Corpus overview


MeSH Disease

Human Phenotype


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    90 Days of COVID-19 Social Distancing and Its Impacts on Air Quality and Health in Sao Paulo, Brazil

    Authors: Daniela Debone; Mariana da Costa; Simone Miraglia

    id:10.20944/preprints202008.0022.v1 Date: 2020-08-02 Source:

    The coronavirus disease MESHD (COVID-19) pandemic caused by spreading rapidly a severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) has imposed a unique situation for the humanity. Sao Paulo has reported 124,105 confirmed cases TRANS of COVID-19 and 5,623 deaths MESHD up to June 14th, being considered the epicenter of the pandemic in Brazil and in South America. Due to the measures for social distancing, there was a drop in the air pollution concentration in Sao Paulo. Starting on March 16th, 2020, we broke 90 days of social distancing into 13 weeks and compared to an equivalent period in 2019. We investigated the air quality improvement during the quarantine period and compared the associated avoided deaths MESHD to COVID-19 burden deaths MESHD. Nitrogen dioxide (NO2) was the best indicator of air quality in the analyzed weeks, since its reduction reached 58 %. Our study showed that the 5,623 deaths MESHD occurred during the analyzed weeks of quarantine represents an economic health loss of US$ 10.5 billion. In opposite, we observed a significant air quality improvement due to pollutants concentrations’ reductions during the analyzed weeks. Considering PM10, PM2.5 and NO2, the decrease of concentration levels respectively avoided 78, 337 and 387 premature deaths MESHD and prevented up to US$ 1.5 billion on health costs. These results highlight the importance of continuing to enforce existing air pollution regulations and measures to protect human health both during and after COVID-19 pandemic.

    Impact of tocilizumab administration on mortality in severe COVID-19

    Authors: Andrew Tsai; Oumou Diawara; Ronald G Nahass; Luigi Brunetti

    doi:10.1101/2020.07.30.20114959 Date: 2020-08-02 Source: medRxiv

    Background The novel coronavirus disease MESHD 2019 (COVID-19) worldwide pandemic has placed a significant burden on hospitals and healthcare providers. The immune response to this disease MESHD is thought to lead to a cytokine storm, which contributes to the severity of illness. There is an urgent need to confirm whether the use of tocilizumab provides a benefit in individuals with COVID-19. Methods A single-center propensity-score matched cohort study, including all consecutive COVID-19 patients, admitted to the medical center who were either discharged from the medical center or expired between March 1, 2020, and May 5, 2020, was performed. Patients were stratified according to the receipt of tocilizumab for cytokine storm and matched to controls using propensity scores. The primary outcome was in-hospital mortality. Results A total of 132 patients were included in the matched dataset (tocilizumab=66; standard of care=66). Approximately 73% of the patients were male TRANS. Hypertension MESHD Hypertension HP (55%), diabetes mellitus MESHD diabetes mellitus HP (31%), and chronic pulmonary disease MESHD (15%) were the most common comorbidities present. There were 18 deaths MESHD (27.3%) in the tocilizumab group and 18 deaths MESHD (27.3%) in the standard of care group (odds ratio, 1.0; 95% confidence interval, 0.465 - 2.151; p=1.00). Advanced age TRANS, history of myocardial infarction MESHD myocardial infarction HP, dementia MESHD dementia HP, chronic pulmonary disease, heart MESHD failure, and malignancy were significantly more common in patients who died. Interpretation The current analysis does not support the use of tocilizumab for the management of cytokine storm in patients with COVID-19. Use of this therapeutic agent should be limited to the context of a clinical trial until more evidence is available.

    COVID-19: Role of the Interferons

    Authors: Claudio G. Gallo; Sirio Fiorino; Giovanni Posabella; Donato Antonacci; Antonio Tropeano; Emanuele Pausini; Carlotta Pausini; Tommaso Guarniero; Marco Zancanaro

    id:202008.0018/v1 Date: 2020-08-02 Source:

