Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
    displaying 1 - 10 records in total 35
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    Hydroxychloroquine in the treatment of outpatients with mildly symptomatic COVID-19: A multi-center observational study

    Authors: Andrew Ip; Jaeil Ahn; Yizhao Zhou; Andre H Goy; Eric Hansen; Andrew L Pecora; Brittany A Sinclaire; Urszula Bednarz; Michael Marafelias; Shivam Mathura; Ihor S Sawczuk; Joseph P Underwood III; David M Walker; Rajiv Prasad; Robert L Sweeney; Marie G Ponce; Samuel LaCapra; Frank J Cunningham; Arthur G Calise; Bradley L Pulver; Dominic Ruocco; Greggory E Mojares; Michael P Eagan; Kristy L Ziontz; Paul Mastrokyriakos; Stuart L Goldberg; Felecia Cerrato; Maha Farhat; Damien Slater; Jason B Harris; John Branda; David Hooper; Jessie M Gaeta; Travis P. Baggett; James O'Connell; Andreas Gnirke; Tami D Lieberman; Anthony Philippakis; Meagan Burns; Catherine Brown; Jeremy Luban; Edward T Ryan; Sarah E Turbett; Regina C LaRocque; William P. Hanage; Glen Gallagher; Lawrence C Madoff; Sandra Smole; Virginia M. Pierce; Eric S Rosenberg; Pardis Sabeti; Daniel J Park; Bronwyn L MacInnis

    doi:10.1101/2020.08.20.20178772 Date: 2020-08-25 Source: medRxiv

    Background: Hydroxychloroquine has not been associated with improved survival among hospitalized COVID-19 patients in the majority of observational studies and similarly was not identified as an effective prophylaxis following exposure in a prospective randomized trial. We aimed to explore the role of hydroxychloroquine therapy in mildly symptomatic patients diagnosed in the outpatient setting. Methods: We examined the association between outpatient hydroxychloroquine exposure and the subsequent progression of disease among mildly symptomatic non-hospitalized patients with documented SARS-CoV-2 infection MESHD. The primary outcome assessed was requirement of hospitalization. Data was obtained from a retrospective review of electronic health records within a New Jersey USA multi-hospital network. We compared outcomes in patients who received hydroxychloroquine with those who did not applying a multivariable logistic model with propensity matching. Results: Among 1274 outpatients with documented SARS-CoV-2 infection MESHD 7.6% were prescribed hydroxychloroquine. In a 1067 patient propensity matched cohort, 21.6% with outpatient exposure to hydroxychloroquine were hospitalized, and 31.4% without exposure were hospitalized. In the primary multivariable logistic regression analysis with propensity matching there was an association between exposure to hydroxychloroquine and a decreased rate of hospitalization from COVID-19 (OR 0.53; 95% CI, 0.29, 0.95). Sensitivity SERO analyses revealed similar associations. QTc prolongation MESHD events occurred in 2% of patients prescribed hydroxychloroquine with no reported arrhythmia HP arrhythmia MESHD events among those with data available. Conclusions: In this retrospective observational study of SARS-CoV-2 infected MESHD non-hospitalized patients hydroxychloroquine exposure was associated with a decreased rate of subsequent hospitalization. Additional exploration of hydroxychloroquine in this mildly symptomatic outpatient population is warranted.

    Companion diagnostic for the chloroquine use in the treatment of COVID-19: systems biology report of candidate markers.

