Corpus overview


MeSH Disease

Human Phenotype


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    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 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 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. 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 chronic kidney disease MESHD, chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD, dementia HP dementia MESHD, heart disease MESHD, hyperlipidemia HP hyperlipidemia MESHD, hypertension HP hypertension MESHD, malignant neoplasm HP neoplasm MESHD, obesity HP obesity MESHD, and type 2 diabetes MESHD) 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. 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.

    Clinical, Behavioral and Social Factors Associated with Racial Disparities in Hospitalized and Ambulatory COVID-19 Patients from an Integrated Health Care System in Georgia

    Authors: Felipe Lobelo; Alan X Bienvenida; Serena Leung; Armand N Mbanya; Elizabeth J. Leslie; Kate E Koplan; S. Ryan Shin

    doi:10.1101/2020.07.08.20148973 Date: 2020-07-10 Source: medRxiv

    Introduction: Racial and ethnic minorities have shouldered a disproportioned burden of coronavirus disease MESHD 2019 (COVID-19) infection MESHD to date in the US, but data on the various drivers of these disparities is limited. Objectives: To describe the characteristics and outcomes of COVID-19 patients and explore factors associated with hospitalization risk by race. Methods: Case series of 448 consecutive patients with confirmed COVID-19 seen at Kaiser Permanente Georgia (KPGA), an integrated health care system serving the Atlanta metropolitan area, from March 3 to May 12, 2020. KPGA members with laboratory-confirmed COVID-19. Multivariable analyses for hospitalization risk also included an additional 3489 persons under investigation (PUI) with suspected infection MESHD. COVID-19 treatment and outcomes, underlying comorbidities and quality of care management metrics, socio-demographic and other individual and community-level social determinants of health (SDOH) indicators. Results: Of 448 COVID-19 positive members, 68,3% was non-Hispanic Black (n=306), 18% non-Hispanic White (n=81) and 13,7% Other race (n=61). Median age TRANS was 54 [IQR 43-63) years. Overall, 224 patients were hospitalized, median age TRANS 60 (50-69) years. Black race was a significant factor in the Confirmed + PUI, female TRANS and male TRANS models (ORs from 1.98 to 2.19). Obesity HP was associated with higher hospitalization odds in the confirmed, confirmed + PUI, Black and male TRANS models (ORs from 1.78 to 2.77). Chronic disease MESHD control metrics ( diabetes MESHD, hypertension HP hypertension MESHD, hyperlipidemia HP hyperlipidemia MESHD) were associated with lower odds of hospitalization ranging from 48% to 35% in the confirmed + PUI and Black models. Self-reported physical inactivity was associated with 50% higher hospitalization odds in the Black and Female TRANS models. Residence in the Northeast region of Atlanta was associated with lower hospitalization odds in the Confirmed + PUI, White and female TRANS models (ORs from 0.22 to 0.64) Conclusions: We found that non-Hispanic Black KPGA members had a disproportionately higher risk of infection TRANS risk of infection TRANS infection MESHD and, after adjusting for covariates, twice the risk of hospitalization compared to other race groups. We found no significant differences in clinical outcomes or mortality across race/ethnicity groups. In addition to age TRANS, sex and comorbidity burden, pre-pandemic self-reported exercise, metrics on quality of care and control of underlying cardio-metabolic diseases MESHD, and location of residence in Atlanta were significantly associated with hospitalization risk by race groups. Beyond well-known physiologic and clinical factors, individual and community-level social indicators and health behaviors must be considered as interventions designed to reduce COVID-19 disparities and the systemic effects of racism are implemented.

    Severe obesity HP obesity MESHD is associated with higher in-hospital mortality in a cohort of patientswith COVID-19 in the Bronx, New York

