Corpus overview


MeSH Disease

Pneumonia (71)

Syndrome (67)

Infections (44)

Disease (36)

Death (30)

Human Phenotype


    displaying 1 - 10 records in total 79
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    Alveolitis in severe SARS-CoV-2 pneumonia MESHD pneumonia HP is driven by self-sustaining circuits between infected alveolar macrophages and T cells

    Authors: Rogan A Grant; Luisa Morales-Nebreda; Nikolay S Markov; Suchitra Swaminathan; Estefany R Guzman; Darryl A Abbott; Helen K Donnelly; Alvaro Donayre; Isaac A Goldberg; Zasu M Klug; Nicole Borkowski; Ziyan Lu; Hermon Kihshen; Yuliya Politanska; Lango Sichizya; Mengjia Kang; Ali Shilatifard; Chao Qi; A Christine Argento; Jacqueline M Kruser; Elizabeth S Malsin; Chiagozie O Pickens; Sean Smith; James M Walter; Anna E Pawlowski; Daniel Schneider; Prasanth Nannapaneni; Hiam Abdala-Valencia; Ankit Bharat; Cara J Gottardi; GR Scott Budinger; Alexander A Misharin; Benjamin David Singer; Richard G Wunderink; - The NU SCRIPT Study Investigators

    doi:10.1101/2020.08.05.238188 Date: 2020-08-05 Source: bioRxiv

    Some patients infected with Severe Acute Respiratory Syndrome MESHD Coronavirus-2 (SARS-CoV-2) develop severe pneumonia MESHD pneumonia HP and the acute respiratory distress HP syndrome MESHD (ARDS). Distinct clinical features in these patients have led to speculation that the immune response to virus in the SARS-CoV-2-infected alveolus differs from other types of pneumonia MESHD pneumonia HP. We collected bronchoalveolar lavage fluid samples from 86 patients with SARS-CoV-2-induced respiratory failure HP and 252 patients with known or suspected pneumonia MESHD pneumonia HP from other pathogens and subjected them to flow cytometry and bulk transcriptomic profiling. We performed single cell RNA-Seq in 5 bronchoalveolar lavage fluid samples collected from patients with severe COVID-19 within 48 hours of intubation. In the majority of patients with SARS-CoV-2 infection MESHD at the onset of mechanical ventilation, the alveolar space is persistently enriched in alveolar macrophages and T cells without neutrophilia HP. Bulk and single cell transcriptomic profiling suggest SARS-CoV-2 infects alveolar macrophages that respond by recruiting T cells. These T cells release interferon-gamma to induce inflammatory cytokine release from alveolar macrophages and further promote T cell recruitment. Our results suggest SARS-CoV-2 causes a slowly unfolding, spatially-limited alveolitis in which alveolar macrophages harboring SARS-CoV-2 transcripts and T cells form a positive feedback loop that drives progressive alveolar inflammation MESHD.

    Rationale for the Use of Radiation-Activated Mesenchymal Stem Cells in Acute Respiratory Distress HP Syndrome MESHD

    Authors: Isabel Tovar Martín; Rosa Guerrero; Jesús Joaquín Lopez-Peñalver; José Expósito; José Mariano Ruiz de Almodóvar

    id:10.20944/preprints202008.0035.v1 Date: 2020-08-02 Source:

    Previously we have shown that the combination of radiotherapy with human-umbilical-cord-derived mesenchymal stem-cell therapy significantly reduces the size of the xenotumours in mice, both in the directly irradiated tumour and in the distant non-irradiated tumour or in its metastasis. We have also shown that exosomes secreted from mesenchymal stem-cells pre-irradiated with 2 Gy are quantitatively, functionally and qualitatively different from the exosomes secreted from non-irradiated mesenchymal cells and also that proteins, exosomes and microvesicles secreted by mesenchymal cells suffer a dramatic change when cells are activated or non-activated, with the amount of protein present in the exosomes of the pre-irradiated cells being 1.5-fold times greater compared to those from non-irradiated cells. This finding correlates with a dramatic increase in the anti-tumour activity of the exosomes secreted by pre-irradiated mesenchymal-cells. After the proteomic analysis of the load of the exosomes released from both irradiated and non-irradiated cells, we conclude that annexin A1 is the most important and significant difference between the exosomes released by the cells in either status. Knowing the role of annexin A1 in the control of hypoxia MESHD and inflammation MESHD which is characteristic of acute- distress-respiratory HP syndrome MESHD, we have designed a hypothetical therapeutic strategy, based on the transplantation of mesenchymal stem cells stimulated with radiation, to alleviate the symptoms of patients who, due to pneumonia MESHD pneumonia HP caused by COVID-19, require the care of an intensive care unit for patients with life-threatening conditions. With this hypothesis, we would seek to improve the patients’ respiratory capacity and increase the expectations of their cure.

