Corpus overview


MeSH Disease

Human Phenotype


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    Clinical analysis of gastrointestinal bleeding MESHD in patients with severe coronavirus disease MESHD (COVID-19): A retrospective observational study

    Authors: Jinfen Dai; Song Hu; Yi Chen; Pengbo Wu; Mei Liu

    doi:10.21203/ Date: 2020-09-17 Source: ResearchSquare

    Background: The epidemic of Novel coronavirus disease MESHD 2019(COVID-19) has attracted the great attention of people all over the world. Gastrointestinal bleeding MESHD in patients with COVID-19 has been studied rarely. We mean to investigate the clinical characteristics of gastrointestinal bleeding MESHD in patients with severe coronavirus disease MESHD (COVID-19).Methods: Nineteen severe COVID-19 patients with gastrointestinal bleeding MESHD were retrospectively studied. Clinical data, including medical history, symptoms, laboratory characteristics, and treatment, were collected and analyzed. We also compared the characteristics of patients with different degrees of bleeding MESHD.Results: Fourteen patients (73.6%) were men. Mean age TRANS was 63.8 (±15.6) years. Most patients (89.4%) had no history of gastrointestinal bleeding MESHD. The most common presentation of gastrointestinal bleeding MESHD was a positive fecal occult blood SERO test (15/19 cases, 78.9%). Fifteen patients (78.9%) did not require blood SERO transfusion. Five of 15 patients (33%) received anticoagulants and antiplatelet drugs before gastrointestinal bleeding MESHD in the mild bleeding group, and 2/4 (50%) in the severe bleeding MESHD group. Four of 15 patients (27%) died in the mild bleeding MESHD group and no patients died in the severe bleeding MESHD group.Conclusions: The presentations of gastrointestinal bleeding MESHD in severe COVID-19 patients are not obvious, and frequent fecal occult blood SERO test is needed to detect gastrointestinal bleeding MESHD early. Patients receiving anticoagulants and antiplatelet drugs need a close observation for gastrointestinal bleeding MESHD. Gastrointestinal bleeding MESHD may not increase the mortality, after giving blood SERO transfusion support therapy.

    Plasma SERO tissue plasminogen activator and plasminogen activator inhibitor-1 in hospitalized COVID-19 patients

    Authors: Yu Zuo; Mark Warnock; Alyssa Harbaugh; Srilakshmi Yalavarthi; Kelsey Gockman; Melanie Zuo; Jacqueline A. Madison; Jason S. Knight; Yogendra Kanthi; Daniel A. Lawrence; Laura Vanessa Montes Fontalvo; Roger Hernandez; Carolin Chavez; Francisco Eduardo Campos; Fadia Uribe; Olguita del Aguila; JORGE ALBERTO RIOS AIDA; Andrea Parra Buitrago; Lina Maria Betancur Londono; Leon Felipe Mendoza Vega; Carolina Almeida Hernandez; Michela Sali; JULIAN HIGUITA PALACIO; Jessica Gomez-Vargas; Adriana Yock Corrales; Danilo Buonsenso

    doi:10.1101/2020.08.29.20184358 Date: 2020-09-02 Source: medRxiv

    Background: Patients with coronavirus disease MESHD 19 (COVID-19) are at high risk for thrombotic arterial and venous occlusions MESHD venous occlusions HP, while lung histopathology often reveals fibrin-based occlusion of small vessels in patients who succumb to the disease. At the same time, bleeding MESHD complications have been observed in some patients. Better understanding the balance between coagulation and fibrinolysis will help inform optimal approaches to thrombosis MESHD prophylaxis and potential utility of fibrinolytic-targeted therapies. Objective: To evaluate fibrinolysis among a large cohort of hospitalized COVID-19 patients. Patients and methods: 118 hospitalized COVID-19 patients and 30 healthy controls were included in the study. We measured plasma SERO antigen levels of tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) and performed spontaneous clot lysis assays. Results: We found markedly elevated levels of tPA and PAI-1 among patients hospitalized with COVID-19. Both factors demonstrated a strong correlation with neutrophil counts and markers of neutrophil activation, but not with D-dimer. High levels of tPA and PAI-1 were associated with worse respiratory status. High levels of tPA, in particular, were also strongly correlated with mortality and with a significant enhancement in spontaneous ex vivo clot lysis. Conclusion: While both tPA and PAI-1 are elevated among COVID-19 patients, extremely high levels of tPA enhance spontaneous fibrinolysis and are significantly associated with mortality in some patients. These data indicate that fibrinolytic homeostasis in COVID-19 is complex with a subset of patients expressing a balance of factors that may favor fibrinolysis and suggests that further study of tPA as a potential biomarker is warranted.

