Corpus overview


MeSH Disease

Human Phenotype


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    Hydroxychloroquine for prevention of COVID-19 mortality: a population-based cohort study

    Authors: Christopher T Rentsch; Nicholas J DeVito; Brian MacKenna; Caroline E Morton; Krishnan Bhaskaran; Jeremy P Brown; Anna Schultze; William J Hulme; Richard Croker; Alex J Walker; Elizabeth J Williamson; Chris Bates; Seb Bacon; Amir Mehrkar; Helen J Curtis; David Evans; Kevin Wing; Peter Inglesby; Rohini Mathur; Henry Drysdale; Angel YS Wong; Helen I McDonald; Jonathan Cockburn; Harriet Forbes; John Parry; Frank Hester; Sam Harper; Liam Smeeth; Ian J Douglas; William G Dixon; Stephen JW Evans; Laurie Tomlinson; Ben Goldacre; Sacha Gnjatic; Noam Harpaz; Silvio Danese; Adeeb Rahman; Nikhil A Kumta; Alessio Aghemo; Francesca Petralia; Harm van Bakel; Adolfo Garcia-Sastre; Saurabh Mehandru

    doi:10.1101/2020.09.04.20187781 Date: 2020-09-09 Source: medRxiv

    Background. Hydroxychloroquine has been shown to inhibit severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) in vitro, but early clinical studies found no benefit treating patients with coronavirus disease MESHD 2019 (COVID-19). We set out to evaluate the effectiveness of hydroxychloroquine for prevention, as opposed to treatment, of COVID-19 mortality. Methods. We pre-specified and conducted an observational, population-based cohort study using national primary care data and linked death registrations in the OpenSAFELY platform, representing 40% of the general population in England. We used Cox regression to estimate the association between ongoing routine hydroxychloroquine use prior to the COVID-19 outbreak in England and risk of COVID-19 mortality among people with rheumatoid arthritis HP rheumatoid arthritis MESHD ( RA MESHD) or systemic lupus erythematosus HP systemic lupus erythematosus MESHD ( SLE MESHD). Model adjustment was informed by a directed acyclic graph. Findings. Of 194,637 patients with RA MESHD or SLE MESHD, 30,569 (15.7%) received [≥]2 prescriptions of hydroxychloroquine in the six months prior to 1 March 2020. Between 1 March 2020 and 13 July 2020, there were 547 COVID-19 deaths, 70 among hydroxychloroquine users. Estimated standardised cumulative COVID-19 mortality was 0.23% (95% CI 0.18-0.29) among users and 0.22% (95% CI 0.20-0.25) among non-users; an absolute difference of 0.008% (95% CI -0.051-0.066). After accounting for age TRANS, sex, ethnicity, use of other immunuosuppressives, and geographic region, no association with COVID-19 mortality was observed (HR 1.03, 95% CI 0.80-1.33). We found no evidence of interactions with age TRANS or other immunosuppressives. Quantitative bias analyses indicated observed associations were robust to missing information regarding additional biologic treatments for rheumatological disease MESHD. We observed similar associations with the negative control outcome of non-COVID-19 mortality. Interpretation. We found no evidence of a difference in COVID-19 mortality among patients who received hydroxychloroquine for treatment of rheumatological disease MESHD prior to the COVID-19 outbreak in England.

    C-C chemokine receptor type 5 links COVID-19, Rheumatoid arthritis HP Rheumatoid arthritis MESHD, and Hydroxychloroquine: In silico analysis 

    Authors: MAHMOOD Yaseen HACHIM; Ibrahim Hachim; Kashif Naeem; Haifa Hannawi; Issa Al Salmi; Suad Hannawi

