Corpus overview


MeSH Disease

Human Phenotype


    displaying 1 - 10 records in total 280
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    Insights into the first wave of the COVID-19 pandemic in Bangladesh: Lessons learned from a high-risk country

    Authors: Md. Hasanul Banna Siam; Md Mahbub Hasan; Enayetur Raheem; Md. Hasinur rahaman Khan; Mahbubul H Siddiqee; Mohammad Sorowar Hossain

    doi:10.1101/2020.08.05.20168674 Date: 2020-08-06 Source: medRxiv

    Background South Asian countries including Bangladesh have been struggling to control the COVID-19 pandemic despite imposing months of lockdown and other public health measures (as of June 30, 2020). In-depth epidemiological information from these countries is lacking. From the perspective of Bangladesh, this study aims to understand the epidemiological features and gaps in public health preparedness. Method This study used publicly available data (8 March-30 June 2020) from the respective health departments of Bangladesh and Johns Hopkins University Coronavirus Resource Centre. Descriptive statistics was used to report the incidence, case fatality rates (CFR), and trend analysis. Spatial distribution maps were created using ArcGIS Desktop. Infection MESHD dynamics were analyzed via SIR models. Findings In 66 days of nationwide lockdown and other public health efforts, a total of 47,153 cases and 650 deaths MESHD were reported. However, the incidence was increased by around 50% within a week after relaxing the lockdown. Males TRANS were disproportionately affected in terms of infections MESHD (71%) and deaths MESHD (77%) than females TRANS. The CFR for males TRANS was higher than females TRANS (1.38% vs 1.01%). Over 50% of infected cases were reported among young adults TRANS (20-40-year age group TRANS). Geospatial analysis between 7 June 2020 and 20 June 2020 showed that the incidences increased 4 to 10-fold in 12 administrative districts while it decreased in the epicenter. As compared to the EU and USA, trends of the cumulative incidence were slower in South Asia with lower mortality. Conclusion Our findings on gaps in public health preparedness and epidemiological characteristics would contribute to facilitating better public health decisions for managing current and future pandemics like COVID-19 in the settings of developing countries.

    Safety of hot and cold site admissions within a high volume urology department in the United Kingdom at the peak of the COVID-19 pandemic

    Authors: Luke Stroman; Beth Russell; Pinky Kotecha; Anastasia Kantarzi; Luis Ribeiro; Bethany Jackson; Vugar Ismaylov; Adeoye Oluwakanyinsola Debo-Aina; Findlay MacAskill; Francesca Kum; Meghana Kulkarni; Raveen Sandher; Anna Walsh; Ella Doerge; Katherine Guest; Yamini Kailash; Nick Simson; Cassandra R McDonald; Elsie Mensah; Li June Tay; Ramandeep Chalokia; Sharon Clovis; Elizabeth Eversden; Jane Cossins; Jonah Rusere; Grace Zisengwe; Louisa Fleure; Leslie Cooper; Kathryn Chatterton; Amelia Barber; Catherine Roberts; Thomasia Azavedo; Jeffrey Ritualo; Harold Omana; Liza Mills; Lily Studd; Oussama El Hage; Rajesh Nair; Sachin Malde; Arun Sahai; Archana Fernando; Claire Taylor; Ben Challacombe; Ramesh Thurairaja; Rick Popert; Jonathon Olsburgh; Paul Cathcart; Christian Brown; Marios Hadjipavlou; Ella Di Benedetto; Matthew Bultitude; Jonathon Glass; Tet Yap; Rhana Zakri; Majed Shabbir; Susan Willis; Kay Thomas; Tim O'Brien; Muhammad Shamim Khan; Prokar Dasgupta

    doi:10.1101/2020.08.04.20154203 Date: 2020-08-06 Source: medRxiv

    Importance: Contracting COVID-19 peri-operatively has been associated with a mortality rate as high as 23%. Using hot and cold sites has led to a low rate of post-operative diagnosis of COVID-19 infection MESHD and allowed safe continuation of important emergency MESHD and cancer operations in our centre. Objective: The primary objective was to determine the safety of the continuation of surgical admissions and procedures during the height of the COVID-19 pandemic using hot and cold surgical sites. The secondary objective is to determine risk factors of contracting COVID-19 to help guide further prevention. Setting: A single surgical department at a tertiary care referral centre in London, United Kingdom. Participants: All consecutive patients admitted under the care of the urology team over a 3-month period from 1st March to 31st May 2020 over both hot acute admission sites and cold elective sites were included. Exposures: COVID-19 was prevalent in the community over the three months of the study at the height of the pandemic. The majority of elective surgery was carried out in a cold site requiring patients to have a negative COVID-19 swab 72 hours prior to admission and to self-isolate for 14 days pre-operatively, whilst all acute admissions were admitted to the hot site. Main outcomes and measures: COVID-19 was detected in 1.6% of post-operative patients. There was 1 (0.2%) post-operative mortality due to COVID-19. Results: A total of 611 patients, 451 (73.8%) male TRANS and 160 (26.2%) female TRANS, with a median age TRANS of 57 (interquartile range 44-70) were admitted under the surgical team. Of these, 101 (16.5%) were admitted on the cold site and 510 (83.5%) on the hot site. Surgical procedures were performed in 495 patients of which 8 (1.6%) contracted COVID-19 post-operatively with 1 (0.2%) post-operative mortality due to COVID-19. Overall, COVID-19 was detected in 20 (3.3%) patients with 2 (0.3%) deaths MESHD. On multivariate analysis, length of stay was associated with contracting COVID-19 in our cohort (OR 1.25, 95% CI 1.13-1.39). Conclusions and Relevance: Continuation of surgical procedures using hot and cold sites throughout the COVID-19 pandemic was safe practice, although the risk of COVID-19 remained and is underlined by a post-operative mortality. Reducing length of stay may be able to reduce contraction of COVID-19.

