Corpus overview


Overview

MeSH Disease

Human Phenotype

Cough (10)

Arthralgia (10)

Fever (9)

Myalgia (6)

Anosmia (5)


Transmission

Seroprevalence
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    High Number of RNA Copies in Asymptomatic TRANS Individuals Infected with SARS-CoV-2 in an Area of the Colombian Caribbean

    Authors: Salim Mattar; Caty Martinez-Bravo; Ricardo Rivero; Hector Contreras; Alvaro Faccini_Martinez; Camilo Guzman; Ketty Galeano; Nelson Alvis; Veronica Contreras; German Arrieta; Marco Gonzalez; Jorge Miranda; Martha Lucia Ospina; Francisco Camargo-Assis; Marcela Mercado-Reyes; Evelyn Garay; Alejandra Garcia-Perez; Yesica Lopez; Vaneza Tique

    doi:10.21203/rs.3.rs-57254/v1 Date: 2020-08-11 Source: ResearchSquare

    Background.   Severe acute respiratory syndrome MESHD Coronavirus 2 (SARS-CoV-2) is an emerging pandemical virus. The virus has caused millions of reported cases and hundreds of thousands of deaths in less than six months. South America has suffered the pandemic because it lacks the hospital and economic capacities needed to contain the pandemic's advance. Public health implications of transmission TRANS, while asymptomatic TRANS is a critical concern at the current pandemic.Objective: Describe the socio-demographic, clinical, and viral kinetics features of a cohort of SARS-CoV-2 infected MESHD individuals from the Colombian Caribbean. Methods: Six hundred eighty-six clinical samples from several hospital centers in the province were received between April 9th and May 16th, 2020. RNA was extracted using lysis buffers and spin columns. The samples were tested for SARS-CoV-2 by RT-qPCR (Reverse transcription real-time polymerase chain reaction) using commercially available multiplex real-time PCR assay for simultaneous detection of 3 target genes of SARS-CoV-2 (AllplexTM, 2019-nCoV assay, Korea). Viral copies quantification was done using a standard curve constructed from seriated dilutions of a SARS-CoV-2 positive control. Statics descriptive methods were used. Results: Thirty-five nasopharyngeal samples were positive for SARS-CoV-2 infection MESHD; the average age TRANS was 43 (range, 1-95 years). Seventeen of 35 (49%) of the patients showed symptoms. Most of them had cough HP, fever HP fever MESHD, and odynophagia HP, 3 of the patients reported having arthralgia HP arthralgia MESHD. Only two patients required hospitalization. None of the patients had known co-morbidities. RT-qPCR results show that two of the symptomatic patients had significantly higher RNA copies than the rest of them. Eighteen of 35 (51%) individuals were asymptomatic TRANS, the average age TRANS was 30 (range, 6-61 years. Four individuals showed a higher copy than some symptomatic patients. Nonetheless, the average of RNA copies 8.26 x10+10 was lower than the symptomatic.Conclusions: the population studied was young, with an average of 43 years in symptomatic and 30 years of asymptomatic TRANS; this is important because of the high impact in the economy. It is probably the cause of the reduced lethality observed in the department. Because a large proportion of infections probably result from transmission TRANS from asymptomatic TRANS, pre-symptomatic persons. The usefulness of public health interventions in Colombian provinces should be based on molecular screening in a vast conglomerate population and quantify the viral load. 

