Corpus overview


MeSH Disease

Human Phenotype

Cough (103)

Fever (97)

Pneumonia (40)

Fatigue (39)

Diarrhea (23)


    displaying 1 - 10 records in total 103
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    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 MESHD pneumonia HP 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 syndrome MESHD and results in a high mortality rate if pneumonia MESHD pneumonia HP is involved. Currently, it is difficult to quickly identify asymptomatic TRANS cases or COVID-19 patients with pneumonia MESHD pneumonia HP 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 disease MESHD 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 MESHD pneumonia HP. 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 MESHD cough HP', ' Fatigue MESHD Fatigue HP', 'Breathlessness', 'No body temperature decrease after antibiotic treatment', 'Fingertip blood SERO oxygen saturation<=93%', ' Lymphopenia MESHD Lymphopenia HP', 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 MESHD asymptomatic TRANS patients at the community level.

    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 MESHD 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 MESHD cough HP, fever MESHD fever HP, chest tightness HP, and fatigue MESHD fatigue HP 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 MESHD cough HP and fever MESHD fever HP was positively correlated with the duration of the positive NAT results. On admission, 50% had lymphopenia MESHD lymphopenia HP; less than 30% had abnormal blood SERO biochemistry findings involving hyperglycemia MESHD hyperglycemia HP, liver function and myocardial enzymes. At discharge, the laboratory indexes were substantially improved. Two weeks after discharge, 5.6% survivors experienced a recurrence MESHD 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.

    Elevated oxygen demand in a case of COVID-19 with severe ARDS: a point for optimal oxygenation therapy including ECMO management

    Authors: Taku Oshima; Takehiko Oami; Mana Yamashiro; Akiko Higashi; Yosuke Hayashi; Natsumi Suga; Shin Takayanagi; Seiichiro Sakao; Taka-aki Nakada

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

    Background: Coronavirus disease MESHD 2019 (COVID-19) caused by SARS-CoV-2 has become a global pandemic, and those developing critically ill conditions have been reported to have mortality in the range of 39% to 61%. Due to the lack of definitive treatments, mechanical ventilation and supportive oxygenation therapy are key management strategies for the survival of patients with acute respiratory distress HP syndrome MESHD (ARDS). Optimizing oxygenation therapy is mandatory to treat patients with severe respiratory failure HP, to sufficiently compensate for the oxygen (O2) demand. We experienced a case of severe ARDS due to COVID-19 successfully treated with extracorporeal membrane oxygenation (ECMO) after increasing oxygen delivery according to O2 consumption measurement by indirect calorimetryCase Presentation: A 29-year-old obese but otherwise healthy man was hospitalized for treatment of COVID-19 pneumonia MESHD pneumonia HP presenting with a 4-day history of persisting cough MESHD cough HP, high fever MESHD fever HP, and dyspnea MESHD dyspnea HP. Mechanical ventilation, nitric oxide inhalation, and prone positioning were initiated in the ICU against severe respiratory dysfunction. Indirect calorimetry on the 3rd and 6th ICU days revealed persistent elevation of oxygen consumption (VO2) of 380 mL/min. Veno-venous ECMO was initiated on the 7th ICU day after further deterioration of respiratory failure HP. Periodic events of SpO2 decline due to effortful breathing was not resolved by neuromuscular blockade in attempt to reduce O2 consumption. Increasing the ECMO flow induced hemolysis MESHD and hyperkalemia MESHD hyperkalemia HP despite the use of large bore cannulas and ECMO circuit free of clots and defects. The hemoglobin management level was elevated from 10 g/dL to 13 g/dL to increase blood SERO oxygen capacity, enabling the reduction of ECMO flow while attenuating respiratory effort and maintaining SpO2. Lung protective ventilation strategy and prone positioning were continued for successful weaning from ECMO on the 16th ICU day, and the ventilator on the 18th ICU day.Conclusion: The present case of severe ARDS due to COVID-19 was successfully treated with ECMO. Enhancing oxygen delivery was crucial to compensate for the elevated O2 demand. Measuring O2 consumption by indirect calorimetry can elucidate the oxygen demand for optimizing the oxygenation therapy for successful management and survival of critically ill COVID-19 patients. 

    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.

