Corpus overview


MeSH Disease

Human Phenotype


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    Risk factors associated with fatal outcomes of novel coronavirus infection pneumonia MESHD pneumonia HP (COVID-19): A systematic review and meta-analysis

    Authors: Can Chen; Danying Yan; Yuqing Zhou; Guo Tian; Jie Wu; Xiaoxiao Liu; Chenyang Huang; Xiaofang Fu; Cheng Ding; Lei Lan; Chencheng Wang; Wei Wu; Robert Hecht; Changtai Zhu; Lanjuan Li; Shigui Yang

    doi:10.21203/ Date: 2020-04-15 Source: ResearchSquare

    Background: The COVID-19 infection MESHD has caused 111652 deaths worldwide as of 13 April 2020. Risk factors for fatal outcomes of COVID-19 have varied across studies due to limited samples and have lacked effective qualitative and quantitative measurements. We performed a meta-analysis to evaluate risk factors for fatal outcomes of COVID-19.Methods: Data on demographic, clinic, laboratory findings and complications were extracted. Quantitative and qualitative synthesis was conducted for weighted-mean-difference (WMD) and odds-ratio (OR).Results: A total of 30 studies involving 5741 survivors and 1670 deaths were included. The death MESHD cases were significantly older than survivors (WMD=15.36, 95% CI: 12.90-17.82), male TRANS and smoking history showed higher risk to develop fatal outcome (OR=3.37, 95% CI: 2.27-5.01; OR=1.37, 95% CI: 1.02-1.83, respectively). The clinical symptoms including dyspnea HP dyspnea MESHD (OR=4.63, 95% CI: 2.85-7.54), hemoptysis HP (OR=3.11, 95% CI: 1.26-7.56), malaise (OR=2.44, 95% CI: 1.49-3.97). comorbidities with coronary heart disease MESHD (OR=4.36, 95% CI: 1.91-9.97), COPD MESHD (OR=3.70, 95% CI: 2.03-6.73) and cardiovascular disease MESHD (OR=3.45, 95% CI: 2.54-4.70). Compared to survivors, many laboratory indexes increased in deaths group, including serum SERO ferritin (WMD=741.47, 95% CI: 566.77-916.16), lactate dehydrogenase (WMD=226.86, 95% CI: 177.08-276.64) and myoglobin (WMD=102.58, 95% CI: 65.12-140.04), and the decreased indexes included PaO2/FiO2 (WMD=-71.61, 95% CI: -134.11 to -9.11), platelets (WMD=-41.09, 95% CI: -47.33 to -34.85) and PaO2 (WMD=-26.09, 95% CI: -38.9 to -13.29). Main complications contributed to the fatal outcome included sepsis HP sepsis MESHD (OR=184.61, 95% CI: 33.43-1019.42), shock HP shock MESHD (OR=133.76, 95% CI: 36.86-485.34) and respiratory failure HP respiratory failure MESHD (OR=47.37, 95% CI: 20.65-108.66). Conclusion: The main risk factors associated with fatal outcome of COVID-19 involved male TRANS, older age TRANS, smoking history, chronic medical conditions including coronary heart disease MESHD, COPD MESHD and cardiovascular disease MESHD, clinical symptoms including dyspnea HP dyspnea MESHD, hemoptysis HP hemoptysis MESHD and malaise, the increased laboratory indexes including serum SERO ferritin, lactate dehydrogenase and myoglobin, the decreased indexes including PaO2/FiO2, platelets and PaO2, main complications including sepsis HP sepsis MESHD, shock HP shock MESHD and respiratory failure HP respiratory failure MESHD. These factors could be considered in triaging patients and allocating medical resources when such medical resources are scarce, devising improved protocols for patient diagnosis and management, and developing new drugs and other therapies to treat COVID-19 patients.