    doi:10.21203/ Date: 2020-07-23 Source: ResearchSquare

    Patients with rheumatoid arthritis HP heumatoid arthritis MESHD(R A) MESHD represent one of the fragile patient groups that might be susceptible to the critical form of the coronavirus disease -19 (COVID-19) . On the other side, R A MESHDpatients have been found not to have an increased risk of C OVID-19 infection. MESHD Moreover, some of the Disease-Modifying Anti-Rheumatic Drugs (DMARDS)  commonly used to treat r heumatic diseases MESHDlike Hydroxychloroquine (HCQ) were proposed as a potential therapy for COVID-19  with a lack of full understanding of their molecular mechanisms. This highlights the need for the discovery of common pathways that may link both diseases at the molecular side. In this research, we used the in silico approach to investigate the transcriptomic profile of R A MESHDsynovium to identify shared molecular pathways with that of severe acute r espiratory syndrome-corona virus-2 (SARS-COV-2) infected lung MESHDtissue. Our results showed upregulation of chemotactic factors, including CCL4, CCL8, and CCL11, that all shared CCR5 as their receptor, as a common derangement observed in both diseases; R A MESHDand COVID-19. Moreover, our results also highlighted a possible mechanism through which HCQ, which can be used as a monotherapy in mild R A MESHDor as one of the triple-DMARDs therapy (tDMARDs; methotrexate, sulphasalazine, and HCQ), might interfere with the COVID-19 i nfection. MESHD This might be achieved through the ability of HCQ to upregulate specific immune cell populations like activated natural killer (NK) cells, which were found to be significantly reduced in COVID-19 i nfection. MESHD In addition to its ability to block CCR5 rich immune cell recruitment that also was upregulated in the S ARS-COV-2 infected lungs. MESHD This might explain some of the reports that showed beneficial effects. 

    Prevalence SERO of Coronavirus Disease MESHD 2019 in Rheumatic MESHD Patients and Evaluation of The Effect of Disease-Modifying Anti-Rheumatic Drugs

    Authors: Soroush Moradi; Maryam Masoumi; Somayeh Mohammadi; Jamshid Vafaeimanesh; Mohaddeseh Mohseni; Hossein Mahdavi; Armin Aryannejad

    doi:10.21203/ Date: 2020-07-16 Source: ResearchSquare

    Background: One of the most controversial issues among rheumatologists is the best approach to managing a rheumatic MESHD patient (RP) with coronavirus disease MESHD 2019 (COVID-19).Objectives: This study aims to evaluate the prevalence SERO of COVID-19 in RPs and compare it to thegeneral population (healthy individuals). Besides, it assesses the incidence of COVID-19 based on rheumatologic diseases MESHD ( RDs MESHD) categories and immunosuppressive (IS) drug history.Methods: In a cross-sectional study, all RPs of the rheumatology clinic of Shahid BeheshtiHospital, Qom, Iran were included (the case group), and the prevalence SERO of COVID-19 was compared to that in healthy individuals (the control group), between December 1,  2019, andFebruary 29, 2020. Qom city was the first city in Iran in which COVID-19 was identified and spread rapidly. The participants were recruited from hospital records for the case group and QomHealth Network’s database for the control group.Results: The prevalence SERO of COVID-19 is significantly less in RPs than in the healthy population.Moreover, patients who were under treatment with biologic diseas-modifying anti-rheumatic drugs(DMARDs) and IS drugs had milder symptoms in the case of COVID-19. Two RPs died from COVID-19, both of whom had granulomatosis HP granulomatosis MESHD and polyangiitis ( GPA MESHD).Conclusion: The prevalence SERO of COVID-19 in the RPs was lower than the general population, which was determined to be associated with more adherence to the quarantine and social distancing rules by RPs. Besides, using leflunomide (a DMARD) and IS drugs might have a protective effect against severe COVID-19.

    The impact of the COVID-19 Pandemic on Patients with Chronic Rheumatic Diseases MESHD: A Study in 15 Arab Countries

    Authors: Nelly Ziade; Lina el Kibbi; Ihsane Hmamouchi; Nizar Abdulateef; Hussein Halabi; Wafa Hamdi; Fatemah Abutiban; Manal el Rakawi; Mervat Eissa; Basel Masri