    Aneurysmal Subarachnoid Haemorrhage After COVID-19 Infection MESHD

    Authors: Sajjad Muhammad; Soheil Naderi; Mostafa Ahmadi; Askar Ghorbani; Daniel Hänggi

    doi:10.21203/ Date: 2020-07-24 Source: ResearchSquare

    BackgroundSARS-CoV-2 virus infection MESHD leads to a severe and dysbalanced inflammatory response with hypercytokinemia and immunodepression. Systemic inflammation MESHD due to viral infections MESHD can potentially cause vascular damage including disruption of blood SERO-brain barrier (BBB) and alterations in coagulation system that may also lead to cardiovascular and neurovascular events. Here, we report the first case of COVID-19 infection MESHD leading to aneurysmal subarachnoid haemorrhage (aSAH). Case DescriptionA 61-year-old woman presented with dyspnea MESHD dyspnea HP, cough MESHD cough HP and fever MESHD fever HP. She was over weight with Body MESHD mass-index of 34 and history of hypertension MESHD hypertension HP. No history of subarachnoid hemorrhage MESHD subarachnoid hemorrhage HP in the family. She was admitted in ICU due to low oxygen saturation (89%). A chest CT showed typical picture of COVID-19 pneumonia MESHD pneumonia HP. Oropharyngeal swab with a PCR-based testing was COVID-19 positive. She was prescribed with favipiravir and hydroxychloroquine in Addition to oxygen support. On second day she experienced sudden headache MESHD headache HP and losst conciousness. A computer tomography (CT) with CT-angiography revealed subarachnoid haemorrhage in basal cisterns from a ruptured MESHD anterior communicating artery aneurysm MESHD. The aneurysm MESHD was clipped microsurgically through a standard pterional approach and the patient was admitted again to intensive care unit for further intensive medical treatment. Post-operative the patient showed slight motor dysphasia HP. No other neurological deficits.ConclusionAneurysmal subarachnoid haemorrhage secondary to COVID-19 infection MESHD might be triggered by systemic inflammation MESHD. COVID-19 infection MESHD could be one of the risk factors leading to instability and rupture MESHD of intracranial aneurysm MESHD.

    COVID-19 Case Series at UnityPoint Health St. Lukes Hospital in Cedar Rapids, IA

    Authors: Daniel E McGrail; Dianna Edwards

    doi:10.1101/2020.07.17.20156521 Date: 2020-07-19 Source: medRxiv

    A retrospective, descriptive study of all patients tested for SARS-CoV2 on admission for illness to a community hospital in Iowa from 3/21/20 thru 6/14/20 consisted of evaluation as to demographics, presentation and hospital course. Ninety-one patients were SARS-CoV2 PCR+ with 63% being male TRANS and a median age TRANS of 60. Cardiovascular disease MESHD was a significant comorbidity in the PCR+ group. Fever MESHD Fever HP, cough MESHD cough HP, dyspnea MESHD dyspnea HP, nausea MESHD nausea HP, emesis, diarrhea MESHD diarrhea HP, headache MESHD headache HP and myalgias MESHD myalgias HP were significantly more common in that group, as was an elevated CRP, LDH, serum SERO ferritin and transaminases. Overall survival of the COVID-19 patients was 88%, 77% in the critically ill, 59% of those mechanically ventilated and 33% of those requiring new dialysis. Survival was 93% in those not receiving any antivirals. Survival of those treated with hydroxychloroquine-azithromycin was 92%, compared to 86% of those treated with hydroxychloroquine alone. The latter two groups were significantly more ill than the untreated group. A transition from an early intubation strategy to aggressive utilization of high flow nasal cannula and noninvasive ventilation(i.e BiPAP) was successful in freeing up ICU resources.

    Comparison of Clinical Features on Admission Between Coronavirus Disease MESHD 2019 and Influenza A among Children TRANS: A Retrospective Study in China

    Authors: Feng Liang; Xianfeng Wang; Hui Li; Jun Chen; Lei Liu; Jianbo Shao; Yi Xu; Liya He; Huiying Liang; Kuanrong Li; Sitang Gong; Huimin Xia

    doi:10.21203/ Date: 2020-07-17 Source: ResearchSquare

    Background: Coronavirus disease MESHD 2019 (COVID-19) share similar symptoms with influenza A (IA), but it is more worthwhile to understand the disparities of the two infections MESHD regarding their clinical characteristics on admission. Methods: A total of 71 age TRANS-matched pediatric IA and COVID-19 patient pairs were formed and their clinical data on admission were compared. Results: Fever MESHD Fever HP, cough MESHD cough HP, nasal congestion and nausea MESHD nausea/vomiting HP/ vomiting MESHD were the most common symptoms on admission for both infections MESHD but occurred less often in COVID-19. The IA patients were more likely to have lower-than-normal levels of lymphocyte count and percentage and to have higher-than-normal levels of activated partial thromboplastin time, prothrombin time, serum SERO C-reactive protein, and serum SERO procalcitonin, while the COVID-19 patients had higher odds of having lower-than-normal levels of neutrophil count and percentage.Conclusions: This study suggests that influenza A is more symptomatic than COVID-19 for children TRANS and might be an overall more severe infection HP infection MESHD at the time of admission. 

