Corpus overview


MeSH Disease

Human Phenotype

Pneumonia (131)

Fever (97)

Cough (75)

Severe infection (41)

Fatigue (31)


    displaying 41 - 50 records in total 797
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    Asymptomatic TRANS cases and limited transmission TRANS of SARS-CoV-2 in residents and healthcare workers in three Dutch nursing homes

    Authors: Laura W van Buul; Judith Henriette van den Besselaar; Fleur M.H.P.H. Koene; Bianca M. Buurman; Cees M.P.M. Hertogh; Kamalini Lokuge; Ali H Mokdad; Peter J. Hotez; Robin B. Gasser; Parveen Bahel; Kent Owusu; Yu Yamamoto; Tanima Arora; Deepak S. Atri; Amisha Patel; Rana Gbyli; Jennifer Kwan; Christine H. Won; Charles Dela Cruz; Christina Price; Jonathan Koff; Brett A. King; Henry M. Rinder; F. Perry Wilson; John Hwa; Stephanie Halene; William Damsky; David van Dijk; Alfred Ian Lee; Hyung Chun; Akhil Vaid; Guillermo Barturen; Scott R. Tyler; Hardik Shah; Yinh-chih Wang; Shwetha Hara Sridhar; Juan Soto; Swaroop Bose; Kent Madrid; Ethan Ellis; Elyze Merzier; Konstantinos Vlachos; Nataly Fishman; Manying Tin; Melissa Smith; Hui Xie; Manishkumar Patel; Kimberly Argueta; Jocelyn Harris; Neha Karekar; Craig Batchelor; Jose Lacunza; Mahlet Yishak; Kevin Tuballes; Leisha Scott; Arvind Kumar; Suraj Jaladanki; Ryan Thompson; Evan Clark; Bojan Losic; - The Mount Sinai COVID-19 Biobank Team; Jun Zhu; Wenhui Wang; Andrew Kasarskis; Benjamin S. Glicksberg; Girish Nadkarni; Dusan Bogunovic; Cordelia Elaiho; Sandeep Gangadharan; George Ofori-Amanfo; Kasey Alesso-Carra; Kenan Onel; Karen M. Wilson; Carmen Argmann; Marta E. Alarcón-Riquelme; Thomas U. Marron; Adeeb Rahman; Seunghee Kim-Schulze; Sacha Gnjatic; Bruce D. Gelb; Miriam Merad; Robert Sebra; Eric E. Schadt; Alexander W. Charney

    doi:10.1101/2020.08.31.20185033 Date: 2020-09-02 Source: medRxiv

    Purpose Many nursing homes worldwide have been hit by outbreaks of the new severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2). We aimed to assess the contribution of a- and presymptomatic residents and healthcare workers in transmission TRANS of SARS-CoV-2 in three nursing homes. Methods Two serial point- prevalence SERO surveys, 1 week apart, among residents and healthcare workers of three Dutch nursing homes with recent SARS-CoV-2 introduction MESHD. Nasopharyngeal and oropharyngeal testing for SARS-CoV-2, including reverse-transcriptase polymerase chain reaction (rRT-PCR) was conducted with reporting of cycle threshold (Ct). Participants were categorized as symptomatic, presymptomatic or asymptomatic TRANS with standardized symptom assessment. Results In total, 297 residents and 542 healthcare workers participated in the study. At the first point- prevalence SERO survey, 15 residents tested positive of which one was presymptomatic (Ct value>35) and three remained asymptomatic TRANS (Ct value of 23, 30 and 32). At the second point- prevalence SERO survey one resident and one healthcare worker tested SARS-CoV-2 positive (Ct value >35 and 24, respectively) and both remained asymptomatic TRANS. Conclusion This study confirms a- and presymptomatic occurrence of Covid-19 among residents and health care workers. Ct values below 25 suggested that these cases have the potential to contribute to viral spread. However, very limited transmission TRANS impeded the ability to answer the research question. We describe factors that may contribute to the prevention of transmission TRANS and argue that the necessity of large-scale preemptive testing in nursing homes may be dependent of the local situation regarding prevalence SERO of cases in the surrounding community and infection MESHD control opportunities.

