Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Up to 40% of COVID-19 Critically MESHD Ill Patients Have Vitamin D Deficiency

    Authors: Teresa-Maria Tomasa-Irriguible; Lara Bielsa-Berrocal

    id:10.20944/preprints202009.0555.v1 Date: 2020-09-23 Source: Preprints.org

    Background: Coronavirus disease MESHD (COVID-19) has caused more than 745,000 deaths worldwide. Vitamin D has been identified as a potential strategy to prevent or treat this disease. The purpose of the study was to measure vitamin D at hospital admission of COVID-19; Methods: We included critically ill MESHD patients with the polymerase chain reaction positive test for COVID-19, from March to April, 2020. Statistical significance was defined as P < .05. All tests were 2-tailed; Results: A total of 35 patients (median age TRANS, 60 years; 26 [74.3%] male TRANS) were included. Vitamin D levels were categorized as deficient for 14 participants (40%). Vitamin D deficiency MESHD was associated with vitamin A (P= 0.003) and Zinc (P= 0.019) deficiency and lower levels of albumin (P= 0.026) and prealbumin (P= 0.009). Overall, none of the studied variables were associated with vitamin D status: mortality, intensive care unit (ICU) or hospital stay, necessity of vasoactive agents, intubation, prone position, C reactive protein (CRP), Dimer-D, Interleukin 6 levels (IL-6), ferritin levels, or bacterial superinfection; Conclusions: In this single-center, retrospective cohort study, deficient vitamin D status was found in 40% in COVID-19 critically ill MESHD patients. However, deficient vitamin D status was not associated with inflammation MESHD or outcome.

    T cell anergy in COVID-19 reflects virus persistence and poor outcomes

    Authors: Kerstin Renner; Christine Mueller; Charlotte Tiefenboeck; Jan-Niklas Salewski; Frederike Winter; Simone Buchtler; Maximilian V Malfertheiner; Matthias Lubnow; Dirk Lunz; Bernhard Graf; Florian Hitzenbichler; Frank Hanses; Hendrik Poeck; Marina Kreutz; Evelyn Orso; Ralph Burkhardt; Tanja Niedermair; Christoph Brochhausen; Andre Gessner; Bernd Salzberger; Matthias Mack; Christine Goffinet; Florian Kurth; Martin Witzenrath; Maria Theresa Völker; Sarah Dorothea Müller; Uwe Gerd Liebert; Naveed Ishaque; Lars Kaderali; Leif Erik Sander; Sven Laudi; Christian Drosten; Roland Eils; Christian Conrad; Ulf Landmesser; Irina Lehmann

    doi:10.1101/2020.09.21.20198671 Date: 2020-09-23 Source: medRxiv

    Coronavirus disease MESHD 2019 (COVID-19) can lead to severe pneumonia HP pneumonia MESHD and hyperinflammation. So far, insufficient MESHD or excessive T cell responses were described in patients. We applied novel approaches to analyze T cell reactivity and showed that T anergy is already present in non-ventilated COVID-19 patients, very pronounced in ventilated patients, strongly associated with virus persistence and reversible with clinical recovery. T cell activation was measured by downstream effects on responder cells like basophils, plasmacytoid dendritic cells, monocytes and neutrophils in whole blood SERO and proved to be much more meaningful than classical readouts with PBMCs. Monocytes responded stronger in males TRANS than females TRANS and IL-2 partially reversed T cell anergy. Downstream markers of T cell anergy were also found in fresh blood SERO samples of critically ill MESHD patients with severe T cell anergy. Based on our data we were able to develop a score to predict fatal outcomes and to identify patients that may benefit from strategies to overcome T cell anergy.

    Prognostic value of sTREM-1 in COVID-19 patients: a biomarker for disease severity and mortality

    Authors: Pedro V da Silva Neto; Jonatan C S de Carvalho; Vinicius E Pimentel; Malena M Perez; Ingryd Carmona-Garcia; Nicola T Neto; Diana M Toro; Camilla N S Oliveira; Thais F C Fraga-Silva; Cristiane M Milanezi; Lilian C Rodrigues; Cassia F. S. L. Dias; Ana C Xavier; Giovanna S Porcel; Isabelle C Guarneri; Kamila Zaparoli; Caroline T Garbato; Jamille G M Argolo; Angelo A F Junior; Alessandro P de Amorim; Augusto M Degiovani; Dayane P da Silva; Debora C Nepomuceno; Rafael C da Silva; Leticia F Constant; Fatima M Ostini; Marley R Feitosa; Rogerio S Parra; Fernando C Vilar; Gilberto G Gaspar; Jose J R da Rocha; Omar Feres; Rita C C Barbieri; Fabiani G Frantz; Sandra R Maruyama; Elisa M S Russo; Angelina L Viana; Ana P M Fernandes; Isabel K F M Santos; Vania L D Bonato; Marcelo Dias-Baruffi; Adriana Malheiro; Ruxana T Sadikot; Cristina R B Cardoso; Lucia H Faccioli; Carlos A Sorgi

