustafa Erelel; Mustafa Oral Oncul; Gulistan Bahat; Tufan Tukek

    doi:10.21203/ Date: 2020-07-22 Source: ResearchSquare

    Objective: Older adults TRANS have been continuously reported to be at higher risk for adverse outcomes of Covid-19. We aimed to describe clinical characteristics and early outcomes of the older Covid-19 patients hospitalized in our center comparatively with the younger patients, and also to analyze the triage factors that were related to the in-hospital mortality of older adults TRANS.Design: Retrospective; observational studySetting: Istanbul Faculty of Medicine hospital, TurkeyParticipants: 362 hospitalized patients with laboratory-confirmed Covid-19 from March 11 to May 11, 2020.Measurements: The demographic information; associated comorbidities; presenting clinical, laboratory, radiological characteristics on admission and outcomes from the electronic medical records were analyzed comparatively between the younger (<65 years) and older (≥65 years) adults TRANS. Factors associated with in-hospital mortality of the older adults TRANS were analyzed by multivariate regression analyses.Results: The median age TRANS was 56 years (interquartile range [IQR], 46-67), and 224 (61.9%) were male TRANS. There were 104 (28.7%) patients ≥65 years of age TRANS. More than half of the patients (58%) had one or more chronic comorbidity. The three most common presenting symptoms in the older patients were fatigue MESHD fatigue HP/ myalgia MESHD myalgia HP (89.4%), dry cough MESHD cough HP (72.1%), and fever MESHD fever HP (63.5%). Cough MESHD Cough HP and fever MESHD fever HP were significantly less prevalent in older adults TRANS compared to younger patients (p=0.001 and 0.008, respectively). Clinically severe pneumonia MESHD pneumonia HP was present in 31.5% of the study population being more common in older adults TRANS (49% vs. 24.4%) (p<0.001). The laboratory parameters that were significantly different between the older and younger adults TRANS were as follows: the older patients had significantly higher CRP, D-dimer, TnT, pro-BNP, procalcitonin levels, higher prevalence SERO of lymphopenia MESHD lymphopenia HP, neutrophilia HP, increased creatinine, and lower hemoglobin, ALT, albumin level (p<0.05). In the radiological evaluation, more than half of the patients (54.6%) had moderate-severe pneumonia MESHD pneumonia HP, which was more prevalent in older patients (66% vs. 50%) (p=0.006). The adverse outcomes were significantly more prevalent in older adults TRANS compared to the younger patients (ICU admission, 28.8% vs. 8.9%; mortality, 23.1% vs. 4.3%, p<0.001).  Among the triage evaluation parameters, the only factor associated with higher mortality was the presence of clinically severe pneumonia MESHD pneumonia HP on admission (Odds Ratio=12.3, 95% confidence interval=2.7-55.5, p=0.001).Conclusion: Older patients presented with more prevalent chronic comorbidities, less prevalent symptomatology but more severe respiratory signs and laboratory abnormalities than the younger patients. Among the triage assessment factors, the clinical evaluation of pulmonary involvement came in front to help clinicians to stratify the patients for mortality risk.

    Age TRANS is not the only risk factor in COVID-19: the role of comorbidities and of long staying in residential care homes.

    Authors: Michela D'Ascanio; Marta Innammorato; Lara Pasquariello; Dario Pizzirusso; Giulio Guerrieri; Silvia Castelli; Aldo Pezzuto; Claudia De Vitis; Rita Mancini; Alberto Ricci; Salvatore Sciacchitano