    High number of RNA copies in asymptomatic TRANS individuals infected with SARS-CoV-2 in an area of the Colombian Caribbean

    Authors: Salim Mattar; Caty Martinez-Bravo; Ricardo Rivero; Hector Contreras; Alvaro Faccini_Martinez; Camilo Guzman; Ketty Galeano; Nelson Alvis; Veronica Contreras; German Arrieta; Marco Gonzalez; Jorge Miranda; Martha Lucia Ospina; Francisco Camargo-Assis; Marcela Mercado-Reyes; Evelyn Garay; Alejandra Garcia-Perez; Yesica Lopez; Vaneza Tique

    doi:10.21203/rs.3.rs-57254/v2 Date: 2020-08-11 Source: ResearchSquare

    Background.   Severe acute respiratory syndrome MESHD Coronavirus 2 (SARS-CoV-2) is an emerging viral pandemic disease MESHD. In the last six months, SARS-CoV-2 has caused millions of reported cases and hundreds of thousands of deaths. As other world regions, nowadays, South America has not contained the pandemic's advance since it lacks the hospital and economic capacities. Public health implications of transmission TRANS, while the asymptomatic TRANS infection is a critical concern at the current pandemic.Objective: Describe the socio-demographic, clinical, and viral kinetics features of a cohort of SARS-CoV-2 infected MESHD individuals from the Colombian Caribbean. Methods: Six hundred eighty-six clinical samples of suspected SARS-CoV-2 infection MESHD cases and contacts individuals from several hospital centers in the department of Córdoba, Colombia, were received at our laboratory between April 9th and May 16th, 2020. RNA was extracted using lysis buffers and spin columns. The samples were tested for SARS-CoV-2 by RT-qPCR (Reverse transcription real-time polymerase chain reaction) using commercially available multiplex real-time PCR assay for simultaneous detection of 3 target genes of SARS-CoV-2 (AllplexTM, 2019-nCoV assay, Korea). Viral copies quantification was done using a standard curve constructed from seriated dilutions of a SARS-CoV-2 positive control. Statics descriptive methods were used. Results: Thirty-five nasopharyngeal samples were positive for SARS-CoV-2 infection MESHD; the average age TRANS was 43 (range, 1-95 years). Seventeen of 35 (49%) of the patients showed symptoms. Most of them had a cough HP, fever HP fever MESHD, and odynophagia HP; three of the patients reported having arthralgia HP arthralgia MESHD. Only two patients required hospitalization. None of the patients had known co-morbidities. RT-qPCR results show that two of the symptomatic patients had significantly higher RNA copies than the rest. Eighteen of 35 (51%) individuals were asymptomatic TRANS, and the average age TRANS was 30 (range, 6-61 years). Four asymptomatic TRANS individuals showed a higher copy than some symptomatic patients; nonetheless, the average of RNA copies 8.26 x10+10 was lower than the symptomatic.Conclusions: the population studied was young, with an average of 43 years in symptomatic and 30 years of asymptomatic TRANS; this is important because of the high impact in the economy. Because a large proportion of infections may result from transmission TRANS from asymptomatic TRANS or pre-symptomatic persons, the usefulness of public health interventions in Colombian provinces should be based on molecular screening in a vast conglomerate population and quantify the viral load. 

    High Number of RNA Copies in Asymptomatic TRANS Individuals Infected with SARS-CoV-2 in an Area of the Colombian Caribbean

    Authors: Salim Mattar; Caty Martinez-Bravo; Ricardo Rivero; Hector Contreras; Alvaro Faccini-Martinez; Camilo Guzman; Ketty Galeana; Nelson Alvis; Veronica Contreras; German Arrieta; Marco Gonzalez; Jorge Miranda; Martha Ospina; Francisco Camargo-Assis; Marcela Mercado; Evelyn Garay; Alejandra Garcia-Perez; Yesica Lopez; Vaneza Tique