    Clinical analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)  infection MESHD in children TRANS

    Authors: Guilang Zheng; Chuxing Xie; Dongli Liu; Guojing Ye; Xiaoqian Chen; Pei Wang; Yang Zhou; Jiayi Liang; Dian Hong; Zhizhou Shen; Jinjin Yu; Yanhao Wang; Qiong Meng; Yuxin Zhang; Suhua Jiang; Guojun Liu; Yuxiong Guo

    doi:10.21203/ Date: 2020-04-07 Source: ResearchSquare

    Background: The number of coronavirus disease MESHD 2019 (COVID-19) cases caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD has significantly increased, and the disease is rapidly spreading to all parts of the country and around the world. A retrospective study of children TRANS with SARS-CoV-2 provides a reference for the diagnosis and treatment of children TRANS during this epidemic.Methods: We retrospectively studied 12 cases of children TRANS with viral infection MESHD caused by SARS-CoV-2 admitted to 6 hospitals in Guangdong Province between January 25, 2020, and February 12, 2020, and analyzed the clinical features and outcomes of the patients.Results: A total of 12 children TRANS with SARS-CoV-2 infection MESHD from 6 hospitals were enrolled in the study; 6 were boys. The mean age TRANS was 9.8 ± 4.7 years, with a minimum age TRANS of 2 years and 10 months. The mean body weight was 37.3 ± 23.6 kg, with a minimum body weight of 13.0 kg. There were no severe cases or critical severe cases. There were 2 cases of mild pneumonia HP pneumonia MESHD (16.7%), 7 cases of acute upper respiratory tract infection MESHD respiratory tract infection HP (58.3%), and 3 cases of latent infection MESHD (25.0%). In terms of symptoms, there were 7 cases of fever HP fever MESHD (58.3%), 5 cases of cough HP (41.7%), 3 cases of runny nose (25.0%), 2 cases of systemic fatigue MESHD fatigue HP and soreness (16.7%), and 4 cases of no symptoms (33.3%). Three patients (75.0%) showed decreased white blood SERO cell (WBC) counts for their first complete blood SERO count (CBC) after admission, and one patient (8.3%) had a low lymphocyte count. There were no obvious abnormalities in C-reactive protein (CRP, 1.53 ± 2.28 mg/l), procalcitonin (PCT, 0.21 ± 0.13 ng/ml), or coagulation function. No abnormalities were detected for creatine kinase (CK), creatine kinase-MB (CKMB), lactate dehydrogenase (LDH), aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood SERO urea nitrogen (BUN) and serum SERO creatinine (Scr). Six cases (50.0%) were positive for Mycoplasma pneumoniae HP antibodies SERO. 2 cases showed pulmonary exudative lesions on chest X-ray or computed tomography (CT). All children TRANS tested positive for SARS-CoV-2 by real-time reverse-transcription–polymerase-chain-reaction (RT-PCR) assays of throat swabs. 9 patients received antiviral treatment with lopinavir/ritonavir. All patients received symptomatic supportive treatment and were quarantined, and their conditions improved. There was no respiratory failure HP respiratory failure MESHD, acute respiratory distress syndrome MESHD respiratory distress HP syndrome, shock HP shock MESHD complications, or death observed for any case. All patients recovered and were discharged, with an average length of hospital stay of 14 days.Conclusions: This study with a small sample size suggests that all SARS-CoV-2-infected MESHD children TRANS had normal or reduced WBCs; however, fever HP fever MESHD was not as common as expected, and a decrease in lymphocyte count was rare. The clinical manifestations of SARS-CoV-2 infection MESHD in children TRANS are mild, COVID⁃19 is rare, and the prognosis is good. But the presence of latent SARS-CoV-2 infection MESHD in children TRANS presents new challenges for effective clinical prevention and control.