    doi:10.21203/ Date: 2020-07-09 Source: ResearchSquare

    Aim. To evaluate the impact of the Coronavirus Disease MESHD 2019 pandemic (COVID-19) on the access to rheumatology care for patients with chronic rheumatic diseases MESHD ( CRD MESHD) in the Arab countries.Method. A web-based cross-sectional survey was designed by the Arab Adult TRANS Arthritis HP Arthritis MESHD Awareness group (AAAA) consisting of 16 rheumatologists representing countries from the Arab League of Associations for Rheumatology (ArLAR), and was validated by the ArLAR scientific committee. The survey was disseminated through social media and patients' associations' channels between May 8 and May 22, 2020. The steering committee developed recommendations to improve the care of patients with CRD MESHD during the COVID-19 pandemic.Results. A total of 2163 patients were included in the analysis; 72% were females TRANS; mean age TRANS was 40 years (SD 11.9). The Levant, the Gulf, and North Africa contributed almost equally to the sample. The pandemic had a significant negative impact on rheumatology visits in 82% of cases, on access to hydroxychloroquine (47%), and on chronic medication persistency (28%). The negative impact on rheumatology visits was associated with female TRANS gender TRANS, country, medication non-persistency, isolation due to COVID-19, and impact on mental health. Sixty-one patients (2.8%) stated that they had COVID-19, 5% said that a close contact TRANS was infected, and 47% were in isolation because of COVID-19.Conclusion. The current study highlights the deleterious consequences of the COVID-19 pandemic on the continuity of rheumatology care. Therefore, an action plan, including establishing a telemedicine platform, securing drug availability, and promoting medication persistence through the appropriate communication channels, is strongly recommended.

    A COVID-19 outbreak in a rheumatology department upon the early days of the pandemic

    Authors: Vasco C. Romão; Filipa Oliveira-Ramos; Ana Rita Cruz-Machado; Patrícia Martins; Sofia Barreira; Joana Silva-Dinis; Luís Galaio; Helena Proença; José Melo Cristino; Ema Sacadura-Leite; Nikita Khmelinskii; José Carlos Romeu; João Eurico Fonseca; - CHULN Rheumatology Department

    doi:10.1101/2020.06.05.20107011 Date: 2020-06-08 Source: medRxiv

    Objectives: To describe our experience with a coronavirus disease MESHD 2019 (COVID-19) outbreak within a large rheumatology department, early in the pandemic. Methods: Symptomatic and asymptomatic TRANS healthcare workers (HCWs) had a naso-oropharyngeal swab for detection of severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) and were followed clinically. Reverse transcription polymerase-chain reaction (RT-PCR) was repeated to document cure, and serological response was assessed. Patients with risk contacts within the department in the 14 days preceding the outbreak were screened for COVID-19 symptoms. Results: 14/34 HCWs (41%; 40{+/-}14 years, 71% female TRANS) tested positive for SARS-CoV-2, and 11/34 (32%) developed symptoms but were RT-PCR-negative. Half of RT-PCR-positive HCWs did not report fever HP fever MESHD, cough HP cough MESHD, or dyspnoea MESHD before testing, which were absent in 3/14 cases (21%). Mild disease prevailed (79%), but 3 HCWs had moderate disease requiring further assessment, which excluded severe complications. Nevertheless, symptom duration (28{+/-}18 days), viral shedding (31{+/-}10 days post- symptom onset TRANS, range 15-51) and work absence (29{+/-}28 days) were prolonged. 13/14 (93%) of RT-PCR-positive and none of the RT-PCR-negative HCWs had a positive humoral response, with higher IgG-index in individuals over 50 years (14.5{+/-}7.7 vs 5.0{+/-}4.4, p=0.012). Of 617 rheumatic MESHD patients, 8 (1.3%) developed COVID-19 symptoms (1/8 hospitalisation, 8/8 complete recovery), following a consultation/procedure with an asymptomatic TRANS (7/8) or mildly-symptomatic (1/8) HCW. Conclusions: A COVID-19 outbreak can occur among HCWs and rheumatic MESHD patients, swiftly spreading over the presymptomatic stage. Mild disease without typical symptoms should be recognised, and may evolve with delayed viral shedding, prolonged recovery, and adequate immune response in most individuals.

    The Psychological State and Changes in the Routine of the Patients with Rheumatic Diseases MESHD during the First Month of the Lockdown of the Coronavirus Disease MESHD (COVID-19) Outbreak in Turkey

    Authors: Emire Seyahi; Burc Cagri Poyraz; Necdet Sut; Selma Akdogan; Vedat Hamuryudan