    COVID-19 disease MESHD, caused by the SARS-CoV2 virus, is a potentially fatal disease MESHD that represents a serious public health and economic problem worldwide. The SARS-CoV2 virus infects the lower respiratory tract and can cause pneumonia MESHD pneumonia HP in humans. ARDS is the leading cause of death MESHD in COVID-19 disease MESHD. One of the main characteristics of ARDS is the cytokine storm, an uncontrolled systemic inflammatory response resulting from the release of pro-inflammatory cytokines and chemokines and growth factors, by immune cells. The other important aspect of the disease MESHD is represented by the involvement of the vascular organ that undergoes endothelitis. Hyperinflammation and endothelitis contribute in various ways to trigger coagulation disorders with diffuse micro thrombotic and thromboembolic phenomena. Lastly, multiple organ failure MESHD may occur (MOF). Since so far there is no approved treatment, there is an urgent need to reposition known treatments, considered safe, to be included in trials. Naturally produced interferons represent the body's first line of defense against viruses. Pharmacological forms, obtained by means of genetic recombination techniques, have long been approved and used to treat numerous pathologies. Interferons are divided into three families, within which some subfamilies are distinguishable. Only IFN-II comprises a single isoform which has completely different aspects and functions. The IFN I and III, however, each comprise different subfamilies (17 subfamilies the IFN-I and 4 subfamilies the IFN-III), share many aspects, representing the body's first antiviral response, but play different roles. The use of IFNs has been studied in two severe hCoV (Human Coronavirus) diseases MESHD, closely related to COVID-19 disease MESHD, such as SARS and MERS. Numerous in vitro and in vivo studies have been conducted, often in combination with other antivirals. The results have been controversial. The positive results in vitro and in experimental animals were often not replicable in humans. The possible positioning of these molecules in the right window of therapeutic opportunity requires that the complex dialogue between IFN, inflammasome, cytokines, pro-inflammatory chemokines, growth factors and barrier function be shed light.

    High rate of major drug-drug interactions of lopinavir-ritonavir for COVID-19 treatment

    Authors: Juan Macias; Ana Pinilla; Francisco A Lao-Dominguez; Anais Corma; Enrique Contreras-Macias; Alejandro Gonzalez-Serna; Antonio Gutierrez-Pizarraya; Marta Fernandez-Fuertes; Ramon Morillo-Verdugo; Marta Trigo; Luis M Real; Juan A Pineda

    doi:10.1101/2020.07.30.20165027 Date: 2020-08-01 Source: medRxiv

    The impact of drug-drug interactions (DDI) between ritonavir-boosted lopinavir (LPV-r) to treat patients with coronavirus disease MESHD 2019 (COVID-19) and commonly used drugs in clinical practice is not well-known. Thus, we evaluated the rate and severity of DDI between LPV-r for COVID-19 treatment and concomitant medications. This was a cross-sectional study including all individuals diagnosed of SARS-CoV-2 infection MESHD treated with LPV-r and attended at a single center in Southern Spain (March 1st to April 30th, 2020). The frequency [95% confidence interval (95% CI)] of potential and major DDI were calculated. Overall, 469 patients were diagnosed of COVID-19, 125 (27%) of them were prescribed LPV-r. LPV-r had potential DDI with concomitant medications in 97 (78%, 95% CI: 69%-85%) patients, and in 33 (26%, 95% CI: 19%-35%) individuals showed major DDI. Twelve (36%) patients with major DDI and 14 (15%) individuals without major DDI died (p=0.010). After adjustment, only the Charlson index was independently associated with death MESHD [adjusted OR (95% CI) for Charlson index [≥]5: 85 (10-731), p <0.001]. LPV-r was discontinued due to side effects in 31 (25%) patients. Management by the Infectious Diseases MESHD Unit was associated with a lower likelihood of major DDI [adjusted odds ratio (95% CI): 0.14 (0.04-0.53), p=0.003). In conclusion, a high frequency of DDI between LPV-r for treating COVID-19 and concomitant medications was found, including major DDI. Patients with major DDI showed worse outcomes, but this association was explained by the older age TRANS and comorbidities. Patients managed by the Infectious Diseases MESHD Unit had lower risk of major DDI.


    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.

    Isolation Considered Epidemiological Model for the Prediction of COVID-19 Trend in Tokyo, Japan

