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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Pathogenesis Clues from the Early Clinical Presentation of 300 Hospitalized COVID-19 Patients

    Authors: Feng Yu; Xuemei Deng; Li Ni; Wei Li; Ping Yan; Mian Huang; xiongbiao wang

    doi:10.21203/rs.3.rs-42484/v1 Date: 2020-07-13 Source: ResearchSquare

    Background: The global spread of the 2019 coronavirus disease MESHD (COVID-19) has lasted more than half a year. Except for the gene sequence and viral structure of SARS-CoV-2, its clinical characteristics, pathological mechanisms and corresponding measures have not been fully revealed. We aimed to speculate about the possible pathological mechanism from the early clinical manifestations of patients with COVID-19. Methods: The onset symptoms TRANS, laboratory examinations and CT findings on admission of 300 patients in two wards of Wuhan Third Hospital from January 28 to March 15 were analyzed retrospectively. Results: There was no difference in incidence between men and women, but women were hospitalized later after onset. Upper respiratory symptoms and sputum were rare. The incidence of fever HP fever MESHD was 71%. Blood SERO lymphocyte counts were decreased significantly on admission and were related to the severity of the disease. In moderate patients without hypoxia MESHD, thrombocytopenia HP thrombocytopenia MESHD occurred in 12.37%, CRP rose in 64.43%, BUN was elevated in 20.62%, creatinine rose in 17.53%, D-dimer was elevated in 74.74%, and creatine kinase and α-hydroxybutyrate dehydrogenase were elevated in 45.36% and 54.12% of patients, respectively. Early CT showed a small amount of infiltration in the subpleural and lateral zones of the lung and thickening of the interlobular septum. Approximately 5 days later, infiltration was worse in some of the patients, and the proportion of involvement of the affected lung was negatively correlated with the lymphocyte count. Conclusions: There was no sex difference in patients with SARS-CoV-2 infection MESHD. Alveolar MESHD cells and T lymphocytes may be the main targets of the virus, and apoptosis may be the primary mechanism of pathogenesis. The virus entering the lung may be transmitted through lymph or blood SERO vessels rather than directly dispersing through the respiratory tract. Early damage to multiple organs may be caused by the immune response. 

    COVID-19: The Rollercoaster of Fibrin(ogen), D-dimer, von Willebrand MESHD Factor, P-selectin and Their Interactions with Endothelial Cells, Platelets and Erythrocytes MESHD

    Authors: Corlia Grobler; Jhade Bredenkamp; Mireille Grobbelaar; Sipho Maphumulo; Jaco Laubscher; Janami Steenkamp; Douglas Kell; Etheresia Pretorius

    id:10.20944/preprints202007.0142.v1 Date: 2020-07-08 Source: Preprints.org

    Severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), coronavirus disease MESHD 2019 (COVID-19)-induced infection MESHD is strongly associated with various coagulopathies MESHD that may result in either bleeding MESHD and thrombocytopenia HP thrombocytopenia MESHD or hypercoagulation MESHD and thrombosis MESHD. Thrombotic and bleeding MESHD or thrombotic MESHD pathologies are significant accompaniments to acute respiratory syndrome MESHD and lung complications MESHD in COVID-19. Thrombotic MESHD events and bleeding MESHD, often occurs in subjects with weak multiple risk factors and co-morbidities. Of particular interest are the various circulating inflammatory coagulation biomarkers involved directly in clotting, with specific focus on fibrin(ogen), D-dimer, P-selectin and von Willebrand MESHD Factor (vWF). Central to activity of these biomarkers are their receptors and signaling pathways on endothelial cells, platelets and erythrocytes. In this review, we discuss vascular implications of COVID-19, and relate this to circulating biomarker, endothelial, erythrocyte and platelet dysfunction MESHD. During the progression of the disease, these markers may either be within healthy levels, upregulated or eventually depleted. Most significant is that patients need to be treated early in the disease progression, when high levels of vWF, P-selectin and fibrinogen are present with still low levels of D-dimer. Progression to vWF and fibrinogen depletion with high D-dimer levels and even higher P-selectin levels, followed by the cytokine storm, will be indicative of a poor prognosis. We conclude by looking at point-of-care devises and methodologies in COVID-19 management and suggest that a personalized medicine approach should be considered in the treatment of patients.

