Corpus overview


MeSH Disease

Human Phenotype


    displaying 1 - 10 records in total 82
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    60-day survival of critically ill COVID-19 first comers

    Authors: Corinna N. Lang; V. Zotzmann; B. Schmid; M. Berchtold-Herz; S. Utzolino; P.M. Biever; T. Pottgießer; D. Duerschmied; C. Bode; T. Wengenmayer; D.L. Staudacher

    doi:10.21203/ Date: 2020-07-29 Source: ResearchSquare

    Background: Germany reported sufficient intensive care unit (ICU) resources throughout the first wave of coronavirus disease MESHD 2019 (COVID-19). The treatment of critically ill COVID-19 patients without rationing may improve the outcome. We therefore analyzed resources allocated to critically ill COVID-19 patients and their outcomes. Methods: Retrospectively, we enrolled SARS-CoV2 PCR positive patients with respiratory failure HP from 03/08/2020 to 04/08/2020 and followed until 05/28/2020 in the university hospital of Freiburg, Germany. Results: Thirty-four COVID-19 patients were admitted to the ICU in the defined interval with medium age TRANS of 67±13 (31-86) years. 6/34 (17.6%) were female TRANS. All patients suffered from moderate or severe acute respiratory distress HP syndrome MESHD (ARDS), 91.2% of the patients were intubated and 23.5% required extracorporeal membrane oxygenation (ECMO). Proning was performed in 67.6%, renal replacement therapy (RRT) was required in 35.3%. 96% required more than 20 nursing hours per day. Mean ICU stay was 21±19 (1-81) days. 60-day survival of critically ill COVID-19 patients was 50.0% (17/34). Causes of death MESHD were multi-organ failure (52.9%), refractory ARDS (17.6%) and intracerebral hemorrhage MESHD (17.6%). Conclusions: Treatment of critically ill COVID-19 patients is protracted and resource intense. In a context without resources shortage, 50% of critically ill COVID-19 survived up to 60 days.

    Prophylaxis with tetracyclines in ARDS: Potential therapy for COVID-19-induced ARDS?

    Authors: James D Byrne; Rameen Shakur; Joy Collins; Sarah L Becker; Cameron C Young; Hannah Boyce; Carlo Traverso

    doi:10.1101/2020.07.22.20154542 Date: 2020-07-28 Source: medRxiv

    There is an immediate need for therapies related to coronavirus disease MESHD 2019 (COVID-19), especially candidate drugs that possess anti-inflammatory and immunomodulatory effects with low toxicity profiles. We hypothesized the application of pleiotropic tetracyclines as potential therapeutic candidates. Here, we present a retrospective multi-institutional cohort study evaluating ventilatory status in patients who had taken a tetracycline antibiotic within a year prior to diagnosis of acute respiratory distress HP syndrome MESHD (ARDS). The primary outcomes were the need for mechanical ventilation and duration of mechanical ventilation. The secondary outcome was the duration of intensive care unit (ICU) stay. Data was evaluated using logistic regression and treatment effects regression models. Minocycline or doxycycline treatment within a year prior to ARDS diagnosis was associated with a 75% reduced likelihood for mechanical ventilation during hospital stay. Furthermore, tetracycline antibiotic therapy corresponded to significant reductions in duration of mechanical ventilation and ICU stay in ARDS patients. These data suggest tetracyclines may provide prophylactic benefit in reducing ventilatory support for ARDS patients and support further evaluation in a randomized prospective trial.

    Developing the nomogram for the prediction of in-hospital incidence of acute respiratory distress syndrome MESHD in patients with COVID-19

    Authors: Ning Ding; Yang Zhou; Guifang Yang; Cuirong Guo; Fengning Tang; Xiangping Chai