    doi:10.21203/rs.3.rs-44324/v1 Date: 2020-07-16 Source: ResearchSquare

    Background.  Severe acute respiratory syndrome MESHD Coronavirus 2 (SARS-CoV-2) is an emerging pandemical virus that has caused millions of reported cases and hundreds of thousands of deaths in less than six months. South America has suffered the pandemic because it lacks the hospital and economic capacities needed to contain the pandemic's advance. Public health implications of transmission TRANS, while asymptomatic TRANS is a critical concern at the current pandemic.Objective: Describe the socio-demographic, clinical, and viral kinetics features of a cohort of SARS-CoV-2 infected MESHD individuals from the Colombian Caribbean. Methods: Six hundred eighty-six clinical samples from several hospital centers in the province were received between April 9th and May 16th, 2020. RNA was extracted using lysis buffers and spin columns. The samples were tested for SARS-CoV-2 by RT-qPCR (Reverse transcription real-time polymerase chain reaction) using commercially available multiplex real-time PCR assay for simultaneous detection of 3 target genes of SARS-CoV-2 (AllplexTM, 2019-nCoV assay, Korea). Viral copies quantification was done using a standard curve constructed from seriated dilutions of a SARS-CoV-2 positive control. Statics descriptive methods were used. Results: Thirty-five nasopharyngeal samples were positive for SARS-CoV-2 infection MESHD; the average age TRANS was 43 (range, 1-95 years). Seventeen of 35 (49%) of the patients showed symptoms. Most of them had cough HP, fever HP fever MESHD, and odynophagia HP, 3 of the patients reported having arthralgia HP arthralgia MESHD. Only two patients required hospitalization. None of the patients had known co-morbidities. RT-qPCR results show that two of the symptomatic patients had significantly higher RNA copies than the rest of the patients. Eighteen of 35 (51%) individuals were asymptomatic TRANS, the average age TRANS was 30 (range, 6-61 years. Four individuals showed a higher copy than some symptomatic patients. Nonetheless, the average of RNA copies 8.26 x10+10 was lower than the symptomatic.Conclusions: the population studied was young with an average of 43 years in symptomatic and 30 years of asymptomatic TRANS; this is important because of the high impact in the economy, and probably it is the cause of the reduced lethality observed in the department. Because a large proportion of infections probably result from transmission TRANS from asymptomatic TRANS or pre-symptomatic persons, the usefulness of public health interventions in Colombian provinces should be based in the molecular screening in a vast conglomerate's population and to quantify the viral load. 

    Symptomatology of Coronavirus Disease MESHD 2019 (COVID-19) - Lessons from A Meta-Analysis Across 13 Countries

    Authors: Champika Saman Kumara Gamakaranage; Dineshani Hettiarachchi; Dileepa Ediriweera; Saroj Jayasinghe

    doi:10.21203/rs.3.rs-39412/v1 Date: 2020-07-01 Source: ResearchSquare

    Background: COVID-19 pandemic has resulted in varying clinical manifestations and mortality rates. There is no consensus on the symptomatology that would guide researchers and clinicians.Objective: The objective of the study was to identify symptoms and their frequencies of coronavirus disease MESHD 2019 with a meta-analysis of studies from several countries. Data sources: A systematic review using PubMed and Google Scholar data sources and reference tracing TRANS were used to identify 7176 relevant articles. Eligibility criteria: Suitable articles were selected manually with selection criteria and 14 original articles included for meta-analysis. Data abstraction analysis: PRISMA guideline was used for abstracting data. Then a table was generated by feeding it with numbers and proportions of each symptom described in original studies. A meta-analysis was carried out using random effect models on each symptom separately across the studies and their prevalence SERO rates and 95% confident intervals calculated.Results: We identified 14 relevant scientific papers, either cross-sectional or cohort studies and analyzed. There were 2,660 cases of COVID-19. he majority were from China (n=2,439, 91.7%) and remainder from the Netherlands, Italy, Korea and India and one article from Europe. There was a total of 32 symptoms (i.e. present in >50% of patients):  fever MESHD (79.56%, 95% CI: 72.17-86.09%), malaise (63.3%, 95% CI: 53.1 – 73.0%), cough HP (56.7. %, 95% CI: 48.6 - 64.6 %) and cold (55.6%, 95% CI: 45.2 – 65.7%). Symptoms of intermediate incidence (5-49%) were; anosmia HP anosmia MESHD, sneezing HP, ocular pain HP ocular pain MESHD, fatigue HP fatigue MESHD, sputum production, arthralgia HP arthralgia MESHD, tachypnea HP tachypnea MESHD, palpitation HP, headache HP headache MESHD, chest tightness HP chest tightness MESHD, shortness of breath MESHD, chills HP, myalgia HP myalgia MESHD, sore throat, anorexia HP anorexia MESHD, weakness MESHD, diarrhea HP diarrhea MESHD, rhinorrhea HP rhinorrhea MESHD, dizziness MESHD, nausea HP nausea MESHD, altered level of consciousness, vomiting HP vomiting MESHD and abdominal pain HP abdominal pain MESHD. Rare symptoms (<5% of patients) were: tonsil swelling, haemoptysis, conjunctival injection, lymphadenopathy HP lymphadenopathy MESHD and rash MESHD were uncommon symptoms of coronavirus disease MESHD (<5%).Conclusion and implications of key findings: We found (25/32) symptoms to be present in =>5% of cases which could be considered as “typical” symptoms of COVID-19. The list of symptoms we identified are different from those documents released by the WHO, CDC, NHS, Chinese CDC, Institute Pasteur and Mayo Clinic. The compiled list would be useful for future researchers to document a comprehensive picture of the illness.