    SARS-CoV-2 Viral RNA Load Dynamics in the Nasopharynx of Infected Children TRANS

    Authors: Kai-qian Kam; Koh Cheng Thoon; Matthias Maiwald; Chia Yin Chong; Han Yang Soong; Liat Hui Loo; Woon Hui Natalie Tan; Jiahui Li; Karen Donceras Nadua; Chee Fu Yung; Norbert Kaiser; Hannes Ganzer; Mathias Strohle; Andreas Walser; Dorothee von Laer; Lothar Hennighausen; Changqing Lin; Qinghua Hu; Tie Song; Ruifu Yang; Xiaoyu Zhang; Kai Sun; Pieter S. Hiemstra; Bruce A. Ponder; Mika J Makela; Kristiina Malmstrom; Robert C. Rintoul; Paul A. Reyfman; Fabian J. Theis; Corry-A Brandsma; Ian Adcock; Wim Timens; Cheng J. Xu; Maarten van den Berge; Roland F. Schwarz; Gerard H. Koppelman; Martijn C. Nawijn; Alen Faiz

    doi:10.1101/2020.08.31.20185488 Date: 2020-09-02 Source: medRxiv

    It is important to understand the temporal trend of pediatric severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) viral load to estimate the transmission TRANS potential of children TRANS in schools and communities. We determined differences in SARS-CoV-2 viral load dynamics between nasopharyngeal samples of infected asymptomatic TRANS and symptomatic children TRANS. The daily cycle threshold values of SARS-CoV-2 in the nasopharynx of a cohort of infected children TRANS were collected for analysis. Among 17 infected children TRANS, 10 (58.8%) were symptomatic. Symptomatic children TRANS, when compared to asymptomatic TRANS children TRANS, had higher viral load (mean cycle threshold on day 7 of illness 28.6 versus 36.7, p = 0.02). Peak SARS-CoV-2 viral loads occured around days 2-3 of illness/days of diagnosis in infected children TRANS. After adjusting for the estimated date of infection MESHD, the higher SARS-CoV-2 viral loads in symptomatic children TRANS remained. We postulate that symptomatic SARS-CoV-2-infected MESHD children TRANS may have higher transmissibility TRANS than asymptomatic TRANS children TRANS. As peak viral load in infected children TRANS occurred in the early stage of illness, viral shedding and transmission TRANS in the pre-symptomatic phase probable. Our study highlights the importance of screening for SARS-CoV-2 in children TRANS with epidemiological risk factors, even when they are asymptomatic TRANS in order to improve containment of the virus in the community, including educational settings.

    74 Days Dynamic Changes of Chest CT Images of Coronavirus Disease MESHD 2019 (COVID-19) in Hebei Province, China

    Authors: jianqin Liang; Guizeng Liu; Shuzhuang Yu; Yang Yang; Yanchun Li; Hongli Tian; Zhe Chen

    doi:10.21203/ Date: 2020-09-02 Source: ResearchSquare

    Background Since December 2019, the COVID-19 infection broke MESHD out in many parts of the world with confirmed and death MESHD cases rapidly increasing, which posed a great threat to human life and health. Current nucleic acid detection and antibody testing SERO for the SARS-CoV-2 were the main methods for diagnosis of COVID-19, but not so sensitive, with high false negative rate and missed diagnosis rate. Imaging changes of COVID-19 not only precede symptomatic changes, but also have different imaging characteristics in different periods. We conducted 74 days of dynamic chest CT imaging observation on COVID-19 patients in Hebei province, aiming to understand the dynamic characteristics of the chest CT changes of COVID-19, so as to find the source of infection early, take early intervention measures, and judge the prognosis. Methods Chest CT examinations at intervals 1 to 4 days were conducted for 11 patients with a diagnosis of COVID-19. On the 74th day after onset, chest CT was reexamined to analyze the characteristics of chest CT in each stage. Results Of the 11 cases, 1 case was imported from Wuhan, 10 cases were infected for family clustering after close contact TRANS with confirmed COVID-19 cases. There were 3 ordinary cases, 3 severe cases and 5 critical cases. Among them, 2 critical cases died for old age TRANS and complications of underlying diseases MESHD, while 9 cases were cured by April 7, 2020. The changes of chest CT imaging in 1 child TRANS appeared prior to the clinical symptoms. 1–4 days after onset of the initial symptom were the early stages: Chest CT was mainly characterized by single lung quasi-circular ground glass shadow and fine mesh shadow. 5–10 days were the progressive stages: The lesion spread along the axial interstitium of the bronchi and gradually diffused to the whole lung, and reach the peak on day 6 to 9, which was characterized by consolidation, paving stone sign, halo sign, reversed halo sign, and even ‘white lung’ for the critical patients. The recovery stages began on day 11 after onset: The fiber cord, ground glass and consolidation shadow were gradually absorbed. After 74 days of follow-up, no serious permanent lung injury MESHD was found. Conclusion Chest CT could determine the different stages of COVID-19. Dynamic follow-up chest CT showed a good prognosis of COVID-19 in Hebei Province, China