    Clinical, Laboratory and Imaging Features of COVID-19: A Systematic Review and Meta-analysis

    Authors: Alfonso J. Rodriguez-Morales; Jaime A. Cardona-Ospina; Estefanía Gutiérrez-Ocampo; Rhuvi Villamizar-Peña; Yeimer Holguin-Rivera; Juan Pablo Escalera-Antezana; Lucia Elena Alvarado-Arnez; D. Katterine Bonilla-Aldana; Carlos Franco-Paredes; Andrés F. Henao-Martinez; Alberto Paniz-Mondolfi; Guillermo J. Lagos-Grisales; Eduardo Ramírez-Vallejo; Jose A. Suárez; Lysien I. Zambrano; Wilmer E. Villamil-Gómez; Graciela J. Balbin-Ramon; Ali A. Rabaan; Harapan Harapan; Kuldeep Dhama; Hiroshi Nishiura; Hiromitsu Kataoka; Tauseef Ahmad; Ranjit Sah

    id:10.20944/preprints202002.0378.v3 Date: 2020-03-11 Source:

    Introduction: An epidemic of Coronavirus Disease MESHD 2019 (COVID-19) begun in December 2019 in China, causing a Public Health Emergency of International Concern. Among raised questions, clinical, laboratory, and imaging features have been partially characterized in some observational studies. No systematic reviews have been published on this matter. Methods: We performed a systematic literature review with meta-analysis, using three databases to assess clinical, laboratory, imaging features, and outcomes of COVID-19 confirmed cases TRANS. Observational studies, and also case reports, were included and analyzed separately. We performed a random-effects model meta-analysis to calculate the pooled prevalence SERO and 95% confidence interval (95%CI). Results: 660 articles were retrieved (1/1/2020-2/23/2020). After screening by abstract/title, 27 articles were selected for full-text assessment. Of them, 19 were finally included for qualitative and quantitative analyses. Additionally, 39 case report articles were included and analyzed separately. For 656 patients, fever HP fever MESHD (88.7%, 95%CI 84.5-92.9%), cough HP (57.6%, 40.8-74.4%) and dyspnea HP dyspnea MESHD (45.6%, 10.9-80.4%) were the most prevalent manifestations. Among the patients, 20.3% (95%CI 10.0-30.6%) required intensive care unit (ICU), with 32.8% presenting acute respiratory distress HP respiratory distress MESHD syndrome ( ARDS MESHD) (95%CI 13.7-51.8), 6.2% (95%CI 3.1-9.3) with shock HP shock MESHD and 13.9% (95%CI 6.2-21.5%) of hospitalized patients with fatal outcomes (case fatality rate, CFR).Conclusion: COVID-19 brings a huge burden to healthcare facilities, especially in patients with comorbidities. ICU was required for approximately 20% of polymorbid, COVID-19 infected MESHD patients and this group was associated with a CFR of over 13%. As this virus spreads globally, countries need to urgently prepare human resources, infrastructure, and facilities to treat severe COVID-19.

    Clinical Characteristics of SARS-CoV-2 Pneumonia HP Compared to Controls in Chinese Han Population

    Authors: Yang Xu; Yi-rong Li; Qiang Zeng; Zhi-bing Lu; Yong-zhe Li; Wei Wu; Sheng-yong Dong; Gang Huang; Xing-huan Wang