    doi:10.21203/ Date: 2020-07-14 Source: ResearchSquare

    Background: The actual SARS-CoV-2 outbreak caused a highly transmissible disease MESHD with a tremendous impact on elderly TRANS people. So far, few studies focused on very elderly TRANS patients (over 80 years old). In this study we examined the clinical presentation and the evolution of the disease MESHD in this group of patients, admitted to our Hospital in RomeMethods: This is a single-center, retrospective study performed in the Sant’Andrea University Hospital of Rome. We included patients older than 65 years of age TRANS with a diagnosis of COVID-19, from March 2020 to may 2020, divided in two groups according to their age TRANS (G1 65-80 years old; G2 >80 years old). Data extracted from the each patient record included age TRANS, sex, comorbidities, symptoms at onset TRANS, the Pneumonia MESHD Pneumonia HP Severity Index (PSI), the ratio of the partial pressure of oxygen in arterial blood SERO (PaO2) to the inspired oxygen fraction (FiO2) (P/F) on admission, laboratory tests, radiological findings on computer tomography (CT), length of hospital stay (LOS), mortality rate and the viral shedding. The differences between the two groups were analyzed by the Fisher’s exact test or the Wilcoxon signed-rank test for categorical variables and the Mann-Whitney U test for continuous variables. The survival time was estimated by Kaplan-Meier method and Log Rank Test. Univariable Cox proportional hazard regression and ordinal logistic regression were performed to estimate associations between age TRANS, comorbidities and provenance from residential care homes and clinical outcomes.Results: We found that G2 patients had an increased mortaliy rate, also due to (the frequent prevalence SERO of) multiple comorbidities. Moreover we found that patients coming from long-stay residential care homes appeared to be highly susceptible and vulnerable to develop severe manifestations of the disease MESHD.Conclusion: We demonstrate that there were considerable differences between Elderly TRANS and Very Elderly TRANS patients in terms of inflammatory activity, severity of disease MESHD, adverse clinical outcomes; moreover, to establish a correct risk stratification, comorbidities and information about provenience from residential care homes should be considered.

    Pericarditis MESHD Pericarditis HP and myocarditis MESHD myocarditis HP long after SARS-CoV-2 infection: a cross MESHD-sectional descriptive study in health-care workers

    Authors: Rocio Eiros; Manuel Barreiro-Perez; Ana Martin-Garcia; Julia Almeida; Eduardo Villacorta; Alba Perez-Pons; Soraya Merchan; Alba Torres-Valle; Clara Sanchez-Pablo; David Gonzalez-Calle; Oihane Perez-Escurza; Ines Toranzo; Elena Diaz-Pelaez; Blanca Fuentes-Herrero; Laura Macias-Alvarez; Guillermo Oliva-Ariza; Quentin Lecrevisse; Rafael Fluxa; Jose L Bravo-Grandez; Alberto Orfao; Pedro L Sanchez

    doi:10.1101/2020.07.12.20151316 Date: 2020-07-14 Source: medRxiv

    Background: Cardiac sequelae of past SARS-CoV-2 infection MESHD are still poorly documented. We conducted a cross-sectional study in health-care workers to report evidence of pericarditis MESHD pericarditis HP and myocarditis MESHD myocarditis HP after SARS-CoV-2 infection MESHD. Methods We studied 139 health-care workers with confirmed past SARS-CoV-2 infection MESHD (103 diagnosed by RT-PCR and 36 by serology). Participants underwent clinical assessment, electrocardiography, laboratory tests including immune cell profiling and cardiac magnetic resonance (CMR) imaging. Pericarditis MESHD Pericarditis HP was diagnosed when classical criteria were present, and the diagnosis of myocarditis MESHD myocarditis HP was based on the updated CMR Lake-Louise-Criteria. Results: Median age TRANS was 52 years (IQR 41-57), 100 (72%) were women, and 23 (16%) were previously hospitalized for Covid-19 pneumonia MESHD pneumonia HP. At examination (10.4 [9.3-11.0] weeks after infection MESHD-like symptoms), all participants presented hemodynamic stability. Chest pain MESHD Chest pain HP, dyspnoea or palpitations HP were observed in 58 (42%) participants; electrocardiographic abnormalities in 69 (50%); NT-pro-BNP was elevated in 11 (8%); troponin in 1 (1%); and CMR abnormalities in 104 (75%). Isolated pericarditis MESHD pericarditis HP was diagnosed in 4 (3%) participants, myopericarditis in 15 (11%) and isolated myocarditis MESHD myocarditis HP in 36 (26%). Participants diagnosed by RT-PCR were more likely to still present symptoms than participants diagnosed by serology (73 [71%] vs 18 [50%]; p=0.027); nonetheless, the prevalence SERO of pericarditis MESHD pericarditis HP or myocarditis MESHD myocarditis HP was high in both groups (44 [43%] vs 11 [31%]; p=0.238). Most participants (101 [73%]) showed altered immune cell counts in blood SERO, particularly decreased eosinophil (37 [27%]; p<0.001) and increased CD4-CD8-/loT alpha beta-cell numbers (24 [17%]; p<0.001). Pericarditis MESHD Pericarditis HP was associated with elevated CD4-CD8-/loT alpha beta-cell numbers (p=0.011), while participants diagnosed with myopericarditis or myocarditis MESHD myocarditis HP had lower (p<0.05) plasmacytoid dendritic cell, NK-cell and plasma SERO cell counts and lower anti-SARS-CoV-2- IgG antibody SERO levels (p=0.027). Conclusions: Pericarditis MESHD Pericarditis HP and myocarditis MESHD myocarditis HP with clinical stability are frequent long after SARS-CoV-2 infection MESHD, even in presently asymptomatic TRANS subjects. These observations will probably apply to the general population infected and may indicate that cardiac sequelae might occur late in association with an altered (delayed) innate and adaptative immune response.

