Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    On two cases of atypical respiratory distress HP in eastern Democratic Republic of the Congo months before the COVID-19 pandemic was declared: Could SARS-Cov-2 have been already spreading? Case report

    Authors: Guy-Quesney MATESO; Marius BAGUMA; Pacifique MWENE-BATU; Ghislain MAHESHE BALEMBA; Fabrice NZABARA; Samuel MAKALI; Aline BEDHA; Bonheur FURAHA; Jimmy MINANI; Christian TSHONGO MUHINDO; Espoir BWENGE MALEMBAKA; Mannix Imani MASIMANGO; Tony Akilimali SHINDANO; Justin Cirhuza CIKOMOLA; Kanigula MUBAGWA

    doi:10.21203/rs.3.rs-39772/v1 Date: 2020-07-01 Source: ResearchSquare

    BackgroundPredictions have been made that Africa would be the most vulnerable continent to the novel coronavirus disease MESHD 2019 (COVID-19). Interestingly, the spread of the disease TRANS disease MESHD in Africa seems to have been delayed and initially slower than in many parts of the World. Here we report on two cases which make us suspect that COVID-19 might have been present in our region before the official declaration of the disease MESHD in December 2019.Case presentationThese two cases (one 55-year-old man and one 25-year-old woman) of acute respiratory distress HP secondary to atypical pneumonia MESHD pneumonia HP were seen in Bukavu, in eastern Democratic Republic of the Congo (DRC), between September and December 2019. One patient had returned from China and the other had close contacts TRANS with travellers from China in the 2 weeks prior to the onset of symptoms TRANS. In either case, the aetiology could not be accurately determined. However, the two cases presented a clinical picture (progressive dyspnoea, preceded by dry cough MESHD cough HP and fever MESHD fever HP) and laboratory changes (procalcitonin within the normal range, slight inflammation MESHD, and lymphopenia MESHD lymphopenia HP) compatible with a viral infection MESHD. The chest X-Rays series of the first patient showed lesions (reticulations, ground glass, and nodules ≤ 6 mm) similar to those found in COVID-19. In addition, unlike the 25-year-old female TRANS patient who had no comorbidity, the 55-year-old male TRANS patient who had hypertension MESHD hypertension HP as comorbidity, developed a more severe acute respiratory distress HP which progressed to death MESHD.ConclusionThese cases bring to the attention a number of facts which make us suspect that the COVID-19 epidemic may have already been present in the region months before the official beginning of the pandemic.

    Mechanical ventilation utilization in COVID-19: A systematic review and meta-analysis

    Authors: Mohammed A Almeshari; Nowaf Y Alobaidi; Mansour Al Asmri; Eyas Alhuthail; Ziyad Alshehri; Farhan Alenezi; Elizabeth Sapey; Dhruv Parekh

    doi:10.1101/2020.06.04.20122069 Date: 2020-06-05 Source: medRxiv

    Background: In December 2019, SARS-CoV-2 caused a global pandemic with a viral infection MESHD called COVID-19. The disease MESHD usually causes respiratory symptoms but in a small proportion of patients can lead to pneumonitis, Adult Respiratory Distress Syndrome MESHD Adult TRANS Respiratory Distress HP Syndrome and death MESHD. Invasive Mechanical Ventilation (IMV) is considered a life-saving treatment for COVID-19 patients and a huge demand for IMV devices was reported globally. This review aims to provide insight on the initial IMV practices for COVID-19 patients in the initial phase of the pandemic. Methods: Electronic databases (Embase and MEDLINE) were searched for applicable articles using relevant keywords. The references of included articles were hand searched. Articles that reported the use of IMV in adult TRANS COVID-19 patients were included in the review. The NIH quality assessment tool for cohort and cross-sectional studies was used to appraise studies. Results: 106 abstracts were identified from the databases search, of which 16 were included. 4 studies were included in the meta-analysis. In total, 9988 patients were included across all studies. The overall cases of COVID-19 requiring IMV ranged from 2-75%. Increased age TRANS and pre-existing comorbidities increased the likelihood of IMV requirement. The reported mortality rate in patients receiving IMV ranged between 50-100%. On average, IMV was required and initiated between 10-10.5 days from symptoms onset TRANS. When invasively ventilated, COVID-19 patients required IMV for a median of 10-17 days across studies. Little information was provided on ventilatory protocols or management strategies and was inconclusive. Conclusion: In these initial reporting studies for the first month of the pandemic, patients receiving IMV were older and had more pre-existing co-morbidities than those who did not require IMV. The mortality rate was high in COVID-19 patients who received IMV. Studies are needed to evaluate protocols and modalities of IMV to improve outcomes and identify the populations most likely to benefit from IMV.