    doi:10.1101/2020.03.08.20031658 Date: 2020-03-10 Source: medRxiv

    Background In December 2019, novel coronavirus (SARS-CoV-2) infected pneumonia MESHD pneumonia HP occurred in Wuhan, China. The number of cases has increased rapidly but information on the clinical characteristics of SARS-CoV-2 pneumonia MESHD pneumonia HP without comorbidities compared to normal controls in Chinese Han population is limited. Our objective is to describe the epidemiological and clinical characteristics of SARS-CoV-2 pneumonia MESHD pneumonia HP without comorbidities compared to normal controls in the Chinese Han population. Methods Retrospective, multi-center case series of the 69 consecutive hospitalized patients with confirmed SARS-CoV-2 pneumonia MESHD pneumonia HP, from February 7 to February 28, 2020; final date of follow-up was February 29, 2020. Results The study population included 69 hospitalized patients with confirmed SARS-CoV-2 pneumonia MESHD pneumonia HP without comorbidities and 14,117 normal controls. 50.7% patients were male TRANS and 49.3% were female TRANS; 1.5% patients were asymptomatic TRANS cases, 63.8% patients were mild cases, and 36.2% patients were severe or critical cases. Compared with mild patients (n = 44), severe or critical patients (n = 25) were significantly older (median age TRANS, 67 years [IQR, 58-79] vs. 49 years [IQR, 36-60]; P < 0.01). Fever HP Fever MESHD was present in 98.6% of the patients. The second most common symptom was cough HP (62.3%), fatigue HP fatigue MESHD (58.0%), sputum (39.1%), and headache HP headache MESHD (33.3%). The median incubation period TRANS was 4 days (IQR, 2 to 7). Leukocyte count was 74.1% of normal controls and lymphocyte count was 45.9% of normal controls. The phenomenon of lymphocyte depletion (PLD) observed in severe or critical cases in 100%. Levels of lactate dehydrogenase, D-dimer, procalcitonin, and interleukin-6 were showed significant differences between mild and severe or critical cases. Chest computed tomographic scans showed bilateral patchy patterns (49.3%), local patchy shadowing (29.0%), and ground glass opacity (21.7%). 7.3% patients were diagnosed ARDS, 7.3% patients were diagnosed acute cardiac injury MESHD (troponin I >28 pg/mL) and 4.4% patients were diagnosed fungal infections MESHD or shock HP shock MESHD. 4.3% patients have been discharged; 1.5% patient had died; 1.5% patient had recovery. Conclusions In this multicenter case series of 69 patients without comorbidities, the full spectrum of asymptomatic TRANS, mild, severe, and critical cases is described. 50.7% patients were male TRANS and 49.3% were female TRANS; 1.5% patients were asymptomatic TRANS cases, 63.8% patients were mild cases, and 36.2% patients were severe or critical cases. 4.3% patients have been discharged; 1.5% patient had died; 1.5% patient had recovery. Among the 25 patients with severe or critical disease MESHD, 12.0% patients were underwent non-invasive mechanical ventilation, 8.0% patients underwent invasive mechanical ventilation, and 4.0% patients died.

    Clinical course and outcome of 107 patients infected with the novel coronavirus, SARS-CoV-2, discharged from two hospitals in Wuhan, China.

    Authors: Dawei Wang; Yimei Yin; Chang Hu; Xing Liu; Xingguo Zhang; Shuliang Zhou; Mingzhi Jian; Haibo Xu; John Prowle; Bo Hu; Yirong Li; Zhi-Yong Peng

    doi:10.21203/ Date: 2020-03-04 Source: ResearchSquare

    Background In December 2019, Coronavirus Disease MESHD 2019 (COVID-19) outbreak was reported from Wuhan, China. Information on the clinical course and prognosis of COVID-19 was not thoroughly described. We described the clinical courses and prognosis in COVID-19 patients. Methods Retrospective case series of COVID-19 patients from Zhongnan Hospital of Wuhan University in Wuhan, and Xi-shui Hospital, Hubei Province, China, up to February 10, 2020. Epidemiological, demographic and clinical data were collected. Clinical course of survivors and non-survivors were compared. Risk factors for death MESHD were analyzed. Results A total of 107 discharged patients with COVID-19 were enrolled. The clinical course of COVID-19 presented as a tri-phasic pattern. Week 1 after illness onset was characterized by fever HP fever MESHD, cough HP cough MESHD, dyspnea HP dyspnea MESHD, lymphopenia HP lymphopenia MESHD and radiological multilobar pulmonary infiltrates HP. In severe cases, thrombocytopenia HP thrombocytopenia MESHD, acute kidney injury HP acute kidney injury MESHD, acute myocardial injury MESHD or adult TRANS adult MESHD respiratory distress HP syndrome were observed. During week 2, in mild cases, fever HP fever MESHD, cough HP cough MESHD and systemic symptoms began to resolve and platelet count rose to normal range, but lymphopenia HP lymphopenia MESHD persisted. In severe cases, leukocytosis HP leukocytosis MESHD, neutrophilia HP and deteriorating multi-organ dysfunction were dominant. By week 3, mild cases had clinically resolved except for lymphopenia HP lymphopenia MESHD. However, severe cases showed persistent lymphopenia HP lymphopenia MESHD, severe acute respiratory dyspnea syndrome MESHD dyspnea HP syndrome , refractory shock MESHD shock HP, anuric acute kidney injury MESHD acute kidney injury HP, coagulopathy MESHD, thrombocytopenia HP thrombocytopenia MESHD and death MESHD. Older age TRANS and male TRANS sex were independent risk factors for poor outcome of the illness. Conclusions A period of 7–13 days after illness onset is the critical stage in COVID-19 course. Age TRANS and male TRANS gender TRANS were independent risk factors for death of COVID-19.