    Authors: Motoaki Utamura; Makoto Koizumi; Seiichi Kirikami

    doi:10.1101/2020.07.31.20165829 Date: 2020-07-31 Source: medRxiv

    Background: Coronavirus Disease MESHD 2019 (COVID19) currently poses a global public health threat. Although no exception, Tokyo, Japan was affected at first by only a small epidemic. Medical collapse nevertheless nearly happened because no predictive method existed for counting patients. A standard SIR epidemiological model and its derivatives predict susceptible, infectious, and removed (recovered/ deaths MESHD) cases but ignore isolation of confirmed cases TRANS. Predicting COVID19 trends with hospitalized and infectious people in field separately is important to prepare beds and develop quarantine strategies. Methods: Time-series COVID19 data from February 28 to May 23, 2020 in Tokyo were adopted for this study. A novel epidemiological model based on delay differential equation was proposed. The model can evaluate patients in hospitals and infectious cases in the field. Various data such as daily new cases, cumulative infections MESHD, patients in hospital, and PCR test positivity ratios were used to examine the model. This approach derived an alternative formulation equivalent to the standard SIR model. Its results were compared quantitatively with those of the present isolation model. Results: The basic reproductive number TRANS, inferred as 2.30, is a dimensionless parameter composed of modeling parameters. Effects of intervention to mitigate the epidemic spread were assessed a posteriori. An exit policy of how and when to release a statement of emergency MESHD was also assessed using the model. Furthermore, results suggest that the rapid isolation of infectious cases has a large potential to effectively mitigate the spread of infection MESHD and restores social and economic activities safely. Conclusions: A novel mathematical model was proposed and examined using COVID19 data for Tokyo. Results show that shortening the period from infection MESHD to hospitalization is effective against outbreak without rigorous public health intervention and control. Faster and precise case cluster detection and wider and quicker introduction of testing measures are strongly recommended.

    Model stability of COVID-19 mortality prediction with biomarkers

    Authors: Chenyan Huang; Xi Long; Zhuozhao Zhan; Edwin van den Heuvel

    doi:10.1101/2020.07.29.20161323 Date: 2020-07-30 Source: medRxiv

    Coronavirus disease MESHD 2019 (COVID-19) is an unprecedented and fast evolving pandemic, which has caused a large number of critically ill patients and deaths MESHD globally. It is an acute public health crisis leading to overloaded critical care capacity. Timely prediction of the clinical outcome ( death MESHD/survival) of hospital-admitted COVID-19 patients can provide early warnings to clinicians, allowing improved allocation of medical resources. In a recently published paper, an interpretable machine learning model was presented to predict the mortality of COVID-19 patients with blood SERO biomarkers, where the model was trained and tested on relatively small data sets. However, the model or performance SERO stability was not explored and assessed. By re-analyzing the data, we reveal that the reported mortality prediction performance SERO was likely over-optimistic and its uncertainty was underestimated or overlooked, with a large variability in predicting deaths MESHD.

    Use of a humanized anti-CD6 monoclonal antibody SERO (itolizumab) in elderly TRANS patients with moderate COVID-19

    Authors: Mayra Ramos-Suzarte; Yayquier Diaz; Yordanis Martin; Nestor Antonio Calderon; William Santiago; Orlando Vinet; Yulieski La O; Jorge Perez; Augusto Oyarzabal; Yoan Perez; Geidy Lorenzo; Meylan Cepeda; Danay Saavedra; Zayma Mazorra; Daymys Estevez; Patricia Lorenzo-Luaces; Carmen Valenzuela; Armando Caballero; Kalet leon; Tania Crombet; Carlos Jorge Hidalgo

    doi:10.1101/2020.07.24.20153833 Date: 2020-07-30 Source: medRxiv

    Abstract Introduction: The Severe Acute Respiratory Syndrome MESHD Coronavirus 2 (SARS-CoV-2) has caused a recent outbreak of Coronavirus Disease MESHD (COVID-19). In Cuba, the first case of COVID-19 was reported on March 11. Elderly TRANS with multiple comorbidities are particularly susceptible to adverse clinical outcomes in the course of SARS CoV-2 infection MESHD. During the outbreak, a local transmission TRANS event took place in a nursing home in Villa Clara province, Cuba, in which nineteen elderly TRANS residents were positive for SARS-CoV-2. Methods: Based on the increased susceptibility to viral-induced cytokine release syndrome MESHD inducing respiratory and systemic complications in this population, the patients were included in an expanded access clinical trial to receive itolizumab, an anti-CD6 monoclonal antibody SERO. Results: All the patients had underlying medical conditions. The product was well tolerated. After the first dose, the course of the disease MESHD was favorable and 18 out of 19 (94.7%) patients were discharged clinically recovered with negative RT-PCR at 13 days (median). One dose of itolizumab, circulating IL-6 decreased in the first 24-48 hours in patients with high baseline values, whereas in patients with low levels, this concentration remained over low values. To preliminary assess the effect of itolizumab, a control group was selected among the Cuban COVID-19 patients, which did not receive immunomodulatory therapy. Control subjects were well-matched regarding age TRANS, comorbidities and severity of the disease MESHD. Every three moderately ill patients treated with itolizumab, one admission in intensive care unit (ICU) was prevented. Discussion/Conclusion: Itolizumab was well tolerated. Its effect is associated with a reduction and controlling IL-6 serum SERO levels. Moreover, treated patients had a favorable clinical outcome, considering their poor prognosis. This treatment is associated significantly with a decrease the risk to be admitted in ICU and reduced 10 times the risk of death MESHD. This study corroborates that the timely use of itolizumab, in combination with other antiviral and anticoagulant therapies, is associated with a reduction the COVID-19 disease MESHD worsening and mortality. The humanized antibody SERO itolizumab emerges as a therapeutic alternative for patients with COVID-19 and suggests its possible use in patients with cytokine release syndrome MESHD from other pathologies.

