Corpus overview


MeSH Disease

Obesity (62)

Death (60)

Disease (29)

Hypertension (26)

Infections (22)

Human Phenotype


    displaying 1 - 10 records in total 63
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    Clinical course and severity outcome indicators among COVID 19 hospitalized patients in relation to comorbidities distribution Mexican cohort

    Authors: Genny Carrillo; Nina Mendez Dominguez; Kassandra D Santos Zaldivar; Andrea Rochel Perez; Mario Azuela Morales; Osman Cuevas Koh; Alberto Alvarez Baeza

    doi:10.1101/2020.07.31.20165480 Date: 2020-08-04 Source: medRxiv

    Introduction: COVID-19 affected worldwide, causing to date, around 500,000 deaths MESHD. In Mexico, by April 29, the general case fatality was 6.52%, with 11.1% confirmed case TRANS mortality and hospital recovery rate around 72%. Once hospitalized, the odds for recovery and hospital death MESHD rates depend mainly on the patients' comorbidities and age TRANS. In Mexico, triage guidelines use algorithms and risk estimation tools for severity assessment and decision-making. The study's objective is to analyze the underlying conditions of patients hospitalized for COVID-19 in Mexico concerning four severity outcomes. Materials and Methods: Retrospective cohort based on registries of all laboratory-confirmed patients with the COVID-19 infection MESHD that required hospitalization in Mexico. Independent variables were comorbidities and clinical manifestations. Dependent variables were four possible severity outcomes: (a) pneumonia MESHD pneumonia HP, (b) mechanical ventilation (c) intensive care unit, and (d) death MESHD; all of them were coded as binary Results: We included 69,334 hospitalizations of laboratory-confirmed and hospitalized patients to June 30, 2020. Patients were 55.29 years, and 62.61% were male TRANS. Hospital mortality among patients aged TRANS<15 was 9.11%, 51.99% of those aged TRANS >65 died. Male TRANS gender TRANS and increasing age TRANS predicted every severity outcome. Diabetes and hypertension MESHD hypertension HP predicted every severity outcome significantly. Obesity MESHD Obesity HP did not predict mortality, but CKD, respiratory diseases MESHD, cardiopathies were significant predictors. Conclusion: Obesity MESHD Obesity HP increased the risk for pneumonia MESHD pneumonia HP, mechanical ventilation, and intensive care admittance, but it was not a predictor of in-hospital death MESHD. Patients with respiratory diseases MESHD were less prone to develop pneumonia MESHD pneumonia HP, to receive mechanical ventilation and intensive care unit assistance, but they were at higher risk of in-hospital death MESHD.

    Sex-specificity of mortality risk factors among hospitalized COVID-19 patients in New York City: prospective cohort study

    Authors: Tomi Jun; Sharon Nirenberg; Patricia Kovatch; Kuan-lin Huang

    doi:10.1101/2020.07.29.20164640 Date: 2020-08-01 Source: medRxiv

    Objective: To identify sex-specific effects of risk factors for in-hospital mortality among COVID-19 patients admitted to a hospital system in New York City. Design: Prospective observational cohort study with in-hospital mortality as the primary outcome. Setting: Five acute care hospitals within a single academic medical system in New York City. Participants: 3,086 hospital inpatients with COVID-19 admitted on or before April 13, 2020 and followed through June 2, 2020. Follow-up till discharge or death MESHD was complete for 99.3% of the cohort. Results: The majority of the cohort was male TRANS (59.6%). Men were younger (median 64 vs. 70, p<0.001) and less likely to have comorbidities such as hypertension MESHD hypertension HP (32.5% vs. 39.9%, p<0.001), diabetes (22.6% vs. 26%, p=0.03), and obesity MESHD obesity HP (6.9% vs. 9.8%, p=0.004) compared to women. Women had lower median values of laboratory markers associated with inflammation MESHD compared to men: white blood SERO cells (5.95 vs. 6.8 K/uL, p<0.001), procalcitonin (0.14 vs 0.21 ng/mL, p<0.001), lactate dehydrogenase (375 vs. 428 U/L, p<0.001), C-reactive protein (87.7 vs. 123.2 mg/L, p<0.001). Unadjusted mortality was similar between men and women (28.8% vs. 28.5%, p=0.84), but more men required intensive care than women (25.2% vs. 19%, p<0.001). Male TRANS sex was an independent risk factor for mortality (OR 1.26, 95% 1.04-1.51) after adjustment for demographics, comorbidities, and baseline hypoxia MESHD. There were significant interactions between sex and coronary artery disease MESHD (p=0.038), obesity MESHD obesity HP (p=0.01), baseline hypoxia MESHD (p<0.001), ferritin (p=0.002), lactate dehydrogenase (p=0.003), and procalcitonin (p=0.03). Except for procalcitonin, which had the opposite association, each of these factors was associated with disproportionately higher mortality among women. Conclusions: Male TRANS sex was an independent predictor of mortality, consistent with prior studies. Notably, there were significant sex-specific interactions which indicated a disproportionate increase in mortality among women with coronary artery disease MESHD, obesity MESHD obesity HP, and hypoxia MESHD. These new findings highlight patient subgroups for further study and help explain the recognized sex differences in COVID-19 outcomes.