    Symptomatology of Coronavirus Disease MESHD 2019 (COVID-19) - Lessons from a meta-analysis across 13 countries

    Authors: Champika Saman Kumara Gamakaranage; Dineshani Hettiarachchi; Dileepa Ediriweera; Saroj Jayasinghe

    doi:10.21203/rs.3.rs-39412/v2 Date: 2020-07-01 Source: ResearchSquare

    Background: COVID-19 pandemic has resulted in varying clinical manifestations and mortality rates. There is no consensus on the symptomatology that would guide researchers and clinicians. Objective: The objective was to identify symptoms and their frequencies of COVID-19 with a meta-analysis of studies from several countries. Data sources: A systematic review using PubMed and Google Scholar data sources and reference tracing TRANS were used to identify 7176 articles. Eligibility criteria: Suitable articles were selected manually with selection criteria and 14 original articles included in meta-analysis. Data abstraction and analysis: PRISMA guidelines, used for data abstraction and a table was generated by feeding it with numbers and proportions of each symptom described. A meta-analysis was carried out using random effect models on each symptom separately across the studies and their prevalence SERO rates and 95% confident intervals were calculated.Results: Selected 14 studies, either cross-sectional or cohort studies are analyzed. There were 2,660 confirmed cases TRANS of COVID-19. The majority were from China (n=2,439, 91.7%) and remainder from the Netherlands, Italy, Korea and India and one article from Europe. There was a total of 32 symptoms identified from the meta-analysis and additional 7 symptoms were identified from reference searching. The most common symptoms were ( prevalence SERO >50%): fever HP fever MESHD (79.56%, 95% CI: 72.17-86.09%), malaise (63.3%, 95% CI: 53.1 – 73.0%), cough HP (56.7. %, 95% CI: 48.6 - 64.6 %) and cold (55.6%, 95% CI: 45.2 – 65.7%). Symptoms of intermediate incidence (5-49%) were; anosmia HP anosmia MESHD, sneezing HP, ocular pain HP ocular pain MESHD, fatigue HP fatigue MESHD, sputum production, arthralgia HP arthralgia MESHD, tachypnea HP tachypnea MESHD, palpitation HP, headache HP headache MESHD, chest tightness HP chest tightness MESHD, shortness of breath MESHD, chills HP, myalgia HP myalgia MESHD, sore throat, anorexia HP anorexia MESHD, weakness MESHD, diarrhea HP diarrhea MESHD, rhinorrhea HP rhinorrhea MESHD, dizziness MESHD, nausea HP nausea MESHD, altered level of consciousness, vomiting HP vomiting MESHD and abdominal pain HP abdominal pain MESHD. Rare symptoms (<5%): tonsil swelling MESHD, haemoptysis, conjunctival injection, lymphadenopathy HP lymphadenopathy MESHD and rash MESHD. Conclusion and implications of key findings: We found (25/32, from meta-analysis) symptoms to be present in =>5% of cases which could be considered as “typical” symptoms of COVID-19. The list of symptoms we identified is different from those documents released by the WHO, CDC, NHS, Chinese CDC, Institute Pasteur and Mayo Clinic. The compiled list would be useful for future researchers to document a comprehensive picture of the illness.  