    Clinical features of critically ill MESHD patients with COVID-19 infection MESHD in China

    Authors: Bo Hu; Dawei Wang; Chang Hu; Ming Hu; Fangfang Zhu; Hui Xiang; Beilei Zhao; Xiaoyi Zhang; Kianoush B. Kashani; Zhiyong Peng

    doi:10.21203/ Date: 2020-03-02 Source: ResearchSquare

    Importance: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections MESHD outbreak in China is now a global issue. There is only a limited understanding of the clinical characteristics of patients with SARS-CoV-2 infections MESHD is available.Objective:To describe the characteristics, management strategies, and outcomes of critically ill MESHD patients with SARS-CoV-2 infection MESHD.Design, Setting, and Patients: This is aretrospective, multi-center case series of 50 critically ill MESHD patients with confirmed SARS-CoV-2 infection MESHD who were admitted at Zhongnan Hospital of Wuhan University and Wuhan Pulmonary Hospital in Wuhan, China, from January 8 to February 9, 2020.Exposures:Documented Corona Virus Disease MESHD, 2019 (COVID-19).Main Outcome Measures: Demographic, clinical, laboratory, imaging data were collected along with management strategies, complications and outcomes of enrolled individuals. Results Fifty critically ill MESHD patients with SARS-CoV-2 infections MESHD were enrolled. Their median age TRANS was 62 (range, 29-92) [IQR,49.5-69.0] years, 68% were male TRANS, and 28 (56%) patients had comorbidities, the most common being hypertension HP hypertension MESHD. In this cohort, 20(40%) patients survived ,16(32%) patients died, and the rest remained hospitalized. The invasive mechanical ventilator was used in 36(72%) patients with 15(30%) of them requiring prone positioning, and 17(34%) switched to ECMO. The compliance scores of lungs (Cstat)on the day of ICU admission among survivors were higher than those in non-survivors [42.0(18.0-47.0), vs. 19.5(14.0-24.2), p=0.038].The blood SERO IL-6 levels and neutrophils counts at the first day of ICU admission were significantly higher in non-survivors compared to survivors [123.7(85.3-228.8), vs. 20.2(6.8-67.2) ng/ml, p=0.025 for IL-6, and 20.2(6.8-67.2) vs. 4.01(1.99-7.05) × 10⁹/L, p=0.02 for neutrophils counts].The heart rates, PaCO2, lung injury MESHD scale (LIS), and positive end-expiratory pressure levels were constantly higher for 10 days in non-survivors than those who survived (p<0.05). The frequency of vasopressor uses and neuromuscular blockers was higher in non-survivors from day 1 to day 10 compared to survivors (p<0.05). In the whole cohort, the most common complications were ARDS (97%), shock HP shock MESHD (44%), arrhythmia HP arrhythmia MESHD (38%), acute cardiac injury MESHD (26%), and acute kidney injury HP acute kidney injury MESHD (22%). A secondary bacterial infection MESHD was noted in 17(34%) patients. Univariate analysis indicated that lower lung complianceand higher neutrophil counts at the day of ICU admission were related to higher mortality (p-0.03, and 0.04, respectively)ConclusionWe demonstrated that SARS-CoV-2 infection MESHD-related critical illness predominantly affected old individuals with comorbidities and characterized by severe hypoxemic respiratory failure MESHD respiratory failure HP, often requiring prolonged mechanical ventilation and rescue therapies. Low lung compliance and persistently elevated PaCO2 indicated poor outcomes.

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MeSH Disease
Human Phenotype

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