Corpus overview


MeSH Disease

Fatigue (150)

Fever (141)

Coronavirus Infections (81)

Cough (76)

Dyspnea (65)

Human Phenotype

Cough (171)

Fatigue (171)

Fever (157)

Pneumonia (48)

Myalgia (47)


    displaying 11 - 20 records in total 171
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    Robust, reproducible clinical patterns in hospitalised patients with COVID-19

    Authors: Jonathan E Millar; Lucile Neyton; Sohan Seth; Jake Dunning; Laura Merson; Srinivas Murthy; Clark D Russell; Sean Keating; Maaike Swets; Carole H Sudre; Timothy D Spector; Sebastien Ourselin; Claire J Steves; Jonathan Wolf; - ISARIC4C Investigators; Annemarie B Docherty; Ewen M Harrison; Peter JM Openshaw; Malcolm G Semple; J Kenneth Baillie

    doi:10.1101/2020.08.14.20168088 Date: 2020-08-16 Source: medRxiv

    Severe COVID-19 is characterised by fever HP fever MESHD, cough HP cough MESHD, and dyspnoea MESHD. Symptoms affecting other organ systems have been reported. The clinical associations of different patterns of symptoms can influence diagnostic and therapeutic decision-making: for example, significant differential therapeutic effects in sub-groups of patients with different severities of respiratory failure HP respiratory failure MESHD have already been reported for the only treatment so far shown to reduce mortality in COVID-19, dexamethasone. We obtained structured clinical data on 68914 patients in the UK (the ISARIC Coronavirus Clinical Characterisation Consortium, 4C) and used a principled, unsupervised clustering approach to partition the first 33468 cases according to symptoms reported at recruitment. We validated our findings in a second group of 35446 cases recruited to ISARIC-4C, and in separate cohort of community cases. A core symptom set of fever HP fever MESHD, cough HP cough MESHD, and dyspnoea co MESHD-occurred with additional symptoms in three patterns: fatigue HP fatigue MESHD and confusion HP confusion MESHD, diarrhoea and vomiting MESHD vomiting HP, or productive cough HP. Presentations with a single reported symptom of dyspnoea MESHD or confusion HP confusion MESHD were common, and a subgroup of patients reported few or no symptoms. Patients presenting with gastrointestinal symptoms MESHD were more commonly female TRANS, had a longer duration of symptoms before presentation, and had lower 30-day mortality. Patients presenting with confusion HP confusion MESHD, with or without core symptoms, were older and had a higher unadjusted mortality. Symptom clusters were highly consistent in replication analysis using a further 35446 individuals subsequently recruited to ISARIC-4C. Similar patterns were externally verified in 4445 patients from a study of self-reported symptoms of mild disease. The large scale of ISARIC-4C study enabled robust, granular discovery and replication of patient clusters. Clinical interpretation is necessary to determine which of these observations have practical utility. We propose that four patterns are usefully distinct from the core symptom groups: gastro-intestinal disease MESHD, productive cough HP, confusion HP confusion MESHD, and pauci-symptomatic presentations. Importantly, each is associated with an in-hospital mortality which differs from that of patients with core symptoms. These observations deepen our understanding of COVID-19 and will influence clinical diagnosis, risk prediction, and future mechanistic and clinical studies.

    A case report of moderate COVID-19 with an extremely long-term viral shedding period in China

    Authors: yonghong wang; chaoyuan liu; qinghui meng; shuang gui; yu wu; pengjiang cheng; peng wang; xiuyong liao