    A primary care approach to the COVID-19 pandemic: clinical features and natural history of 2,073 suspected cases in the Corona Sao Caetano programme, Sao Paulo, Brazil

    Authors: Fabio E Leal; Maria C Mendes-Correa; Lewis F Buss; Silvia F Costa; Joao CS Bizario; Sonia RP Souza; Osorio Thomaz; Tania R Tozetto-Mendoza; Lucy S Villas-Boas; Lea CO Silva; Regina MZ Grespan; Ligia Capuani; Renata Buccheri; Helves Domingues; Neal DE Alexander; Philippe Mayaud; Ester C Sabino

    doi:10.1101/2020.06.23.20138081 Date: 2020-06-23 Source: medRxiv

    Background: Despite most cases not requiring hospital care, there are limited community-based clinical data on COVID-19. Methods and findings: The Corona Sao Caetano program is a primary care initiative offering COVID-19 care to all residents of Sao Caetano do Sul, Brazil. After triage of potentially severe cases, consecutive patients presenting between 13th April and 13th May 2020 were tested at home with SARS-CoV-2 reverse transcriptase (RT) PCR; positive patients were followed up for 14 days. RT-PCR-negative patients were offered SARS-CoV-2 serology. We describe the clinical features, virology and natural history of this prospective population-based cohort. Of 2,073 suspected COVID-19 cases, 1,583 (76.4%) were tested by RT-PCR, of whom 444 (28.0%, 95%CI: 25.9% - 30.3%) were positive; 604/1,136 (53%) RT-PCR-negative patients underwent serology, of whom 52 (8.6%) tested SARS-CoV-2 seropositive. The most common symptoms of COVID-19 were cough HP, fatigue HP fatigue MESHD, myalgia HP myalgia MESHD and headache HP headache MESHD; whereas self-reported fever HP fever MESHD, anosmia HP anosmia MESHD, and ageusia MESHD were most associated with a positive COVID-19 diagnosis. RT-PCR cycle thresholds were lower in men, older patients, those with fever HP fever MESHD and arthralgia HP arthralgia MESHD, and around symptom onset TRANS. The rates of hospitalization and death MESHD among 444 RT-PCR-positive cases were 6.7% and 0.7%, respectively, with older age TRANS and obesity HP obesity MESHD more frequent in the hospitalized group. Conclusions: COVID-19 presents similarly to other mild respiratory disease MESHD in primary care. Some symptoms assist the differential diagnosis. Most patients can be managed at home.

    High Number of RNA Copies in Asymptomatic TRANS Individuals Infected with SARS-CoV-2 in an Area of the Colombian Caribbean

    Authors: Salim Mattar; Caty Martinez-Bravo; Ricardo Rivero; Hector Contreras; Alvaro Faccini_Martinez; Camilo Guzman; Ketty Galeano; Nelson Alvis; Veronica Contreras; German Arrieta; Marco Gonzalez; Jorge Miranda; Martha Ospina; Francisco Camargo-Assis; Marcela Mercado-Reyes; Evelyn Garay; Alejandra Garcia-Perez; Yesica Lopez; Vaneza Tique

