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    Clinical Characteristics and Outcomes of Diabetic MESHD COVID-19 patients in Kuwait

    Authors: Hamad Ali; Abdullah Alshukry; Mohammad Bu Abbas; Yaseen Ali; Barrak Alahmad; Abdullah A Al-Shammari; Mohamed Abu-farha; Jehad Abubakr; Srirman Devarajan; Ali A. Dashti; Fahd Al-Mulla; Chris Gale; Mamas Mamas; Ian Reckless; Tim Brooks; Andre Charlett; Matthew Hickman; Isabel Oliver; David Wyllie

    doi:10.1101/2020.08.20.20178525 Date: 2020-08-22 Source: medRxiv

    Background: Severe Acute Respiratory Syndrome Coronavirus 2 MESHD (SARS-CoV-2) emerged in Wuhan, China, in 2019 and rapidly turned into a global pandemic, resulting in what is now known as Coronavirus Disease MESHD 2019 (COVID-19). COVID-19 has a highly variable clinical presentation, ranging from asymptomatic TRANS to severe respiratory symptoms MESHD and death MESHD. Diabetes MESHD seems to be one of the main comorbidities contributing to a worse COVID-19 outcome. Methods: In this single-center, retrospective study of 417 consecutive COVID-19 patients in Kuwait, we analyze and compare disease severity, outcome, associated complications, and clinical laboratory findings between diabetic MESHD and non-diabetic MESHD COVID-19 patients. Results: COVID-19 patients with diabetes MESHD had a higher prevalence SERO of comorbidities, such as hypertension HP hypertension MESHD, higher levels of inflammatory markers, lower estimated glomerular filtration rate, and a higher incidence of complications. All of these factors could lead to more severe outcomes and higher mortality than non- diabetic MESHD COVID-19 patients. Conclusion: Diabetes MESHD could be a major contributor to COVID-19 worsening outcomes.

    A SARS-CoV-2 neutralizing antibody SERO protects from lung pathology in a COVID-19 hamster model

    Authors: Jakob Kreye; S Momsen Reincke; Hans-Christian Kornau; Elisa Sanchez-Sendin; Victor Max Corman; Hejun Liu; Meng Yuan; Nicholas C Wu; Xueyong Zhu; Chang-Chun D Lee; Jakob Trimpert; Markus Hoeltje; Kristina Dietert; Laura Stoeffler; Niels von Wardenburg; Scott van Hoof; Marie A Homeyer; Julius Hoffmann; Azza Abdelgawad; Achim D Gruber; Luca D Bertzbach; Daria Vladimirova; Lucie Y Li; Paula Charlotte Barthel; Karl Skriner; Andreas C Hocke; Stefan Hippenstiel; Martin Witzenrath; Norbert Suttorp; Florian Kurth; Christiana Franke; Matthias Endres; Dietmar Schmitz; Lara Maria Jeworowski; Anja Richter; Marie Luisa Schmidt; Tatjana Schwarz; Marcel Alexander Mueller; Christian Drosten; Daniel Wendisch; Leif E Sander; Nikolaus Osterrieder; Ian A Wilson; Harald Pruess

    doi:10.1101/2020.08.15.252320 Date: 2020-08-16 Source: bioRxiv

    The emergence of SARS-CoV-2 led to pandemic spread of coronavirus disease MESHD 2019 (COVID-19), manifesting with respiratory symptoms MESHD and multi-organ dysfunction MESHD. Detailed characterization of virus- neutralizing antibodies SERO and target epitopes is needed to understand COVID-19 pathophysiology and guide immunization strategies. Among 598 human monoclonal antibodies SERO (mAbs) from ten COVID-19 patients, we identified 40 strongly neutralizing mAbs. The most potent mAb CV07-209 neutralized authentic SARS-CoV-2 with IC50 of 3.1 ng/ml. Crystal structures of two mAbs in complex with the SARS-CoV-2 receptor-binding domain at 2.55 and 2.70 A revealed a direct block of ACE2 attachment. Interestingly, some of the near-germline SARS-CoV-2 neutralizing mAbs reacted with mammalian self-antigens. Prophylactic and therapeutic application of CV07-209 protected hamsters from SARS-CoV-2 infection MESHD, weight loss HP weight loss MESHD and lung pathology. Our results show that non-self-reactive virus-neutralizing mAbs elicited during SARS-CoV-2 infection MESHD are a promising therapeutic strategy.