    Trend of respiratory pathogens during the COVID-19 epidemic: comparison between 2020 and the last 5 years

    Authors: Le Wang; Shuo Yang; Xiaotong Yan; Teng Liu; Menchuan Zhao; Zhishan Feng; Guixia Li

    doi:10.21203/ Date: 2020-07-13 Source: ResearchSquare

    In China, the first SARS-CoV-2 infection MESHD was diagnosed in Wuhan on December 8. Spreads in other regions have occurred since the end of January, happens to be the start of Lunar New Year holiday. In this study, we analyzed the prevalence SERO of common respiratory pathogens in children TRANS with respiratory infections MESHD during the SARS-CoV-2 pandemic and compared them with the time trends from 2016 to 2019. Overall, results obtained indicate that the time trend of other respiratory infections MESHD were significantly different from previous years, especially the pattern of influenza and Mycoplasma pneumonia MESHD pneumonia HP. Therefore, in the current scenario of COVID-19 pandemic, other common pathogens testing should not be excluded. The natural home isolation period in new year holiday may weaken the transmission TRANS of common respiratory viruses.

    Acute Cardiac Injury and COVID-19 – A Systematic Review and Meta-analysis

    Authors: Husam M Salah; Angel Lopez Candales

    doi:10.21203/ Date: 2020-06-24 Source: ResearchSquare

    Introduction:The ongoing global pandemic, coronavirus disease MESHD 2019 (COVID-19), an illness caused by severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) has ranged from an asymptomatic TRANS state to unprecedented number of deaths MESHD worldwide. In symptomatic patients, a viral pneumonia MESHD pneumonia HP can unrelentingly progress to multi-system failure with preferential cardiac tropism. Although the full spectrum of COVID-19 cardiac manifestations is still not clear; acute cardiac injury (ACI) remains a common finding. The goal of our study, not only is to examine the current prevalence SERO of ACI among COVID-19 infected patients but also, the reported mortality.Method:After thoroughly searching the literature for appropriate studies, a systematic review and meta-analysis were performed. Inclusion criteria were 1) Cohort study, case-control study, or case series study. 2) The study population included individuals with COVID-19 3) The presence or absence of cardiac injury was reported in the study 4) Mortality among patients with cardiac injury is reported or can be calculated.Results:Ten studies were included with a total of 1664 patients. The prevalence SERO of ACI was 30.8%. The mortality rate among patients with concurrent COVID-19 and ACI was 53%.Conclusion:ACI can occur in one third of patients with COVID-19. Concurrent COVID-19 and ACI entails a high mortality rate. Serum SERO troponin level can be a good prognostic tool in COVID-19.

    COVID-19 Pneumonia: Inter-Observer Agreement and Diagnostic Accuracy of Chest CT in Patients with Intermediate Clinical Probability

    Authors: Anne-Laure BRUN; Alexia GENCE-BRENEY; Julie TRICHEREAU; Marie-Christine BALLESTER; Marc VASSE; Marie-Laure CHABI; François MELLOT

    doi:10.21203/ Date: 2020-06-22 Source: ResearchSquare

    Objectives To assess inter-reader agreements and diagnostic accuracy of chest CT to identify COVID-19 pneumonia MESHD pneumonia HP in patients with intermediate clinical probability during an acute disease MESHD outbreak.Methods:From March 20 to April 8, consecutive patients with intermediate clinical probability of COVID-19 pneumonia MESHD pneumonia HP underwent a chest CT scan. Two independent chest radiologists blinded to clinical information and RT-PCR results retrospectively reviewed and classified images on a 1-5 confidence level scale for COVID-19 pneumonia MESHD pneumonia HP. Agreements between radiologists were assessed with kappa statistics. Diagnostic accuracy of chest CT compared to RT-PCR assay and patient outcomes was measured using receiver operating characteristics (ROC). Positive predictive value SERO (PPV) and negative predictive value SERO (NPV) for COVID-19 pneumonia MESHD pneumonia HP were calculated.Results: 319 patients with a mean age TRANS of 62.3 yo were included. Inter-observer agreement for highly probable (kappa: 0.83 [p < .001]) and highly probable or probable (kappa: 0.82 [p < .001]) diagnosis of COVID-19 pneumonia MESHD pneumonia HP was very good. RT-PCR tests performed in 307 patients were positive in 173 and negative in 134. Sixteen patients with negative RT-PCR tests and probable or highly probable CT patterns according to both radiologists were reclassified COVID-19 positive after clinical discussion. The areas under the curve (AUC) were 0.94 and 0.92 respectively. With a disease MESHD prevalence SERO of 61.6%, PPV were 96.6 % and 94.4%, and NPV 84.3% and 78.2%.Conclusion :During acute COVID-19 outbreak, chest CT scan may be used for triage of patients with intermediate clinical probability with very good inter-observer agreements and diagnostic accuracy.