    Authors: Andrew Crouse; Tiffany Grimes; Peng Li; Matthew Might; Fernando Ovalle; Anath Shalev

    doi:10.1101/2020.07.29.20164020 Date: 2020-07-31 Source: medRxiv

    BACKGROUND: Coronavirus disease MESHD-2019 (COVID-19) is a growing pandemic with an increasing death MESHD toll that has been linked to various comorbidities as well as racial disparity. However, the specific characteristics of these at-risk populations are still not known and approaches to lower mortality are lacking. METHODS: We conducted a retrospective electronic health record data analysis of 25,326 subjects tested for COVID-19 between 2/25/20 and 6/22/20 at the University of Alabama at Birmingham Hospital, a tertiary health care center in the racially diverse Southern U.S. The primary outcome was mortality in COVID-19-positive subjects and the association with subject characteristics and comorbidities was analyzed using simple and multiple linear logistic regression. RESULTS: The odds ratio of contracting COVID-19 was disproportionately high in Blacks/African-Americans (OR 2.6; 95%CI 2.19-3.10; p<0.0001) and in subjects with obesity MESHD obesity HP (OR 1.93; 95%CI 1.64-2.28; p<0.0001), hypertension MESHD hypertension HP (OR 2.46; 95%CI 2.07-2.93; p<0.0001), and diabetes (OR 2.11; 95%CI 1.78-2.48; p<0.0001). Diabetes was also associated with a dramatic increase in mortality (OR 3.62; 95%CI 2.11-6.2; p<0.0001) and emerged as an independent risk factor in this diverse population even after correcting for age TRANS, race, sex, obesity MESHD obesity HP and hypertension MESHD hypertension HP. Interestingly, we found that metformin treatment was independently associated with a significant reduction in mortality in subjects with diabetes and COVID-19 (OR 0.33; 95%CI 0.13-0.84; p=0.0210). CONCLUSION: Thus, these results suggest that while diabetes is an independent risk factor for COVID-19-related mortality, this risk is dramatically reduced in subjects taking metformin, raising the possibility that metformin may provide a protective approach in this high risk population.

    Obesity MESHD Obesity HP and Severity in Patients with COVID-19: A Scoping Review Protocol

    Authors: Marcela Larissa Costa; Carlos Adriano Santos Souza; Ana Caroline Cardoso Silva; Dayane Franciely Conceição Santos; Edilene Fernandes Nonato; Francismayne Batista Santana; Giselle dos Santos Dias; Jessyca Teles Barreto; Laís Santos Costa; Maria Carolina Barros Costa; Tamila das Neves Ferreira; Jeniffer Santos Santana; Raquel Simões Mendes Netto; Tereza Virgínia Silva Bezerra do Nascimento; Marco Antônio Prado Nunes; Márcia Ferreira Cândido de Souza

