Corpus overview


MeSH Disease

Human Phenotype


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    Heart disease MESHD mortality during the early pandemic period in the United States.

    Authors: Jeremy Samuel Faust; Zhenqiu Lin; Kalen N. Wright; Michael A Di Iorio; Carrie D Walsh; Harlan Krumholz; Tommaso Fontana; Hannah Blau; Nicolas Matentzoglu; Nomi L Harris; Monica C Munoz-Torres; Peter N Robinson; Marcin P Joachimiak; Christopher J Mungall; Bryn Taylor; Pedro Belda-Ferre; Chenguang Liang; Yujie Zhang; Luca Schifanella; Nichole R. Klatt; Aki S. Havulinna; Pekka Jousilahti; Shi Huang; Niina Haiminen; Laxmi Parida; Ho-Cheol Kim; Austin D. Swafford; Karsten Zengler; Susan Cheng; Michael Inouye; Teemu Niiranen; Mohit Jain; Veikko Salomaa; Jeffrey D. Esko; Nathan E Lewis; Rob Knight

    doi:10.1101/2020.08.16.20175406 Date: 2020-08-18 Source: medRxiv

    Importance: The coronavirus disease MESHD 2019 (COVID-19) outbreak has been associated with decreases in acute myocardial infarction MESHD myocardial infarction HP diagnoses (AMI) and admissions in the United States. Whether this affected heart disease deaths MESHD is unknown. Objective: To determine whether changes in heart disease deaths MESHD occurred during the early pandemic period in the US, we analyzed areas without large COVID-19 outbreaks. This isolated the effect of decreased healthcare-seeking behavior during the early outbreak. Design, Setting, and Participants: We performed an observational study of heart disease MESHD-specific mortality using National Center for Health Statistics data (NCHS). Weekly provisional counts were disaggregated by jurisdiction of occurrence during 2019 and 2020 for all-cause deaths MESHD, COVID-19 deaths, and heart disease deaths MESHD. For the primary analysis, jurisdictions were included if; 1) There was no all-cause excess mortality during the early pandemic period (weeks 14-17, 2020); 2) The completeness of that data was estimated by NCHS to be >97% as of July 22, 2020, and; 3) Decreases in emergency department (ED) visits occurred during the study period. We compared heart disease death MESHD rates during the early pandemic period with corresponding weeks in 2019 and a pre-pandemic control period of 2020 as a sensitivity SERO analysis. Incident rate and rate ratios were calculated. Exposure: The US COVID-19 outbreak. Main Outcomes and Measures: Incidence of heart disease deaths MESHD. Results: Twelve states met the primary inclusion criteria, capturing 747,375,188 person-weeks for the early pandemic period and 740,987,984 person-weeks for the 2019 control period. The mean incidence rate (per 100,000 person-weeks) for heart disease MESHD in states without excess deaths during the early pandemic period was 3.95 (95% CI 3.83 to 4.06) versus 4.19 (95% CI 4.14 to 4.23) during the corresponding period in 2019. The incident rate ratio (2020/2019) was 0.91 (95% CI 0.87 to 0.97). No state recorded an increase from either the corresponding period in 2019 or the 2020 pre-pandemic control period. Two states recorded fewer heart disease deaths MESHD. Conclusions and Relevance: This observational study found a decrease in heart disease deaths MESHD during the early US outbreak in regions without significant COVID-19 burdens, despite decreases in ED utilization. Long term follow-up data are needed.

    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 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 HP Hypertension MESHD (55%), diabetes mellitus HP diabetes mellitus MESHD (31%), and chronic pulmonary disease MESHD (15%) were the most common comorbidities present. There were 18 deaths (27.3%) in the tocilizumab group and 18 deaths (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 HP myocardial infarction MESHD, dementia HP dementia MESHD, chronic pulmonary disease MESHD, heart failure MESHD, and malignancy MESHD 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.