    Systemic and mucosal antibody SERO secretion specific to SARS-CoV-2 during mild versus severe COVID-19

    Authors: Carlo Cervia; Jakob Nilsson; Yves Zurbuchen; Alan Valaperti; Jens Schreiner; Aline Wolfensberger; Miro E. Raeber; Sarah Adamo; Marc Emmenegger; Sara Hasler; Philipp P. Bosshard; Elena De Cecco; Esther Baechli; Alain Rudiger; Melina Stuessi-Helbling; Lars C. Huber; Annelies S. Zinkernagel; Dominik J. Schaer; Adriano Aguzzi; Ulrike Held; Elsbeth Probst-Mueller; Silvana K. Rampini; Onur Boyman

    doi:10.1101/2020.05.21.108308 Date: 2020-05-23 Source: bioRxiv

    BackgroundInfection with the severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) causes an acute illness termed coronavirus disease MESHD 2019 (COVID-19). Humoral immune responses likely play an important role in containing SARS-CoV-2, however, the determinants of SARS-CoV-2-specific antibody SERO responses are unclear. MethodsUsing immunoassays SERO specific for the SARS-CoV-2 spike protein, we determined SARS-CoV-2-specific immunoglobulin A (IgA) and immunoglobulin G (IgG) in sera and mucosal fluids of two cohorts, including patients with quantitative reverse-transcriptase polymerase chain reaction (RT-qPCR)-confirmed SARS-CoV-2 infection MESHD (n = 56; median age TRANS 61 years) with mild versus severe COVID-19, and SARS-CoV-2-exposed healthcare workers (n = 109; median age TRANS 36 years) with or without symptoms and tested negative or positive by RT-qPCR. FindingsOn average, SARS-CoV-2-specific serum SERO IgA titers in mild COVID-19 cases became positive eight days after symptom onset TRANS and were often transient, whereas serum SERO IgG levels remained negative or reached positive values 9-10 days after symptom onset TRANS. Conversely, patients with severe COVID-19 showed a highly significant increase of SARS-CoV-2-specific serum SERO IgA and IgG titers as a function of duration since symptom onset TRANS, independent of patient age TRANS and comorbidities. Very high levels of SARS-CoV-2-specific serum SERO IgA correlated with severe acute respiratory distress HP syndrome MESHD (ARDS). Interestingly, some of the SARS-CoV-2-exposed healthcare workers with negative SARS-CoV-2-specific IgA and IgG serum SERO titers had detectable SARS-CoV-2-specific IgA antibodies SERO in their nasal fluids and tears. Moreover, SARS-CoV-2-specific IgA levels in nasal fluids of these healthcare workers were inversely correlated with patient age TRANS. InterpretationThese data show that systemic IgA and IgG production against SARS-CoV-2 develops mainly in severe COVID-19, with very high IgA levels seen in patients with severe ARDS, whereas mild disease MESHD may be associated with transient serum SERO titers of SARS-CoV-2-specific antibodies SERO but stimulate mucosal SARS-CoV-2-specific IgA secretion. The findings suggest four grades of antibody SERO responses dependent on COVID-19 severity.

    On two cases of atypical respiratory distress HP in eastern Democratic Republic of the Congo months before the COVID-19 pandemic was declared. Could SARS-Cov-2 have been already spreading? Case report

    Authors: Guy-Quesney MATESO; Marius BAGUMA; Pacifique MWENE-BATU; Ghislain MAHESHE BALEMBA; Fabrice NZABARA; Samuel MAKALI; Aline BEDHA; Bonheur FURAHA; Jimmy MINANI; Christian TSHONGO MUHINDO; Espoir BWENGE MALEMBAKA; Mannix Imani MASIMANGO; Tony Akilimali SHINDANO; Justin Cirhuza CIKOMOLA; Kanigula MUBAGWA