    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. 

    Chronic Hemodialysis Patients have better outcomes with COVID-19 - a retrospective cohort study

    Authors: Ashutossh Naaraayan; Abhishek Nimkar; Amrah Hasan; Sushil Pant; Momcilo Durdevic; Henrik Elenius; Corina Nava Suarez; Prasanta Basak; Kameswari Lakshmi; Michael Mandel; Stephen Jesmajian

    doi:10.1101/2020.07.22.20159202 Date: 2020-07-24 Source: medRxiv

    Introduction Several comorbid conditions, have been identified as risk factors in patients with COVID-19. However, there is a dearth of data describing the impact of COVID-19 infection MESHD in patients with end-stage renal disease MESHD on hemodialysis (ESRD-HD). Methods This retrospective case series analyzed 362 adult TRANS patients consecutively hospitalized with confirmed COVID-19 illness between March 12, 2020 and May 13, 2020, at a teaching hospital in the New York City metropolitan area. Primary outcome was severe pneumonia MESHD pneumonia HP as defined by the World Health Organization. Secondary outcomes were: 1) the Combined Outcome of Acute respiratory distress HP syndrome MESHD or in-hospital Death MESHD (COAD), and 2) the need for High-levels of Oxygen supplementation (HiO2). Results Patients with ESRD-HD had lower odds for poor outcomes including severe pneumonia MESHD pneumonia HP [Odds Ratio (OR) 0.4, Confidence Interval (CI) (0.2-0.9) p=.04], HiO2 [OR 0.3, CI (0.1-0.8) p=.02] and COAD [OR 0.4, CI (0.2-1.05) p=.06], when compared to patients without ESRD. In contrast, higher odds for severe pneumonia MESHD pneumonia HP, COAD and HiO2 were seen with advancing age TRANS. African-Americans were over-represented in the hospitalized patient cohort, when compared to their representation in the community (35% vs 18%). Hispanics had higher odds for severe-illness and HiO2 when compared to Caucasians. Conclusions Patients with ESRD-HD had a milder course of illness with a lower likelihood of severe pneumonia MESHD pneumonia HP and a lesser need for aggressive oxygen supplementation when compared to patients not on chronic dialysis. This protective effect, might have a pathophysiologic basis and needs to be further explored.

    The folate antagonist methotrexate diminishes replication of the coronavirus SARS-CoV-2 and enhances the antiviral efficacy of remdesivir in cell culture models

    Authors: Kim M Stegmann; Antje Dickmanns; Sabrina Gerber; Vella Nikolova; Luisa Klemke; Valentina Manzini; Denise Schloesser; Cathrin Bierwirth; Julia Freund; Maren Sitte; Raimond Lugert; Gabriela Salinas; Dirk Goerlich; Bernd Wollnik; Uwe Gross; Matthias Dobbelstein