    doi:10.21203/ Date: 2020-08-14 Source: ResearchSquare

    BackgroundAn ongoing outbreak of novel coronavirus disease MESHD 2019 (COVID-19) from Wuhan, China, is currently recognized as a global public health emergency, which has subsequently spread to the rest of China and other countries. The WHO raised the COVID-19 alert to the highest level. The virus is a new highly contagious via human-to-human transmission TRANS. The median duration of viral shedding is 20.0 days. We report that the longest duration of viral shedding was 32.0 days from illness onset in a patient with moderate COVID-19 admitted to QianJiang Central Hospital.Case presentationA 37-year-old male TRANS sought medical advice while suffering from fever HP fever MESHD, dry cough MESHD cough HP, fatigue HP fatigue MESHD, dizziness MESHD, runny nose and diarrhoea MESHD. Five days before the visit, he had a history of travel TRANS from affected geographic areas. The patient had a positive RT-PCR test, and chest CT images showed multiple nodules and mixed ground-glass opacification with consolidation in both lungs. Laboratory findings showed that his lymphocyte and CD4+ counts were below the normal range. The patient was given antiviral treatment, including arbidol, lopinavir, IFN-α, and traditional Chinese medicine, and other necessary support care. All clinical symptoms and CT imaging manifestation abnormalities resolved during the course of therapy.ConclusionAlthough the positive RT-PCR tests were verified in consecutive upper respiratory specimens, the clinical symptoms, CT imaging findings, CD4 + lymphocyte counts, and IgG antibody SERO levels had obviously improved. Positive tests may be detecting pieces of inactive viruses, which would not be transmissible in individual cases.

    A Large-Scale Clinical Validation Study Using nCapp Cloud Plus Terminal by Frontline Doctors for the Rapid Diagnosis of COVID-19 and COVID-19 pneumonia HP pneumonia MESHD in China

    Authors: Dawei Yang; Tao Xu; Xun Wang; Deng Chen; Ziqiang Zhang; Lichuan Zhang; Jie Liu; Kui Xiao; Li Bai; Yong Zhang; Lin Zhao; Lin Tong; Chaomin Wu; Yaoli Wang; Chunling Dong; Maosong Ye; Yu Xu; Zhenju Song; Hong Chen; Jing Li; Jiwei Wang; Fei Tan; Hai Yu; Jian Zhou; Jinming Yu; Chunhua Du; Hongqing Zhao; Yu Shang; Linian Huang; Jianping Zhao; Yang Jin; Charles A. Powell; Yuanlin Song; Chunxue Bai