    Acute Lung injury MESHD evolution in Covid-19

    Authors: Claudio Doglioni; Claudia Ravaglia; Giulio Rossi; Alessandra Dubini; Federica Pedica; Sara Piciucchi; Antonio Vizzuso; Lorenza Pecciarini; Franco Stella; Stefano Maitan; Vanni Agnoletti; Emiliano Gamberini; Emanuele Russo; Silvia Puglisi; Antonella Arcadu; Luca Donati; Simona Di Cesare; Carmela Grosso; Giovanni Poletti; Vittorio Sambri; Elisabetta Fabbri; Giovanni Pizzolo; Stefano Ugel; Vincenzo Bronte; Athol U Wells; Marco Chilosi; Venerino Poletti; Tobias Boettler; Bertram Bengsch; Robert Thimme; Maike Hofmann; Christoph Neumann-Haefelin

    doi:10.1101/2020.08.09.20170910 Date: 2020-08-13 Source: medRxiv

    BACKGROUND Pathogenesis of Coronavirus disease MESHD 2019 (Covid-19) is poorly understood. Most histologic studies come from post-mortem analysis, with existing data indicating that histologic features of acute respiratory distress syndrome MESHD respiratory distress HP syndrome are typically present in fatal cases. However, this observation may be misleading, due to confounding factors in pre-terminal disease, including injury resulting from prolonged mechanical ventilation. Ante-mortem lung biopsy may provide major pathogenetic insights, potentially providing a basis for novel treatment approaches. AIM This comparative, multicenter, prospective, observational study was planned to identify ante-mortem histological profile and immunohistochemical features of lung tissue in patients with Covid-19 in early and late phases of the disease, including markers of inflammatory cells and major pathways involved in the cytokine storm triggering. METHODS Enrolled patients underwent lung biopsy, according to the study protocol approved by local Ethical Committee, either within 15 days of the first symptoms appearing (early phase) or after > 15 days (more advanced disease). Key exclusion criteria were excessive or uncorrectable bleeding MESHD risk and cardiovascular disease MESHD with heart failure MESHD. Lung samples were obtained by conventional trans-bronchialbiopsy, trans-bronchial lung cryobiopsy or surgical lung biopsy. RESULTS 23 patients were enrolled: 12 patients underwent lung biopsy within 15 days and 11 patients more than 15 days after the onset of symptoms TRANS. Early biopsies were characterized by spots of patchy acute lung injury MESHD ( ALI MESHD) with alveolar type II MESHD cells hyperplasia MESHD and significant vascular abnormalities MESHD (disordered angiogenesis with alveolar capillary hyperplasia, luminal enlargement MESHD and thickened walls of pulmonary venules, perivascularCD4-T-cell infiltration), with no hyaline membranes. In the later stages, the alveolar architecture MESHD appeared disrupted, with areas of organizing ALI MESHD, venular congestion and capillary thromboembolic microangiopathy MESHD. Striking phenotypic features were demonstrated in hyper plastic pneumocytes MESHD and endothelial cells, including the expression of phospho-STAT3 and molecules involved in immunoinhibitory signals (PD-L1 and IDO1). Alveolar MESHD macrophages exhibited macrophage-related markers (CD68, CD11c, CD14) together with unusual markers, such as DC-Lamp/CD208, CD206, CD123/IL3AR. CONCLUSION A morphologically distinct Covid pattern was identified in the earlier stages of the disease, with prominent epithelial and endothelial cell abnormalities, that may be potentially reversible, differing strikingly from findings in classical diffuse alveolar damage MESHD. These observations may have major therapeutic implications, justifying studies of early interventions aimed at mitigating inflammatory organ injury.