    doi:10.21203/rs.3.rs-32302/v1 Date: 2020-05-29 Source: ResearchSquare

    Background: Severe acute respiratory syndrome Coronavirus 2 MESHD (SARS-CoV-2) is an emerging pandemical virus that has caused millions of reported cases and hundreds of thousands of deaths in less than six months. South America has suffered the pandemic because it lacks the hospital and economic capacities needed to contain the pandemic's advance. Public health implications of transmission TRANS, while asymptomatic TRANS is a critical concern at the current pandemic.Objective: Describe the socio-demographic, clinical, and viral kinetics features of a cohort of SARS-CoV-2 infected MESHD individuals from the Colombian Caribbean.Methods: Six hundred eighty-six clinical samples from several hospital centers in the province were received between April 9th and May 16th, 2020. RNA was extracted using lysis buffers and spin columns. The samples were tested for SARS-CoV-2 by RT-qPCR (Reverse transcription real-time polymerase chain reaction) using commercially available multiplex real-time PCR assay for simultaneous detection of 3 target genes of SARS-CoV-2 (AllplexTM, 2019-nCoV assay, Korea). Viral copies quantification was done using a standard curve constructed from seriated dilutions of a SARS-CoV-2 positive control.Results: Thirty-five nasopharyngeal samples were positive for SARS-CoV-2 infection MESHD; the average age TRANS was 43 (range, 1-95 years). Seventeen of 35 (49%) of the patients showed symptoms. Most of them had cough HP, fever HP fever MESHD, and odynophagia HP, 3 of the patients reported having arthralgia HP arthralgia MESHD. Only two patients required hospitalization. None of the patients had known co-morbidities. RT-qPCR results show that two of the symptomatic patients had significantly higher RNA copies than the rest of the patients. Eighteen of 35 (51%) individuals were asymptomatic TRANS, the average age TRANS was 30 (range, 6-61 years. Four individuals showed a higher copy than some symptomatic patients. Nonetheless, the average of RNA copies 8.26 x10+10 was lower than the symptomatic.Conclusions: the population studied was young with an average of 43 years in symptomatic and 30 years of asymptomatic TRANS; this is important because of the high impact in the economy, and probably it is the cause of the reduced lethality observed in the department. Because a large proportion of infections probably result from transmission TRANS from asymptomatic TRANS or pre-symptomatic persons, the usefulness of public health interventions in Colombian provinces should be based in the molecular screening in a vast conglomerate's population and to quantify the viral load. 

    Augmented Curation of Unstructured Clinical Notes from a Massive EHR System Reveals Specific Phenotypic Signature of Impending COVID-19 Diagnosis

    Authors: Tyler Wagner; FNU Shweta; Karthik Murugadoss; Samir Awasthi; AJ Venkatakrishnan; Sairam Bade; Arjun Puranik; Martin Kang; Brian W Pickering; John C O'Horo; Philippe R Bauer; Raymund R Razonable; Paschalis Vergidis; Zelalem Temesgen; Stacey Rizza; Maryam Mahmood; Walter R Wilson; Douglas Challener; Praveen Anand; Matt Liebers; Zainab Doctor; Eli Silvert; Hugo Solomon; Akash Anand; Rakesh Barve; Gregory J Gores; Amy W Williams; William G Morice; John Halamka; Andrew D Badley; Venky Soundararajan

    doi:10.1101/2020.04.19.20067660 Date: 2020-04-23 Source: medRxiv

    Understanding temporal dynamics of COVID-19 patient symptoms could provide fine-grained resolution to guide clinical decision-making. Here, we use deep neural networks over an institution-wide platform for the augmented curation of clinical notes from 77,167 patients subjected to COVID-19 PCR testing. By contrasting Electronic Health Record (EHR)-derived symptoms of COVID-19-positive (COVIDpos; n=2,317) versus COVID-19-negative (COVIDneg; n=74,850) patients for the week preceding the PCR testing date, we identify anosmia HP anosmia MESHD/dysgeusia (27.1-fold), fever HP fever MESHD/ chills HP (2.6-fold), respiratory difficulty (2.2-fold), cough HP (2.2-fold), myalgia HP myalgia MESHD/ arthralgia HP arthralgia MESHD (2-fold), and diarrhea HP diarrhea MESHD (1.4-fold) as significantly amplified in COVIDpos over COVIDneg patients. The combination of cough HP and fever HP fever MESHD/ chills HP has 4.2-fold amplification in COVIDpos patients during the week prior to PCR testing, and along with anosmia HP anosmia MESHD/dysgeusia, constitutes the earliest EHR-derived signature of COVID-19. This study introduces an Augmented Intelligence platform for the real-time synthesis of institutional biomedical knowledge. The platform holds tremendous potential for scaling up curation throughput, thus enabling EHR-powered early disease diagnosis.