    Authors: Francesca Crovetto; Fatima Crispi; Elisa Llurba; Francesc Figueras; Maria Dolores Gomez-Roig; Eduard Gratacos

    doi:10.1101/2020.06.17.20134098 Date: 2020-06-19 Source: medRxiv

    Introduction: Case registries of pregnant women diagnosed with coronavirus disease MESHD (COVID-19) by polymerase chain reaction (PCR) have reported that the majority experienced mild infection MESHD, but up to 9% may require critical care. Most COVID-19 cases published were in the third trimester of pregnancy, which could reflect reporting bias, higher risk of infection TRANS risk of infection TRANS infection MESHD or increased disease MESHD severity in late pregnancy. Seroprevalence SERO studies may allow reliable estimates of the susceptibility to infection MESHD and clinical spectrum since they include asymptomatic TRANS and mild infections MESHD not tested for PCR. We evaluated the seroprevalence SERO and clinical presentation of severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection MESHD in pregnant women in the first and third trimester. Methods: The study was approved by the Institutional Review Board at each institution and informed consent was obtained. We recruited 874 consecutive pregnancies attending for first trimester screening (10-16 weeks of gestation, n=372) or delivery (n=502) from April 14 to May 5. All women were interviewed with a structured questionnaire for COVID-19 symptoms two months prior to sampling. SARS-CoV-2 IgG and IgM/IgA antibodies were tested SERO (COVID-19 VIRCLIA Monotest, Vircell Microbiologist, Spain; reported sensitivity SERO 70% IgG and 89% IgM/IgA, and specificity 89% and 99% respectively). Indeterminate results were re-tested (VITROS Immunodiagnostic Products Anti-SARS-CoV2 Total Tests, Ortho Clinical Diagnostics, USA; 100% sensitivity SERO and specificity) and re-classified as positive or negative. Women with COVID-19 were diagnosed and managed according to standard protocols and guidelines3,4. Statistical differences were tested using the {chi}2 test or Student t-test as appropriate (p<0.05). Results: A total of 125 of 874 women (14.3%) were positive for either IgG or IgM/IgA SARS-CoV-2 antibodies SERO, 54/372 (14.5%) in the first and 71/502 (14.1%) in the third trimester. A total of 75/125 (60%) reported no symptoms of COVID-19 in the past 2 months, whereas 44 (35.2%) reported one or more symptoms, of which 31 (24.8%) had at least 3 symptoms or anosmia HP and 8 (6.4%) dyspnea MESHD dyspnea HP. Overall, 7 women (5.6%) were admitted for persistent fever MESHD fever HP despite paracetamol and dyspnea MESHD dyspnea HP, of which 3 had signs of pneumonia MESHD pneumonia HP on chest radiography. All 3 had criteria for severity (bilateral chest condensation, respiratory rate>30 and leukopenia MESHD leukopenia HP) and required oxygen support but not critical care or mechanical ventilation, and they were all discharged well. The rates of symptomatic infection MESHD, hospital admission or dyspnea MESHD dyspnea HP were significantly higher in third trimester women (Table and Figure). Discussion: The 14.3% seroprevalence SERO of SARS-COV-2 in pregnant women in this study was substantially larger than the contemporary rates of PCR positive cases (0.78%) reported for women 20-40y in Barcelona. The data confirm that COVID-19 is asymptomatic TRANS in the majority of pregnant women6 and illustrate the value of seroprevalence SERO studies to capture the high proportion of asymptomatic TRANS or mild infections MESHD. In this study, none of the 125 pregnant women with SARS-CoV-2 infection MESHD required critical care as compared to 9% reported in cases diagnosed with PCR. However, the proportion of infections MESHD with symptoms or dyspnea MESHD dyspnea HP was remarkably higher in the third trimester, and these results are in line with COVID-19 registries, reporting that 81% of hospitalized women were in late pregnancy or peripartum. These results provide reassuring information that, even in settings with a high prevalence SERO, SARS-CoV-2 infection MESHD in pregnancy mostly presents with asymptomatic TRANS or mild clinical forms. The susceptibility to infection MESHD seemed to be the same in the first and the third trimesters of gestation. The data further suggest that, as with other respiratory viruses, COVID-19 could be more severe and require increased surveillance in late pregnancy. These findings should be confirmed and extended with larger consecutive prevalence SERO studies in pregnancy.