    Intracerebral hemorrhage MESHD in COVID-19 patients with pulmonary failure MESHD – a propensity score matched registry study

    Authors: Corinna N. Lang; Johanna S. Dettinger; Michael Berchtold-Herz; Stefan Utzolino; Xavier Bemtgen; Viviane Zotzmann; Bonaventura Schmid; Paul M. Biever; Christoph Bode; Katharina Müller-Peltzer; Daniel Duerschmied; Tobias Wengenmayer; Wolf-Dirk Niesen; Dawid L. Staudacher

    doi:10.21203/ Date: 2020-08-09 Source: ResearchSquare

    Background: Hypercoagulopathy in coronavirus disease MESHD 2019 (COVID-19) causing deep vein thrombosis MESHD and pulmonary artery embolism MESHD necessitate systemic anticoagulation. Case reports of intracerebral hemorrhages MESHD in ventilated COVID-19 patients warrant precaution. It is unclear however, if COVID-19 patients with acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD) with and without extracorporeal membrane oxygenation therapy (ECMO) have more intracerebral hemorrhages MESHD ( ICH MESHD) compared to other ARDS MESHD patients.Methods: We conducted a retrospective observational single center study enrolling all patients with ARDS MESHD from 01/2018-05/2020. Patients with ARDS MESHD positive for SARS-CoV2 PCR were allocated to the COVID-19 group. Propensity score matching was performed for age TRANS, ECMO and risk of bleeding MESHD according to HAS-BLED score.Results: A total of 163, mostly severe ARDS MESHD patients were identified, 116 (71.2%) without COVID-19 and 47 (28.8%) positive for SARS-CoV-2. The two groups were comparable concerning the main confounders of ICH MESHD including age TRANS, HAS-BLED score, need for ECMO-therapy as well as anticoagulation levels reported. In 63/163 cases (38.7%), veno-venous ECMO therapy was required and ICU survival was 52.8%. Although HAS-BLED-score on admission was generally low (1.6±1.3), intracerebral hemorrhage MESHD was detected in 22 patients (13.5%) with no statistical difference between the groups (11.2 vs. 19.1% with and without SARS-CoV-2, respectively, p=0.21). Propensity score matching confirmed similar intracerebral bleeding MESHD rates in both groups (12.8 vs. 19.1% with and without SARS-CoV-2, respectively, p=0.57). Conclusions: Intracerebral hemorrhage MESHD was detectable in every tenth patient with ARDS MESHD. We found no statistically significant increased bleeding MESHD rate in patients with ARDS MESHD due to COVID-19 compared to other causes of ARDS MESHD.

    COVID-19: The Rollercoaster of Fibrin(ogen), D-dimer, von Willebrand MESHD Factor, P-selectin and Their Interactions with Endothelial Cells, Platelets and Erythrocytes MESHD

    Authors: Corlia Grobler; Jhade Bredenkamp; Mireille Grobbelaar; Sipho Maphumulo; Jaco Laubscher; Janami Steenkamp; Douglas Kell; Etheresia Pretorius

    id:10.20944/preprints202007.0142.v1 Date: 2020-07-08 Source:

    Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), coronavirus disease MESHD 2019 (COVID-19)-induced infection MESHD is strongly associated with various coagulopathies MESHD that may result in either bleeding MESHD and thrombocytopenia HP thrombocytopenia MESHD or hypercoagulation MESHD and thrombosis MESHD. Thrombotic and bleeding MESHD or thrombotic MESHD pathologies are significant accompaniments to acute respiratory syndrome MESHD and lung complications MESHD in COVID-19. Thrombotic MESHD events and bleeding MESHD, often occurs in subjects with weak multiple risk factors and co-morbidities. Of particular interest are the various circulating inflammatory coagulation biomarkers involved directly in clotting, with specific focus on fibrin(ogen), D-dimer, P-selectin and von Willebrand MESHD Factor (vWF). Central to activity of these biomarkers are their receptors and signaling pathways on endothelial cells, platelets and erythrocytes. In this review, we discuss vascular implications of COVID-19, and relate this to circulating biomarker, endothelial, erythrocyte and platelet dysfunction MESHD. During the progression of the disease, these markers may either be within healthy levels, upregulated or eventually depleted. Most significant is that patients need to be treated early in the disease progression, when high levels of vWF, P-selectin and fibrinogen are present with still low levels of D-dimer. Progression to vWF and fibrinogen depletion with high D-dimer levels and even higher P-selectin levels, followed by the cytokine storm, will be indicative of a poor prognosis. We conclude by looking at point-of-care devises and methodologies in COVID-19 management and suggest that a personalized medicine approach should be considered in the treatment of patients.

    Vascular Obliteration Due To Endothelial And Myointimal Growth In COVID-19

    Authors: Jara Valtueña; Gerardo Martínez-García; Daniel Ruiz-Sánchez; María Garayar-Cantero; Carlos Dueñas; Ángel Aguado-García; Jose María Prieto de Paula; Pilar Manchado López

    doi:10.21203/ Date: 2020-05-28 Source: ResearchSquare

    Background: Severe coronavirus disease MESHD 2019 (Covid-19) is a systemic multi-organ viral invasion. Previous studies found that many patients had a procoagulant state and/or severe hypoxemia HP hypoxemia MESHD with relatively well-preserved lung mechanics. Mechanisms underlying the vascular and its surrounding tissue are not well known yet.  Histological data in Covid-19 tissues´ patients are still limited and mainly focused on post-mortem analysis. Since SARS-CoV-2 largely affects cutaneous tissue, we aim to examine in depth skin lesions MESHD related to Covid-19 in order to understand better how the disease might affect living tissue.Methods: Five skin lesions from Covid-19 adult TRANS patients were selected for histological tissue examination. Vast amount of data of immunohistochemistry (IHC) and direct immunofluorescent (DIF) were part of the assessment. Results: A common strong vasculopathic reaction pattern based on prominent vascular endothelial and myointimal cellgrowth was identified. Endothelial cell distortion generated vascular lumen obliteration and a strike erythrocyte and serum SERO extravasation. Extensive significant vascular C4d and C3 deposition throughout vascular cell wall was also identified. A regenerative epidermal hyperplasia MESHD with tissue structure preservation was found. Conclusions: Covid-19 could comprise an obliterative micro-angiopathy consisting on endothelial and myointimal intensive growth with complement activation. This mechanism, together with increased vascular permeability identified, could contribute to obliterative vascular lumen and hemorrhage MESHD in Covid-19. Activation of the complement and angiogenic pathways could have an important role in inducing and maintaining this vasculopathic reaction pattern. Thus, anticoagulation by itself could not completely reverse vascular lumen obliteration, with consequent hemorrhagic increased risk associated. Skin is the largest organ in the body, the most accessible one and can mirror other organs of the body. Findings of this study could contribute to a better understanding of physio-pathological mechanisms underlying SARS-CoV-2 infection MESHD on living tissue and could help further studies find potential targets for specific therapeutic interventions in Covid-19 severe patients. 