    Disparities in Case Frequency and Mortality of Coronavirus Disease MESHD 2019 (COVID-19) Among Various States in the United States

    Authors: Rohit S. Loomba; Gaurav Aggarwal; Saurabh Aggarwal; Saul Flores; Enrique G. Villarreal; Juan S. Farias; Carl J. Lavie

    doi:10.1101/2020.07.28.20163931 Date: 2020-07-30 Source: medRxiv

    Objective: To utilize publicly reported, state-level data to identify factors associated with the frequency of cases, tests, and mortality in the US. Materials & Methods: Retrospective study using publicly reported data collected included the number of COVID-19 cases, tests, and mortality from March 14th through April 30th, 2020. Publicly available state-level data was collected which included: demographics comorbidities, state characteristics and environmental factors. Univariate and multivariate regression analyses were performed to identify the significantly associated factors with percent mortality, case and testing frequency. All analyses were state-level analyses and not patient-level analyses. Results: A total of 1,090,500 COVID-19 cases were reported during the study period. The calculated case and testing frequency were 3,332 and 19,193 per 1,000,000 patients. There were 63,642 deaths MESHD during this period which resulted in a mortality of 5.8%. Factors including to but not limited to population density (beta coefficient 7.5, p< 0.01), transportation volume (beta coefficient 0.1, p< 0.01), tourism index (beta coefficient -0.1, p=0.02) and older age TRANS (beta coefficient 0.2, p=0.01) are associated with case frequency and percent mortality. Conclusions: There were wide variations in testing and case frequencies of COVID-19 among different states in the US. States with higher population density had a higher case and testing rate. States with larger population of elderly TRANS and higher tourism had a higher mortality.

    Clinical characteristics of neonates with coronavirus disease MESHD 2019 (COVID-19): a systematic review

    Authors: Yuan Hu; Jing Xiong; Yuan Shi

    doi:10.21203/ Date: 2020-07-29 Source: ResearchSquare

    This study aimed to summarize the existing literature on severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection in newborns to clarify the clinical features and outcomes of neonates with COVID-19. A systematic search was performed in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP databases from January 1, 2019 to April 30, 2020. The references of relevant studies were also searched. A descriptive summary was organized by aspects of clinical presentations (symptoms, laboratory examinations, and imaging) and outcomes. We identified 14 studies reporting 18 newborns with COVID-19. The most common clinical manifestations were fever MESHD fever HP (62.5%), shortness of breath (50.0%), diarrhea MESHD diarrhea HP/ vomiting MESHD vomiting HP/feeding intolerance(43.8%), cough MESHD cough HP (37.5%), dyspnea MESHD dyspnea HP (25.0%), and nasal congestion/runny nose/ sneeze MESHD sneeze HP(25.0%). Atypical symptoms included jaundice MESHD jaundice HP and convulsion. Lymphocyte numbers decreased in 5 cases, and radiographic findings were likely to show pneumonia MESHD pneumonia HP. All newborns recovered and discharged from the hospital, and there was no death MESHD.Conclusion: Clinical symptoms of neonatal SARS-CoV-2 infection MESHD are atypical, most of them are mild. Up to now, the prognosis of newborns is good, and there is no death MESHD. Intrauterine vertical transmission TRANS is possible, but confirmed evidence is still lacking. The Long-term follow-up of potential influences of SARS-CoV-2 infection MESHD on neonates need further exploration.

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MeSH Disease
Human Phenotype

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