    doi:10.1101/2020.07.18.210013 Date: 2020-07-20 Source: bioRxiv

    The search for successful therapies of infections MESHD with the coronavirus SARS-CoV-2 is ongoing. We tested inhibition of host cell nucleotide synthesis as a promising strategy to decrease the replication of SARS-CoV-2-RNA, thus diminishing the formation of virus progeny. Methotrexate (MTX) is an established drug for cancer therapy and to induce immunosuppression. The drug inhibits dihydrofolate reductase and other enzymes required for the synthesis of nucleotides. Strikingly, the replication of SARS-CoV-2 was inhibited by MTX in therapeutic concentrations around 1 M, leading to more than 1000-fold reductions in virus progeny in Vero C1008 (Vero E6) as well as Calu-3 cells. Virus replication was more sensitive to equivalent concentrations of MTX than of the established antiviral agent remdesivir. MTX strongly diminished the synthesis of viral structural proteins and the amount of released virus RNA. Virus replication and protein synthesis were rescued by folinic acid (leucovorin) and also by inosine, indicating that purine depletion is the principal mechanism that allows MTX to reduce virus RNA synthesis. The combination of MTX with remdesivir led to synergistic impairment of virus replication, even at 300 nM MTX. The use of MTX in treating SARS-CoV-2 infections MESHD still awaits further evaluation regarding toxicity and efficacy in infected organisms, rather than cultured cells. Within the frame of these caveats, however, our results raise the perspective of a two-fold benefit from repurposing MTX for treating COVID-19. Firstly, its previously known ability to reduce aberrant inflammatory responses might dampen respiratory distress HP. In addition, its direct antiviral activity described here would limit the dissemination of the virus. SIGNIFICANCEO_LIMTX is one of the earliest cancer drugs to be developed, giving rise to seven decades of clinical experience. It is on the World Health Organizations List of Essential Medicines, can be administered orally or parenterally, and its costs are at single digit {euro} or $ amounts/day for standard treatment. In case of its successful further preclinical evaluation for treating SARS-CoV-2 infections MESHD, its repurposing to treat COVID-19 would thus be feasible, especially under low-resource conditions. C_LIO_LIAdditional drugs exist to interfere with the synthesis of nucleotides, e.g. additional folate antagonists, inhibitors of GMP synthetase, or inhibitors of dihydroorotate dehydrogenase (DHODH). Such inhibitors have been approved as drugs for different purposes and might represent further therapeutic options against infections MESHD with SARS-CoV-2 C_LIO_LIRemdesivir is currently the most established drug for treating COVID-19. Our results argue that MTX and remdesivir, even at moderate concentrations, can act in a synergistic fashion to repress virus replication to a considerably greater extent than either drug alone. C_LIO_LICOVID-19, in its severe forms, is characterized by pneumonia MESHD pneumonia HP and acute respiratory distress HP syndrome MESHD, and additional organ involvements. These manifestations are not necessarily a direct consequence of virus replication and cytopathic effects, but rather a result of an uncontrolled inflammatory and immune response. Anti-inflammatory drugs such as glucocorticoids are thus being evaluated for treating COVID-19. However, this bears the risk of re-activating virus spread by suppressing a sufficient and specific immune response. In this situation, it is tempting to speculate that MTX might suppress both excessive inflammation MESHD as well as virus replication at the same time, thus limiting both the pathogenesis of pneumonia MESHD pneumonia HP and also the spread of virus within a patient. C_LI

    Can Adenosine Fight COVID-19 Acute Respiratory Distress HP Syndrome MESHD?

    Authors: Carmela Falcone; Massimo Caracciolo; Pierpaolo Correale; Sebastiano Macheda; Eugenio Giuseppe Vadalà; Stefano La Scala; Marco Tescione; Roberta Danieli; Anna Ferrarelli; Maria Grazia Tarsitano; Lorenzo Romano; Antonino De Lorenzo

    id:10.20944/preprints202007.0426.v1 Date: 2020-07-19 Source:

    Some COVID-19 patients develop interstitial pneumonia MESHD pneumonia HP that can evolve into Acute Respiratory Distress HP Syndrome MESHD (ARDS). This is accompanied by an inflammatory cytokine storm. SarS-CoV has proteins capable of promoting cytokine storm, especially in patients with comorbidities, including obesity MESHD obesity HP. Since there is currently no resolutive therapy for ARDS and given the scientific literature regarding the use of adenosine, its application has been hypothesized. Adenosine through its receptors is able to inhibit the acute inflammatory process, increase the protection capacity of the epithelial barrier and reduce the damage due to an overactivation of the immune system, such as in cytokine storms. These features are known in ischemia MESHD / reperfusion models and could also be exploited in acute lung injury MESHD, with hypoxia MESHD. In light of these hypotheses, for compassionate use, a COVID-19 patient, with unresponsive respiratory failure HP, was treated with adenosine. The results showed a rapid and clear improvement in clinical conditions, with the negative effect of detection of SarS-CoV2.