    Authors: SERHIY SOUCHELNYTSKYI; Nazariy Souchelnytskyi

    doi:10.21203/rs.3.rs-64108/v1 Date: 2020-08-22 Source: ResearchSquare

    BACKGROUND Chloroquine is used for the treatment of COVID-19 patients. However, efficacy of the chloroquine has been under discussion. Variability of clinical outputs of the drug application requires implementation of a companion diagnostic that would allow monitoring responsiveness to chloroquine. The first line of such markers would be markers already used in clinics. Analysis of reported mechanisms of COVID-19 and chloroquine may lead to such markers.METHODS Systemic analysis of molecular mechanisms and markers engaged by chloroquine and COVID-19 virus was performed. The networks of regulatory mechanisms were explored for an intersection and relevance to clinical markers.RESULTS Reported here systemic analysis describes the intersection of molecular mechanisms of chloroquine and processes engaged by COVID-19. 266 nodes provide insight into the mechanisms of chloroquine impact on the infection MESHD and represent a pool of companion diagnostic markers. As an example, an intersection with the markers of heart arrhythmia MESHD arrhythmia HP retrieved 19 nodes. Thirteen of them were reported in human plasma SERO: levels of albumin, amyloid precursor protein, and endoglin correlate with adverse cardiac effects.CONCLUSIONS Reported nodes are the candidate markers for companion diagnostic of the chloroquine application to COVID-19 patients. Some of these markers are already used in the clinic and their interpretation may contribute to monitoring for adverse effects of chloroquine.

    Impact of COVID-19 on Health-related Quality of Life in Patients With Cardiovascular Disease MESHD: A Multi-ethnic Asian Study

    Authors: Shir Lynn Lim; Kai Lee Woo; Eleanor Lim; Faclin Ng; Mark YY Chan; Mihir Gandhi

    doi:10.21203/rs.3.rs-60893/v1 Date: 2020-08-17 Source: ResearchSquare

    BackgroundLittle is known about the impact of the global coronavirus disease-2019 (COVID-19) pandemic on patients with cardiovascular disease MESHD ( CVD MESHD), the biggest global killer and major risk factor for severe COVID-19 infections. We aim to explore the indirect consequences of COVID-19 on health-related quality of life (HRQoL) of patients with CVD MESHD. MethodsEighty-one adult TRANS outpatients with CVD MESHD were assessed using the EQ-5D, a generic health status instrument with five dimensions (mobility, self-care, usual activities, pain HP pain MESHD/discomfort, anxiety HP anxiety MESHD/depression), before and during the pandemic. Changes in the EQ-5D dimensional responses were compared categorically as well as using the dimension-specific sum-score (range 1 to 3, with a higher score indicates worse health). The responses and sum-score were compared using the exact test of symmetry and the paired t-test, respectively. ResultsThese patients [mean age TRANS (SD) 59.8 (10.5); 92.6% males TRANS; 56% New York Heart Association (NYHA) functional class I] had coronary artery disease MESHD (69%), heart failure MESHD (28%), or arrhythmias HP arrhythmias MESHD (15%). None experienced change in NYHA class between assessments. About 30% and 38% of patients reported problems with at least one of the EQ-5D dimensions pre- and during the pandemic, respectively. The highest increase in health problems was reported for anxiety HP anxiety MESHD/depression (12.5% pre-pandemic vs 23.5% during pandemic; p = 0.035) with mean domain-specific score from 1.12 (SD 0.33) to 1.25 (SD 0.46) (p = 0.012). There was no meaningful change in other dimensions as well as overall HRQoL. Conclusion The COVID-19 pandemic is associated with a significant worsening of the mental health of patients with CVD MESHD

    Observations on echocardiographic findings in patients with COVID-19

    Authors: Ahsan A Khan; Sunil James; Mengshi Yuan; Latoya Woolery; Nina Huppertz; Mushidur Rahman; Chetan Varma; Stavros Apostolakis; Vinoda Sharma