    Acute kidney injury HP kidney injury MESHD is associated with severe and fatal outcomes in patients with Coronavirus disease MESHD 2019 (COVID-19) infection: a systematic review and meta-analysis of observational studies

    Authors: Mohammad Parohan; Sajad Yaghoubi; Mahmoud Djalali; Asal Seraji; Mohammad Hassan Javanbakht; Zahra Mousavi

    doi:10.1101/2020.08.27.20183632 Date: 2020-09-01 Source: medRxiv

    Coronavirus disease MESHD 2019 (COVID-19) is a pandemic impacting 213 countries and territories with more than 17,918,582 cases worldwide. Kidney dysfunction MESHD has been reported to occur in severe and death MESHD cases. This meta-analysis was done to summarize available studies on the association between acute kidney injury HP kidney injury MESHD and severity of COVID-19 infection MESHD. Online databases including Web of Science, PubMed/Medline, Cochrane Library, Scopus and Google Scholar were searched to detect relevant articles up to 1 July 2020, using relevant keywords. To pool data, a random- or fixed-effects model was used based on the heterogeneity between studies. In total, 50 studies with 8,180 COVID-19 confirmed cases TRANS (severe cases=1,823 and death MESHD cases=775), were included in this meta-analysis. Higher serum SERO levels of creatinine (weighted mean difference ( WMD MESHD) for disease severity=5.47 mol/L, 95% CI=2.89 to 8.05, P<0.001 and WMD for mortality=18.32 mol/L, 95% CI=12.88 to 23.75, P<0.001), blood SERO urea nitrogen (BUN) ( WMD MESHD for disease severity=1.10 mmol/L, 95% CI=0.67 to 1.54, P<0.001 and WMD for mortality=3.56 mmol/L, 95% CI=2.65 to 4.48, P<0.001) and lower levels of estimated glomerular filtration rate (eGFR) ( WMD MESHD for disease severity=-15.34 mL/min/1.73 m2, 95% CI=-18.46 to -12.22, P<0.001 and WMD for mortality=-22.74 mL/min/1.73 m2, 95% CI=-27.18 to -18.31, P<0.001) were associated with a significant increase in the severity and mortality of COVID-19 infection MESHD. Acute kidney injury HP kidney injury MESHD, as assessed by kidney biomarkers ( serum SERO creatinine, BUN and eGFR), was associated with severe outcome and death MESHD from COVID-19 infection MESHD.

    Analyzing inherent biases in SARS-CoV-2 PCR and serological epidemiologic metrics

    Authors: Monia Makhoul; Farah Abou-Hijleh; Shaheen Seedat; Ghina R Mumtaz; Hiam Chemaitelly; Houssein Ayoub; Laith J. Abu-Raddad