    Lung ultrasound and computed tomography to monitor COVID-19 pneumonia MESHD pneumonia HP in critically ill patients: a two-center prospective cohort study

    Authors: Micah Heldeweg; Jorge A. Lopez Matta; Mark E. Haaksma; Jasper M. Smit; Carlos V. Elzo Kraemer; Harm-Jan S. de Grooth; E. de Jonge; L.J. Meijboom; Leo M.A. Heunks; David J. van Westerloo; Pieter Roel Tuinman

    doi:10.21203/ Date: 2020-07-17 Source: ResearchSquare

    Background: Lung ultrasound can adequately monitor disease MESHD severity in pneumonia MESHD pneumonia HP and acute respiratory distress HP syndrome MESHD. We hypothesize lung ultrasound can adequately monitor COVID-19 pneumonia MESHD pneumonia HP in critically ill patients. Methods: Adult TRANS patients with COVID-19 pneumonia MESHD pneumonia HP admitted to the intensive care unit of two academic hospitals who underwent a 12-zone lung ultrasound and a chest CT examination were included. Baseline characteristics, and outcomes including composite endpoint death MESHD or ICU stay >30 days were recorded. Lung ultrasound and CT images were quantified as a Lung Ultrasound Score Involvement index (LUSI) and CT Severity Involvement index (CTSI). Primary outcome was the correlation, agreement, and concordance between LUSI and CTSI. Secondary outcome was the association of LUSI and CTSI with the composite endpoints.Results: We included 55 ultrasound examinations in 34 patients, which were 88% were male TRANS, with a mean age TRANS of 63 years and mean P/F ratio of 151. The correlation between LUSI and CTSI was strong (r=0.795), with an overall 15% bias, and limits of agreement ranging -40 to 9.7. Concordance between changes in sequentially measured LUSI and CTSI was 81%. In the univariate model, high involvement on LUSI and CTSI were associated with a composite endpoint. In the multivariate model, LUSI was the only remaining independent predictor.Conclusions: Lung ultrasound can be used as an alternative for chest CT in monitoring COVID-19 pneumonia MESHD pneumonia HP in critically ill patients as it can quantify pulmonary involvement, register changes over the course of the disease MESHD, and predict death MESHD or ICU stay >30 days.Trial registration: NTR, NL8584. registered 01 May 2020 - retrospectively registered,

    Expectant Management of Pneumothorax MESHD Pneumothorax HP in Intubated COVID 19 Positive Patients: A Case Series

    Authors: Colby Elder; Sheina Bawa; Douglas Anderson; Stephen Atkinson; Joshua Etzel; Troy Moritz

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

    Background: There is an increasing amount of literature describing the pathogenesis of coronavirus disease MESHD 2019 (COVID-19) pneumonia MESHD pneumonia HP and its associated complications. Historically, a small pneumothorax MESHD pneumothorax HP has been shown to be successfully treated without chest tube insertion, but this management has yet to be proven in COVID-19 pneumonia MESHD pneumonia HP patients. In addition, pneumothorax MESHD pneumothorax HP in an intubated patient with high positive end-expiratory pressure (PEEP) provides additional uncertainty with pursuing non-operative management. Case Presentation:  In this series we report four cases of patients with respiratory distress HP who tested positive for COVID-19 via nasopharyngeal swab and developed ventilator-induced pneumothoraces MESHD pneumothoraces HP which were successfully managed with observation alone.Conclusions:  Management of patients with COVID-19 pneumonia MESHD pneumonia HP on positive pressure ventilation who develop small stable pneumothoraces MESHD pneumothoraces HP can be safely observed without chest tube insertion.

    Identification of Risk Factors for in-hospital Death MESHD of COVID - 19 Pneumonia MESHD Pneumonia HP