    A Rapid Decrease in Stroke HP Stroke MESHD, Acute Coronary Syndrome MESHD, and Corresponding Interventions at 65 United States Hospitals Following Emergence of COVID-19

    Authors: Adam de Havenon; John Ney; Brian Callaghan; Alen Delic; Sam Hohmann; Ernie Shippey; Shadi Yaghi; Mohammad Anadani; Gregory Esper; Jennifer Majersik

    doi:10.1101/2020.05.07.20083386 Date: 2020-05-11 Source: medRxiv

    Background Following the emergence of coronavirus disease MESHD 2019 (COVID-19), early reports suggested a decrease in stroke HP stroke MESHD and acute coronary syndrome MESHD ( ACS MESHD). We sought to provide descriptive statistics for stroke HP stroke MESHD and ACS MESHD from a sample of hospitals throughout the United States, comparing data from March 2020 to similar months pre-COVID. Methods We performed a retrospective analysis of 65 academic and community hospitals in the Vizient Clinical Data Base. The primary outcome is monthly count of stroke HP stroke MESHD and ACS MESHD, and acute procedures for both, from February and March in 2020 compared to the same months in 2018 and 2019. Results are aggregated for all hospitals and reported by Census Region. Results We identified 51,246 strokes HP strokes MESHD (42,780 ischemic MESHD, 8,466 hemorrhagic MESHD), 1,043 mechanical thrombectomies (MT), 836 tissue plasminogen activator (tPA) administrations, 36,551 ACS MESHD, and 3,925 percutaneous coronary interventions (PCI) for ACS MESHD. In February 2020, relative to February 2018 and 2019, hospitalizations with any discharge diagnosis of stroke HP stroke MESHD and ACS MESHD increased by 9.8% and 12.1%, respectively, while in March 2020 they decreased 18.5% and 7.5%, relative to March 2018 and 2019. When only including hospitalizations with the primary discharge diagnosis of stroke HP stroke MESHD or ACS MESHD, in March 2020 they decreased 17.6% and 25.7%, respectively. In March 2020, tPA decreased 3.3%, MT increased 18.8%, although in February 2020 it had increased 36.8%, and PCI decreased 14.7%. These decreases were observed in all Census regions. Conclusions Following greater recognition of the risks of COVID-19, hospitalizations with stroke HP stroke MESHD and ACS MESHD were markedly diminished in a geographically diverse sample of United States hospitals. Because the most likely explanation is that some patients with stroke HP stroke MESHD and ACS MESHD did not seek medical care, the underlying reasons for this decrease warrant additional study to inform public health efforts and clinical care during this and future pandemics.

    Early postmortem brain MRI findings in COVID-19 non-survivors

    Authors: Tim Coolen; Valentina Lolli; Niloufar Sadeghi; Antonin Rovai; Nicola Trotta; Fabio S Taccone; Jacques Creteur; Sophie Henrard; Jean-Christophe Goffard; Olivier Dewitte; Gilles Naeije; Serge Goldman; Xavier De Tiege

    doi:10.1101/2020.05.04.20090316 Date: 2020-05-08 Source: medRxiv

    Importance: The severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) is considered to have potential neuro-invasiveness that might lead to acute brain disorders MESHD or contribute to respiratory distress HP in patients with coronavirus disease MESHD 2019 (COVID-19). Brain magnetic resonance imaging (MRI) data in COVID-19 patients are scarce due to difficulties to obtain such examination in infected unstable patients during the COVID-19 outbreak. Objective: To investigate the occurrence of structural brain abnormalities MESHD in non-survivors of COVID-19 in a virtopsy framework. Design: Prospective, case series study with postmortem brain MRI obtained early (<24h) after death MESHD. Setting: Monocentric study. Participants: From 31/03/2020 to 24/04/2020, consecutive decedents who fulfilled the following inclusion criteria were included: death <24 hours, SARS-CoV-2 detection on nasopharyngeal swab specimen, chest computerized tomographic (CT) scan suggestive of COVID-19, absence of known focal brain lesion MESHD, and MRI compatibility. Main Outcome(s) and Measure(s): Signs of acute brain injury MESHD and MRI signal abnormalities along the olfactory tract and brainstem were searched independently by 3 neuroradiologists, then reviewed with neurologists and clinicians. Results: Among the 62 patients who died from COVID-19 during the inclusion period, 19 decedents fulfilled inclusion criteria. Subcortical micro- and macro-bleeds (2 decedents), cortico-subcortical edematous MESHD changes evocative of posterior reversible encephalopathy HP encephalopathy MESHD syndrome ( PRES MESHD, one decedent), and nonspecific deep white matter changes (one decedent) were observed. Asymmetric olfactory bulbs were found in 4 other decedents without downstream olfactory tract abnormalities. No brainstem MRI signal abnormality. Conclusions and Relevance: Postmortem brain MRI demonstrates hemorrhagic MESHD and PRES-related brain lesions in non-survivors of COVID-19 that might be triggered by the virus-induced endothelial disturbances. SARS-CoV-2-related olfactory impairment seems to be limited to olfactory bulbs. The absence of brainstem MRI abnormalities does not support a brain-related contribution to respiratory distress HP in COVID-19.