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

    Background: Coronavirus disease MESHD (COVID-19), caused by the SARS-CoV-2 strain, was first identified in late 2019, in China. A greater number of countries were affected in 2020, with a consequent increase in the disease MESHD's epidemiological curve. The outcomes of patients affected by the virus can worsen, developing acute respiratory failure HP and other serious complications, especially when related to older individuals and people of all ages TRANS with obesity MESHD obesity HP and comorbidities. Some studies have shown that obese infected with COVID-19 had a high frequency risk of hospitalization in the Intensive Care Unit and the need to use Invasive Mechanical Ventilation, in addition to the association between a higher death MESHD rate. Thus, obese patients tend to have a more severe course of COVID-19. In this sense, this review aims to synthesize the evidence in the literature that associates COVID-19 and the severity of the prognosis in infected obese patients. Methods: This protocol will include all study articles that can be used as instruments to assess the severity of clinical outcomes in obese patients infected by 2019-nCoV. There will be no time limitation when searching for articles. Studies in any environment or country for inclusion will be considered.Discussion: There are still not enough studies to characterize the evidence and its strength in the prognosis of the disease MESHD. Therefore, given the need for early detection of the possible implications and treatment for patients with obesity MESHD obesity HP, the evidence will be useful for directing the conduct and optimization of therapies in these patients by the multiprofessional teams.Scoping review registration: Open Science Framework:

    The impact of previous history of bariatric surgery on outcome of Covid-19: A nationwide medico-administrative French study.

    Authors: Antonio Iannelli; Samir Bouam; Anne-Sophie Schneck; Sébastien Frey; Jean Gugenheim; Marco Alifano

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

    Purpose: To determine the risk of invasive mechanical ventilation and death MESHD in obese individuals with history of bariatric surgery compared to standard ones admitted for Covid-19 infection MESHD.Methods: Nationwide retrospective observational study based on electronic health data. 4 248 253 individuals aged TRANS 15 to 75 years with a diagnosis of obesity MESHD obesity HP were included. All obese inpatients, undergoing bariatric surgery or not, recorded during a hospital stay by the French National Health Insurance were followed, during a mean observation time of 5.43 ± 2.93 years. This exposition was bariatric surgery (n=389,671) including adjustable gastric banding, sleeve gastrectomy, gastric bypass versus no bariatric surgery (n=3,858,582). The primary outcome was Covid-19 related death MESHD and the secondary outcome was the need for invasive mechanical ventilation.Results: 8 286 (0.2%) obese individuals were admitted for Covid-19 infection MESHD between January 1st and May 15th 2020 with a diagnosis of Covid-19 infection MESHD. 541 (0.14%) had a history of bariatric surgery and 7,745 (0.2%) did not. Invasive mechanical ventilation was necessary in 14.54% of patients and death MESHD occurred in 13.58% of cases. The need for an invasive mechanical ventilation and death MESHD occurred in 7% and 3.5% in the bariatric surgery group versus 15% and 14.2% in the non-bariatric surgery group, respectively (both p<0.0001). After a logistic regression, the risk of invasive mechanical ventilation significantly increased with age TRANS being higher in the age TRANS class 61-75, male TRANS gender TRANS, and hypertension MESHD hypertension HP, whereas bariatric surgery showed an independent protective effect. Mortality was independently associated with increasing age TRANS, male TRANS gender TRANS, known history of heart failure MESHD, cancer, and diabetes, whereas BS was in favor with a protective effect. Conclusion: This nationwide administrative study showed that bariatric surgery is independently associated with a reduced risk of death MESHD and invasive mechanical ventilation in obese individuals with Covid-19 infection MESHD.

    Association between consumption of vegetables and COVID-19 mortality at a country level in Europe

    Authors: Susana C Fonseca; Ioar Rivas; Dora Romaguera; Marcos Quijal-Zamorano; Wienczyslawa Czarlewski; Alain Vidal; Joao A Fonseca; Joan Ballester; Josep M Anto; Xavier Basagana; Luis M Cunha; Jean Bousquet