    Characterization of prolonged COVID-19 symptoms and patient comorbidities in an outpatient telemedicine cohort

    Authors: James B O'Keefe; Michele Cellai

    doi:10.1101/2020.07.05.20146886 Date: 2020-07-07 Source: medRxiv

    We identified patients with coronavirus disease MESHD 2019 (COVID-19) in a telemedicine clinic who requested ongoing follow-up 6 weeks after symptom onset TRANS. Patients with prolonged symptoms often have not returned to work or usual activity. Respiratory symptoms MESHD are most common, and underlying asthma HP asthma MESHD and lung disease occur frequently.

    Poor Outcomes in Patients with Cirrhosis HP Cirrhosis MESHD and COVID-19

    Authors: Shalimar; Anshuman Elhence; Manas Vaishnav; Ramesh Kumar; Piyush Pathak; Kapil Dev Soni; Richa Aggarwal; Manish Soneja; Pankaj Jorwal; Arvind Kumar; Puneet Khanna; Akhil Kant Singh; Ashutosh Biswas; Neeraj Nischal; Lalit Dhar; Aashish Choudhary; Krithika Rangarajan; Anant Mohan; Pragyan Acharya; Baibaswata Nayak; Deepak Gunjan; Anoop Saraya; Soumya Mahapatra; Govind Makharia; Anjan Trikha; Pramod Garg

    doi:10.21203/rs.3.rs-40220/v1 Date: 2020-07-06 Source: ResearchSquare

    Background and AimThere is a paucity of data on the clinical presentations and outcomes of Coronavirus disease MESHD 2019(COVID-19) in patients with underlying liver disease MESHD. We aimed to summarize the presentations and outcomes of COVID-19 positive patients and compare with historical controls.MethodsPatients with known chronic liver disease MESHD who presented with superimposed COVID- 19(n=28) between 22nd April and 22nd June 2020 were studied. Seventy-eight cirrhotic patients from historical controls were taken as comparison group.ResultsA total of 28 COVID patients- two without cirrhosis HP cirrhosis MESHD, one with compensated cirrhosis HP cirrhosis MESHD, sixteen with acute decompensation (AD), and nine with acute-on-chronic liver failure MESHD( ACLF MESHD) were included. The etiology of cirrhosis HP cirrhosis MESHD was alcohol(n=9), non-alcoholic fatty liver disease MESHD(n=2), viral(n=5), autoimmune hepatitis MESHD hepatitis HP(n=4), and cryptogenic cirrhosis HP(n=6). The clinical presentations included complications of cirrhosis HP cirrhosis MESHD in 12(46.2%), respiratory symptoms in 3(11.5%) and combined complications of cirrhosis HP cirrhosis MESHD and respiratory symptoms in 11(42.3%) patients. The median hospital stay was 8(7-12) days. The mortality rate in COVID-19 patients was 42.3%(11/26), as compared to 23.1%(18/78) in the historical controls(p=0.077). All COVID-19 patients with ACLF(9/9) died compared to 53.3%(16/30) in ACLF of historical controls(p=0.015). Mortality rate was higher in COVID patients with compensated cirrhosis HP cirrhosis MESHD and AD MESHD as compared to historical controls 2/17(11.8%) vs 2/48(4.2%), though not statistically significant (p=0.278). Requirement of mechanical ventilation independently predicted mortality (hazard ratio, 13.68). Both non-cirrhotic patients presented with respiratory symptoms MESHD and recovered uneventfully.ConclusionCOVID-19 is associated with poor outcomes in patients with cirrhosis HP cirrhosis MESHD, with worst survival rates in ACLF. Mechanical ventilation is associated with a poor outcome.