    doi:10.1101/2020.08.07.20163402 Date: 2020-08-11 Source: medRxiv

    Background The outbreak of coronavirus disease MESHD 2019 (COVID-19) has become a global pandemic acute infectious disease MESHD, especially with the features of possible asymptomatic TRANS carriers TRANS and high contagiousness. It causes acute respiratory distress HP respiratory distress MESHD syndrome and results in a high mortality rate if pneumonia HP is involved. Currently, it is difficult to quickly identify asymptomatic TRANS cases or COVID-19 patients with pneumonia HP pneumonia MESHD due to limited access to reverse transcription-polymerase chain reaction (RT-PCR) nucleic acid tests and CT scans, which facilitates the spread of the disease TRANS at the community level, and contributes to the overwhelming of medical resources in intensive care units. Goal This study aimed to develop a scientific and rigorous clinical diagnostic tool for the rapid prediction of COVID-19 cases based on a COVID-19 clinical case database in China, and to assist global frontline doctors to efficiently and precisely diagnose asymptomatic TRANS COVID-19 patients and cases who had a false-negative RT-PCR test result. Methods With online consent, and the approval of the ethics committee of Zhongshan Hospital Fudan Unversity (approval number B2020-032R) to ensure that patient privacy is protected, clinical information has been uploaded in real-time through the New Coronavirus Intelligent Auto-diagnostic Assistant Application of cloud plus terminal (nCapp) by doctors from different cities (Wuhan, Shanghai, Harbin, Dalian, Wuxi, Qingdao, Rizhao, and Bengbu) during the COVID-19 outbreak in China. By quality control and data anonymization on the platform, a total of 3,249 cases from COVID-19 high-risk groups were collected. These patients had SARS-CoV-2 RT-PCR test results and chest CT scans, both of which were used as the gold standard for the diagnosis of COVID-19 and COVID-19 pneumonia HP pneumonia MESHD. In particular, the dataset included 137 indeterminate cases who initially did not have RT-PCR tests and subsequently had positive RT-PCR results, 62 suspected cases who initially had false-negative RT-PCR test results and subsequently had positive RT-PCR results, and 122 asymptomatic TRANS cases who had positive RT-PCR test results, amongst whom 31 cases were diagnosed. We also integrated the function of a survey in nCapp to collect user feedback from frontline doctors. Findings We applied the statistical method of a multi-factor regression model to the training dataset (1,624 cases) and developed a prediction model for COVID-19 with 9 clinical indicators that are fast and accessible: 'Residing or visiting history in epidemic regions', 'Exposure history to COVID-19 patient', 'Dry cough HP', ' Fatigue HP', 'Breathlessness', 'No body temperature decrease after antibiotic treatment', 'Fingertip blood SERO oxygen saturation<=93%', ' Lymphopenia HP Lymphopenia MESHD', and 'C-reactive protein (CRP) increased'. The area under the receiver operating characteristic (ROC) curve (AUC) for the model was 0.88 (95% CI: 0.86, 0.89) in the training dataset and 0.84 (95% CI: 0.82, 0.86) in the validation dataset (1,625 cases). To ensure the sensitivity SERO of the model, we used a cutoff value of 0.09. The sensitivity SERO and specificity of the model were 98.0% (95% CI: 96.9%, 99.1%) and 17.3% (95% CI: 15.0%, 19.6%), respectively, in the training dataset, and 96.5% (95% CI: 95.1%, 98.0%) and 18.8% (95% CI: 16.4%, 21.2%), respectively, in the validation dataset. In the subset of the 137 indeterminate cases who initially did not have RT-PCR tests and subsequently had positive RT-PCR results, the model predicted 132 cases, accounting for 96.4% (95% CI: 91.7%, 98.8%) of the cases. In the subset of the 62 suspected cases who initially had false-negative RT-PCR test results and subsequently had positive RT-PCR results, the model predicted 59 cases, accounting for 95.2% (95% CI: 86.5%, 99.0%) of the cases. Considering the specificity of the model, we used a cutoff value of 0.32. The sensitivity SERO and specificity of the model were 83.5% (95% CI: 80.5%, 86.4%) and 83.2% (95% CI: 80.9%, 85.5%), respectively, in the training dataset, and 79.6% (95% CI: 76.4%, 82.8%) and 81.3% (95% CI: 78.9%, 83.7%), respectively, in the validation dataset, which is very close to the published AI model. The results of the online survey 'Questionnaire Star' showed that 90.9% of nCapp users in WeChat mini programs were 'satisfied' or 'very satisfied' with the tool. The WeChat mini program received a significantly higher satisfaction rate than other platforms, especially for 'availability and sharing convenience of the App' and 'fast speed of log-in and data entry'. Discussion With the assistance of nCapp, a mobile-based diagnostic tool developed from a large database that we collected from COVID-19 high-risk groups in China, frontline doctors can rapidly identify asymptomatic TRANS patients and avoid misdiagnoses of cases with false-negative RT-PCR results. These patients require timely isolation or close medical supervision. By applying the model, medical resources can be allocated more reasonably, and missed diagnoses can be reduced. In addition, further education and interaction among medical professionals can improve the diagnostic efficiency for COVID-19, thus avoiding the transmission TRANS of the disease from asymptomatic TRANS patients at the community level.

    Clinical Characteristics of COVID-19 Patients with Recurrent PCR Positivity After Hospital Discharge

    Authors: Kaige Wang; Panwen Tian

    doi:10.21203/ Date: 2020-08-06 Source: ResearchSquare

    Objective: This study aimed to investigate the clinical characteristics of COVID-19 patients with recurrent SARS-CoV-2 positivity after hospital discharge. Methods: This retrospective study included COVID-19 patients who were readmitted for recurrence of positive SARS-CoV-2 RNA. Univariate and multivariate analyses were performed to assess the risk factors associated to the duration of recurrent RNA positivity.Results: Among the 287 discharged COVID-19 patients, 33 (11.5%) patients with recurrent PCR positivity were included. Among these patients, 21 (63.7%) patients were female TRANS, their mean age TRANS was 48.7 (±19.7) years old. 22 (66.7%) patients were asymptomatic TRANS. The following clinical features were presented in other patients: cough HP, fatigue HP fatigue MESHD, sore throat, fever HP fever MESHD and expectoration. The chest CT findings revealed that 8 (24.2%) patients were characterized by deterioration compared to the previous results. The median duration of recurrent RNA positivity was 9.0 days (IQR, 6.0, 15.0). We found that increased serum SERO SARS-CoV-2-specific IgG antibody SERO titer, elevated serum creatinine HP serum SERO creatinine level, and female TRANS gender TRANS were the risk factors for the prolonged duration of recurrent RNA positivity.Conclusion: SARS-CoV-2 turned positive in a minority of discharged patients with COVID-19. Most patients experienced mild clinical course. Increased IgG antibody SERO titer, creatinine and female TRANS gender TRANS were correlated to the prolonged RNA clearance time.