    Factors Associated with Hospitalization and Disease Severity in a Racially and Ethnically Diverse Population of COVID-19 Patients

    Authors: Angelico Mendy; Senu Apewokin; Anjanette A Wells; Ardythe L Morrow

    doi:10.1101/2020.06.25.20137323 Date: 2020-06-26 Source: medRxiv

    Background: The coronavirus disease MESHD (COVID-19) first identified in Wuhan in December 2019 became a pandemic within a few months of its discovery. The impact of COVID-19 is due to both its rapid spread and its severity, but the determinants of severity have not been fully delineated. Objective: Identify factors associated with hospitalization and disease severity in a racially and ethnically diverse cohort of COVID-19 patients. Methods: We analyzed data from COVID-19 patients diagnosed at the University of Cincinnati health system from March 13, 2020 to May 31, 2020. Severe COVID-19 was defined as admission to intensive care unit or death MESHD. Logistic regression modeling adjusted for covariates was used to identify the factors associated with hospitalization and severe COVID-19. Results: Among the 689 COVID-19 patients included in our study, 29.2% were non-Hispanic White, 25.5% were non-Hispanic Black, 32.5% were Hispanic, and 12.8% were of other race/ethnicity. About 31.3% of patients were hospitalized and 13.2% had severe disease. In adjusted analyses, the sociodemographic factors associated with hospitalization and/or disease severity included older age TRANS, non-Hispanic Black or Hispanic race/ethnicity (compared to non-Hispanic White), and smoking. The following comorbidities: diabetes MESHD, hypercholesterolemia HP hypercholesterolemia MESHD, asthma HP asthma MESHD, COPD MESHD, chronic kidney disease HP chronic kidney disease MESHD, cardiovascular diseases MESHD, osteoarthritis HP osteoarthritis MESHD, and vitamin D deficiency MESHD were associated with hospitalization and/or disease severity. Hematological disorders MESHD such as anemia HP anemia MESHD, coagulation disorders MESHD, and thrombocytopenia HP thrombocytopenia MESHD were associated with both hospitalization and disease severity. Conclusion: This study confirms race and ethnicity as predictors of severe COVID-19. It also finds clinical risk factors for hospitalization and severe COVID-19 not previously identified such a vitamin D deficiency MESHD, hypercholesterolemia HP hypercholesterolemia MESHD, osteoarthritis HP osteoarthritis MESHD, and anemia HP anemia MESHD.

    Afebrile patients with severe acute respiratory syndrome coronavirus 2 infection MESHD have a longer viral positivity duration: a retrospective analysis of 143 patients

    Authors: Rui Ding; Rugang Zhao; Wen Xie; Ying Fan; Ligai Liu; Ying Cao; Cheng Cheng; JingJing Wang; Qi Wang; Yanbin Wang; Ting Zhang; Minghui LI

    doi:10.21203/rs.3.rs-36961/v2 Date: 2020-06-19 Source: ResearchSquare

    Background A pandemic of severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) is on-going. Clinical characters of afebrile cases infected with SARS-CoV-2 remain poorly understood and informations are limited on the duration of SARS-CoV-2 viral positivity.Methods We performed a single-center retrospective study of 143 patients with SARS-CoV-2 infection MESHD in Beijing Ditan Hospital, Capital Medical University from January 26 to April 15, 2020. Differences were compared among patients with/without fever HP fever MESHD. Risk factors for the duration of SARS-CoV-2 viral positivity were evaluated.Results A total of 143 patients with positive SARS-CoV-2 test were enrolled, including 38 afebrile patients and 105 febrile patients. On admission, a total of 40 (28%) patients had leukopenia HP leukopenia MESHD, 44 (30.8%) had lymphopenia HP lymphopenia MESHD and 8 (5.6%) had thrombocytopenia HP thrombocytopenia MESHD. 78 patients (54.5%) had decreased T lymphocytes and 105 patients (73.4%) had decreased CD4+T lymphocytes. Compared with febrile cases, afebrile patients had a significantly higher white blood SERO cell count (P = 0.02), total lymphocytes (P < 0.01), platelet count (P < 0.01), T lymphocytes (P < 0.01) and CD8+ T lymphocytes (P = 0.02). The median SARS-CoV-2 viral positivity duration of these 143 patients was 14 days (IQR, 10-30 days) and for febrile and afebrile group were 13 days (IQR, 10-29 days) and 20 days (IQR, 11-31 days) respectively. Multivariate Cox regression results showed that the fever HP fever MESHD [hazard ratio (HR) = 0.49, P < 0.01]and higher count of platelet (HR = 5.47, P = 0.02) were the predominant risk factor for the SARS-CoV-2 viral positivity duration.Conclusion The SARS-CoV-2 virial positivity duration of the afebrile group was significantly longer than that in the febrile group. Fever HP Fever MESHD and a higher count of platelet were the independent protective factors for a shorter SARS-CoV-2 RNA positivity duration.