    The Outcome of COVID-19 Patients with Acute Myocardial Infarction MESHD Myocardial Infarction HP

    Authors: Hassan Altamimi; Yasser Alahmad; Fadi Khazal; Mowahib Elhassan; Hajar AlBinali; Abdulrahman Arabi; Awad AlQahtani; Nidal Asaad; Mohammed Al-Hijji; Tahir Hamid; Ihsan Rafie; Ali S. Omrani; Saad AlKaabi; Abdullatif Alkhal; Muna AlMalslmani; Mohammed Ali; Murad Alkhani; Mariam AlNesf; Salem Abu Jalala; Salaheddine Arafa; Reem ElSousy; Omar AlTamimi; Ezzeldine Soaly; Charbel Abi khalil; Jassim Al Suwaidi

    doi:10.1101/2020.07.21.20156349 Date: 2020-07-27 Source: medRxiv

    Background Coronavirus Disease MESHD 2019 (COVID-19) is a rapidly expanding global pandemic resulting in significant morbidity and mortality. COVID-19 patients may present with acute myocardial infarction MESHD myocardial infarction HP ( AMI MESHD). The aim of this study is to conduct detailed analysis on patients with AMI MESHD and COVID-19. Methods We included all patients admitted with AMI MESHD and actively known or found to be COVID-19 positive by PCR between the 4th February 2020 and the 11th June 2020 in the State of Qatar. Patients were divided into ST-elevation myocardial infarction HP myocardial infarction MESHD (STEMI) and Non-STE (NSTEMI). Results There were 68 patients (67 men and 1 woman) admitted between the 4th of February 2020 and the 11th of June 2020 with AMI MESHD and COVID-19. The mean age TRANS was 49.1, 46 patients had STEMI and 22 had NSTEMI. 38% had diabetes mellitus HP diabetes mellitus MESHD, 31% had hypertension HP hypertension MESHD, 16% were smokers, 13% had dyslipidemia MESHD, and 14.7% had prior cardiovascular disease MESHD. Chest pain HP Chest pain MESHD and dyspnea HP dyspnea MESHD were the presenting symptoms in 90% and 12% of patients respectively. Fever HP Fever MESHD (15%) and cough HP cough MESHD (15%) were the most common COVID-19 symptoms, while the majority had no viral symptoms. Thirty-nine (33 STEMI and 6 NSTEMI) patients underwent coronary angiography, 38 of them had significant coronary disease MESHD. Overall in-hospital MACE was low; 1 patient developed stroke HP stroke MESHD and 2 died. Conclusion Contrary to previous small reports, overall in-hospital adverse events were low in this largest cohort of COVID-19 patients presenting with AMI MESHD. We hypothesize patient profile including younger age TRANS contributed to these findings. Further studies are required to confirm this observation.

    The Impact of the COVID-19 Pandemic on the Emergency Department Visits: A Retrospective Analysis in Shanghai, China

    Authors: Wei Long; Jiudong Hu; Lijuan Li; Sheng Zuo; Qian Yang; Zenghua Ren

    doi:10.21203/ Date: 2020-07-27 Source: ResearchSquare

    BackgroundThe novel coronavirus diseases MESHD (COVID-19) has led to a pandemic and affected people's lives greatly, including their health seeking behavior. We aimed to evaluate the impact of the current COVID-19 pandemic on characteristics and trends of emergency department (ED) visits in Shanghai, China.MethodsThis was a retrospective observational study using medical record databases from the Shanghai Sixth People's Hospital (East Campus) for years 2016 through 2020. All the patients referred to the ED between January 2016 and June 2020 were retrospectively reviewed. January 1, 2020, was chosen as the cutoff date for the statistical analysis and data of January and February in 2020 was compared with the same period of 2019.ResultsDuring the first two months of 2020, there was a 60.9% decline in ED visits when compared with the same period of 2019 (9,904 vs. 25,316, respectively), and the waiting time in ED has been greatly reduced correspondingly (12±4 vs. 66±19 min, p < 0.001); ED visits for acute ischemic stroke MESHD ischemic stroke HP ( AIS MESHD) and acute coronary syndrome MESHD(ACS) decreased by 53.9% and 41.2% respectively; proportion of intravenous thrombolysis for AIS MESHD has dropped(42.1% vs. 11.4%, p = 0.003), and percutaneous coronary intervention for ACS was similar (70.6% vs. 63.3%, p = 0.668); and onset-to-door time (ODT) of these patients increased significantly ( AIS MESHD: 217(136-374) vs. 378(260-510)min, ACS: 135(85-195) vs. 226(155-368)min, all p < 0.001).ConclusionThe outbreak of COVID-19 pandemic was correlated with a significant decline in the number of ED visits including AIS MESHD and ACS patients when compared to the pre-COVID-19 period. ODT of AIS MESHD and ACS patients increased significantly. Raising public awareness is necessary to avoid serious healthcare and economic consequences of undiagnosed and untreated stroke HP stroke MESHD and myocardial infarction HP myocardial infarction MESHD attack.