    COVID-19 Vaccine Candidates by Identification of B and T Cell Multi-Epitopes Against SARS-COV-2 MESHD

    Authors: Suresh Kumar; Sarmilah Mathavan; Wee Jia Jin; Nur Azznira Bt Azman; Devindren Subramanaiam; Nur Afiqah Binti Zainalabidin; Dhivashini Lingadaran; Zainah Binti Abdul Sattar; Danniya Lakshmi Manickam; Priscilla Sheba Anbananthan; Johan Ahmad Taqiyuddin; Yuvapriya Thevarajan

    id:10.20944/preprints202008.0092.v1 Date: 2020-08-04 Source:

    Coronavirus disease (COVID-19) is a new discovered strain where WHO officially declares the disease as COVID-19 while the virus responsible for it called Severe Acute Respiratory Syndrome Coronavirus 2 MESHD or SARS-CoV-2. The incubation period TRANS of this disease is between 14 days. Ordinary clinical symptoms that reported around the world include fever HP fever MESHD, cough HP cough MESHD, fatigue HP fatigue MESHD, diarrhoea MESHD and vomiting HP vomiting MESHD as well as asymptomatic TRANS for certain people. Infection is spread mainly through broad droplets. In early March 2020, WHO again has announced that COVID-19 is a pandemic with currently no specific treatment. The potential use of SARS-COV-2 proteome as a vaccine candidate by analysing through B-cell and T-cell antigenicity by using a immunoinformatics approach as a vaccine development early stage. In this study, we used consensus sequence for SARS-COV-2 proteome that was retrieved from NCBI database. VaxiJen 2.0 was mainly used to identify the antigenic property of SARS-COV-2 proteins. IEDB then used to analyse the B-cell epitope, the presence of T cell immunogenic epitope in SARS-COV-2 proteins was obtained by using compromise method of MHC class I and II tools that accessible respectively using ProPred-1 server and MHC II Binding Prediction in IEDB database. The best epitopes of B and T-cell epitopes were predicted with high antigencity and the information is disseminated through web-based database resource ( This study will be useful to find a new epitope-based candidate for SARS-COV-2. However, further study needs to be done for the next stages of vaccine development.

    Clinical Course and Management of 73 Hospitalized Moderate Patients with COVID-19 Outside Wuhan

    Authors: Xiaojuan Peng; Qi Liu; Zhaolin Chen; Guiyan Wen; Qing Li; Yanfang Chen; Jie Xiong; Xinzhou Meng; Yuanjin Ding; Ying Shi; Shaohui Tang