    doi:10.21203/rs.3.rs-29541/v1 Date: 2020-05-18 Source: ResearchSquare

    Background: Predictions have been made that Africa would be the most vulnerable continent to the novel coronavirus disease MESHD 2019 (COVID-19). Interestingly, the spread of the disease TRANS disease MESHD in Africa seems to be slower than in many parts of the World. Among possible hypotheses, some parts of Africa may have undergone a “silent” COVID-19 epidemic and acquired a herd immunity before the official declaration of the disease MESHD in December 2019.Case presentation: We report two cases (one 55-year-old man and one 25-year-old woman) of acute respiratory distress HP secondary to atypical pneumonia MESHD pneumonia HP in Bukavu, in eastern Democratic Republic of the Congo (DRC) which occurred between September and December 2019, before the official beginning of the COVID-19 pandemic. One patient had returned from China and the other had close contacts TRANS with travellers from China in the 2 weeks prior to the onset of symptoms TRANS. In either case, the aetiology could not be accurately determined. However, the two cases presented a clinical picture (progressive dyspnoea, preceded by dry cough MESHD cough HP and fever MESHD fever HP) and laboratory changes (procalcitonin within the normal range, slight inflammation MESHD, and lymphopenia MESHD lymphopenia HP) compatible with a viral infection MESHD. The chest X-Rays series of the first patient showed lesions (reticulations, ground glass, and nodules ≤ 6 mm) similar to those found in COVID-19. In addition, unlike the 25-year-old female TRANS patient who had no comorbidity, the 55-year-old male TRANS patient who had hypertension MESHD hypertension HP as comorbidity, developed a more severe acute respiratory distress HP which progressed to death MESHD.Conclusion: These cases bring to the attention a number of facts which make us suspect that the COVID-19 epidemic may have already been present in the region months before the official beginning of the pandemic. 

    Epidemiologic, Clinical, and Laboratory Findings of the COVID-19 in the current pandemic: Systematic Review and Meta-analysis

    Authors: Yewei Xie; Zaisheng Wang; Huipeng Liao; Gifty Marley; Dan Wu; Weiming Tang

    doi:10.21203/rs.3.rs-28367/v2 Date: 2020-05-11 Source: ResearchSquare

    Background: The COVID-19 pandemic has affected the world deeply, with more than 3,000,000 people infected and nearly 200,000 deaths MESHD. This review aimed to summarize the epidemiologic traits, clinical spectrum, CT results and laboratory findings of the COVID-19 pandemic.Methods: We scoped for relevant literatures published during 1st Dec 2019 to 23rd Apr 2020 based on four databases using English and Chinese languages. We reviewed and analyzed the relevant clinic outcomes of COVID-19.Results: The COVID-19 pandemic was found to have a higher transmission TRANS rate compared to SARS and MERS and involved 4 stages of evolution. The basic reproduction number TRANS ( R0 TRANS) is 3.32 (95% CI:3.24-3.39), the incubation period TRANS was 5.24 days (95% CI:3.97-6.50, 5 studies) on average, and the average time for symptoms onset TRANS varied by countries. Common clinical spectrums identified included fever MESHD fever HP (38.1-39.0℃), cough MESHD cough HP and fatigue MESHD fatigue HP, with Acute Respiratory Distress HP Syndrome MESHD (ARDS) being the most common complication reported. Body temperatures above 39.0 ℃, dyspnea MESHD dyspnea HP, and anorexia MESHD anorexia HP were more common symptoms in severe patients. Aged TRANS over 60 years old, having co-morbidities, and developing complications were the commonest high-risk factors associated with severe conditions. Leucopenia and lymphopenia MESHD lymphopenia HP were the most common signs of infection MESHD while liver and kidney damage were rare but may cause bad outcomes for patients. The bilateral, multifocal Ground-Glass Opacification (GGO) on peripheral, and the consolidative pulmonary opacity HP were the most frequent CT results and the tendency of mortality rates differed by region.Conclusions: We provided a bird’s-eye view of the COVID-19 during the current pandemic, which will help better understanding the key traits of the disease MESHD. The findings could be used for disease’s future research, control and prevention.

    Characterization of clinical progression of COVID-19 patients in Shenzhen, China

    Authors: Qifang Bi; Chengcheng Hong; Juan Meng; Zhenke Wu; Pengzheng Zhou; Chenfei Ye; Binbin Sun; Lauren M Kucirka; Andrew S Azman; Tong Wang; Jiancong Chen; Zhaoqin Wang; Lei Liu; Justin Lessler; Jessie K Edwards; Ting Ma; Guoliang Zhang

