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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    The impact of COVID-19 on patients with asthma HP asthma MESHD: A Big Data analysis

    Authors: Jose Luis Izquierdo; Carlos Almonacid; Yolanda Gonzalez; Carlos Del Rio-Bermudez; Julio Ancochea; Remedios Cardenas; Joan B Soriano

    doi:10.1101/2020.07.24.20161596 Date: 2020-07-24 Source: medRxiv

    Background: From the onset of the COVID-19 pandemic, an association between the severity of COVID-19 and the presence of certain medical chronic conditions has been suggested. However, unlike influenza and other viruses, the burden of the disease in patients with asthma HP asthma MESHD has been less evident. Objective: This study aims at a better understanding of the burden of COVID-19 in patients with asthma HP asthma MESHD and the impact of asthma HP, its related comorbidities, and treatment on the prognosis of COVID-19. Methods: We analyzed clinical data from patients with asthma HP asthma MESHD from January 1st to May 10th, 2020 using big data analytics and artificial intelligence through the SAVANA Manager clinical platform. Results: Out of 71,192 patients with asthma HP asthma MESHD, 1,006 (1.41%) suffered from COVID-19. Compared to asthmatic individuals without COVID-19, patients with asthma HP asthma MESHD and COVID-19 were significantly older (55 vs. 42 years), predominantly female TRANS (66% vs. 59%), had higher prevalence SERO of hypertension HP hypertension MESHD, dyslipidemias MESHD, diabetes MESHD, and obesity HP obesity MESHD, and smoked more frequently. Contrarily, allergy HP allergy MESHD-related factors such as rhinitis HP rhinitis MESHD and eczema HP eczema MESHD were less frequent in asthmatic patients with COVID-19 (P < .001). Higher prevalence SERO of hypertension HP hypertension MESHD, dyslipidemia MESHD, diabetes MESHD, and obesity HP obesity MESHD was also confirmed in those patients with asthma HP asthma MESHD and COVID-19 who required hospital admission. The percentage of individuals using inhaled corticosteroids ( ICS MESHD) was lower in patients who required hospitalization due to COVID-19, as compared to non-hospitalized patients (48.3% vs. 61.5%; OR: 0.58: 95% CI 0.44-0.77). During the study period, 865 (1.21%) patients with asthma HP asthma MESHD were being treated with biologics. Although these patients showed increased severity and more comorbidities at the ear, nose, and throat (ENT) level, their hospital admission rates due to COVID-19 were relatively low (0.23%). COVID-19 increased inpatient mortality in asthmatic patients (2.29% vs 0.54%; OR 2.29: 95% CI 4.35-6.66). Conclusion: Our results indicate that the number of COVID-19 cases in patients with asthma HP has been low, although higher than the observed in the general population. Patients with asthma HP asthma MESHD and COVID-19 were older and were at increased risk due to comorbidity-related factors. ICS and biologics are generally safe and may be associated with a protective effect against severe COVID-19 infection MESHD.

    Azithromycin added to Hydroxychloroquine for Patients Admitted to Intensive Care due to Coronavirus Disease MESHD 2019 (COVID-19) – Protocol of Randomized Controlled Trial AZIQUINE-ICU

    Authors: František Duška; Petr Waldauf; Milada Halačová; Václav Zvoníček; Jakub Bala; Jan Beneš; Martin Balík; Olga Klementová; Irena Kozáková; Viktor Kubricht; Anne Le Roy; Veronika Řehořová; Tomáš Vymazal; Vladimír Černý

    doi:10.21203/rs.3.rs-22892/v2 Date: 2020-04-14 Source: ResearchSquare

    •      Background: Novel coronavirus SARS-CoV-2 is known to be susceptible in vitro to exposure to hydroxychloroquine and its effect have been found to be potentiated by azithromycin. We hypothesize, that early administration of hydroxychloroquine alone or in combination with azithromycin can prevent respiratory deterioration MESHD in patients admitted to intensive care due to rapidly progressive COVID-19 infection MESHD. •      Methods: Design: Prospective, multi-centre, double blind, randomised, controlled trial (RCT). Participants: Adult TRANS (>18 years) within 24 hours of admission to intensive care unit with proven or suspected COVID-19 infection MESHD, whether or not mechanically ventilated. Exclusion criteria include duration symptoms of febrile disease for ≥1 week, treatment limitations in place or moribund patients, allergy HP allergy MESHD or intolerance of any study treatment, pregnancy. Interventions: Patients will be randomized in 1:1:1 ratio to receive Hydroxychloroquine 800mg orally in two doses followed by 400mg daily in two doses and Azithromycin 500 mg orally in one dose followed by 250 mg in one dose for a total of 5 days ( HC MESHD-A group) or Hydroxychloroquine+ placebo ( HC MESHD group) or placebo + placebo (C-group) in addition to best standard of care, which may evolve during the trial period but will not differ between groups. Primary outcome is the composite percentage of patients alive and not on end-of-life pathway who are free of mechanical ventilation at day 14. Secondary outcomes: The percentage of patients who were prevented from needing intubation until day 14; ICU length of stay; mortality (in hospital) at day 28 and 90.•      Discussion: Although both investigational drugs are often administered off label to patients with severe COVID-19, at present, there is no data from RCTs on their safety and efficacy. In vitro and observational trial suggest their potential to limit viral replication and the damage to lungs as the most common reason for ICU admission. Therefore, patients most likely to benefit from the treatment are those with severe, but early disease. This trial is designed and powered to investigate whether the treatment in this cohort of patients leads to improved clinical patients-centered outcomes, such as mechanical ventilation-free survival. Trial registration: Clinical trials.gov: NCT04339816 (Registered on 9th April 2020); Eudra CT number: 2020-001456-18 (Registered on 29th March 2020)

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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