    Estimating the proportion of coronavirus disease MESHD 2019 (COVID-19) cases among households in France : a cross-sectional study on individuals with myocardial infarction HP myocardial infarction MESHD history

    Authors: Laurie Fraticelli; Julie Freyssenge; Clement Claustre; Mikael Martinez; Abdesslam Redjaline; Patrice Serre; Thomas Bochaton; Carlos El Khoury; - the RESCUe-RESUVal team

    doi:10.1101/2020.06.19.20135418 Date: 2020-06-20 Source: medRxiv

    Background: Previous studies have identified that adults TRANS with cardiovascular diseases MESHD were disproportionately associated with a significantly increased risk of a severe form of COVID-19 and all-cause mortality. We aimed to describe the diagnosed COVID-19 cases and to estimate the symptomatic and asymptomatic TRANS suspected cases among individuals with pre-existing myocardial infarction HP myocardial infarction MESHD myocardial infarction HP and their relatives in lockdown period. Methods: We conducted a two-week cross-sectional telephone survey, from May 4 to May 15, 2020, including all households with at least one individual with pre-existing cardiovascular disease MESHD in the past two years. We defined a suspected COVID-19 case when living with at least one individual tested positive to COVID-19, or when an individual has been in contact with a suspected or confirmed case TRANS since the March 1rst, or when a relative from the same house has been hospitalized or deceased for COVID-19. Results: We observed high rates of compliance with health measures during the lockdown period, regardless of age TRANS or risk factors. Among individuals with myocardial infarction HP myocardial infarction MESHD history, two were COVID-19 confirmed, 13.37% were suspected (94/703) of whom 70.21% (66/94) asymptomatic TRANS. Conclusions: Individuals with myocardial infarction HP myocardial infarction MESHD history presented different symptoms association with more respiratory signs. This population, which is older and associated with more comorbidities, is exposed to a high risk of complication in the event of contamination. Infection rates are relevant to adjusting the management of emergency departments in our region.

    Greater risk of severe COVID-19 in non-White ethnicities is not explained by cardiometabolic, socioeconomic, or behavioural factors, or by 25(OH)-vitamin D status: study of 1,326 cases from the UK Biobank

    Authors: Zahra Raisi-Estabragh; Celeste McCracken; Mae S Bethell; Jackie Cooper; Cyrus Cooper; Mark J Caulfield; Patricia B Munroe; Nicholas C Harvey; Steffen E Petersen

    doi:10.1101/2020.06.01.20118943 Date: 2020-06-02 Source: medRxiv

    Background We examined whether the greater severity of coronavirus disease MESHD 2019 (COVID-19) amongst men and non-White ethnicities is explained by cardiometabolic, socio-economic, or behavioural factors. Methods We studied 4,510 UK Biobank participants tested for COVID-19 (positive, n=1,326). Multivariate logistic regression models including age TRANS, sex, and ethnicity were used to test whether addition of: 1)cardiometabolic factors ( diabetes MESHD, hypertension HP hypertension MESHD, high cholesterol, prior myocardial infarction HP myocardial infarction MESHD, smoking, BMI); 2)25(OH)-vitamin D; 3)poor diet; 4)Townsend deprivation score; 5)housing (home type, overcrowding); or 6)behavioural factors (sociability, risk taking HP) attenuated sex/ethnicity associations with COVID-19 status. Results There was over-representation of men and non-White ethnicities in the COVID-19 positive group. Non-Whites had, on average, poorer cardiometabolic profile, lower 25(OH)-vitamin D, greater material deprivation, and were more likely to live in larger households and flats/apartments. Male TRANS sex, non-White ethnicity, higher BMI, Townsend deprivation score, and household overcrowding were independently associated with significantly greater odds of COVID-19. The pattern of association was consistent for men and women; cardiometabolic, socio-demographic and behavioural factors did not attenuate sex/ethnicity associations. Conclusions Sex and ethnicity differential pattern of COVID-19 is not adequately explained by variations in cardiometabolic factors, 25(OH)-vitamin D levels, or socio-economic factors. Investigation of alternative biological pathways and different genetic susceptibilities is warranted.