    doi:10.21203/ Date: 2020-08-01 Source: ResearchSquare

    Background: Moderate cases account for the majority in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD and can also progress to severe/critical condition. Here, we investigated the clinical course and management of hospitalized moderate SARS-CoV-2 patients.Methods: The medical records and follow-up data were analyzed from the SARS-CoV-2 patients outside Wuhan.Results: A total of 73 moderate patients (38 men, 35 women) were included, with median age TRANS of 47.0 (38.5-57.5) years. Among them, only one patient (1.4%) died using active treatment to improve symptoms. The median duration of the four main symptoms cough HP, fever HP fever MESHD, chest tightness HP chest tightness MESHD, and fatigue HP fatigue MESHD were about 1-2 weeks; the median duration of the positive nucleic acid test (NAT) results for SARS-CoV-2 was slightly more than 2 weeks; the median hospitalization time was almost four weeks in 72 moderate survivors. The duration of cough HP cough MESHD and fever HP fever MESHD was positively correlated with the duration of the positive NAT results. On admission, 50% had lymphopenia HP lymphopenia MESHD; less than 30% had abnormal blood SERO biochemistry findings involving hyperglycemia HP hyperglycemia MESHD, liver function and myocardial enzymes. At discharge, the laboratory indexes were substantially improved. Two weeks after discharge, 5.6% survivors experienced a recurrence of the positive NAT results. Conclusions: Moderate SARS-CoV-2 patients have a good prognosis by the active treatment. After discharge, it is necessary that moderate survivors undergo at least a 2-week collective medical observation in quarantine places, which can identify and treat a proportion of patients with re-positive NAT results and to prevent the spread of the potential sources of infection MESHD.

    Fighting COVID-19 spread among nursing home residents even in absence of molecular diagnosis: a retrospective cohort study.

    Authors: Alessio Strazzulla; Paul Tarteret; Maria Concetta Postorino; Marie Picque; Astrid de Pontfarcy; Nicolas Vignier; Catherine Chakvetadze; Coralie Noel; Cecile Drouin; Zine Eddine Benguerdi; Sylvain Diamantis

    doi:10.21203/ Date: 2020-07-30 Source: ResearchSquare

    Background Access to molecular diagnosis was limited out-of-hospital in France during the 2020 coronavirus disease 2019 (COVID-19) epidemic. This study describes the evolution of COVID-19 outbreak in a nursing home in absence of molecular diagnosis. Methods A monocentric prospective study was conducted in a French nursing home from March 17th, 2020 to June 11th, 2020. Because of lack of molecular tests for severe acute respiratory syndrome 2 (SARS-Cov2) infection MESHD, probable COVID-19 cases were early identified considering only respiratory and not-respiratory symptoms and therefore preventing measures and treatments were enforced. Once available, serology tests were performed at the end of the study.A chronologic description of new cases and deaths MESHD was made together with a description of COVID-19 symptoms. Data about personal characteristics and treatments were collected and the following comparisons were performed: i) probable COVID-19 cases vs asymptomatic TRANS residents; ii) SARS-Cov2 seropositive residents vs seronegative residents. Results Overall, 32/66 (48.5%) residents and 19/39 (48.7%) members of health-care personnel were classified as probable COVID-19 cases. A total of 34/61 (55.7%) tested residents resulted seropositive. Death occurred in 4/66 (6%) residents. Diagnosis according to symptoms had 65% of sensitivity SERO, 78% of specificity, 79% of positive predictive value SERO and 64% of negative predictive value SERO.In resident population, the following symptoms were registered: 15/32 (46.8%) lymphopenia HP lymphopenia MESHD, 15/32 (46.8%) fever HP fever MESHD, 8/32 (25%) fatigue HP fatigue MESHD, 8/32 (25%) cough HP, 6/32 (18.8%) diarrhoea MESHD, 4/32 (12.5%) severe respiratory distress HP requiring oxygen therapy, 4/32 (12.5%) fall HP, 3/32 (9.4%) conjunctivitis HP conjunctivitis MESHD, 2/32 (6.3%) abnormal pulmonary noise at chest examination and 2/32 (6,25%) abdominal pain HP abdominal pain MESHD. Probable COVID-19 cases were older (81.3 vs 74.9; p=0.007) and they had higher prevalence SERO of atrial fibrillation HP atrial fibrillation MESHD (8/32, 25% vs 2/34, 12%; p=0.030); insulin treatment (4/34, 12% vs 0, 0%; p=0.033) and positive SARS-Cov2 serology (22/32, 69% vs 12/34, 35%; p=0.001) than asymptomatic TRANS residents. Seropositive residents had lower prevalence SERO of diabetes MESHD (4/34, 12% vs 9/27, 33%; p=0.041) and angiotensin-converting-enzyme inhibitors’ intake (1/34, 1% vs 5/27, 19%; p=0.042). Conclusions During SARS-Cov2 epidemic, early detection of respiratory and not-respiratory symptoms allowed to enforce extraordinary measures. They achieved limiting contagion and deaths among nursing home residents, even in absence of molecular diagnosis.