    doi:10.21203/rs.3.rs-58076/v1 Date: 2020-08-12 Source: ResearchSquare

    Background The novel coronavirus (SARS-CoV-2) has created global havoc by causing Coronavirus Disease MESHD 2019 (COVID-19). Cardiovascular involvement MESHD in COVID-19 varies from troponin rise or arrhythmia HP arrhythmia MESHD/ myocarditis HP myocarditis MESHD to fulminant cardiogenic shock HP cardiogenic shock MESHD. There is limited data on echocardiographic findings in such patients. We aimed to assess abnormal echocardiographic findings and contributory factors in patients with COVID-19.Methods We performed retrospective analysis of COVID-19 positive patients who underwent a transthoracic echocardiogram (TTE) at Sandwell and West Birmingham (SWBH) NHS Trust between March 2020 and May 2020. Patients were compared based on TTE changes and divided into two groups (abnormal TTE and normal TTE).Results 66 out of 463 patients with COVID-19 had a TTE. 46 patients (69.7%) had abnormal findings on their TTE. Tricuspid regurgitation HP Tricuspid regurgitation MESHD was the most common abnormality observed (26 (56.5%) patients), followed by aortic regurgitation HP aortic regurgitation MESHD (13 (28.3%) patients) and mitral regurgitation HP mitral regurgitation MESHD (12 (26.1%) patients). Haemoglobin and LDH were predictors of abnormal TTE (Hb OR: 0.97, p = 0.049, LDH, OR: 1.00, p = 0.03). Significantly more patients in the abnormal TTE group died during their inpatient stay compared to normal TTE (p = 0.01). Having an abnormal TTE was an independent predictor of death on regression analysis (OR: 0.229, p = 0.034).Conclusions This is the first detailed observational study looking at echocardiographic changes in admitted COVID-19 patients irrespective of disease severity. The most common abnormality was valve regurgitation MESHD. Patients with abnormal TTE were more likely to die in hospital.

    The Spectrum of Cardiovascular Complications MESHD in COVID-19- A Comprehensive Literature Review

    Authors: Raja Shakeel Mushtaque; Rabia Mushtaque; Shahbano Baloch; Aadil Raza; Haseeb Bhatti; Zohaib Khan

    id:10.20944/preprints202008.0257.v1 Date: 2020-08-11 Source: Preprints.org

    A newly identified novel coronavirus named as severe acute respiratory syndrome MESHD-related coronavirus2 (SARS‐CoV 2) has given rise to the global pandemic. SARS-CoV2 which causes coronavirus disease MESHD 2019 (COVID-19), is a positive-stranded RNA virus with nucleocapsid. It binds to host angiotensin-converting enzyme2 (ACE2) receptor through surface glycoprotein (S protein). These ACE 2 receptors are attached to the cell membranes of many organs. Thus, COVID-19 does not only result in acute respiratory distress syndrome MESHD respiratory distress HP syndrome but also affects multiple organ systems, requiring a multidisciplinary approach to manage this disease. COVID-19 can damage the myocardial cells and result in fulminant myocarditis HP myocarditis MESHD, acute cardiac injury MESHD, cardiomyopathy HP cardiomyopathy MESHD, heart failure MESHD, cardiogenic shock HP cardiogenic shock MESHD, or arrhythmia HP arrhythmia MESHD. COVID-19 seeds harmful immune response through cytokine storm leading to indirect organ damage. In this literature review, the available data is comprehended regarding cardiovascular complications in COVID-19, and the correlation of biomarkers with the disease activity is discussed. This literature review also highlights the important treatment options and outcomes of the individual study.

    Characteristics of 24,516 Patients Diagnosed with COVID-19 Illness in a National Clinical Research Network: Results from PCORnet

    Authors: Jason P Block; Keith A. Marsolo; Kshema Nagavedu; L Charles Bailey; Henry Cruz; Christopher B. Forrest; Kevin Haynes; Adrian F. Hernandez; Rainu Kaushal; Abel Kho; Kathleen M. McTigue; Vinit P. Nair; Richard Platt; Jon Puro; Russell L. Rothman; Elizabeth Shenkman; Lemuel Russell Waitman; Mark G. Weiner; Neely Williams; Thomas W. Carton