    Afebrile Patients with Severe Acute Respiratory Syndrome Coronavirus 2 Infection MESHD have a Longer Viral Positivity Duration: A Retrospective Analysis of 125 Patients

    Authors: Rui Ding; Rugang Zhao; Wen Xie; Ying Fan; Ligai Liu; Ying Cao; Cheng Cheng; JingJing Wang; Qi Wang; Yanbin Wang; Ting Zhang; Minghui LI

    doi:10.21203/rs.3.rs-36961/v1 Date: 2020-06-19 Source: ResearchSquare

    Background: A pandemic of severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) is on-going. Clinical characters of afebrile cases infected with SARS-CoV-2 remain poorly understood and informations are limited on the duration of SARS-CoV-2 viral positivity.Methods: We performed a single-center retrospective study of 125 patients with SARS-CoV-2 infection MESHD in Beijing Ditan Hospital, Capital Medical University from January 26 to March 15, 2020. Differences were compared among patients with/without fever HP fever MESHD. Risk factors for the duration of SARS-CoV-2 viral positivity were evaluated.Results: A total of 125 patients with positive SARS-CoV-2 test were enrolled, including 38 afebrile patients and 87 febrile patients. On admission, a total of 35 (28%) patients had leukopenia HP leukopenia MESHD, 41 (32.8%) had lymphopenia HP lymphopenia MESHD and 6 (4.8%) had thrombocytopenia HP thrombocytopenia MESHD. 73 patients (58.4%) had a loss of T lymphocytes and 96 patients (76.8%) had decreased CD4+T lymphocytes. Compared with febrile cases, afebrile patients had a significantly higher white blood SERO cell count (P = 0.001), total lymphocytes (P < 0.001), platelet count (P < 0.001), T lymphocytes (P = 0.013) and CD8+ T lymphocytes (P = 0.002). The median SARS-CoV-2 viral positivity duration of these 125 patients was 14 days (IQR, 10-30 days) and for febrile and afebrile group were 12 days (IQR, 9-23 days) and 23 days (IQR, 11-30 days) respectively. Multivariate Cox regression results showed that the fever HP fever MESHD [hazard ratio (HR) = 0.497, P = 0.006], young age TRANS (HR = 0.965, P = 0.018), and higher count of platelet (HR = 4.555, P = 0.034) were the predominant risk factor for the SARS-CoV-2 viral positivity duration.Conclusion: The SARS-CoV-2 virial MESHD positivity duration of the afebrile group was significantly longer than that in the febrile group. Fever HP Fever MESHD, young age TRANS and a higher count of platelet were the independent protective factors for a shorter SARS-CoV-2 RNA positivity duration.

    A Case Report of Heparin-Induced Thrombocytopenia HP Thrombocytopenia MESHD in a Patient One Month after Coronary Artery Bypass Graft Surgery in the Era of Coronavirus Disease MESHD 2019

    Authors: ibrahim mungan; seval izdeş

    doi:10.21203/rs.3.rs-34795/v1 Date: 2020-06-12 Source: ResearchSquare

    Background : Coronavirus infectious disease MESHD 2019 (COVID-19), which evolved to a global pandemic issue leads to coagulation system abnormalities MESHD and low molecular heparin or unfractionated heparin is advised. Heparin-induced thrombocytopenia HP thrombocytopenia MESHD ( HIT MESHD) is one of the most worried complications of heparin exposure.Case Presentation: In this case report, we presented a 75 year- old male TRANS patient with suspicious COVID-19 infection MESHD who admitted to our intensive care unit one month after cardiac surgery. On admission due to increased D-dimer level and history of CABG, he was started to LMWH (enoxaparin) 0.5 mg/kg twice daily yet HIT MESHD occurred and enoxaparin was held. Fondaparinux was started to decrease the thrombosis MESHD risk.Conclusion: In the era of COVID-19, the management of coagulopathy MESHD is important while HIT MESHD should be mind in every patient after the preliminary heparin treatment.