    doi:10.1101/2020.04.22.20076190 Date: 2020-04-27 Source: medRxiv

    Background: Understanding clinical progression of COVID-19 is a key public health priority that informs resource allocation during an emergency MESHD. We characterized clinical progression of COVID-19 and determined important predictors for faster clinical progression to key clinical events and longer use of medical resources. Methods and Findings: The study is a single-center, observational study with prospectively collected data from all 420 patients diagnosed with COVID-19 and hospitalized in Shenzhen between January 11th and March 10th, 2020 regardless of clinical severity. Using competing risk regressions according to the methods of Fine and Gray, we found that males TRANS had faster clinical progression than females TRANS in the older age group TRANS and the difference could not be explained by difference in baseline conditions or smoking history. We estimated the proportion of cases in each severity stage over 80 days following symptom onset TRANS using a nonparametric method built upon estimated cumulative incidence of key clinical events. Based on random survival forest models, we stratified cases into risk sets with very different clinical trajectories. Those who progressed to the severe stage (22%,93/420), developed acute respiratory distress HP syndrome MESHD (9%,39/420), and were admitted to the intensive care unit (5%,19/420) progressed on average 9.5 days (95%CI 8.7,10.3), 11.0 days (95%CI 9.7,12.3), and 10.5 days (95%CI 8.2,13.3), respectively, after symptom onset TRANS. We estimated that patients who were admitted to ICUs remained there for an average of 34.4 days (95%CI 24.1,43.2). The median length of hospital stay was 21.3 days (95%CI, 20.5,22.2) for cases who did not progress to the severe stage, but increased to 52.1 days (95%CI, 43.3,59.5) for those who required critical care. Conclusions: Our analyses provide insights into clinical progression of cases starting early in the course of infection MESHD. Patient characteristics near symptom onset TRANS both with and without lab parameters have tremendous potential for predicting clinical progression and informing strategic response.

    Clinical and Imaging Findings in COVID-19 Patients Complicated by Pulmonary Embolism MESHD Pulmonary Embolism HP

    Authors: Ting Li; Gregory Kicska; Paul E Kinahan; Chengcheng Zhu; Murat Alp Oztek; Wei Wu

    doi:10.1101/2020.04.20.20064105 Date: 2020-04-24 Source: medRxiv

    Objective: To describe clinical, and imaging findings including the evolution pattern in COVID-19 pneumonia MESHD pneumonia HP complicated by pulmonary embolism MESHD pulmonary embolism HP (PE). Methods: Eleven of 1453 patients with a probable diagnosis of COVID-19 pneumonia MESHD pneumonia HP were retrospectively selected for the presence of PE. Clinical and laboratory data were recorded. All cross-sectional CT imaging was qualitatively scored for the first 28 days after onset of symptoms TRANS. Results: Of 24 patients underwent CTA-PE, 11 were confirmed with PE. All 11 patients developed acute respiratory distress HP syndrome MESHD (ARDS). We observed an evolution pattern of predominant findings with ground-glass opacities (GGO) to GGO with crazy paving in 3 patients, then to consolidation with linear densities, or to reticulation in 9 patients. Lung cysts MESHD or traction bronchiectasis MESHD bronchiectasis HP could be seen from day 5 to 9 after symptoms and reticulation, subpleural curvilinear lines were more common from day 20. The pulmonary opacities HP were predominantly peripheral in distribution with relative sparing of nondependent lungs. The severity of lung involvement was high with an average score of 9.7 in the first phase, 18 in the second phase plateauing in the next two phases, with a slight decrease to 16.9 in the late phase. The pulmonary emboli were most common in segmental and subsegmental pulmonary arteries. Conclusion: The incidence of PE among suspected patients in COVID-19 was high. Our study suggests PE may occur with increased frequency in the ARDS subgroup. The evolution of radiographic abnormalities showed a general pattern, but are also unique with more extensive lung injury MESHD and specific imaging features.

    Protocol for a randomized controlled trial testing inhaled nitric oxide therapy in spontaneously breathing patients with COVID-19

    Authors: Lorenzo Berra; Chong Lei; Binxiao Su; Hailong Dong; Bijan Safaee Fakhr; Luigi Giuseppe Grassi; Raffaele Di Fenza; Stefano Gianni; Riccardo Pinciroli; Emanuele Vassena; Caio Cesar Araujo Morais; Andrea Bellavia; Stefano Spina; Robert Kacmarek; Ryan Carroll