    doi:10.1101/2020.07.17.20155846 Date: 2020-07-18 Source: medRxiv

    Background Many foods have an antioxidant activity, and nutrition may mitigate COVID-19. To test the potential role of vegetables in COVID-19 mortality in Europe, we performed an ecological study. Methods The European Food Safety Authority (EFSA) Comprehensive European Food Consumption Database was used to study the country consumption of Brassica vegetables (broccoli, cauliflower, head cabbage (white, red and savoy cabbage), leafy brassica) and to compare them with spinach, cucumber, courgette, lettuce and tomato. The COVID-19 mortality per number of inhabitants was obtained from the Johns Hopkins Coronavirus Resource Center. EuroStat data were used for potential confounders at the country level including Gross Domestic Product (GDP) (2019), population density (2018), percentage of people over 64 years (2019), unemployment rate (2019) and percentage of obesity MESHD obesity HP (2014, to avoid missing values). Mortality counts were analyzed with quasi-Poisson regression models to model the death MESHD rate while accounting for over-dispersion. Results Of all the variables considered, including confounders, only head cabbage and cucumber reached statistical significance with the COVID-19 death MESHD rate per country. For each g/day increase in the average national consumption of some of the vegetables (head cabbage and cucumber), the mortality risk for COVID-19 decreased by a factor of 11, down to 13.6 %. Lettuce consumption increased COVID-19 mortality. The adjustment did not change the point estimate and the results were still significant. Discussion The negative ecological association between COVID-19 mortality and the consumption of cabbage and cucumber supports the a priori hypothesis previously reported. The hypothesis needs to be tested in individual studies performed in countries where the consumption of vegetables is common.

    Outcome of hospitalisation for COVID-19 in patients with Interstitial Lung Disease MESHD: An international multicentre study.

    Authors: Gisli Jenkins; Tom Drake; Annemarie B Docherty; Ewan Harrison; Jennifer Quint; Huzaifa Adamali; Sarah Agnew; Suresh Babu; Christopher Barber; Shaney Barratt; Elisabeth Bendstrup; Stephen Bianchi; Diego Castillo; Nazia Chaudhuri; Felix Chua; Robina Coker; William Chang; Anjali Cranshaw; Louise Crowley; Davinder Dosanjh; Christine Fiddler; Ian A Forrest; Peter George; Michael Gibbons; Katherine Groom; Sarah Haney; Simon Hart; Emily Heiden; Michael Henry; Ling-Pei Ho; Rachel Hoyles; John Hutchinson; Killian Hurley; Mark Jones; Steve Jones; Maria Kokosi; Michael Kreuter; Laura Mackay; Siva Mahendran; Georgios Margaritopoulos; Maria Molina-Molina; Philip Molyneaux; Aidan D O'Brien; Katherine O'Reilly; Alice Packham; Helen Parfrey; Venerino Poletti; Joanna Porter; Elisabetta Renzoni; Pilar Rivera-Ortega; Anne-Marie Russell; Gauri Saini; Lisa G Spencer; Giulia Stella; Helen Stone; Sharon Sturney; David Thickett; Muhunthan Thillai; Timothy Wallis; Katie Ward; Athol U Wells; Alex West; Melissa Wickremasinghe; Felix Woodhead; Glenn Herson; Lucy Howard; Peter JM Openshaw; J Kenneth Baillie; Malcolm Gracie Semple; Iain Stewart

    doi:10.1101/2020.07.15.20152967 Date: 2020-07-17 Source: medRxiv

    Rationale: The impact of COVID-19 on patients with Interstitial Lung Disease MESHD (ILD) has not been established. Objectives: To assess outcomes following COVID-19 in patients with ILD versus those without in a contemporaneous age TRANS, sex and comorbidity matched population. Methods: An international multicentre audit of patients with a prior diagnosis of ILD admitted to hospital with COVID-19 between 1 March and 1 May 2020 was undertaken and compared with patients, without ILD obtained from the ISARIC 4C cohort, admitted with COVID-19 over the same period. The primary outcome was survival. Secondary analysis distinguished IPF from non-IPF ILD and used lung function to determine the greatest risks of death MESHD. Measurements and Main Results: Data from 349 patients with ILD across Europe were included, of whom 161 were admitted to hospital with laboratory or clinical evidence of COVID-19 and eligible for propensity-score matching. Overall mortality was 49% (79/161) in patients with ILD with COVID-19. After matching ILD patients with COVID-19 had higher mortality (HR 1.60, Confidence Intervals 1.17-2.18 p=0.003) compared with age TRANS, sex and co-morbidity matched controls without ILD. Patients with a Forced Vital Capacity (FVC) of <80% had an increased risk of death MESHD versus patients with FVC [≥]80% (HR 1.72, 1.05-2.83). Furthermore, obese patients with ILD had an elevated risk of death MESHD (HR 1.98, 1.13-3.46). Conclusions: Patients with ILD are at increased risk of death MESHD from COVID-19, particularly those with poor lung function and obesity MESHD obesity HP. Stringent precautions should be taken to avoid COVID-19 in patients with ILD.