    doi:10.21203/ Date: 2020-07-26 Source: ResearchSquare

    Background: Acute respiratory distress HP syndrome MESHD (ARDS) was the most common complication of coronavirus disease MESHD-2019(COVID-19), leading to poor clinical outcomes. However, the model to predict the in-hospital incidence of ARDS in patients with COVID-19 is limited. Therefore, we aimed to develop a predictive nomogram for the in-hospital incidence of ARDS in COVID-19 patients.Methods: Patients with COVID-19 admitted to Changsha Public Health Centre between Jan 30, 2020, and Feb 22, 2020, were enrolled. Clinical characteristics and laboratory variables were analyzed in patients with ARDS. Risk factors for ARDS were selected by LASSO binary logistic regression. Nomogram was established based on risk factors and validated by the dataset.Results: A total of 113 patients, involving 99 in the non-ARDS group and 14 in the ARDS group were included in the study. 8 variables including hypertension MESHD hypertension HP, chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP (COPD), cough MESHD cough HP, lactate dehydrogenase (LDH), creatine kinase (CK), white blood SERO count (WBC), body temperature, and heart rate were identified to be included in the model. The specificity, sensitivity SERO, and accuracy of the full model were 100%, 85.7%, and 87.5% respectively. The calibration curve also showed good agreement between the predicted and observed values in the model.Conclusions: The nomogram can predict the in-hospital incidence of ARDS in COVID-19 patients. It helps physicians to make an individualized treatment plan for each patient.

    Cell type-specific immune dysregulation HP in severely ill COVID-19 patients

    Authors: Changfu Yao; Stephanie A Bora; Tanyalak Parimon; Tanzira Zaman; Oren A Friedman; Joseph A Palatinus; Nirmala S Surapaneni; Yuri P Matusov; Giuliana Cerro Chiang; Alexander G Kassar; Nayan Patel; Chelsi ER Green; Adam W Aziz; Harshpreet Suri; Jo Suda; Andres A Lopez; Gislaine A Martins; Barry R Stripp; Sina A Gharib; Helen S Goodridge; Peter Chen

    doi:10.1101/2020.07.23.20161182 Date: 2020-07-24 Source: medRxiv

    Coronavirus disease MESHD 2019 (COVID-19) has quickly become the most serious pandemic since the 1918 flu pandemic. In extreme situations, patients develop a dysregulated inflammatory lung injury MESHD called acute respiratory distress HP syndrome MESHD (ARDS) that causes progressive respiratory failure HP requiring mechanical ventilatory support. Recent studies have demonstrated immunologic dysfunction in severely ill COVID-19 patients. To further delineate the dysregulated immune response driving more severe clinical course from SARS-CoV-2 infection MESHD, we used single-cell RNA sequencing (scRNAseq) to analyze the transcriptome of peripheral blood SERO mononuclear cells (PBMC) from hospitalized COVID-19 patients having mild disease MESHD (n = 5), developing ARDS (n = 6), and recovering from ARDS (n = 6). Our data demonstrated an overwhelming inflammatory response with select immunodeficiencies HP within various immune populations in ARDS patients. Specifically, their monocytes had defects in antigen presentation and deficiencies in interferon responsiveness that contrasted the higher interferon signals in lymphocytes. Furthermore, cytotoxic activity was suppressed in both NK and CD8 lymphocytes whereas B cell activation was deficient, which is consistent with the delayed viral clearance in severely ill COVID-19 patients. Finally, we identified altered signaling pathways in the severe group that suggests immunosenescence and immunometabolic changes could be contributing to the dysfunctional immune response. Our study demonstrates that COVID-19 patients with ARDS have an immunologically distinct response when compared to those with a more innocuous disease MESHD course and show a state of immune imbalance in which deficiencies in both the innate and adaptive immune response may be contributing to a more severe disease MESHD course in COVID-19.

    Sequential use of hemadsorption using Cytosorb® and Biosky® filter- technology in a COVID-19 patient suffering from severe ARDS 

    Authors: Matthias Mezger; Ingo Eitel; Stephan Ensminger; Dirk Pogorzalek; Zhipan Huang; Tobias Graf

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

    In March 2020, the World Health Organization (WHO) declared the novel coronavirus disease MESHD (COVID- 19) pandemic. Here, we present the case of a patient who was admitted to our hospital with acute respiratory distress HP syndrome MESHD (ARDS) following infection MESHD with COVID-19. After initial stabilization through restrictive fluid management, hemadsorption using Cytosorb® was performed and finally temporary extubation of the patient was possible. However, the patient again clinically deteriorated and needed ventilation and finally ECMO-support and high catecholamine application. Whilst being on VV- ECMO, hemadsorption using Biosky® MG 350 filter was performed. In this manuscript, after a brief overview of the role of hemadsorption in ARDS, a detailed case presentation is followed by a critical discussion of the current literature.