    Evaluation of variation in D-dimer levels among COVID-19 and bacterial pneumonia MESHD pneumonia HP: a retrospective analysis

    Authors: Bilian Yu; Xin Li; Jin Chen; Mingqi Ouyang; Hong Zhang; Xinge Zhao; Liang Tang; Qin Luo; Min Xu; Lizhen Yang; Guxiang Huang; Xianling Liu; Jianjun Tang

    doi:10.21203/ Date: 2020-03-29 Source: ResearchSquare

    Background:In the recent outbreak of novel coronavirus infection MESHD worldwide, the risk of thrombosis MESHD and bleeding MESHD should be concerned. Objectives: We aimed to observe the dynamic changes of D-dimer levels during disease progression to evaluate their value for thrombosis MESHD. Methods: In this study, we report the clinical and laboratory results of 57 patients with confirmed COVID-19 pneumonia HP pneumonia MESHD and 46 patients with confirmed community-acquired bacterial pneumonia MESHD pneumonia HP (CAP). And their concentrations of D-dimer, infection-related biomarkers, and conventional coagulation were retrospectively analyzed.Results: On admission, both in COVID-19 patients and CAP MESHD patients, D-dimer levels were significantly increased, and compared with CAP MESHD patients, D-Dimer levels were higher in COVID-19 patients (P<0.05). Besides, we found that in COVID-19 patients, D-dimer were related with markers of inflammation MESHD, especially with hsCRP (R=0.426, P<0.05), and after treatments, D-dimer levels decreased which was synchronous with hsCRP levels in patients with good clinical prognosis, but there were still some patients with anomalous increasing D-dimer levels after therapy.Conclusions: Elevated baseline D-dimer levels are associated with inflammation MESHD in COVID-19 patients, and the abnormal changes of D-dimer and inflammatory factors suggest that anticoagulant therapy might be needed.

    Three Unsuspected CT Diagnoses of COVID-19

    Authors: Vu, David; Ruggiero, Maryanne; Choi, Woo Sung; Masri, Daniel; Flyer, Mark; Shyknevsky, Inna; Stein, Evan G.

    doi:10.21203/ Date: 2020-03-26 Source: ResearchSquare

    PURPOSE: Coronavirus disease 2019 (COVID-19) is caused by a novel strain of coronavirus named severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) that has quickly spread around the globe. Health care facilities in the United States currently do not have an adequate supply of COVID-19 tests to meet the growing demand. Imaging findings for COVID-19 are nonspecific but include pulmonary parenchymal ground-glass opacities in a predominantly basal and peripheral distribution.METHODS: Three patients imaged for non-respiratory related symptoms with a portion of the lungs in the imaged field.RESULTS: Each patient had suspicious imaging findings for COVID-19, prompting the interpreting radiologist to suggest testing for COVID-19. All 3 patients turned out to be infected MESHD with COVID-19 and one patient is the first reported case of the coincident presentation of COVID-19 and an intraparenchymal hemorrhage MESHD.CONCLUSION: Using imaging characteristics of COVID-19 on abdominal or neck CT when a portion of the lungs is included, patients not initially suspected of COVID-19 infection can be quarantined earlier to limit exposure to others.

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MeSH Disease
Human Phenotype

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