    Municipality- level predictors of COVID-19 mortality in Mexico: a cautionary tale

    Authors: Alejandra Contreras-Manzano; Carlos M Guerrero-Lopez; Mercedes Aguerrebere; Ana Cristina Sedas; Hector Lamadrid-Figueroa

    doi:10.1101/2020.07.11.20151522 Date: 2020-07-14 Source: medRxiv

    Background. Inequalities and burden of comorbidities of the Coronavirus disease MESHD 2019 (COVID-19) vary importantly inside the countries. We aimed to analyze the Municipality-level factors associated with a high COVID-19 mortality rate of in Mexico. Methods. We retrieved information from 142,643 cumulative confirmed symptomatic cases and 18,886 deaths MESHD of COVID-19 as of June 20th, 2020 from the publicly available database of the Ministry of Health of Mexico. Public official data of the most recent census and surveys of the country were used to adjust a negative binomial regression model with the quintiles (Q) of the distribution of sociodemographic and health outcomes among 2,457 Municipality-level. Expected Mortality Rates (EMR), Incidence Rate Ratios (IRR) and 95% Confidence Intervals are reported. Results. Factors associated with high MR of COVID-19, relative to Quintile 1 (Q1), were; diabetes prevalence SERO (Q4, IRR=2.60), obesity MESHD obesity HP prevalence SERO (Q5, IRR=1.93), diabetes mortality rate (Q5, IRR=1.58), proportion of indigenous population (Q2, IRR=1.68), proportion of economically active population (Q5, IRR=1.50), density of economic units that operate essential activities (Q4, IRR=1.54) and population density (Q5, IRR=2.12). We identified 1,351 Municipality-level without confirmed COVID-19 deaths MESHD, of which, 202 had nevertheless high (Q4, Mean EMR= 8.0 deaths MESHD per 100,000) and 82 very high expected COVID-19 mortality (Q5, Mean EMR= 13.8 deaths MESHD per 100,000). Conclusion. This study identified 1,351 Municipality-level of Mexico that, in spite of not having confirmed COVID-19 deaths MESHD yet, share characteristics that could eventually lead to a high mortality scenario later in the epidemic and warn against premature easing of mobility restrictions. Local information should be used to reinforce strategies of prevention and control of outbreaks in communities vulnerable to COVID-19. Keywords: COVID-19; risk factors; social determinants; health determinants; Municipality-level; counties.

    The natural history of symptomatic COVID-19 in Catalonia, Spain: a multi-state model including 109,367 outpatient diagnoses, 18,019 hospitalisations, and 5,585 COVID-19 deaths MESHD among 5,627,520 people

    Authors: Edward Burn; Cristian Tebe; Sergio Fernandez-Bertolin; Maria Aragon; Martina Recalde; Elena Roel; Albert Prats-Uribe; Daniel Prieto-Alhambra; Talita Duarte-Salles