    doi:10.1101/2020.08.01.20163733 Date: 2020-08-04 Source: medRxiv

    Background: National data from diverse institutions across the United States are critical for guiding policymakers as well as clinical and public health leaders. This study characterized a large national cohort of patients diagnosed with COVID-19 in the U.S., compared to patients diagnosed with viral pneumonia MESHD pneumonia HP and influenza. Methods and Findings: We captured cross-sectional information from 36 large healthcare systems in 29 U.S. states, participating in PCORnet, the National Patient-Centered Clinical Research Network. Patients included were those diagnosed with COVID-19, viral pneumonia MESHD pneumonia HP and influenza in any care setting, starting from January 1, 2020. Using distributed queries executed at each participating institution, we acquired information for patients on care setting (any, ambulatory, inpatient or emergency department, mechanical ventilator), age TRANS, sex, race, state, comorbidities (assessed with diagnostic codes), and medications used for treatment of COVID-19 (hydroxychloroquine with or without azithromycin; corticosteroids, anti-interleukin-6 agents). During this time period, 24,516 patients were diagnosed with COVID-19, with 42% in an emergency department or inpatient hospital setting; 79,639 were diagnosed with viral pneumonia MESHD pneumonia HP (53% inpatient/ED) and 163,984 with influenza (41% inpatient/ED). Among COVID-19 patients, 68% were 20 to <65 years of age TRANS, with more of the hospitalized/ED patients in older age TRANS ranges (23% 65+ years vs. 12% for COVID-19 patients in the ambulatory setting). Patients with viral pneumonia MESHD pneumonia HP were of a similar age TRANS, and patients with influenza were much younger. Comorbidities were common, especially for patients with COVID-19 and viral pneumonia MESHD pneumonia HP, with hypertension HP hypertension MESHD (32% for COVID-19 and 46% for viral pneumonia HP pneumonia MESHD), arrhythmias HP arrhythmias MESHD (20% and 35%), and pulmonary disease MESHD (19% and 40%) the most common. Hydroxychloroquine was used in treatment for 33% and tocilizumab for 11% of COVID-19 patients on mechanical ventilators (25% received azithromycin as well). Conclusion and Relevance: PCORnet leverages existing data to capture information on one of the largest U.S. cohorts to date of patients diagnosed with COVID-19 compared to patients diagnosed with viral pneumonia MESHD pneumonia HP and influenza.

    Mitigating Arrhythmia HP Arrhythmia MESHD Risk in Hydroxychloroquine and Azithromycin Treated COVID-19 Patients using Arrhythmia HP Arrhythmia MESHD Risk Management Plan

    Authors: Kazimieras Maneikis M.D.; Ugne Ringeleviciute M.D.; Justinas Bacevicius M.D.; Egle Dieninyte-Misiune M.D.; Emilija Burokaite M.D.; Gintare Kazbaraite M.D.; Marta Monika Janusaite M.D.; Austeja Dapkeviciute M.D.; Andrius Zucenka M.D.; Valdas Peceliunas M.D. Ph.D.; Lina Kryzauskaite M.D.; Vytautas Kasiulevicius M.D. Ph.D.; Donata Ringaitiene M.D. Ph.D.; Birute Zablockiene M.D. Ph.D.; Tadas Zvirblis; Germanas Marinskis M.D. Ph.D.; Ligita Jancoriene M.D. Ph.D.; Laimonas Griskevicius M.D. Ph.D.