    doi:10.21203/ Date: 2020-06-04 Source: ResearchSquare

    Objective: We hypothesized that patients with rheumatic diseases MESHD ( RD MESHD) would have increased psychological distress during the COVID-19 outbreak; therefore assessed their psychological symptoms and changes in their routine.  Methods: A web-based study was conducted in a cross-sectional design in 3 groups of participants: 1. patients with RD MESHD, 2. hospital workers and 3. high-school teachers/non-medical academic staff. Psychiatric status was evaluated using Hospital Anxiety HP Anxiety MESHD and Depression Scale and Impact of Event Scale-Revised scale.Results: We studied 771 patients with RD MESHD, 535 hospital workers, and 917 teachers/academic staff. Most of the patients with RD MESHD were unwilling to go to the hospital (86 %) while 22 % discontinued their medications (78%). Biological DMARDS were the most frequent drugs whose doses were altered. Only 4 % were willing to take hydroxychloroquine for protection. Moreover, the frequency of anxiety HP anxiety MESHD (20%), depression MESHD (43%) and post- traumatic stress MESHD (28%) among patients with RD MESHD were found to be comparable to that among the teachers/academic staff (23%, 43% and 29%, respectively), whereas significantly less than that among the hospital workers (40%, 62% and 46%, respectively) (p<0.0001). Female gender TRANS, over social media exposure, comorbid disease, or a psychiatric disorder MESHD were found to be independently associated with psychiatric symptoms MESHD in total study population. Conclusions: The majority of the patients were unwilling to attend outpatient visits and one fifth skipped or stopped their immunosuppressive agents. Psychiatric symptoms in patient’s and teacher’s populations were of considerable clinical concern, despite being significantly lower than that observed among the hospital workers.

    Similar incidence of Coronavirus Disease MESHD 2019 (COVID-19) in patients with rheumatic diseases MESHD with and without hydroxychloroquine therapy

    Authors: Juan Macias; Paz Gonzalez-Moreno; Esther Sanchez-Garcia; Ramon Morillo-Verdugo; Carmen Dominguez-Quesada; Ana Pinilla; MaMar Macho; MaVictoria Martinez; Alejandro Gonzalez-Serna; Anais Corma; Luis Miguel Real; Juan Antonio Pineda

    doi:10.1101/2020.05.16.20104141 Date: 2020-05-20 Source: medRxiv

    Background: Hydroxychloroquine is currently being tested as post-exposure prophylaxis against coronavirus disease MESHD 2019 (COVID-19) in several ongoing clinical trials. Objective: To compare the incidence of COVID-19 in Spanish patients with autoimmune rheumatic diseases MESHD treated with and without hydroxychloroquine. Methods: Retrospective electronic record review, from February 27th to April 16th, of patients with autoimmune inflammatory diseases MESHD followed at two academic tertiary care hospitals in Seville, Spain. The cumulative incidence of COVID-19, confirmed or suspected, was compared between patients with and without hydroxychloroquine as part of their treatment of autoimmune inflammatory diseases MESHD. Results: Among 722 included subjects, 290 (40%) were receiving hydroxychloroquine. During the seven-week study period, five (1.7% [95% CI: 0.5%-4.0%] cases of COVID-19 were registered among patients with hydroxychloroquine and five (1.2% [0.4%-2.7%]) (p=0.523) in without hydroxychloroquine. COVID-19 was confirmed by PCR in one (0.3%, 95% CI 0.008-1.9%) patient with hydroxychloroquine and two (0.5%, 95% CI 0.05%-1.6%) without hydroxychloroquine (p=1.0). One patient on hydroxychloroquine and two subjects without hydroxychloroquine were admitted to the hospital, none of them required to be transferred to the intensive care unit and no patient died during the episode. Conclusions: The incidence and severity of COVID-19 among patients with autoimmune rheumatic diseases with and without hydroxychloroquine was not significantly different. Hydroxychloroquine does not seem to be an appropriate therapy for post-exposure prophylaxis against COVID-19.

    Concerns about disease management and psychological stress MESHD in SAPHO MESHD patients during the COVID-19 epidemic