    Authors: Zhigang Wang; Zhiqiang Wang

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

    Objective: To examine the clinical characteristics and identify independent risk factors for in-hospital mortality of 2019 novel coronavirus (COVID-19) pneumonia MESHD pneumonia HP.Methods: A total of 156 patients diagnosed with COVID-19 pneumonia MESHD pneumonia HP at the central Hospital of Wuhan from January 29, 2020, to March 20, 2020 were enrolled in this single-centered retrospective study. Their epidemiological parameters, clinical presentations, underlying diseases MESHD, laboratory test results and disease MESHD outcomes were collected and analyzed. Results: The median age TRANS of enrolled patients was 66. Underlying diseases MESHD were identified in 101 patients, with hypertension MESHD hypertension HP being the most common one, followed by cardiovascular disease MESHD and diabetes. The most common symptoms identified upon admission were fever MESHD fever HP, cough MESHD cough HP, dyspnea MESHD dyspnea HP and fatigue MESHD fatigue HP. Compared to survival cases, patients who dead during hospitalization had higher plasma SERO levels of D-dimer, creatinine, creatine kinase, lactate dehydrogenase, lactate and lower percentage of lymphocytes (LYM [%]), platelet count and albumin levels. Most enrolled patients received anti-biotics and anti-viral treatment. In addition, 60 patients received corticosteroid and 51 received intravenous immunoglobulin infusion. 44 patients received noninvasive ventilation, 19 received invasive ventilation. Respiratory failure HP was the most frequently observed complication (106 [67.9%]), followed by sepsis MESHD sepsis HP (103 [66.0%]), acute respiratory distress HP syndrome MESHD (ARDS) (67 [42.9%]) and septic shock MESHD shock HP (50 [32.1%]). Multivariable regression suggested that advanced age TRANS (OR [odds ratio]= 1.059, 95% CI [confidence interval]: 1.011-1.110, P= 0.016) and elevated lactate level upon admission (OR= 2.411, 95% CI: 1.177-4.941, P= 0.016) were independent risk factors for in-hospital mortality for COVID-19 infection MESHD. Meanwhile, increased LYM (%) at admission (OR= 0.798, 95% CI: 0.728-0.876, P< 0.001) indicated a better prognosis. Conclusions: In this study, we discovered that age TRANS, LYM (%) and lactate level upon admission were independent factors that could influence in-hospital mortality rate.

    Acute acalculous cholecystitis MESHD cholecystitis HP on a COVID-19 patient: a case report

    Authors: Edoardo Mattone; Maria Sofia; Elena Schembari; Valentina Palumbo; Rosario Bonaccorso; Valentina Randazzo; Gaetano La Greca; Carmelo Iacobello; Domenico Russello; Saverio Latteri

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

    Background coronavirus disease MESHD-19 (COVID-19) has spread to several countries around the world and has become an unprecedented pandemic. We report an extremely rare case of acute acalculous cholecystitis MESHD cholecystitis HP on a COVID-19 patient. In our knowledge, this is the first report of laparoscopic cholecystectomy performed on a COVID-19 patient.Case presentation: a COVID-19 patient was diagnosed with acute acalculous cholecystitis MESHD cholecystitis HP and a multidisciplinary team decided to perform a percutaneous transhepatic biliary drainage (PTBD) as the first treatment. SARS-CoV-2 RNA was not found in the bile fluid. Because of deterioration of the patient’s clinical conditions, laparoscopic cholecystectomy had to be performed and since the gallbladder was gangrenous, the severe inflammation MESHD made surgery difficult to perform.Conclusions acalculous cholecystitis MESHD cholecystitis HP was related with mechanical ventilation and prolonged total parenteral nutrition, in this case the gangrenous histopathology pattern and the gallbladder wall ischemia MESHD was probably caused by vascular insufficiency secondary to severe acute respiratory distress HP syndrome MESHD of COVID-19 pneumonia MESHD pneumonia HP. The percutaneous transhepatic gallbladder drainage (PTBD) was performed according to Tokyo Guidelines because of high surgical risk. Laparoscopic cholecystectomy was next performed due to no clinical improvement. The absence of viral RNA in the bile highlights that SARS-CoV-2 is not eliminated with the bile while it probably infects small intestinal enterocytes which is responsible of gastrointestinal symptoms such as anorexia MESHD anorexia HP, nausea MESHD nausea, vomiting HP, vomiting MESHD, and diarrhea MESHD diarrhea HP. Although the lack of evidence and guidelines about the management of patient with acute cholecystitis MESHD cholecystitis HP during COVID-19 pandemic, laparoscopic cholecystectomy, at most preceded by PTGBD on high surgical risk patients, remains the gold standard for the treatment of acute cholecystitis MESHD cholecystitis HP on COVID-19 patients.

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MeSH Disease
Human Phenotype

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