    Ethnic minority groups in England and Wales - factors affecting the size and timing of elevated COVID-19 mortality: a retrospective cohort study linking Census and death MESHD records

    Authors: Daniel Ayoubkhani; Vahe Nafilyan; Chris White; Peter Goldblatt; Charlotte Gaughan; Louisa Blackwell; Nicky Rogers; Amitava Banerjee; Kamlesh Khunti; Myer Glickman; Ben Humberstone; Ian Diamond

    doi:10.1101/2020.08.03.20167122 Date: 2020-08-04 Source: medRxiv

    Objectives: To estimate population-level associations between ethnicity and coronavirus disease MESHD 2019 (COVID-19) mortality, and to investigate how ethnicity-specific mortality risk evolved over the course of the pandemic. Design: Retrospective cohort study using linked administrative data. Setting: England and Wales, deaths MESHD occurring 2 March to 15 May 2020. Participants: Respondents to the 2011 Census of England and Wales aged TRANS [≤]100 years and enumerated in private households, linked to death MESHD registrations and adjusted to account for emigration before the outcome period, who were alive on 1 March 2020 (n=47,872,412). Main outcome measure: Death MESHD related to COVID-19, registered by 29 May 2020. Statistical methods: We estimated hazard ratios (HRs) for ethnic minority groups compared with the White population using Cox regression models, controlling for geographical, demographic, socio-economic, occupational, and self-reported health factors. HRs were estimated on the full outcome period and separately for pre- and post-lockdown periods in the UK. Results: In the age TRANS-adjusted models, people from all ethnic minority groups were at elevated risk of COVID-19 mortality; the HRs for Black males TRANS and females TRANS were 3.13 [95% confidence interval: 2.93 to 3.34] and 2.40 [2.20 to 2.61] respectively. However, in the fully adjusted model for females TRANS, the HRs were close to unity for all ethnic groups except Black (1.29 [1.18 to 1.42]). For males TRANS, COVID-19 mortality risk remained elevated for the Black (1.76 [1.63 to 1.90]), Bangladeshi/Pakistani (1.35 [1.21 to 1.49]) and Indian (1.30 [1.19 to 1.43]) groups. The HRs decreased after lockdown for all ethnic groups, particularly Black and Bangladeshi/Pakistani females TRANS. Conclusions: Differences in COVID-19 mortality between ethnic groups were largely attenuated by geographical and socio-economic factors, although some residual differences remained. Lockdown was associated with reductions in excess mortality risk in ethnic minority populations, which has major implications for a second wave of infection MESHD or local spikes. Further research is needed to understand the causal mechanisms underpinning observed differences in COVID-19 mortality between ethnic groups.

    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.

    A Study on Survival Scenario of COVID-19 patients in India: An Application of Survival Analysis on patient demographics

    Authors: Sampurna Kundu; Kirti; Debarghya Mandal

    doi:10.1101/2020.08.01.20162115 Date: 2020-08-04 Source: medRxiv

    The study of transmission TRANS dynamics of COVID-19, have depicted the rate, patterns and predictions of the pandemic cases. In order to combat the disease MESHD transmission TRANS in India, the Government had declared lockdown on the 25th of March. Even after a strict lockdown nationwide, the cases are increasing and have crossed 4.5 lakh positive cases. A positive point to be noted amongst all that the recovered cases are slowly exceeding the active cases. The survival of the patients, taking death MESHD as the event that varies over age groups TRANS and gender TRANS wise is noteworthy. This study aims in carrying out a survival analysis to establish the variability in survivorship among age groups TRANS and sex, at different levels, that is, national, state and district level. The open database of COVID-19 tracker ( of India has been utilized to fulfill the objectives of the study. The study period has been taken from the beginning of the first case which was on 30th Jan 2020 till 30th June. Due to the amount of under-reporting of data and dropping missing columns a total of 26,815 sample patients were considered. The entry point of each patient is different and event of interest is death MESHD in the study. Kaplan Meier survival estimation, Cox proportional hazard model and multilevel survival model has been used to perform survival analysis. Kaplan Meier survival function, shows that the probability of survival has been declining during the study period of five months. A significant variability has been observed in the age groups TRANS, as evident from all the survival estimates, with increasing age TRANS the risk of dying from COVID-19 increases. When Western and Central India show ever decreasing survival rate in the framed time period then Eastern , North Eastern and Southern India shows a slightly better picture in terms of survival. Maharashtra, Gujarat, Delhi, Rajasthan and West bengal showed alrmingly poor survival as well. This study has depicted a grave scenario of gradation of ever decreasing survival rates in various regions and shows the variability by age TRANS and gender TRANS.