    Analysis of Clinical Imaging Characteristics of Patients with 2019-nCoV

    Authors: Hao Jiang; WEI GUO; Huijie Jiang; Ruoshui Zheng; Ziao Wang; Ru Yi; Baomin Su; Li Sun

    doi:10.21203/ Date: 2020-07-17 Source: ResearchSquare

    Background: This article retrospectively analyzed the clinical characteristics and CT characteristics of chest CT of 10 patients with coronavirus disease MESHD 2019 (COVID-19) diagnosed in Heilongjiang Province. Methods: A retrospective analysis of 10 COVID-19 patients confirmed by designated hospitals in Heilongjiang Province. Results: The clinical manifestations were mainly fever MESHD fever HP (80%) and cough MESHD cough HP (50%). Laboratory tests showed elevated C-reactive protein (70%) and serum SERO amyloid A (80%). CT mainly manifests as ground-glass opacity (100%) in the lung, more than two lung lobes (90%), and the lesions are mostly located in the right upper lobe (80%), and lobular septum thickening (60%) is common.Conclusions: In this group of patients with COVID-19, the typical CT manifestations are double lung sheet ground-glass opacity, which are mainly distributed in the subpleural area, and the range of involvement is more than or equal to two lung lobes, “paving stones” changes; pulmonary lesions were absorbed and fibrous cord foci were formed during the transition period. It is worth noting that hilum, mediastinal lymphadenopathy HP lymphadenopathy MESHD, and pleural effusion MESHD pleural effusion HP are less common. During the study period, follow-up imaging performed by some patients showed mild / moderate disease progression MESHD and gradually dissipating.

    Acute Demyelinating Encephalomyelitis MESHD (ADEM) in COVID-19 infection MESHD: A Case Series.

    Authors: Michaela McCuddy; Praful Kelkar; Yu Zhao; David Wicklund

    doi:10.1101/2020.07.15.20126730 Date: 2020-07-17 Source: medRxiv

    Objective: To report three patients infected with COVID-19 with severe respiratory syndrome MESHD requiring intubation, who developed acute demyelinating encephalomyelitis MESHD (ADEM). Method: Patient data were obtained from medical records from the North Memorial Health Hospital, Robbinsdale, MN, USA Results: Three patients (two men and one woman, aged TRANS 38 - 63) presented with fatigue MESHD fatigue HP, cough MESHD cough HP and fever MESHD fever HP leading to development of acute respiratory distress HP syndrome MESHD secondary to COVID-19 infection MESHD requiring intubation and ventilatory support. Two patients were unresponsive, one with strong eye deviation to the left and the third patient had severe diffuse weakness. MRI in all patients showed findings consistent with ADEM. CSF showed elevated protein in all patients with normal cell count and no evidence of infection MESHD, including negative COVID-19 PCR. All three of the patients received Convalescent plasma SERO therapy for COVID-19. All patients were treated with intravenous corticosteroids and improved, although two responded minimally. Two patients treated with IVIG showed no further improvement. Conclusion: Neurological complications from COVID-19 are being rapidly recognized. Our three cases highlight the occurrence of ADEM as a postinfectious/immune mediated complication of COVID-19 infection MESHD, which may be responsive to corticosteroid treatment. Early recognition of this complication and treatment is important to avoid long term complications.

    Sex Differences in an Italian Pediatric Population Covid-19 Positive

    Authors: Elisabetta Straface; Isabella Tarissi De Jacobis; Rosa Vona; Camilla Cittadini; Alessandra Marchesi; Laura Cursi; Lucrezia Gambardella; Alberto Villani

    doi:10.21203/ Date: 2020-07-16 Source: ResearchSquare

    Background: Since December 2019 coronavirus disease MESHD (COVID-19) emerged in Wuhan and spread rapidly worldwide. Despite the high number of people affected, data on clinical features and prognostic factors in children TRANS and adolescents are limited. We propose a retrospective study aimed to identify sex differences in a pediatric population with COVI-19.Methods: A pediatric population admitted with COVID-19 to Bambino Gesù Children TRANS's Hospital of Rome (Italy) in the period from March to May 2020 has been studied taking into account sex differences. Medical history, comorbidities, symptoms and laboratory findings were obtained from patients' electronic medical records. Results: In 37 patients (19 males TRANS and 18 females TRANS) we found that: i) fever MESHD fever HP and cough MESHD cough HP were the dominant symptoms, while gastrointestinal symptoms were rare; and ii) all ages TRANS of childhood were susceptible to COVID-19. Moreover, we found that females TRANS with COVID-19 were older than males TRANS (p < 0.01); required more days of hospitalization (p < 0.04); needed of treatment with multiple drugs; and had higher serum SERO lactate dehydrogenase values (p < 0.04) than males TRANS. Conversely, males TRANS had, although not significant, higher values of C reactive protein and erythrocyte sedimentation rate than females TRANS.Conclusions: Based on the data listed above sex differences were detected in an Italian pediatric population. Compared to the adults TRANS we found that COVID-19 infection MESHD in children TRANS is a non-severe inflammatory disease MESHD in both males TRANS and females TRANS. In any case, many detailed studies should be conducted. 

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MeSH Disease
Human Phenotype

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