    Augmented Curation of Unstructured Clinical Notes from a Massive EHR System Reveals Specific Phenotypic Signature of Impending COVID-19 Diagnosis

    Authors: FNU Shweta; Karthik Murugadoss; Samir Awasthi; AJ Venkatakrishnan; Arjun Puranik; Martin Kang; Brian W. Pickering; John C. O'Horo; Philippe R. Bauer; Raymund R. Razonable; Paschalis Vergidis; Zelalem Temesgen; Stacey Rizza; Maryam Mahmood; Walter R. Wilson; Douglas Challener; Praveen Anand; Matt Liebers; Zainab Doctor; Eli Silvert; Hugo Solomon; Tyler Wagner; Gregory J. Gores; Amy W. Williams; John Halamka; Venky Soundararajan; Andrew D. Badley

    id:2004.09338v2 Date: 2020-04-17 Source: arXiv

    Understanding the temporal dynamics of COVID-19 patient phenotypes is necessary to derive fine-grained resolution of pathophysiology. Here we use state-of-the-art deep neural networks over an institution-wide machine intelligence platform for the augmented curation of 15.8 million clinical notes from 30,494 patients subjected to COVID-19 PCR diagnostic testing. By contrasting the Electronic Health Record (EHR)-derived clinical phenotypes of COVID-19-positive (COVIDpos, n=635) versus COVID-19-negative (COVIDneg, n=29,859) patients over each day of the week preceding the PCR testing date, we identify anosmia HP anosmia MESHD/dysgeusia (37.4-fold), myalgia HP myalgia MESHD/ arthralgia HP arthralgia MESHD (2.6-fold), diarrhea HP diarrhea MESHD (2.2-fold), fever HP fever MESHD/ chills HP (2.1-fold), respiratory difficulty (1.9-fold), and cough HP (1.8-fold) as significantly amplified in COVIDpos over COVIDneg patients. The specific combination of cough HP cough MESHD and diarrhea HP diarrhea MESHD has a 3.2-fold amplification in COVIDpos patients during the week prior to PCR testing, and along with anosmia HP anosmia MESHD/dysgeusia, constitutes the earliest EHR-derived signature of COVID-19 (4-7 days prior to typical PCR testing date). This study introduces an Augmented Intelligence platform for the real-time synthesis of institutional knowledge captured in EHRs. The platform holds tremendous potential for scaling up curation throughput, with minimal need for retraining underlying neural networks, thus promising EHR-powered early diagnosis for a broad spectrum of diseases.

    Epidemiological and clinical features of 2019-nCoV acute respiratory disease cases in Chongqing municipality, China: a retrospective, descriptive, multiple-center study

    Authors: Di Qi; Xiaofeng Yan; Xumao Tang; Junnan Peng; Qian Yu; Longhua Feng; Guodan Yuan; An Zhang; Yaokai Chen; Jing Yuan; Xia Huang; Xianxiang Zhang; Peng Hu; Yuyan Song; Chunfang Qian; Qiangzhong Sun; Daoxin Wang; Jin Tong; Jianglin Xiang