    Authors: Enric Monreal; Susana Sainz de la Maza; Elena Natera-Villalba; Alvaro Beltran-Corbellini; Fernando Rodriguez-Jorge; Jose Ignacio Fernandez-Velasco; Paulette Walo-Delgado; Alfonso Muriel; Javier Zamora; Araceli Alonso-Canovas; Jesus Fortun; Luis Manzano; Beatriz Montero-Errasquin; Lucienne Costa-Frossard; Jaime Masjuan; Luisa Maria Villar

    doi:10.1101/2020.07.17.20156315 Date: 2020-07-17 Source: medRxiv

    INTRODUCTION: Despite the increasing evidence of the benefit of corticosteroids for the treatment of moderate-severe Coronavirus disease MESHD 2019 (COVID-19) patients, no data are available about the potential role of high doses of steroids for these patients. METHODS: All consecutive confirmed COVID-19 patients admitted to a single center were selected, including those treated with steroids and an acute respiratory distress HP syndrome MESHD (ARDS). Patients were allocated to the high doses (HD, 250mg/day or more of methylprednisolone) of corticosteroids or the standard doses (SD, 1.5mg/kg/day or more of methylprednisolone) at discretion of treating physician. The primary endpoint was the mortality between both cohorts and secondary endpoints were the risk of need for mechanical ventilation (MV) or death MESHD and the risk of developing a severe ARDS. RESULTS: 573 patients were included: 428 (74.7%) men, with a median (IQR) age TRANS of 64 (54-73) years. In HD cohort, a worse baseline respiratory situation was observed and male TRANS sex, older age TRANS and comorbidities were significantly more common. After adjusting by baseline characteristics, HD were associated with a higher mortality than SD (adjusted-OR 2.46, 95% CI 1.58-3.83, p<0.001) and with an increased risk of needing MV or death MESHD (adjusted-OR 2.50, p=0.001). Conversely, the risk of developing a severe ARDS was similar between groups. Interaction analysis showed that HD increased mortality exclusively in elderly TRANS patients. CONCLUSION: Our real-world experience advises against exceeding 1-1.5mg/kg/day of corticosteroids for severe COVID-19 with an ARDS, especially in older subjects. This reinforces the rationale of modulating rather than suppressing immune responses in these patients.

    Early Improvement of Acute Respiratory Distress HP Syndrome MESHD in Patients with COVID-19: Insights from the Data of ICU Patients in Chongqing, China

    Authors: Zhu Zhan; Xin Yang; Hu Du; Chuanlai Zhang; Yuyan Song; Xiaoyun Ran; An Zhang; Mei Yang

    doi:10.1101/2020.07.15.20154047 Date: 2020-07-16 Source: medRxiv

    Acute respiratory distress HP syndrome MESHD (ARDS) may be the main cause of death MESHD in patients with coronavirus disease MESHD 2019 (COVID-19). Herein, we retrospect clinical features, outcomes and ARDS characteristics of 75 intensive care unit (ICU) patients with COVID-19 in Chongqing, China. We found a 5.3% case fatality rate of the ICU patients in Chongqing. 93% patients developed ARDS during the intensive care, and more than half were moderate. However, most of the patients (55%) supported with high flow nasal cannula (HFNC) oxygen therapy, but not mechanical ventilation. Nearly one third of patients with ARDS got an early improvement (eiARDS), and the rate is much higher than the other causes of ARDS in a previous study. Patients with eiARDS had a higher survival rate and lower length of ICU stay. The age TRANS (< 55 years) is an independent predictor for the eiARDS, and stratification of COVID-19 patients by age TRANS is recommended.