    doi:10.21203/rs.3.rs-50501/v1 Date: 2020-07-29 Source: ResearchSquare

    Background: Hydroxychloroquine and Azithromycin use is associated with QT interval prolongation MESHD and arrhythmias HP arrhythmias MESHD. Despite ongoing multiple clinical trials for treatment of COVID19 infection MESHD, no definite cardiac safety protocols were proposed. The aim of our study was to assess cardiac safety in COVID-19 patients treated with the combination of Hydroxychloroquine and Azithromycin using close monitoring and arrhythmia HP arrhythmia MESHD risk management plan.Methods and results: We retrospectively examined arrhythmia HP arrhythmia MESHD safety of treatment with Hydroxychloroquine and Azithromycin in the setting of pre-defined cardiac arrhythmia MESHD arrhythmia HP risk management plan. 81 patients were included from March 23rd to May 10th 2020. The median age TRANS was 59 years, 58.0% were female TRANS. The majority of the study population (82.7%) had comorbidities, 98.8% had radiological signs of pneumonia HP pneumonia MESHD. 7 patients (8.6%) had QTc prolongation MESHD of ≥500 ms. The treatment was discontinued in 4 patients (4.9%). 14 patients (17.3%) experienced QTc≥480 ms and 16 patients (19.8%) had an increase of QTc≥60 ms. None of the patients developed ventricular tachycardia HP ventricular tachycardia MESHD. The risk factors significantly associated with QTc≥500 ms were hypokalemia HP hypokalemia MESHD (p = 0.032) and use of diuretics during the treatment (p = 0.020). Three patients had a lethal outcome; none of them associated with ventricular arrhythmias HP ventricular arrhythmias MESHD.Conclusion: We recorded a low incidence of QTc prolongation MESHD ≥500 ms and no ventricular tachycardia HP ventricular tachycardia MESHD events in COVID-19 patients treated with Hydroxychloroquine and Azithromycin using cardiac arrhythmia MESHD arrhythmia HP risk management plan.

    Safety of Hydroxychloroquine among Outpatient Clinical Trial Participants for COVID-19

    Authors: SARAH, M M LOFGREN; Melanie R Nicol; Ananta S Bangdiwala; Katelyn A Pastick; Elizabeth C Okafor; Caleb P Skipper; Matthew F Pullen; Nicole W Engen; Mahsa Abassi; Darlisha A Williams; Alanna A Nascene; Margaret L Axelrod; Sylvian A Lother; Lauren J MacKenzie; Glen Drobot; Nicole Marten; Matthew P Cheng; Ryan Zarychanshi; Ilan S Schwartz; Michael Silverman; Zain Chagla; Lauren E Kelley; Emily G McDonald; Todd C Lee; Katherine Huppler Hullsiek; David R Boulware; Radha Rajasingham

    doi:10.1101/2020.07.16.20155531 Date: 2020-07-23 Source: medRxiv

    Introduction: Use of hydroxychloroquine in hospitalized patients with COVID-19, especially in combination with azithromycin, has raised safety concerns. Here, we report safety data from three outpatient randomized clinical trials. Methods: We conducted three randomized, double-blind, placebo-controlled trials investigating hydroxychloroquine as pre-exposure prophylaxis, post-exposure prophylaxis and early treatment for COVID-19. We excluded individuals with contraindications to hydroxychloroquine. We collected side effects and serious adverse events. We report descriptive analyses of our findings. Results: We enrolled 2,795 participants. The median age TRANS of research participants was 40 (IQR 34-49) years, and 59% (1633/2767) reported no chronic medical conditions. Overall 2,324 (84%) participants reported side effect data, and 638 (27%) reported at least one medication side effect. Side effects were reported in 29% with daily, 36% with twice weekly, 31% with once weekly hydroxychloroquine compared to 19% with placebo. The most common side effects were upset stomach or nausea HP nausea MESHD (25% with daily, 18% with twice weekly, 16% with weekly, vs. 10% for placebo), followed by diarrhea HP diarrhea MESHD, vomiting HP vomiting MESHD, or abdominal pain HP abdominal pain MESHD (23% for daily, 16% twice weekly, 12% weekly, vs. 6% for placebo). Two individuals were hospitalized for atrial arrhythmias HP atrial arrhythmias MESHD, one on placebo and one on twice weekly hydroxychloroquine. No sudden deaths occurred. Conclusion: Data from three outpatient COVID-19 trials demonstrated that gastrointestinal side effects were common but mild with the use of hydroxychloroquine, while serious side effects were rare. No deaths occurred related to hydroxychloroquine. Randomized clinical trials can safely investigate whether hydroxychloroquine is efficacious for COVID-19.