    doi:10.21203/ Date: 2020-09-01 Source: ResearchSquare

    Background Prospective observational data show that infected persons with the severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) remain polymerase chain reaction (PCR) positive for a prolonged duration, and that detectable antibodies SERO develop slowly with time. We aimed to analyze how these effects can bias key epidemiological metrics used to track and monitor SARS-CoV-2 epidemics.Methods An age TRANS-structured mathematical model was constructed to simulate progression of SARS-CoV-2 epidemics in populations. PCR testing to diagnose infection MESHD and cross-sectional surveys to measure seroprevalence SERO were also simulated. Analyses were conducted on simulated outcomes assuming a natural epidemic time course and an epidemic in presence of interventions.Results The prolonged PCR positivity biased the epidemiological measures. There was a lag of 10 days between the true epidemic peak and the actually-observed peak. Prior to epidemic peak, PCR positivity rate was 2-fold higher than that based only on current active infection MESHD, and half of those tested positive by PCR were in the prolonged PCR positivity stage after infection clearance. Post epidemic peak, PCR positivity rate poorly predicted true trend in active infection MESHD. Meanwhile, the prolonged PCR positivity did not appreciably bias estimation of the basic reproduction number TRANS R0 TRANS. The time delay in development of detectable antibodies SERO biased measured seroprevalence SERO. The actually-observed seroprevalence SERO substantially underestimated true prevalence SERO of ever infection MESHD, with the underestimation being most pronounced around epidemic peak.Conclusions Caution is warranted in interpreting PCR and serological testing SERO data, and any drawn inferences need to factor the effects of the investigated biases for an accurate assessment of epidemic dynamics.

    Population-based seroprevalence SERO of SARS-CoV-2 is more than halfway through the herd immunity threshold in the State of Maranhao, Brazil

    Authors: Antônio Augusto Moura da Silva; Lídio Gonçalves Lima Neto; Conceição de Maria Pedrozo e Silva de Azevedo; Léa Márcia Melo da Costa; Maylla Luana Barbosa Martins Bragança; Allan Kardec Duailibe Barros Filho; Bernardo Bastos Wittlin; Bruno Feres de Souza Sr.; Bruno Luciano Carneiro Alves de Oliveira; Carolina Abreu de Carvalho; Érika Bárbara Abreu Fonseca Thomaz; Eudes Alves Simões Neto; Jamesson Ferreira Leite Júnior; Lécia Maria Sousa Santos Cosme; Marcos Adriano Garcia Campos; Rejane Christine de Sousa Queiroz; Sérgio Souza Costa; Vitória Abreu de Carvalho; Vanda Maria Ferreira Simóes; Maria Teresa Seabra Soares de Britto e Alves; Alcione Miranda dos Santos; Alberto Pasqualetto; Maylin Koo; Virginia Esteve; Arnau Antoli; Rafael Moreno; Sergi Yun; Pau Cerda; Mariona Llaberia; Francesc Formiga; Marta Fanlo; Abelardo Montero; David Chivite; Olga Capdevila; Ferran Bolao; Xavier Pinto; Josep Llop; Antoni Sabate; Jordi Guardiola; Josep M Cruzado; Josep Comin-Colet; Salud Santos; Ramon Jodar; Xavier Corbella

    doi:10.1101/2020.08.28.20180463 Date: 2020-09-01 Source: medRxiv

    Background: Few population-based studies on the prevalence SERO of severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) have been performed to date, and most of them have used lateral flow immunoassays SERO with finger-prick, which may yield false-negative results and thus underestimate the true infection rate. Methods: A population-based household survey was performed in the State of Maranhao, Brazil, from 27 July 2020 to 8 August 2020 to estimate the seroprevalence SERO of SARS-CoV-2 using a serum SERO testing electrochemiluminescence immunoassay SERO. A three-stage cluster sampling stratified by four state regions was used. The estimates took clustering, stratification, and non-response into account. Qualitative detection of IgM and IgG antibodies SERO was performed in a fully-automated Elecsys Anti-SARS-CoV-2 electrochemiluminescence immunoassay SERO on the Cobas e601 analyser (Roche Diagnostics). Findings: A total of 3156 individuals were interviewed. Seroprevalence SERO of total antibodies SERO against SARS-CoV-2 was 40.4% (95%CI 35.6-45.3). Population adherence to non-pharmaceutical interventions was higher at the beginning of the pandemic than in the last month. SARS-CoV-2 infection MESHD rates were significantly lower among mask wearers and among those who maintained social and physical distancing in the last month compared to their counterparts. Among the infected, 62.2% had more than three symptoms, 11.1% had one or two symptoms, and 26.0% were asymptomatic TRANS. The infection MESHD fatality rate was 0.17%, higher for males TRANS and advanced age groups TRANS. The ratio of estimated infections MESHD to reported cases was 22.2. Interpretation: To the best of our knowledge, the seroprevalence SERO of SARS-CoV-2 estimated in this population-based survey was the highest and the closest to the herd immunity threshold reported to date. Our results suggest that the herd immunity threshold is not as low as 20%, but at least higher than or equal to around 40%. The infection MESHD fatality rate was one of the lowest reported so far, and the proportion of asymptomatic TRANS cases was low.