    Authors: Leonidas Palaiodimos; Damianos G. Kokkinidis; Weijia Li; Dimitrios Karamanis; Jennifer Ognibene; Shitij Arora; William N. Southern; Christos S. Mantzoros

    doi:10.1101/2020.05.05.20091983 Date: 2020-05-09 Source: medRxiv

    Background & Aims: New York is the current epicenter of Coronavirus disease MESHD 2019 (COVID-19) pandemic. The underrepresented minorities, where the prevalence SERO of obesity HP obesity MESHD is higher, appear to be affected disproportionately. Our objectives were to assess the characteristics and early outcomes of patients hospitalized with COVID-19 in the Bronx and investigate whether obesity HP obesity MESHD is associated with worse outcomes. Methods: This retrospective study included the first 200 patients admitted to a tertiary medical center with COVID-19. The electronic medical records were reviewed at least three weeks after admission. The primary endpoint was in-hospital mortality. Results: 200 patients were included ( female TRANS sex: 102, African American: 102). The median BMI was 30 kg/m2. The median age TRANS was 64 years. Hypertension HP Hypertension MESHD (76%), hyperlipemia MESHD (46.2%), and diabetes MESHD (39.5%) were the three most common comorbidities. Fever HP Fever MESHD (86%), cough HP (76.5%), and dyspnea HP dyspnea MESHD (68%) were the three most common symptoms. 24% died during hospitalization (BMI <25 kg/m2: 31.6%, BMI 25-34 kg/m2: 17.2%, BMI[≥]35 kg/m2: 34.8%, p= 0.03). The multivariate analysis for mortality, demonstrates that BMI[≥]35 kg/m2 (OR: 3.78; 95% CI: 1.45 - 9.83; p=0.006), male TRANS sex (OR: 2.74; 95% CI: 1.25 - 5.98; p=0.011) and increasing age TRANS (OR: 1.73; 95% CI: 1.13 - 2.63; p=0.011) were independently associated with higher inhospital mortality. Similar results were obtained for the outcomes of increasing oxygen requirement and intubation. Conclusions: In this cohort of hospitalized patients with COVID-19 in a minority-predominant population, severe obesity HP obesity MESHD, increasing age TRANS, and male TRANS sex were associated with higher in-hospital mortality and in general worse in-hospital outcomes.

    Virologic and clinical characteristics for prognosis of severe COVID-19: a retrospective observational study in Wuhan, China

    Authors: Sha Fu; Xiaoyu Fu; Yang Song; Min Li; Pin-hua Pan; Tao Tang; Chunhu Zhang; Tiejian Jiang; Deming Tan; Xuegong Fan; Xinping Sha; Jingdong Ma; Yan Huang; Shaling Li; Yixiang Zheng; Zhaoxin Qian; Zeng Xiong; Lizhi Xiao; Huibao Long; Jianghai Chen; Yi Ouyang

    doi:10.1101/2020.04.03.20051763 Date: 2020-04-06 Source: medRxiv

    Background: The severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) has progressed to a pandemic associated with substantial morbidity and mortality. The WHO and the United States Center for Disease Control and Prevention (CDC) have issued interim clinical guidance for management of patients with confirmed coronavirus disease MESHD (COVID-19), but there is limited data on the virologic and clinical characteristics for prognosis of severe COVID-19. Methods: A total of 50 patients with severe COVID-19 were divided into good and poor recovery groups. The dynamic viral shedding and serological characteristics of SARS-CoV-2 were explored. The risk factors associated with poor recovery and lung lesion MESHD resolutions were identified. In addition, the potential relationships among the viral shedding, the pro-inflammatory response, and lung lesion MESHD evolutions were characterized. Results: A total of 58% of the patients had poor recovery and were more likely to have a prolonged interval of viral shedding. The longest viral shedding was 57 days after symptom onset TRANS. Older age TRANS, hyperlipemia MESHD, hypoproteinemia HP hypoproteinemia MESHD, corticosteroid therapy, consolidation on chest computed-tomography (CT), and prolonged SARS-CoV-2 IgM positive were all associated with poor recovery. Additionally, the odds of impaired lung lesion MESHD resolutions were higher in patients with hypoproteinemia HP hypoproteinemia MESHD, hyperlipemia MESHD, and elevated levels of IL-4 and ferritin. Finally, viral shedding and proinflammatory responses were closely correlated with lung lesion MESHD evolutions on chest CT. Conclusions Patients with severe COVID-19 have prolonged SARS-CoV-2 infection MESHD and delayed intermittent viral shedding. Older age TRANS, hyperlipemia MESHD, hypoproteinemia HP hypoproteinemia MESHD, corticosteroid usage, and prolonged SARS-CoV-2 IgM positive might be utilized as predicative factors for the patients with poor recovery.

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MeSH Disease
Human Phenotype

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