    The Neutrophil Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR) and routine hematological parameters of COVID-19 Patient : A perspective of the Indian scenario from a frontline pilot study of 32 COVID-19 cases in a Tertiary Care Institute of North India

    Authors: Neema Tiwari; Devajit Nath; Jyotsna Madan; Savitri Singh; Prashant Bajpai; Ujjwal Madan

    doi:10.1101/2020.05.29.20102913 Date: 2020-06-01 Source: medRxiv

    Introduction The coronavirus disease MESHD 2019(COVID-19) is caused by the virus SARS-CoV-2 and is declared as a global pandemic by the World Health Organization (WHO). Various hematological parameters alteration has been documented in the Chinese literature in SARS-Cov-2 infection MESHD. However, there is a need for research to evaluate the pattern of the hematological parameters of COVID-19 patients in the Indian population. Aims & Objectives: The objective of the study is to see the Neutrophil-Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio (PLR), and other hematological parameters alteration of COVID-19 patients along with their clinical course in the Indian scenario. Methods: A single-center prospective study of 32 patients with laboratory-confirmed COVID-19 admitted to Super Speciality Pediatric Hospital & Post Graduate Teaching Institute NOIDA, from March to April, were enrolled for the study. The demographic data, the clinical status of the patients during admission and follow up, baseline, and follow up hematological findings were recorded. Statistical analysis of the data was carried out, and relevant findings were presented. Results: Demographic characterization shows a mean age TRANS of 37.7 years, male TRANS (41.9%), female TRANS (58.1%)with the majority of patients are mildly symptomatic to asymptomatic TRANS(93%). The CBC values and NLR, PLR at baseline between the male TRANS and the female TRANS patients, are not showing any statistically significant difference as the 95% C.I. A statistically significant increment in the lab parameters is observed in follow-up visits. Conclusion: The majority of the patients are younger and have mild clinical presentation with female TRANS predominance. Pediatric cases have mild symptomology. Baseline CBC findings show mild neutrophilia HP, lymphopenia HP lymphopenia MESHD, eosinopenia, and normal to mild thrombocytopenia HP thrombocytopenia MESHD. An increase in CBC parameters, NLR was noted in follow up cases. Anemia HP Anemia MESHD was not noted in baseline CBC and in the follow-up group. A onetime PLR is not indicative of disease progression. Key words: Corona virus,COVID-19,CBC,NLR,PLR

    Clinical, Laboratory, and Radiological Features Indicative of Novel Coronavirus Disease MESHD (COVID-19) in Emergency Departments – A Multicentre Case-Control Study in Hong Kong

    Authors: Rex Pui Kin Lam; Kevin Kei Ching Hung; Eric Ho Yin Lau; Chun Tat Lui; Kin Ling Chan; Chin San Leung; Ion Wa Wong; Kin Wa Wong; Colin A. Graham; Patrick Chiu Yat Woo

    id:10.20944/preprints202005.0285.v1 Date: 2020-05-17 Source: Preprints.org

    (1) Background: It is unclear whether the reported presenting clinical features of coronavirus disease MESHD 2019 (COVID-19) are useful in identifying high-risk patients for early testing and isolation in the emergency department (ED). We aimed to compare the exposure history, clinical, laboratory, and radiographic features of ED patients who tested positive and negative for COVID-19; (2) Methods: We conducted a case-control study in seven EDs during the first five weeks of the COVID-19 outbreak in Hong Kong. Thirty-seven laboratory-confirmed COVID-19 patients were compared with 111 age TRANS- and gender TRANS-matched controls; (3) Results: There were no significant differences in patient characteristics and reported symptoms between the groups, except patient-reported fever HP fever MESHD. A positive travel TRANS history or contact history was the most significant predictor for COVID-19 infection MESHD. After adjustment for age TRANS and presumed location of acquiring the infection in Wuhan/Hubei, patient-reported fever HP fever MESHD (OR 2.6, 95% CI 1.1 to 6.3), delayed presentation (OR 5.0, 95% CI 2.0 to 12.5), having medical consultation before ED presentation (OR 7.4, 95% 2.9 to19.1), thrombocytopenia HP thrombocytopenia MESHD (OR 4.0, 95% CI 1.6 to 9.7), raised lactate dehydrogenase (OR 5.9, 95% CI 1.9 to 18.5), haziness, consolidation or ground-glass opacity on chest radiography (OR 5.6, 95% CI 2.0 to 16.0), and bilateral changes on chest radiography (OR 13.2, 95% CI 4.7 to 37.4) were associated with a higher odds of COVID-19 separately while neutrophilia HP was associated with a lower odds (OR 0.3, 95% CI 0.1-0.8); and (4) Conclusions: This study highlights several features that may be useful in identifying high-risk patients for early testing and isolation while waiting for test result. Further studies are warranted to verify the findings.