    Risk factors for SARS-CoV-2 infection MESHD, hospitalisation, and death in Catalonia MESHD, Spain: a population-based cross-sectional study

    Authors: Judit Villar-Garcia; Rosa Maria Vivanco-Hidalgo; Montserrat Cleries; Elisenda Martinez; David Monterde; Pol Perez-Sust; Luis Garcia-Eroles; Carol Sais; Montserrat Moharra; Emili Vela; Jochen Lennerz; Hetal Desai Marble; Lauren L. Ritterhouse; Julie Batten; N. Zeke Georgantas; Rebecca Pellerin; Sylvia Signorelli; Julia Thierauf; Molly Kemball; Christian Happi; Donald S. Grant; Daouda Ndiaye; Katherine J. Siddle; Samar B Mehta; Jason B. Harris; Edward T Ryan; Virginia M. Pierce; Regina C LaRocque; Jacob Lemieux; Pardis Sabeti; Eric Rosenberg; John Branda; Sarah E Turbett; Gail Carson; Malcolm G Semple; Janet T Scott

    doi:10.1101/2020.08.26.20182303 Date: 2020-09-01 Source: medRxiv

    OBJECTIVE To identify the different subpopulations that are susceptible for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD and hospitalisation or death MESHD due to coronavirus disease MESHD 2019 (COVID-19) in Catalonia, Spain. DESIGN Cross-sectional study. SETTING Data collected from the Catalan Health Surveillance System (CatSalut) in Catalonia, a region of Spain. PARTICIPANTS Using data collected between 1 March and 1 June 2020, we conducted the following comparative analyses: people infected by SARS-CoV-2 (328 892) vs Catalonia's entire population (7 699 568); COVID-19 cases who required hospitalisation (37 638) vs cases who did not require hospitalisation (291 254); and COVID-19 cases who died during the study period vs cases who did not die during the study period (12 287). MAIN OUTCOME MEASURES Three clinical outcomes related to COVID-19 ( infection MESHD, hospitalisation, or death MESHD). We analysed sociodemographic and environment variables (such as residing in a nursing home) and the presence of previous comorbidities. RESULTS A total of 328 892 cases were considered to be infected with SARS-CoV-2 (4.27% of total population). The main risk factors for the diagnostic were: female TRANS gender TRANS (risk ratio [RR] =1.49; 95% confidence interval [95% CI] =1.48-1.50), age TRANS (45-64 years old; RR=1.02; 95% CI=1.01-1.03), high comorbidity burden (GMA index) (RR=3.03; 95% CI=2.97-3.09), reside in a nursing home (RR=11.82; 95% CI=11.66-11.99), and smoking (RR=1.06; 95% CI=1.05-1.07). During the study period, there were 37 638 (11.4 %) hospitalisations due to COVID-19, and the risk factors were: male TRANS gender TRANS (RR=1.45; 95% CI=1.43-1.48), age TRANS > 65 (RR=2.38; 95% CI=2.28-2.48), very low individual income (RR=1.03; 95% CI=0.97-1.08), and high burden of comorbidities (GMA index) (RR=5.15; 95% CI=4.89-5.42). The individual comorbidities with higher burden were obesity HP obesity MESHD (RR=1.23; 95% CI=1.20-1.25), chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD (RR=1.19; 95% CI=1.15-1.22), heart failure MESHD (RR=1.19; 95% CI=1.16-1.22), diabetes mellitus HP diabetes mellitus MESHD (RR=1.07; 95% CI=1.04-1.10), and neuro-psychiatric MESHD comorbidities (RR=1.06; 95% CI=1.03-1.10). A total of 12 287 deaths (3.73%) were attributed to COVID-19, and the main risk factors were: male TRANS gender TRANS (RR=1.73; 95% CI=1.67-1.81), age TRANS > 65 (RR=37.45; 95% CI=29.23-47.93), residing in a nursing home (RR=9.22; 95% CI=8.81-9.65), and high burden of comorbidities (GMA index) (RR=5.25; 95% CI=4.60-6.00). The individual comorbidities with higher burden were: heart failure MESHD (RR=1.21; 95% CI=1.16-1.22), chronic kidney disease HP chronic kidney disease MESHD (RR=1.17; 95% CI=1.13-1.22), and diabetes mellitus HP diabetes mellitus MESHD (RR=1.10; 95% CI=1.06-1.14). These results did not change significantly when we considered only PCR-positive patients. CONCLUSIONS Female TRANS gender TRANS, age TRANS between 45 to 64 years old, high burden of comorbidities, and factors related to environment (nursing home) play a relevant role in SARS-CoV-2 infection MESHD and transmission TRANS. In addition, we found risk factors for hospitalisation and death MESHD due to COVID-19 that had not been described to date, including comorbidity burden, neuro-psychiatric disorders MESHD, and very low individual income. This study supports interventions for transmission TRANS control beyond stratify-and-shield strategies focused only on protecting those at risk of death. Future COVID-19 studies should examine the role of gender TRANS, the burden of comorbidities, and socioeconomic status in disease transmission TRANS, and should determine its relationship to workplaces, especially healthcare centres and nursing homes.