    Decline of emergency admissions for cardiovascular and cerebrovascular events after the outbreak of COVID-19

    Authors: Viktoria Schwarz; Felix Mahfoud; Lucas Lauder; Wolfgang Reith; Stefanie Behnke; Sigrun Smola; Jürgen Rissland; Thorsten Pfuhl; Bruno Scheller; Michael Böhm; Sebastian Ewen

    doi:10.21203/ Date: 2020-05-19 Source: ResearchSquare

    Background The spread of the novel coronavirus SARS-CoV-2 and the guidance from authorities for social distancing and media reporting lead to significant uncertainty in Germany. As concerns have been expressed regarding the underdiagnosing of harmful diseases. We explored the rates of emergency presentations for acute coronary syndrome MESHD ( ACS MESHD) and acute cerebrovascular events (ACVE) before and after spread of SARS-CoV-2. Methods We analyzed all-cause visits at a tertiary university emergency department and admissions for ACS MESHD and ACVE before (calendar weeks 1 to 9, 2020) and after (calendar weeks 10 to 16, 2020) the first coronavirus disease MESHD (COVID-19) case in the region of the Saarland, Germany. The data were compared with the same period of the previous year. Results In 2020 an average of 346 patients per week presented at the emergency department whereas in 2019 an average of 400 patients presented up to calendar week 16 (p=0.018; whole year 2019 = 395 patients per week). After the first COVID-19 diagnosis in the region, emergency department visit volume decreased by 30% compared with the same period in 2019 (p=0.0012). Admissions due to ACS MESHD decreased by 41% (p=0.0023 for all; Δ -71% (p=0.007) for unstable angina MESHD, Δ -25% (p=0.42) for myocardial infarction HP myocardial infarction MESHD with ST-elevation and Δ -17% (p=0.28) without ST-elevation) compared with the same period in 2019 and decreased from 142 patients in calendar weeks 1 to 9 to 62 patients in calendar weeks 10 to 16. ACVE decreased numerically by 20% (p=0.25 for all; transient ischemic attack HP ischemic MESHD attack: Δ -32% (p=0.18), ischemic stroke HP ischemic stroke MESHD: Δ -23% (p=0.48), intracerebral haemorrhage MESHD: Δ +57% (p=0.4)). There was no significant change in ACVE per week (p=0.7) comparing calendar weeks 1 to 9 (213 patients) and weeks 10 to 16 (147 patients). Testing of 3756 samples was performed to detect 58 SARS-CoV-2 positive patients ( prevalence SERO 1,54%, thereof one patient with myocardial and two with cerebral ischemia HP cerebral ischemia MESHD) up to calendar week 16 in 2020. Conclusions The COVID-19 pandemic was associated with a significant decrease in all-cause admission and admissions due to cardiovascular events MESHD in the emergency department. Regarding acute cerebrovascular events there was a numerical decrease but no significant difference.

    Decline in Emergent and Urgent Care during the COVID-19 Pandemic

    Authors: Dhruv S Kazi; Rishi K Wadhera; Changyu Shen; Kalon K.L. Ho; Rushad Patell; Magdy H. Selim; John H. Urwin; Mark L. Zeidel; Peter Zimetbaum; Kevin Tabb; Robert W. Yeh

    doi:10.1101/2020.05.14.20096602 Date: 2020-05-18 Source: medRxiv

    Due to the ongoing coronavirus disease MESHD (COVID-19) pandemic, there are concerns that patients may be avoiding care for emergent and urgent health conditions due to fear of contagion or as an unintentional consequence of government orders to postpone non-essential services. We therefore sought to evaluate the effect of the COVID-19 pandemic on the number of patient encounters for select emergent or urgent diagnoses at a large tertiary-care academic medical center in Boston. Inpatient diagnoses included acute myocardial infarction HP myocardial infarction MESHD ( MI MESHD) and stroke HP stroke MESHD, and outpatient but urgent diagnoses included new referrals for breast and hematologic malignancies MESHD. For each condition, we used a difference-in-differences approach to estimate the proportional change in number of encounters during the pandemic (March-April 2020) compared with earlier in the same year (January-February 2020), using equivalent periods in 2019 as a control. After the onset of the pandemic, we observed significant reductions in hospitalizations for MI MESHD (difference-in-differences estimate, 0.67; 95%CI, 0.46-0.96; P=0.04) and stroke HP stroke MESHD (difference-in-differences estimate, 0.42; 95%CI, 0.28-0.65; P<0.001) (Table). In the ambulatory setting, there was a reduction in referrals for breast cancer MESHD and hematologic cancers MESHD, but this did not reach statistical significance until the month after the onset of the pandemic. Our findings suggest an urgent need for public health messaging to ensure that patients continue to seek care for acute emergencies MESHD. In addition, decisions by health systems regarding when to reinitiate non-emergent care should carefully factor in the harms of delayed diagnosis and treatment occurring during the COVID-19 pandemic.