    Authors: Shuo Zhang; Xinyu Lu; Yihan Cao; Yueting Li; Chen Li; Wen Zhang

    doi:10.1101/2020.05.07.20084087 Date: 2020-05-11 Source: medRxiv

    Objectives The coronavirus disease MESHD 2019 (COVID-19) epidemic brings potentially impact on the care of patients with rheumatic diseases MESHD, including SAPHO syndrome MESHD. We aimed to investigate the disease status, concerns about management, and psychological stress MESHD in SAPHO MESHD patients during the COVID-19 epidemic. Method A structured questionnaire was distributed online to patients with SAPHO syndrome MESHD enrolled in a Chinese cohort study on March 3rd, 2020. Patients were ask about the current treatments, disease status, and concerns about disease management during the epidemic. Psychologic stress (scored from 0 to 10 points) and psychological problems MESHD were reported by the patients. Results A total of 157 patients (mean age TRANS 38.4 {+/-} 12.3 years, 66.9% females TRANS) were included in the study. None of the patients were diagnosed with COVID-19. Sixty-five (41.4%) patients worried about their disease conditions during the epidemic with concerns including medication shortage (73.8%), delay of consultation (46.2%), and disease aggravation (61.5%). Sixty-seven (42.7%) patients had medication withdrawal or dose reduction due to lack of drugs, irregular daily schedule or subjective reasons. The most common psychological problems MESHD reported was little interest or pleasure in doing things (66.2%). Patients with progressive disease condition were more distressed and disturbed by the epidemic. Patients with nail involvement felt more worried about their disease conditions than patients without (59.6% vs 31.0%, p =0. 001). Conclusions The COVID-19 epidemic imposes a negative impact on the disease management and psychological stress MESHD in SAPHO MESHD patients. Patients' access to specialty care and medication well as mental stress is of great concern.

    Knowledge, Attitude and Practice towards COVID-19 among Patients with Musculoskeletal and Rheumatic Diseases MESHD in Nepal: A Web- based Cross-Sectional Study

    Authors: Dr. Binit Vaidya; Dr. Manisha Bhochhibhoya; Dr. Rikesh Baral; Dr. Shweta Nakarmi

    doi:10.21203/ Date: 2020-04-22 Source: ResearchSquare

    Introduction/objectives: The global health crisis created by Coronavirus Disease MESHD (COVID-19) can be a serious concern to rheumatologists. The relationship of rheumatic diseases MESHD, their therapies, and COVID-19 with multiple genuine and malicious information available online can influence the knowledge and attitude of rheumatic MESHD patients. This web-based google-form study was conducted to understand the knowledge, attitude and practices of rheumatologic patients towards COVID-19 in Nepal. Methodology: A web based cross-sectional study was conducted among the patients with rheumatic diseases MESHD. Modified version of questionnaire prepared by Zhong BL et al was used after consent. It was then translated in Nepali language for comprehensibility. The final questionnaire contained a total of 29 questions; 6 for demographic parameters, 12, 5 and 6 for knowledge, attitude and practice behaviors, respectively. Simple descriptive statistics describing the positive responses in each domain. Multiple linear regression analysis done to observe demographic variables associated with the knowledge, attitude and practice. Results: Among 380 participants, 63.2% were female TRANS. Most of the participants were aware of the clinical features of COVID-19 (91.6 %), 71.5% had positive attitude towards its control, some (31.5 %) thought that they had greater chance of getting COVID-19 than others and 18.9 % believed that the anti-rheumatic medications could increase their susceptibility to infection. Majority (> 94.7%) practiced preventive measures.Conclusions: Patients with rheumatic diseases MESHD were aware of the general clinical features, route of transmission TRANS and general preventive measures regarding COVID-19.

    Myths and Facts: Chloroquine May Be A Potential Supportive/Therapeutic Drug in COVID-19 Treatment

    Authors: Muhammad Kashif; Muhammad Aamir; Sadia Minhas; Romeeza Tahir; Shah Jahan; Nadeem Afzal

    id:10.20944/preprints202004.0341.v1 Date: 2020-04-19 Source:

    Quinine and its less toxic derivatives have served humanity for decades as potent antimalarial drugs. Emergence of drug resistance has narrowed the usage of these drugs in malaria MESHD prevention and treatment. Fortunately, these drugs have roles in the treatment of other diseases as well including rheumatic disorders MESHD and viral infections MESHD. Quinine derivatives have proven antiviral effects, especially against human immunodeficiency HP immunodeficiency MESHD virus (HIV), Zika virus (ZiKV), herpes simplex virus (HSV), Ebola virus MESHD and dengue virus (DENV). The prophylactic and therapeutic role of Chloroquine/hydroxychroquine has become a topic of interest after the recent outbreak of novel Corona virus-19 (nCoV-19). This virus is also named severe acute respiratory syndrome coronavirus-2 MESHD (SARS-CoV-2) and WHO has officially named this disease as Corona virus disease MESHD 2019 (COVID-19). This lethal virus has affected almost 186 countries of the world till to date just in a period of four months of its outbreak. No approved antiviral drug is existed for the treatment of COVID-19. Therefore, this review is focused on potential prophylactic and therapeutic role of chloroquine/hydroxychlroquine for COVID-19.

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MeSH Disease
Human Phenotype

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