    Inflammatory olfactory neuropathy MESHD in two patients with Covid-19 

    Authors: Daniel Kirschenbaum; Lukas L. Imbach; Silvia Ulrich; Elisabeth Jane Rushing; Emanuela Keller; Regina R. Reimann; Katrin B.M. Frauenknecht; Mona Lichtblau; Martin Witt; Thomas Hummel; Peter Steiger; Adriano Aguzzi; Karl Frontzek

    doi:10.21203/rs.3.rs-34001/v1 Date: 2020-06-07 Source: ResearchSquare

    C oronavirus disease MESHD2019 (Covid-19) caused by the severe acute r espiratory syndrome coronavirus 2 MESHD(SARS-CoV-2) emerged as a public health emergency recently, leading to fatal respiratory failure HP espiratory failure MESHDin a number of patients. The clinical manifestation of Covid-19 is manifold, c ardio-respiratory symptoms MESHDand multiorgan failure being the most critical. Anosmia HP nosmia MESHDwas reported to be an early symptom in a significant number of Covid-19 patients and is frequently the only symptom without underlying nasal congestion. Here we present neuropathological work-up of olfactory epithelium and associated olfactory nerves from two patients succumbing to Covid-19, one of which was anosmic. We show that S ARS-CoV-2 infection MESHDis associated with i nflammation MESHDin the olfactory epithelium and leads to a xonal damage MESHDin olfactory structures of the CNS - potentially explaining anosmic symptoms.

    Kidney Allograft Recipients Diagnosed with Coronavirus Disease MESHD-2019: A Single Center Report

    Authors: Michelle Lubetzky; Meredith Aull; Rebecca Craig-Shapiro; Jun Lee; John Lee; Samuel Sultan; Jehon Marku-Podvorica; Laura Gingras; Rosy Priya Kodiyanplakkal; Choli Hartono; Stuart Saal; Thangamani Muthukumar; Sandip Kapur; Manikkam Suthanthiran; Darshana Dadhania

    doi:10.1101/2020.04.30.20086462 Date: 2020-05-05 Source: medRxiv

    Background: Organ graft recipients receiving immunosuppressive therapy are likely to be at heighted risk for the Coronavirus Disease MESHD 2019 (Covid-19) and adverse outcomes including death. It is therefore important to characterize the clinical course and outcome of Covid-19 in this vulnerable population and identify therapeutic strategies that are safe. Methods: We performed a retrospective chart review of 54 adult TRANS kidney transplant patients diagnosed with Covid-19 and managed in New York State, the epicenter of Covid-19 pandemic. The patients were evaluated by video visits, phone interviews, or in the Emergency Room for respiratory illness symptoms MESHD consistent with Covid-19 from March 13, 2020 to April 20, 2020. Characteristics of the patients were stratified by hospitalization status and disease severity. Clinical course including alterations in immunosuppressive therapy were retrieved from their electronic medical records. Primary outcomes included recovery from Covid-19 symptoms, acute kidney injury HP acute kidney injury MESHD, graft failure MESHD, and case fatality rate. Results: Of the 54 SARS-Cov-2 positive kidney transplant recipients, 39 with moderate to severe symptoms were admitted and 15 with mild symptoms were managed at home. Hospitalized patients compared to non-hospitalized patients were more likely to be male TRANS, of Hispanic ethnicity, and to have cardiovascular disease MESHD. At baseline, all but 2 were receiving tacrolimus, mycophenolate mofetil (MMF) and 32 were on a steroid free immunosuppression regimen. Tacrolimus dosage was reduced in 46% of hospitalized patients and maintained at baseline level in the non-hospitalized cohort. Mycophenolate mofetil (MMF) dosage was maintained at the baseline dosage in 11% of hospitalized patients and 64% of non-hospitalized patients, and was stopped in 61% hospitalized patients and 0% in the non-hospitalized cohort. Azithromycin or doxycycline were prescribed at a similar rate among hospitalized and non-hospitalized patients (38% vs. 40%). Hydroxychloroquine was prescribed in 79% of hospitalized patients and only one of 15 non-hospitalized patients. Acute kidney injury HP kidney injury MESHD occurred in 51% of hospitalized patients. Patients with severe disease were more likely to have elevations in inflammatory biomarkers at presentation. At a median of 21 days follow up, 67% of patients have had their symptoms resolved or improved and 33% have persistent symptoms. Graft failure MESHD requiring hemodialysis occurred in 3 of 39 hospitalized patients (8%). Three of 39 (8%) hospitalized patients expired and none of the 15 non-hospitalized patients expired. Conclusions: Clinical presentation of Covid-19 in kidney transplant recipients was similar to what has been described in the general population. The case fatality rate in our entire cohort of 54 kidney transplant recipients was reassuringly low and patients with mild symptomology could be successfully managed at home. Data from the pilot study suggest that a strategy of systematic screening and triage to inpatient or outpatient care, close monitoring, and judicious use of immunosuppressive drugs rather than cessation is beneficial.