    Examining Australian's beliefs, misconceptions, and sources of information for COVID-19: A national online survey

    Authors: Rae Thomas; Hannah Greenwood; Zoe A Michaleff; Eman Abukmail; Tammy Hoffmann; Kirsten J McCaffery; Leah Hardiman; Paul Glasziou

    doi:10.1101/2020.07.27.20163204 Date: 2020-07-29 Source: medRxiv

    Objective: Public cooperation to practice preventive health behaviours is essential to manage the transmission TRANS of infectious diseases MESHD such as COVID-19. We aimed to investigate beliefs about COVID-19 diagnosis, transmission TRANS and prevention that have the potential to impact the uptake of recommended public health strategies. Design: An online cross-sectional survey conducted May 8 to May 11 2020. Participants: A national sample of 1500 Australian adults TRANS with representative quotas for age TRANS and gender TRANS provided by online panel provider. Main outcome measure: Proportion of participants with correct/incorrect knowledge of COVID-19 preventive behaviours and reasons for misconceptions. Results: Of the 1802 potential participants contacted, 289 were excluded, 13 declined, and 1500 participated in the survey (response rate 83%). Most participants correctly identified washing your hands regularly with soap and water (92%) and staying at least 1.5m away from others (90%) could help prevent COVID-19. Over 40% (incorrectly) considered wearing gloves outside of the home would prevent them contracting COVID-19. Views about face masks were divided. Only 66% of participants correctly identified that regular use of antibiotics would not prevent COVID-19. Most participants (90%) identified fever HP fever MESHD, fatigue HP fatigue MESHD and cough HP as indicators of COVID-19. However, 42% of participants thought that being unable to hold your breath for 10 seconds without coughing HP was an indicator of having the virus. The most frequently reported sources of COVID-19 information were commercial television channels (56%), the Australian Broadcasting Corporation (43%), and the Australian Government COVID-19 information app (31%). Conclusions: Public messaging about hand hygiene and physical distancing to prevent transmission TRANS appear to have been effective. However, there are clear, identified barriers for many individuals that have the potential to impede uptake or maintenance of these behaviours in the long-term. Currently these non-drug interventions are our only effective strategy to combat this pandemic. Ensuring ongoing adherence to is critical.

    Children TRANS with COVID-19 like symptoms in Italian Pediatric Surgeries: the dark side of the coin

    Authors: Gianfranco Trapani; Vassilios Fanos; Enrico Bertino; Giulia Maiocco; Osama Al Jamal; Michele Fiore; VIncenzo Bembo; Domenico Careddu; Lando Barberio; Luisella Zanino; Giuseppe Verlato

    doi:10.1101/2020.07.27.20149757 Date: 2020-07-29 Source: medRxiv

    BACKGROUND: Symptoms of SARS-CoV-2 infection MESHD in children TRANS are nonspecific and shared with other common acute viral illnesses ( fever HP fever MESHD, respiratory or gastrointestinal symptoms MESHD, and cutaneous signs), thus making clinical differential diagnosis tricky. In Italy, first line management of pediatric care is handed over to Primary Care Pediatricians (PCPs), who were not allowed to directly perform diagnostic tests during the recent COVID-19 outbreak. Without a confirmatory diagnosis, PCPs could only collect information on ''COVID-19 like symptoms'' rather than identify typical COVID-19 symptoms. AIM: To evaluate the prevalence SERO of COVID-19 like symptoms in outpatient children TRANS, during Italian lockdown. To provide PCPs a risk score to be used in clinical practice during the differential diagnosis process. METHODS: A survey was submitted to 50 PCPs (assisting 47,500 children TRANS) from 7 different Italian regions between the 4th of March and the 23rd of May 2020 (total and partial lockdown period). COVID-19 like symptoms in the assisted children TRANS were recorded, as well as presence of confirmed/suspected cases in children TRANS's families, which was taken as proxy of COVID-19. Multivariable logistic regression was accomplished to estimate the risk of having suspected/ confirmed cases TRANS in families, considering symptoms as potential determinants. RESULTS: 2,300 children TRANS (4.8% of overall survey population) fell HP ill with COVID-19 like symptoms, 3.1% and 1.7% during total and partial lockdown period respectively. The concurrent presence of fatigue HP fatigue MESHD, cough HP, and diarrhea HP diarrhea MESHD in children TRANS, in absence of sore throat/ earache MESHD and abnormal skin signs, represents the maximum risk level of having a suspected/ confirmed case TRANS of COVID-19 at home. CONCLUSIONS: The percentage of children TRANS presenting COVID-19 like symptoms at home has been remarkable also during the total lockdown period. The present study identified a pattern of symptoms which could help, in a cost-effective perspective, PCPs in daily clinical practice to define priorities in addressing children TRANS to the proper diagnostic procedure.