    doi:10.1101/2020.03.10.20033522 Date: 2020-03-13 Source: medRxiv

    Introduction: the current worldwide outbreak of Coronavirus disease MESHD 2019 (COVID-19) due to a novel coronavirus (SARS-CoV-2) is seriously threatening the public health. The number of infected patients is continuously increasing and the need for Intensive Care Unit admission ranges from 5 to 26%. The mortality is reported to be around 3.4% with higher values for the elderly TRANS and in patients with comorbidities. Moreover, this condition is challenging the healthcare system where the outbreak reached its highest value. To date there is still no available treatment for SARS-CoV-2. Clinical and preclinical evidence suggests that nitric oxide (NO) has a beneficial effect on the coronavirus-mediated acute respiratory syndrome MESHD, and this can be related to its viricidal effect. The time from the symptoms onset TRANS to the development of severe respiratory distress HP is relatively long. We hypothesize that high concentrations of inhaled NO administered during early phases of COVID-19 infection MESHD can prevent the progression of the disease MESHD. Methods and analysis: This is a multicenter randomized controlled trial. Spontaneous breathing patients admitted to the hospital for symptomatic COVID-19 infection MESHD will be eligible to enter the study. Patients in the treatment group will receive inhaled NO at high doses (140-180 parts per million) for 30 minutes, 2 sessions every day for 14 days in addition to the hospital care. Patient in the control group will receive only hospital care. The primary outcome is the percentage of patients requiring endotracheal intubation due to the progression of the disease MESHD in the first 28 days from enrollment in the study. Secondary outcomes include mortality at 28 days, proportion of negative test for SARS-CoV-2 at 7 days and time to clinical recovery. Ethics and dissemination: The trial protocol has been approved at the Investigation Review Boards of Xijing Hospital (Xi an, China) and The Partners Human Research Committee of Massachusetts General Hospital (Boston, USA) is pending. Recruitment is expected to start in March 2020. Results of this study will be published in scientific journals, presented at scientific meetings, and on related website or media in fighting this widespread contagious disease MESHD. Trial registration. Clinicaltrials.gov. NCT submitted

    Clinical findings in critical ill patients infected with SARS-Cov-2 in Guangdong Province, China: a multi-center, retrospective, observational study

    Authors: Yonghao Xu; Zhiheng Xu; Xuesong Liu; Lihua Cai; Haichong Zheng; Yongbo Huang; Lixin Zhou; Linxi Huang; Yun Lin; Liehua Deng; Jianwei Li; Sibei Chen; Dongdong Liu; Zhimin Lin; Liang Zhou; Weiqun He; Xiaoqing Liu; Yimin Li

    doi:10.1101/2020.03.03.20030668 Date: 2020-03-06 Source: medRxiv

    Abstract Background In December 2019, human infection MESHD with a novel coronavirus, known as SARS-CoV-2, was identified in Wuhan, China. The mortality of critical illness MESHD was high in Wuhan. Information about critically ill patients with SARS-CoV-2 infection MESHD outside of Wuhan is scarce. We aimed to provide the clinical features, treatment, and prognosis of the critically ill patients with SARS-CoV-2 infection MESHD in Guangdong Province. Methods In this multi-centered, retrospective, observational study, we enrolled critically ill patients with SARS-CoV-2 pneumonia MESHD pneumonia HP who were admitted to the intensive care unit (ICU) in Guangdong Province. Demographic data, symptoms, laboratory findings, comorbidities, treatments, and prognosis were collected. Data were compared between patients with and without intubation. Results Forty-five critically ill patients with SARS-CoV-2 pneumonia MESHD pneumonia HP were identified in 7 ICUs in Guangdong Province. The mean age TRANS was 56.7 years, and 29 patients (64.4%) were men. The most common symptoms at the onset TRANS of illness were high fever MESHD fever HP and cough MESHD cough HP. Majority of patients presented with lymphopenia MESHD lymphopenia HP and elevated lactate dehydrogenase. Treatment with antiviral drugs was initiated in all the patients. Thirty-seven patients (82.2%) had developed acute respiratory distress HP syndrome MESHD, and 13 (28.9%) septic shock MESHD shock HP. A total of 20 (44.4%) patients required intubation and 9 (20%) required extracorporeal membrane oxygenation. As of February 28th 2020, only one patient (2.2%) had died and half of them had discharged of ICU. Conclusions Infection MESHD with SARS-CoV-2 in critical illness MESHD is characterized by fever MESHD fever HP, lymphopenia MESHD lymphopenia HP, acute respiratory failure HP failure and multiple organ MESHD dysfunction. Compared with critically ill patients infected with SARS-CoV-2 in Wuhan, the mortality of critically ill patients in Guangdong Province was relatively low. These data provide some general understandings and experience for the critical patients with SARS-CoV-2 outside of Wuhan.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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