    Increased serum SERO levels of soluble TNF-α receptor is associated with mortality of ICU COVID-19 patients

    Authors: Esmaeil Mortaz; Payam Tabarsi; Hamidreza Jamaati; Neda Dalil Roofchayee; Neda KakaDezfuli; Seyed MohammadReza Hashemian; Afshin Moniri; Majid Marjani; Majid Malekmohammd; Davood Manosuri; Mohammd Varahram; Gert Folkerts; Ian M Adcock

    doi:10.1101/2020.07.12.20152066 Date: 2020-07-15 Source: medRxiv

    Background: Severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) that causes coronavirus disease MESHD 2019 (COVID-19) has spread to almost 100 countries, infected over 10M patients and resulted in 505K deaths MESHD worldwide as of 30th June 2020. The major clinical feature of severe COVID-19 requiring ventilation is acute Respiratory Distress HP Syndrome MESHD (ARDS) with multi-functional failure as a result of a cytokine storm with increased serum SERO levels of cytokines such as TNF- and IL-6 being reported. TNF- levels are increased during the cytokine storm in very ill patients and soluble receptors for IL-6 and IL-2 are present in the blood SERO of COVID-19 patients, Objectives: To elucidate the involvement of serum SERO levels of soluble TNF-Receptor of severe and mild COVID-19 patients to determine for severity of disease MESHD. Method: We recruited 16 severe COVID-19 patients in the ICU on ventilator support and 26 milder COVID-19 patients who were hospitalised but not within the intensive care unit (ICU) between March-May 2020 at the Masih Daneshvari Hospital Tehran, Iran. After harvesting of whole blood SERO the serum SERO was isolated and soluble TNF-Receptor levels measured by ELISA SERO. Results: Serum SERO levels of the usually inhibitory soluble TNF receptor 1 (sTNFaR1) were significantly elevated in severe COVID-19 patients at admission to ICU. High serum SERO levels of sTNFaR1 were associated with mortality of severe COVID-19 patients treated within ICU. Conclusions: This pilot study demonstrates for role of STNF-aR1 receptor in severity of disease MESHD. Future studies should examine whether lower levels of systemic sTNFaR1 at admission may indicate a better disease MESHD outcome.

    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.

    Prognostic value of bedside lung ultrasound-score in patients with COVID-19

    Authors: Li Ji; Chunyan Cao; Ying Gao; Wen Zhang; Yuji Xie; Yilian Duan; Shuangshuang Kong; Manjie You; Rong Ma; Lili Jiang; Jie Liu; Zhenxing Sun; Ziming Zhang; Jing Wang; Yali Yang; Qing Lv; Li Zhang; Jinxiang Zhang; Yuman Li; Mingxing Xie

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

    BackgroundBedside lung ultrasound (LUS) has emerged as a useful and non-invasive tool to detect lung involvement and monitor changes in patients with coronavirus disease MESHD 2019(COVID-19). While the clinical significance of LUS-score in patients with COVID-19 remains unknown. We aimed to investigate the prognostic value of LUS-score in patients with COVID-19.MethodsLUS protocol consisted of 12 scanning zones and was performed in 280 consecutive patients with COVID-19. LUS-score based on B-lines, pleural line abnormalities and lung consolidation was evaluated. The primary outcome was a combination of severe acute respiratory distress HP syndrome MESHD (ARDS), and mortality.ResultsCompared with patients in the lowest LUS-score group, those in the highest LUS-score group were more likely to have a lower lymphocyte%, higher levels of D-dimer, C-reactive protein, hypersensitive troponin I and creatine kinase muscle-brain, more invasive mechanical ventilation therapy, higher incidence of ARDS, and higher mortality. After a median follow-up of 14 days, 37 patients progressed to the poor outcome. Compared with event-free survivors, patients with adverse event presented higher rate of bilateral involved, more involved zones and B-lines, pleural lines abnormalities and consolidation, and higher LUS-score. The Cox models adding LUS-score as a continuous variable (hazard ratio [HR]: 1.05, 95% confidence intervals [CI]: 1.02~1.08; P < 0.001; Akaike Information Criterion [AIC] =272; C-index = 0.903) or as a categorical variable (HR: 10.76, 95% CI: 2.75~42.05; P = 0.001; AIC =272; C-index = 0.902) were found to predict poor outcome more accurately than the basic model (AIC =286; C-index = 0.866). LUS-score cutoff >12 would predict adverse events with specificity and sensitivity SERO of 90.5% and 91.9%, respectively.ConclusionsLUS-score is a powerful predictor of adverse events in patients with COVID-19, and is important for risk stratification in COVID-19 patients.

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MeSH Disease
Human Phenotype

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