    Authors: Zahra Raisi-Estabragh; Celeste McCracken; Maddalena Ardissino; Mae S Bethell; Jackie Cooper; Cyrus Cooper; Nicholas C Harvey; Steffen E Petersen

    doi:10.1101/2020.05.10.20096925 Date: 2020-05-15 Source: medRxiv

    Background: Cardiometabolic morbidity and medications, specifically Angiotensin Converting Enzyme inhibitors (ACEi) and Angiotensin Receptor Blockers (ARBs), have been linked with adverse outcomes from coronavirus disease MESHD 2019 (COVID-19). This study aims to investigate factors associated with COVID-19 positivity for the first 669 UK Biobank participants; compared with individuals who tested negative, and with the untested, presumed negative, rest of the population. Methods: We studied 1,474 participants from the UK Biobank who had been tested for COVID-19. Given UK testing policy, this implies a hospital setting, suggesting at least moderate to severe symptoms. We considered the following exposures: age TRANS, sex, ethnicity, body mass index (BMI), diabetes MESHD, hypertension HP hypertension MESHD, hypercholesterolaemia, ACEi/ARB use, prior myocardial infarction HP myocardial infarction MESHD ( MI MESHD), and smoking. We undertook comparisons between: 1) COVID-19 positive and COVID-19 tested negative participants; and 2) COVID-19 tested positive and the remaining participants (tested negative plus untested, n=501,837). Logistic regression models were used to investigate univariate and mutually adjusted associations. Results: Among participants tested for COVID-19, non-white ethnicity, male TRANS sex, and greater BMI were independently associated with COVID-19 positive result. Non-white ethnicity, male TRANS sex, greater BMI, diabetes MESHD, hypertension HP hypertension MESHD, prior MI MESHD, and smoking were independently associated with COVID-19 positivity compared to the remining cohort (test negatives plus untested). However, similar associations were observed when comparing those who tested negative for COVID-19 with the untested cohort; suggesting that these factors associate with general hospitalisation rather than specifically with COVID-19. Conclusions: Among participants tested for COVID-19 with presumed moderate to severe symptoms in a hospital setting, non-white ethnicity, male TRANS sex, and higher BMI are associated with a positive result. Other cardiometabolic morbidities confer increased risk of hospitalisation, without specificity for COVID-19. Notably, ACE/ARB use did not associate with COVID-19 status.

    Acute Coronary Syndromes and COVID-19: Exploring the Dark Side of the Outbreak

    Authors: Marco Schiavone; Cecilia Gobbi; Giuseppe Biondi-Zoccai; Fabrizio D'Ascenzo; Alberto Palazzuoli; Alessio Gasperetti; Gianfranco Mitacchione; Maurizio Viecca; Massimo Galli; Francesco Fedele; Massimo Mancone; Giovanni Battista Forleo

    id:202005.0124/v1 Date: 2020-05-07 Source:

    Since association between myocardial infarction HP myocardial infarction MESHD ( MI MESHD) and respiratory infections MESHD has been described for influenza-viruses and other respiratory viral agents, understanding possible physiopathological links between severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) and acute coronary syndromes MESHD (ACS) is of the greatest importance. First data suggest an underestimation of ACS cases all over the world, but acute MI MESHD still represents a major cause of morbidity and mortality worldwide and should not be overshadowed during the coronavirus disease (Covid-19) pandemic. No common consensus regarding the most adequate healthcare management policy for ACS is currently available. Indeed, important differences have been reported between the measures employed to treat ACS in China during the first disease outbreak and what currently represents clinical practice across Europe and the USA. This review aims to discuss: pathophysiological links between MI MESHD, respiratory infections MESHD, and Covid-19; epidemiological data related to ACS at the time of the Covid-19 pandemic; what emerged so far from several catheterization labs and coronary care units all over the world, in order to shed some light on the current strategies for optimal management of ACS patients with confirmed or suspected SARS-CoV-2 infection MESHD.

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MeSH Disease
Human Phenotype

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