    Older adults TRANS hospitalized with Covid-19: Clinical characteristics and early outcomes from a single center in Istanbul, Turkey 

    Authors: Alpay Medetalibeyoğlu; Naci Senkal; Murat Kose; Yunus Catma; Emine Bilge Caparali; Mustafa Erelel; Mustafa Oral Oncul; Gulistan Bahat; Tufan Tukek

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

    Objective: Older adults TRANS have been continuously reported to be at higher risk for adverse outcomes of Covid-19. We aimed to describe clinical characteristics and early outcomes of the older Covid-19 patients hospitalized in our center comparatively with the younger patients, and also to analyze the triage factors that were related to the in-hospital mortality of older adults TRANS.Design: Retrospective; observational studySetting: Istanbul Faculty of Medicine hospital, TurkeyParticipants: 362 hospitalized patients with laboratory-confirmed Covid-19 from March 11 to May 11, 2020.Measurements: The demographic information; associated comorbidities; presenting clinical, laboratory, radiological characteristics on admission and outcomes from the electronic medical records were analyzed comparatively between the younger (<65 years) and older (≥65 years) adults TRANS. Factors associated with in-hospital mortality of the older adults TRANS were analyzed by multivariate regression analyses.Results: The median age TRANS was 56 years (interquartile range [IQR], 46-67), and 224 (61.9%) were male TRANS. There were 104 (28.7%) patients ≥65 years of age TRANS. More than half of the patients (58%) had one or more chronic comorbidity. The three most common presenting symptoms in the older patients were fatigue HP atigue/ MESHD myalgia HP yalgia MESHD(89.4%), d ry cough MESHD cough HP (72.1%), and fever HP ever MESHD(63.5%). Cough HP and fever HP ever MESHDwere significantly less prevalent in older adults TRANS compared to younger patients (p=0.001 and 0.008, respectively). Clinically severe pneumonia HP neumonia MESHDwas present in 31.5% of the study population being more common in older adults TRANS (49% vs. 24.4%) (p<0.001). The laboratory parameters that were significantly different between the older and younger adults TRANS were as follows: the older patients had significantly higher CRP, D-dimer, TnT, pro-BNP, procalcitonin levels, higher prevalence SERO of lymphopenia HP ymphopenia, MESHD neutrophilia HP, increased creatinine, and lower hemoglobin, ALT, albumin level (p<0.05). In the radiological evaluation, more than half of the patients (54.6%) had moderate-severe pneumonia HP neumonia, MESHD which was more prevalent in older patients (66% vs. 50%) (p=0.006). The adverse outcomes were significantly more prevalent in older adults TRANS compared to the younger patients (ICU admission, 28.8% vs. 8.9%; mortality, 23.1% vs. 4.3%, p<0.001).  Among the triage evaluation parameters, the only factor associated with higher mortality was the presence of clinically severe pneumonia HP neumonia MESHDon admission (Odds Ratio=12.3, 95% confidence interval=2.7-55.5, p=0.001).Conclusion: Older patients presented with more prevalent chronic comorbidities, less prevalent symptomatology but more severe respiratory signs and l aboratory abnormalities MESHDthan the younger patients. Among the triage assessment factors, the clinical evaluation of pulmonary involvement came in front to help clinicians to stratify the patients for mortality risk.

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MeSH Disease
Human Phenotype

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