    The Epidemiology, Evolution, Transmission TRANS and Therapeutics of COVID-19 Outbreak: An Update on the Status

    Authors: Karan Singh Labana; Amit Kumar Mittal; Akash Gujral

    id:10.20944/preprints202004.0525.v1 Date: 2020-04-30 Source: Preprints.org

    Severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) is an etiologic agent of the respiratory disease MESHD in humans that is known as coronavirus disease MESHD 2019 (COVID19). The first outbreak of the disease was initially documented in Wuhan, Hubei Province, China in late December 2019 where people had experienced SARS pneumonia MESHD pneumonia HP-like symptoms with unknown etiology. Since then it has been observed that COVID-19 positive patients have been showing mild to severe upper respiratory illness symptoms MESHD. The type of virus is known to make its transfer from animals to humans and for the concerned virus; researchers have claimed its origin from bat coronavirus at whole-genome level with a 96 % sequence identity. The COVID-19 virus is very contagious and communicable in nature and has been spread throughout the globe since its first outbreak in China. On March 9, 2020, WHO declared it as a Pandemic, and within a month it was already reported to have shown its presence in 213 countries and territories or areas. As of April 29, 2020, this novel virus infected 3,218,183 people and caused 228,029 mortalities worldwide with a variable mortality rate from 3-13 % across the planet and also varied by age TRANS and gender TRANS. Diagnosis of the disease is a key component in understanding and controlling the spread of the virus and several techniques have been devised including RT-PCR, ELISA SERO, and sequencing-based approaches. To cure COVID-19 patients as of now we do not have proven to be a safe and effective treatment. Therapeutic options currently under investigation in various parts of the world. However, there are various effective therapeutic targets to repurpose the present antiviral therapy for developing potential interventions against SARS-CoV-2. Boosting the immune system can also help to prevent and spread of COVID-19 using various medication and exercises. In this review, our goal to summarize and discussed the present scientific advancements to fight against this novel pandemic.

    Authors: Abhijeet Singh; Ayush Gupta; Kamanashish Das

    doi:10.21203/rs.3.rs-22464/v3 Date: 2020-04-11 Source: ResearchSquare

    Background: The ongoing pandemic of novel coronavirus disease MESHD 2019 (COVID-19) has received worldwide attention by becoming a major global health threat. We encountered one case with COVID-19 and tuberculosis MESHD ( TB MESHD) coinfection which has not been frequently reported. Case presentation: A 76 year old female TRANS presented with acute respiratory symptoms MESHD superimposed on chronic symptoms, suggestive to have pneumonia HP pneumonia MESHD. Oropharyngeal throat swab sample for COVID-19 was positive as detected by real-time reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay. GeneXpert Ultra detected Mycobacterium tuberculosis MESHD complex with Rifampicin resistance indeterminate. Patient was treated with appropriate management. Conclusion: Clinicians should suspect coinfection with TB MESHD during ongoing pandemic of COVID-19 as therapeutic strategies need to be determined timely to improve outcome and prevent transmission TRANS in community. 