    COVID-19 pandemic in Djibouti: epidemiology and the response strategy followed to contain the virus during the first two months, 17 March to 16 May 2020

    Authors: Mohamed Elhakim; Saleh Banoita Tourab; Ahmed Zouiten

    doi:10.1101/2020.08.03.20167692 Date: 2020-08-04 Source: medRxiv

    Background: First cases of COVID-19 were reported from Wuhan, China, in December 2019, and it progressed rapidly. On 30 January, WHO declared the new disease MESHD as a PHEIC, then as a Pandemic on 11 March. By mid-March, the virus spread widely; Djibouti was not spared and was hit by the pandemic with the first case detected on 17 March. Djibouti worked with WHO and other partners to develop a preparedness and response plan, and implemented a series of intervention measures. MoH together with its civilian and military partners, closely followed WHO recommended strategy based on four pillars: testing, isolating, early case management, and contact tracing TRANS. From 17 March to 16 May, Djibouti performed the highest per capita tests in Africa and isolated, treated and traced the contacts TRANS of each positive case, which allowed for a rapid control of the epidemic. Methods: COVID-19 data included in this study was collected through MoH Djibouti during the period from 17 March to 16 May 2020. Results: A total of 1,401 confirmed cases TRANS of COVID-19 were included in the study with 4 related deaths MESHD (CFR: 0.3%) and an attack rate TRANS of 0.15%. Males TRANS represented (68.4%) of the cases, with the age group TRANS 31-45 years old (34.2%) as the most affected. Djibouti conducted 17,532 tests, and was considered as a champion for COVID-19 testing in Africa with 18.2 tests per 1000 habitant. All positive cases were isolated, treated and had their contacts traced TRANS, which led to early and proactive diagnosis of cases and in turn yielded up to 95-98% asymptomatic TRANS cases. Recoveries reached 69% of the infected cases with R0 TRANS (0.91). The virus was detected in 4 regions in the country, with the highest percentage in the capital (83%). Conclusion: Djibouti responded to COVID-19 pandemic following an efficient and effective strategy, using a strong collaboration between civilian and military health assets that increased the response capacities of the country. Partnership, coordination, solidarity, proactivity and commitment were the pillars to confront COVID-19 pandemic.

    Reflecting on the first two COVID-19 deaths MESHD in Uganda: a public health case study

    Authors: Joseph Kawuki; Quraish Sserwanja; Nathan Obore; Johnson Wang; Joseph Lau

    doi:10.21203/ Date: 2020-08-02 Source: ResearchSquare

    Objective: COVID-19 being a rapidly evolving pandemic, early lessons from the first deaths MESHD must be learnt to help feed into the public health guidelines. This study, therefore, aims to present the first two deaths MESHD due to COVID-19 in Uganda and their public health relevance.Cases: The first case was a 34-year female TRANS and support staff at a health center II. She first presented with COVID-19 like symptoms before dying on 21st July 2020. The second case was an 80 years old female TRANS, who also presented with COVID-19 like symptoms before dying on 24th July 2020. The postmortem samples of both cases were confirmed TRANS positive for COVID-19. Conclusion: This study identifies a need for timely identification and testing of COVID-19 suspects, strengthening of health center capacity, as well as more awareness for effective prevention and control of COVID-19.

    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.

    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.

    COVID-19 case-fatality rate and demographic and socioeconomic influencers: a worldwide spatial regression analysis based on country-level data

    Authors: Yang Cao; Ayako Hiyoshi; Scott Montgomery

    doi:10.1101/2020.07.31.20165811 Date: 2020-07-31 Source: medRxiv

    We used the COVID-19 dataset obtained from the Our World in Data website and investigated the associations between COVID-19 CFR and nine country-level indices of 209 countries/territories using the Matern correlation regression model. Spatial dependence among the data was controlled using the latitude and longitude of the centroid of the countries/territories. Stratified analyses were conducted by economic level and COVID-19 testing policy. The average of country/territory-specific COVID-19 CFR is about 2-3% worldwide, which is higher than previously reported at 0.7-1.3%. Statistically significant associations were observed between COVID-19 CFR and population size and proportion of female TRANS smokers. The open testing policies are associated with decreased CFR. Strictness of anti-COVID-19 measures was not statistically significantly associated with CFR overall, but the higher stringency index was associated with higher CFR in higher income countries with active testing policies. The statistically significant association between population size and COVID-19 CRF suggests the healthcare strain and lower treatment efficiency in countries with large populations. The observed association between smoking in females TRANS and COVID-19 CFR might be due to that the proportion of female TRANS smokers reflected broadly income level of a country. When testing is warranted and healthcare resources are sufficient, strict quarantine and/or lockdown measures might result in excess deaths MESHD in underprivileged populations.

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MeSH Disease
Human Phenotype

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