    Towards a digital solution: Predicting public take-up of Singapore's contact tracing TRANS application during the COVID-19 crisis

    Authors: Young Ern Saw; Edina Y-Q Tan; Jessica S Liu; Jean CJ Liu; Jianmei Liu; Yuhang Pan; Tanakao Takana; Peiyu Xie; Zhaoguang Wang; Shuocen Liu; George Fu Gao; Guojun He; Maigeng Zhou

    doi:10.1101/2020.08.26.20182386 Date: 2020-09-01 Source: medRxiv

    In the global outbreak of coronavirus disease MESHD 2019 (COVID-19), new digital solutions have been developed for infection MESHD control. In particular, contact tracing TRANS mobile applications provide a means for governments to manage both health and economic concerns. As public reception is paramount to success, we conducted a systematic examination of socio-demographic characteristics that predict downloads of a contact tracing TRANS application. Participants were 505 adults TRANS who completed a web-based survey in Singapore, the site of the first contact tracing TRANS application (TraceTogether). We found that persons who had already changed their lifestyles on account of the pandemic were more likely to download the application. Network analyses revealed that contact tracing TRANS downloads was associated with using hand sanitizers, avoiding public transport, and preferring outdoor over indoor venues during the pandemic. However, demographic and situational characteristics were not significant predictors of application downloads. Together, these findings provide a base for policy makers to promote the uptake of digital contact tracing TRANS.

    The Potential Role of Extracellular Vesicles in COVID-19 Associated Endothelial injury and Pro-inflammation MESHD

    Authors: Balaji Krishnamachary; Christine Cook; Leslie Spikes; Prabhakar Chalise; Navneet K Dhillon; Yuhang Pan; Tanakao Takana; Peiyu Xie; Zhaoguang Wang; Shuocen Liu; George Fu Gao; Guojun He; Maigeng Zhou

    doi:10.1101/2020.08.27.20182808 Date: 2020-09-01 Source: medRxiv

    COVID-19 infection caused by the novel severe acute respiratory syndrome coronavirus-2 MESHD (SARS-CoV-2) has resulted in a global pandemic with the number of deaths growing exponentially. Early evidence points to significant endothelial dysfunction, micro-thromboses, pro- inflammation MESHD as well as a dysregulated immune response in the pathogenesis of this disease. In this study, we analyzed the cargo of EVs isolated from the plasma SERO of patients with COVID-19 for the identification of potential biomarkers of disease severity and to explore their role in disease pathogenesis. Plasma SERO-derived EVs were isolated from 53 hospitalized patients with COVID infection MESHD and compared according to the severity of the disease. Analysis of inflammatory and cardiovascular protein cargo of large EVs revealed significantly differentially expressed proteins for each disease sub-group. Notably, members of the TNF superfamily and IL-6 family were up-regulated in patients on oxygen support with severe and moderate disease. EVs from the severe group were also enhanced with pro- thrombotic MESHD/endothelial injury factors (TF, t-PA, vWF) and proteins associated with cardiovascular pathology (MB, PRSS8, REN, HGF). Significantly higher levels of TF, CD163, and EN-RAGE were observed in EVs from severe patients when compared to patients with a moderate disease requiring supplemental O2. Importantly, we also observed increased caspase 3/7 activity and decreased cell survival in human pulmonary microvascular endothelial cells exposed to EVs from the plasma SERO of patients with severe disease compared to healthy controls. In conclusion, our findings indicate alterations in pro-inflammatory, coagulopathy MESHD, and endothelial injury MESHD protein cargo in large EVs in response to SARS-CoV-2 infection MESHD that may be a causative agent in severe illness.