    Comparison of clinical characteristics and risk factors in hospitalized patients with SARS-CoV-2, MERS-CoV, and SARS-CoV infection MESHD

    Authors: Zhengtu Li; Xidong Wang; Guansheng Su; Zeguang Zheng; Shaoqiang Li; Yuwei Ye; Qiuxue Deng; Jinchuang Li; Xiaoyu Xiong; Xinguang Wei; Zeqiang Lin; Zichen Jie; Feng Ye

    doi:10.21203/rs.3.rs-28847/v1 Date: 2020-05-14 Source: ResearchSquare

    Herein, we compared the risk factors, clinical presentation of patients hospitalized with SARS-CoV-2, SARS-CoV MESHD, or MERS-CoV infection MESHD. Our data sources include PubMed, Embase, CNKI, and Ovid/Medline. The proportion of male TRANS patients with COVID-19 was higher than who with SARS but lower than who with MERS (p<0.001). More patients with COVID-19 had coexisting chronic medical conditions than those with SARS (p<0.001) but fewer than those with MERS (p<0.001), and the prevalence SERO of hypertension HP hypertension MESHD (17%) and smoking history (14%) was higher than in patients with SARS (p<0.001). Furthermore, the symptom of fever HP fever MESHD (53%), hemoptysis HP (1%), diarrhea HP diarrhea MESHD (4%) and vomiting HP vomiting MESHD (3%) of COVID-19 were significantly lower than that in patients with SARS or MERS. The level of ALT and AST in COVID-19 was significantly lower (p<0.001), however, thrombocytopenia HP thrombocytopenia MESHD, high LDH were common. Summary, male TRANS, smoking history and hypertension HP hypertension MESHD were the most common risk factors for hospitalization with COVID-19; and the clinical feature was less severe in COVID-19.

    Methods of An Open-Label Proof-Of-Concept Trial of Intravenous Valproic Acid for Severe COVID-19

    Authors: Erwin Chiquete; Liz Toapanta-Yanchapaxi; Carlos Cantu-Brito

    doi:10.1101/2020.04.26.20079988 Date: 2020-05-01 Source: medRxiv

    Background: Coronavirus disease 2019 (COVID-19) is the systemic entity caused by the severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) that may cause death MESHD through severe atypical pneumonia HP pneumonia MESHD and acute lung injury MESHD. Valproic acid (VPA) has shown anti-inflammatory activity and mild intrinsic antiviral effect. These properties warrant the study of VPA as a possible active treatment in persons with severe COVID-19. Methods: Consecutive adult TRANS patients needing invasive mechanical ventilation (IMV) will be given intravenous (i.v.) VPA at a starting dose of 20 mg/kg/day and up to 60/kg/day (in 60 min i.v. infusions in 250 mL normal saline) as needed to reach plasma SERO VPA concentrations of 50-100 mcg/mL (measured every 72 h). These patients will be followed-up for 10 days for the primary outcome and for a further period of 30 days after treatment completion for the secondary outcome of recurrence. The primary study outcome is the reduction in the case fatality rate of at least 50% after 10 days of treatment (as compared with natural history). Secondary outcomes are the reduction of length of stay (LOS) of at least 50%, as well as COVID-19 recurrence at 30-day follow-up. The most important safety outcomes are acute liver failure MESHD, acute pancreatitis HP acute pancreatitis MESHD, and thrombocytopenia HP thrombocytopenia MESHD. Conclusion: Although long-term adverse effects and even pro-inflammatory consequences have been reported with the chronic use of VPA, given the urgent need for a drug against COVID-19 to shorten the high mortality and LOS, the study of VPA is justified from a scientific standpoint.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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