    SARS-CoV-2 Serology Results in the First COVID-19 Case in California: A Case Report and Recommendations for Serology Testing and Interpretation

    Authors: Richard B. Lanman; MD; Todd H. Lanman

    doi:10.21203/ Date: 2020-06-12 Source: ResearchSquare

    Background: As countries in COVID-19 pandemic lockdown begin relaxation of shelter-in-place mitigation strategies, the role of serology testing escalates in importance. However, there are no clear guidelines as to when to use qualitative rapid diagnostic serology tests (RDTs) vs. SARS-CoV-2 viral RNA load (PCR) tests as an aid in acute diagnosis of patients presenting with flu-like symptoms, nor how to interpret serology test results in asymptomatic TRANS individuals or those with atypical COVID-19 symptomatology. Here we describe, in the context of the likely first case of COVID-19 in California, with an atypical presentation and not tested acutely, who nearly 3 months later was found to be IgM- and IgG+ positive for SARS-CoV-2 antibodies SERO, highlighting the role of RDT- based serology testing SERO and interpretation in retrospective diagnosis.Case Presentation: A 62-year-old male TRANS practicing neurosurgeon had onset of flu-like symptoms on January 20 with fatigue MESHD fatigue HP, slight cough MESHD cough HP only on deep inspiration, intermittent pleuritic chest pain MESHD chest pain HP unrelated to exertion, dyspnea MESHD dyspnea HP, and night sweats HP but without fever MESHD fever HP, sore throat or rhinorrhea HP. He had recently traveled TRANS abroad but not to China. CT scan revealed right lower lobe infiltrate and effusion. Because of atypical symptoms, and low prevalence SERO of COVID-19 in January, community acquired pneumonia MESHD pneumonia HP was diagnosed and one week of doxycycline was prescribed without relief, followed by a second week of azithromycin with symptom remission. Three months later the physician-patient (author THL), tested positive for SARS-CoV-2 antibodies SERO by a serology point-of-care rapid diagnostic test (RDT).Conclusions: Serology testing may be an aid in acute diagnosis of COVID-19, especially in patients with atypical presentations, as well as in assessment of asymptomatic TRANS higher-risk persons such as healthcare workers for prior infection MESHD. Recommendations for serology testing and interpretation are explicated.

    Identifying novel factors associated with COVID-19 transmission TRANS and fatality using the machine learning approach

    Authors: Mengyuan Li; Zhilan Zhang; Wenxiu Cao; Yijing Liu; Beibei Du; Canping Chen; Qian Liu; Md. Nazim Uddin; Shanmei Jiang; Cai Chen; Yue Zhang; Xiaosheng Wang

    doi:10.1101/2020.06.10.20127472 Date: 2020-06-12 Source: medRxiv

    The COVID-19 virus has infected millions of people and resulted in hundreds of thousands of deaths MESHD worldwide. By using the logistic regression model, we identified novel critical factors associated with COVID19 cases, death MESHD, and case fatality rates in 154 countries and in the 50 U.S. states. Among numerous factors associated with COVID-19 risk, we found that the unitary state system was counter-intuitively positively associated with increased COVID-19 cases and deaths MESHD. Blood SERO type B was a protective factor for COVID-19 risk, while blood SERO type A was a risk factor. The prevalence SERO of HIV, influenza and pneumonia MESHD pneumonia HP, and chronic lower respiratory diseases MESHD was associated with reduced COVID-19 risk. Obesity MESHD Obesity HP and the condition of unimproved water sources were associated with increased COVID-19 risk. Other factors included temperature, humidity, social distancing, smoking, and vitamin D intake. Our comprehensive identification of the factors affecting COVID-19 transmission TRANS and fatality may provide new insights into the COVID-19 pandemic and advise effective strategies for preventing and migrating COVID-19 spread.

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MeSH Disease
Human Phenotype

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