    Bronchoscopy on Intubated COVID-19 Patients is Associated with Low Infectious Risk to Operators at a High-Volume Center Using an Aerosol-minimizing Protocol

    Authors: Catherine A. Gao; Joseph Isaac Bailey; James M. Walter; John M. Coleman III; Elizabeth S. Malsin; A. Christine Argento; Michelle H. Prickett; - NU COVID Investigators; Richard G. Wunderink; Sean B. Smith; Samira Mubareka; Allison McGeer; Adrienne K Chan; Anne-Claude Gingras; Tania H Watts; Mario Ostrowski; Elisabet Leiva; Albert Ariza-Sole; Paolo D Dallaglio; Maria Quero; Antonio Soriano; Alberto Pasqualetto; Maylin Koo; Virginia Esteve; Arnau Antoli; Rafael Moreno; Sergi Yun; Pau Cerda; Mariona Llaberia; Francesc Formiga; Marta Fanlo; Abelardo Montero; David Chivite; Olga Capdevila; Ferran Bolao; Xavier Pinto; Josep Llop; Antoni Sabate; Jordi Guardiola; Josep M Cruzado; Josep Comin-Colet; Salud Santos; Ramon Jodar; Xavier Corbella

    doi:10.1101/2020.08.30.20177543 Date: 2020-09-01 Source: medRxiv

    Background: The coronavirus disease MESHD 2019 (COVID-19) pandemic raised concern for exposure to healthcare providers through aerosol generating procedures, such as bronchoalveolar lavage (BAL). Current society guidelines recommended limiting use of BAL to reduce operators' risk for infection TRANS risk for infection TRANS infection MESHD, yet data on the infection rate for providers after BAL is sparse. Since March 2020, our institution used a modified protocol to perform over 450 BALs on intubated COVID-19 patients. We therefore sought to describe the subsequent infectious risks to providers associated with BAL. Methods: Fifty-two pulmonary and critical care providers (faculty and fellows) at our tertiary-care, urban medical center were surveyed. Survey participants were asked to provide the number of BALs on COVID-19 patients they performed, the number of weeks they cared for intensive care unit (ICU) patients with COVID-19, and the results of any SARS-CoV-2 testing that they received. Participants were asked to assess the difficulty of BAL on intubated COVID-19 patients as compared to routine ICU BAL using a numeric perceived difficulty score ranging from 1 (easier) to 10 (harder). Results: We received forty-seven responses from fifty-two surveyed (90% response rate), with 2 declining to participate. Many respondents (19/45, 42%) spent >5 weeks on an ICU service with COVID-19 patients. The number of BALs performed by providers ranged from 0 to >60. Sixteen of the 35 providers (46%) who performed BALs underwent at least one nasopharyngeal (NP) swab to test for SARS-CoV-2, but none were positive. Twenty-seven of the 35 providers (77%) who performed BALs underwent SARS-CoV-2 serology testing, and only one (3.7%) was positive. Respondents indicated occasionally not being able to follow aerosol-minimizing steps but overall felt BALs in COVID-19 patients was only slightly more difficult than routine ICU BAL. Discussion: At a high-volume center having performed >450 BALs on intubated COVID-19 patients with aerosol-limiting precautions, our survey of bronchoscopists found no positive NP SARS-CoV-2 tests and only one positive antibody test SERO result. While the optimal role for COVID-19 BAL remains to be determined, these data suggest that BAL can be safely performed in intubated COVID-19 patients if experienced providers take precautions to limit aerosol generation and wear personal protective equipment.

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MeSH Disease
Human Phenotype

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