    Beta-Adrenergic Receptor Stimulation Limits the Cellular Proarrhythmic Effects of Chloroquine and Azithromycin

    Authors: Henry Sutanto; Jordi Heijman

    id:10.20944/preprints202007.0418.v1 Date: 2020-07-19 Source: Preprints.org

    Background: The antimalarial drug chloroquine and antimicrobial drug azithromycin have received significant attention during the current COVID-19 pandemic. Both drugs can alter cardiac electrophysiology and have been associated with drug-induced arrhythmias HP arrhythmias MESHD. Meanwhile, sympathetic activation is commonly observed during systemic inflammation MESHD and oxidative stress (e.g., in SARS-CoV-2 infection MESHD), and may influence the electrophysiological effects of chloroquine and azithromycin. Here, we investigated the effect of beta-adrenergic stimulation on proarrhythmic properties of chloroquine and azithromycin using a detailed in silico model of ventricular electrophysiology. Methods: Concentration-dependent chloroquine and azithromycin-induced alterations in ion-channel function were incorporated into the Heijman canine ventricular cardiomyocyte MESHD model. Single and combined drug effects on action-potential (AP) properties were analyzed using a population of 592 models accommodating inter-individual variability. Sympathetic stimulation was simulated by an increase in pacing rate and experimentally validated isoproterenol-induced changes in ion-channel function. Results: At 1 Hz pacing, therapeutic doses of chloroquine and azithromycin (5 and 20 µM, respectively) individually prolonged AP duration ( APD MESHD) by 33% and 13%. Their combination produced synergistic APD prolongation MESHD (+161%) with incidence of proarrhythmic early afterdepolarizations in 53.5% of models. Increasing the pacing frequency to 2 Hz shortened APD and together with 1 µM isoproterenol corrected the drug-induced APD prolongation MESHD. No afterdepolarizations occurred following increased rate and simulated application of 0.1-1 µM isoproterenol. Conclusion: Sympathetic stimulation limits chloroquine- and azithromycin-induced proarrhythmia by reducing their APD-prolonging effect, suggesting the importance of heart rate and autonomic status monitoring in particular conditions (e.g., COVID-19).

    Myocardial Injury MESHD in Post Mortem Biopsies of Patients with COVID-19

    Authors: Camila Hartmann; Anna Flavia dos Santos Miggiolaro; Jarbas da Silva Motta Junior; Lucas Baena Carstens; Caroline Busatta Vaz De Paula; Larissa Hermann de Souza Nunes; Gustavo Lenci Marques; Lidia Zytinsky Moura; Jose Rocha Faria Neto; Lucia de Noronha; Cristina Pellegrino Baena

    doi:10.21203/rs.3.rs-45192/v1 Date: 2020-07-17 Source: ResearchSquare

    Background: Myocardial injury MESHD is significantly and independently associated with mortality in COVID-19 patients. However, the pathogenesis of myocardial injury MESHD in COVID-19 is still not clear, and cardiac involvement by SARS-CoV-2 remains a major challenge worldwide.Aim: This histopathological and immunohistochemical study seeks to clarify the pathogenesis of myocardial injury MESHD in COVID-19.Methods: Postmortem minimally invasive autopsies were performed in two patients who died from COVID-19, and the myocardium samples were compared to a control patient. Immunohistochemistry (IHC) staining was performed using monoclonal antibodies SERO against the following targets: caspase-1, ICAM-1, TNF-α, IL-4, IL-6, CD163, TGF-β, MMP-9, type 1 and type 3 collagen.Results: The histopathological analysis showed severe pericellular interstitial edema HP edema MESHD surrounding each of the cardiomyocytes. The IHC analysis showed increased expression of caspase-1, ICAM-1, IL-4, IL-6, CD163, MMP-9 and type 3 collagen in the COVID-19 patients compared to the control. On the other hand, no difference from the control was observed in expression of TNF-α, TGF-β and type 1 collagen. Conclusion: Our findings point to a pathogenesis related with pyroptosis leading to endothelial disfunction. The subsequent inflammation MESHD with associated interstitial edema HP edema MESHD could explain the myocardial disfunction and arrythmias MESHD in COVID-19 patients. The presence of Th2 response, MMP-9 and type-3 collagen suggests progression to myocardial fibrosis HP myocardial fibrosis MESHD in the long term.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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