    Authors: Abhijeet Singh; Ayush Gupta; Kamanashish Das

    doi:10.21203/rs.3.rs-22464/v4 Date: 2020-04-11 Source: ResearchSquare

    Background: The ongoing pandemic of novel coronavirus disease MESHD 2019 (COVID-19) has received worldwide attention by becoming a major global health threat. We encountered one case with COVID-19 and tuberculosis MESHD ( TB MESHD) coinfection which has not been frequently reported. Case presentation: A 76 year old female TRANS presented with acute respiratory symptoms MESHD superimposed on chronic symptoms, suggestive to have pneumonia HP pneumonia MESHD. Oropharyngeal throat swab sample for COVID-19 was positive as detected by real-time reverse-transcriptase–polymerase-chain-reaction (RT-PCR) assay. GeneXpert Ultra detected Mycobacterium tuberculosis MESHD complex with Rifampicin resistance indeterminate. Patient was treated with appropriate management. Conclusion: Clinicians should suspect coinfection with TB MESHD during ongoing pandemic of COVID-19 as therapeutic strategies need to be determined timely to improve outcome and prevent transmission TRANS in community. 

    Acupressure Therapy and Liu-Zi-Jue Qigong for Pulmonary Function and Quality of Life in Patients with Severe Novel Coronavirus Pneumonia MESHD Pneumonia HP (COVID-19): Study Protocol for a Randomized Controlled Trial

    Authors: Shuaipan Zhang; Qingguang Zhu; Chao Zhan; Wei Cheng; Xiaoming Fang; Min Fang; Lei Fang

    doi:10.21203/rs.3.rs-21844/v1 Date: 2020-04-07 Source: ResearchSquare

    Background: In December, 2019, a pneumonia HP pneumonia MESHD associated with the 2019 novel coronavirus (COVID-19) emerged in Wuhan, China. The number of cases has increased rapidly, severe patients have a poor prognosis and there are no effective therapies or vaccines for it. Only one rapid advice guideline for symptomatic supportive care has been used for it. A Traditional Chinese medicine Rehabilitation(TCMR) program consisting of acupressure therapy and Liuzijue Qigong can be used as a complementary therapy for COVID-19.Hence, we designed a randomized trial to evaluate the efficacy and advantages of TCMR for treating severe patients with COVID-19.Methods/design: This is a parallel-design, two-arm, analyst-assessor blinded, randomized controlled trial. A total of 120 patients with COVID-19 aged TRANS from 20 to 80 will be recruited and assigned randomly into a guideline therapy group and a guideline therapy plus TCMR group at a 1:1 ratio. Patients in both groups will receive guideline therapy. The patients in intervention group will perform acupressure therapy and Liuzijue Qigong exercise on the basis of conventional treatments, twice a day, and have been persistent from admission to discharge. The primary outcomes are measured with Modified Dyspnea HP Dyspnea MESHD Scale ( MDS MESHD) and Activities of Daily Living (ADL). The secondary outcomes include Patient Health Questionnaire-9 (PHQ-9), Length of Hospital Stay (LHS), Respiratory Symptoms ( RS MESHD), Liver function test, Renal function test and lung CT. Clinical assessments will at three points (before treatment, 7th day during hospitalization and the discharge day). Adverse events will be noted and recorded for the safety evaluation.Discussion: This trail will provide a high-quality evidence of the value of TCMR, which is consist of acupressure therapy and Liuzijue Qigong exercise for treating severe patients with COVID-19.Trial registration: Chinese Clinical Trial Registry, ChiCTR2000029994 Registered 18 February 2020, http://www.chictr.org.cn/showproj.aspx?proj=49309

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