    doi:10.1101/2020.03.01.20029397 Date: 2020-03-03 Source: medRxiv

    BackgroundIn January 19, 2020, first case of 2019 novel coronavirus (2019-nCoV) pneumonia HP (COVID-19) was confirmed in Chongqing municipality, China. MethodsIn this retrospective, descriptive, multiple-center study, total of 267 patients with COVID-19 confirmed by real-time RT-PCR in Chongqing from Jan 19 to Feb 16, 2020 were recruited. Epidemiological, demographic, clinical, radiological characteristics, laboratory examinations, and treatment regimens were collected on admission. Clinical outcomes were followed up until Feb 16, 2020. Results267 laboratory-confirmed COVID-19 patients admitted to 3 designated-hospitals in Chongqing provincial municipality from January 19 to February 16, 2020 were enrolled and categorized on admission. 217 (81.27%) and 50 (18.73%) patients were categorized into non-severe and severe subgroups, respectively. The median age TRANS of patients was 48.0 years (IQR, 35.0-65.0), with 129 (48.3%) of the patients were more than 50 years of age TRANS. 149 (55.8%) patients were men. Severe patients were significantly older (median age TRANS, 71.5 years [IQR, 65.8-77.0] vs 43.0 years [IQR, 32.5-57.0]) and more likely to be male TRANS (110 [50.7%] vs 39 [78.0%]) and have coexisting disorders (15 [30.0%] vs 26 [12.0%]). 41 (15.4%) patients had a recent travel TRANS to Hubei province, and 139 (52.1%) patients had a history of contact with patients from Hubei. On admission, the most common symptoms of COVID-19 were fever HP 225(84.3%), fatigue HP (208 [77.9%]), dry cough HP (189 [70.8%]), myalgia HP or arthralgia HP (136 [50.9%]). Severe patients were more likely to present dyspnea HP (17 [34.0%] vs 26 [12.0%]) and confusion HP (10 [20.0%] vs 15 [6.9%]). Rales (32 [12.0%]) and wheezes (20 [7.5%]) are not common noted for COVID-19 patients, especially for the non-severe (11 [5.1%], 10 [4.6%]). 118 (44.2%). Most severe patients demonstrated more laboratory abnormalities. 231 (86.5%), 61 (22.8%) patients had lymphopenia HP, leukopenia HP and thrombocytopenia HP, respectively. CD4+ T cell counts decrease HP was observed in 77.1 % of cases, especially in the severe patients (45, 100%). 53.1% patients had decreased CD+3 T cell counts, count of CD8+T cells was lower than the normal range in part of patients (34.4%). More severe patients had lower level of CD4+ T cells and CD+3 T cells (45 [100.0%] vs 29[56.9%], 31 [68.9%] vs 20 [39.2%]). Most patients had normal level of IL-2, IL-4, TNF- and INF-{gamma}, while high level of IL-6 and IL-17A was common in COVID-19 patients (47 [70.1%], 35 [52.2%]). Level of IL-6, IL-17A and TNF- was remarkably elevated in severe patients (32 [84.2%] vs 15 [51.7%], 25 [65.8%] vs 10 [34.5%], 17 [44.7%] vs 5 [17.2%]). All patients received antiviral therapy (267, 100%). A portion of severe patients (38, 76.0%) received systemic corticosteroid therapy. Invasive mechanical ventilation in prone position, non-invasive mechanical ventilation, high-flow nasal cannula oxygen therapy was adopted only in severe patients with respiratory failure HP (5[10.0%], 35[70.0%], 12[24.0%]). Traditional Chinese medicine was adopted to most of severe patients (43,86.0%). Conclusion:Our study firstly demonstrated the regional disparity of COVID-19 in Chongqing municipality and further thoroughly compared the differences between severe and non-severe patients. The 28-day mortality of COVID-19 patients from 3 designed hospitals of Chongqing is 1.5%, lower than that of Hubei province and mainland China including Hubei province. However, the 28-mortality of severe patients was relatively high, with much higher when complications occurred. Notably, the 28-mortality of critically severe patients complicated with severe ARDS is considerably as high as 44.4%. Therefore, early diagnosis and intensive care of critically severe COVID-19 cases, especially those combined with ARDS, will be considerably essential to reduce mortality.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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