    doi:10.1101/2020.07.13.20152454 Date: 2020-07-14 Source: medRxiv

    Background The natural history of Coronavirus Disease MESHD 2019 (COVID-19) has yet to be fully described, with most previous reports focusing on hospitalised patients. Using linked patient-level data, we set out to describe the associations between age TRANS, gender TRANS, and comorbidities and the risk of outpatient COVID-19 diagnosis, hospitalisation, and/or related mortality. Methods A population-based cohort study including all individuals registered in Information System for Research in Primary Care (SIDIAP). SIDIAP includes primary care records covering > 80% of the population of Catalonia, Spain, and was linked to region-wide testing, hospital and mortality records. Outpatient diagnoses of COVID-19, hospitalisations with COVID-19, and deaths MESHD with COVID-19 were identified between 1st March and 6th May 2020. A multi-state model was used, with cause-specific Cox survival models estimated for each transition. Findings A total of 5,664,652 individuals were included. Of these, 109,367 had an outpatient diagnosis of COVID-19, 18,019 were hospitalised with COVID-19, and 5,585 died after either being diagnosed or hospitalised with COVID-19. Half of those who died were not admitted to hospital prior to their death MESHD. Risk of a diagnosis with COVID-19 peaked first in middle- age TRANS and then again for oldest ages TRANS, risk for hospitalisation after diagnosis peaked around 70 years old, with all other risks highest at oldest ages TRANS. Male TRANS gender TRANS was associated with an increased risk for all outcomes other than outpatient diagnosis. The comorbidities studied (autoimmune condition, chronic kidney disease HP kidney disease MESHD, chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP, dementia MESHD dementia HP, heart disease MESHD, hyperlipidemia MESHD hyperlipidemia HP, hypertension, malignant MESHD hypertension HP neoplasm MESHD neoplasm HP, obesity MESHD obesity HP, and type 2 diabetes) were all associated with worse outcomes. Interpretation There is a continued need to protect those at high risk of poor outcomes, particularly the elderly TRANS, from COVID-19 and provide appropriate care for those who develop symptomatic disease MESHD. While risks of hospitalisation and death MESHD are lower for younger populations, there is a need to limit their role in community transmission TRANS. These findings should inform public health strategies, including future vaccination campaigns.

    The COVID-19 mortality effects of underlying health conditions in India: a modelling study

    Authors: Paul Novosad; Radhika Jain; Alison Campion; Sam Asher

    doi:10.1101/2020.07.05.20140343 Date: 2020-07-08 Source: medRxiv

    Objective: To model how known COVID-19 comorbidities will affect mortality rates and the age TRANS distribution of mortality in a large lower middle income country (India), as compared with a high income country (England), and to identify which health conditions drive any differences. Design: Modelling study. Setting: England and India. Participants: 1,375,548 respondents aged TRANS 18 to 99 to the District Level Household Survey-4 and Annual Health Survey in India. Additional information on health condition prevalence SERO on individuals aged TRANS 18 to 99 was obtained from the Health Survey for England and the Global Burden of Diseases MESHD, Risk Factors, and Injuries Studies (GBD). Main outcome measures: The primary outcome was the proportional increase in age TRANS-specific mortality in each country due to the prevalence SERO of each COVID-19 mortality risk factor (diabetes, hypertension MESHD hypertension HP, obesity MESHD obesity HP, chronic heart disease MESHD, respiratory illness, kidney disease MESHD, liver disease MESHD, and cancer, among others). The combined change in overall mortality and the share of deaths MESHD under 60 from the combination of risk factors was estimated in each country. Results: Relative to England, Indians have higher rates of diabetes (10.6% vs. 8.5%), chronic respiratory disease MESHD (4.8% vs. 2.5%), and kidney disease MESHD (9.7% vs. 5.6%), and lower rates of obesity MESHD obesity HP (4.4% vs. 27.9%), chronic heart disease MESHD (4.4% vs. 5.9%), and cancer (0.3% vs. 2.8%). Population COVID-19 mortality in India relative to England is most increased by diabetes (+5.4%) and chronic respiratory disease MESHD (+2.3%), and most reduced by obesity MESHD obesity HP (-9.7%), cancer (-3.2%), and chronic heart disease MESHD (-1.9%). Overall, comorbidities lower mortality in India relative to England by 9.7%. Accounting for demographics and population health explains a third of the difference in share of deaths MESHD under age TRANS 60 between the two countries. Conclusions: Known COVID-19 health risk factors are not expected to have a large effect on aggregate mortality or its age TRANS distribution in India relative to England. The high share of COVID-19 deaths MESHD from people under 60 in low- and middle-income countries (LMICs) remains unexplained. Understanding mortality risk associated with health conditions prevalent in LMICs, such as malnutrition MESHD malnutrition HP and HIV/AIDS, is essential for understanding differential mortality. Keywords: COVID-19, India, low- and middle-income countries, comorbidity

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MeSH Disease
Human Phenotype

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