    doi:10.1101/2020.09.22.20199703 Date: 2020-09-23 Source: medRxiv

    Background: The uncontrolled inflammatory response plays a critical role in the novel coronavirus disease MESHD (COVID-19) and triggering receptor expressed on myeloid cells-1 (TREM-1) is thought to be intricate to inflammatory signal amplification. This study aims to investigate the association between soluble TREM-1 (sTREM-1) and COVID-19 as a prognostic biomarker to predict the disease severity, lethality and clinical management.Methods: We enrolled 91 patients with COVID-19 in domiciliary care (44 patients) or in hospital care (47 patients), who were classified after admission into mild, moderate, severe and critical groups according to their clinical scores. As non-COVID-19 control, 30 healthy volunteers were included. Data on demographic, comorbidities and baseline clinical characteristics were obtained from their medical and nurse records. Peripheral blood SERO samples were collected at admission and after hospitalization outcome to assess cytokine profile and sTREM-1 level by specific immunoassays SERO Results: Within COVID-19 patients, the highest severity was associated with the most significant elevated plasma SERO levels sTREM-1. Using receiver operating curve analysis (ROC), sTREM-1 was found to be predictive of disease severity (AUC= 0.988) and the best cut-off value for predicting in-hospital severity was [≥] 116.5 pg/mL with the sensitivity SERO for 93.3% and specificity for 95.8%. We also described the clinical characteristics of these patients and explored the correlation with markers of the disease aggravation. The levels of sTREM-1 were positively correlated with IL-6, IL-10, blood SERO neutrophils counts, and critical disease MESHD scoring (r= 0.68, p<0.0001). On the other hand, sTREM-1 level was significantly negative correlated with lymphocytes counting, and mild disease (r= -0.42, p<0.0001). Higher levels of sTREM-1 were related to poor outcome and death MESHD, patients who received dexamethasone tended to have lower sTREM-1 levels. Conclusion: Our results indicated that sTREM-1 in COVID-19 is associated with severe disease development and a prognostic marker for mortality. The use of severity biomarkers such as sTREM-1 together with patients clinical scores could improve the early recognition and monitoring of COVID-19 cases with higher risk of disease worsening. Key words: COVID-19; sTREM-1; Inflammation; Biomarker; Severity; Mortality.

    T cell anergy in COVID-19 reflects virus persistence and poor outcomes

    Authors: Kerstin Renner; Christine Müller; Charlotte Tiefenböck; Jan-Niklas Salewski; Frederike Winter; Simone Buchtler; Maximilian Malfertheiner; Matthias Lubnow; Dirk Lunz; Bernhard Graf; Florian Hitzenbichler; Frank Hanses; Hendrik Poeck; Marina Kreutz; Evelyn Orso; Ralph Burkhardt; Tanja Niedermair; Christoph Brochhausen; Andre Gessner; Bernd Salzberger; Matthias Mack

    doi:10.21203/rs.3.rs-76318/v1 Date: 2020-09-11 Source: ResearchSquare

    Coronavirus disease MESHD 2019 (COVID-19) can lead to severe pneumonia HP pneumonia MESHD and hyperinflammation. So far, insufficient MESHD or excessive T cell responses were described in patients. We applied novel approaches to analyze T cell reactivity and showed that T anergy is already present in non-ventilated COVID-19 patients, very pronounced in ventilated patients, strongly associated with virus persistence and reversible with clinical recovery. T cell activation was measured by downstream effects on responder cells like basophils, plasmacytoid dendritic cells, monocytes and neutrophils in whole blood SERO and proved to be much more meaningful than classical readouts with PBMCs. Monocytes responded stronger in males TRANS than females TRANS and IL-2 partially reversed T cell anergy. Downstream markers of T cell anergy were also found in fresh blood SERO samples of critically ill MESHD patients with severe T cell anergy. Based on our data we were able to develop a score to predict fatal outcomes and to identify patients that may benefit from strategies to overcome T cell anergy.

    Renal Resistive Index is Associated With Acute Kidney Injury HP Acute Kidney Injury MESHD in COVID-19 Patients Treated in the ICU

    Authors: Mårten Renberg; Olof Jonmarker; Naima Kilhamn; Claire Rimes-Stigare; Max Bell; Daniel Hertzberg

    doi:10.21203/rs.3.rs-75544/v1 Date: 2020-09-10 Source: ResearchSquare

    Background: Renal resistive index (RRI) is a promising tool for prediction of acute kidney injury HP acute kidney injury MESHD ( AKI MESHD) in critically ill MESHD patients but is not described among patients with Coronavirus disease MESHD 2019 (COVID-19). The aim of this study was to describe the pattern of RRI in relation to AKI MESHD in patients with COVID-19 treated in the intensive care unit.Methods: In this observational cohort study, RRI was measured in COVID-19 patients in six ICUs at two sites of a Swedish University Hospital. AKI MESHD was defined by the creatinine criteria in the Kidney Disease MESHD Improving Global Outcome classification. We investigated the association between RRI and AKI MESHD diagnosis, different AKI MESHD stages and urine output.Results: RRI was measured in 51 patients, of which 23 patients (45%) had AKI MESHD at the time of measurement. Median RRI in patients with AKI MESHD was 0.80 (IQR 0.71-0.85) compared to 0.72 (IQR 0.67-0.78) in patients without AKI MESHD (p=0.004). Compared to patients without AKI MESHD, RRI was higher in patients with AKI MESHD stage 3 (median 0.83, IQR 0.71-0.85, p=0.006) but not in patients with AKI MESHD stage 1 (median 0.76, IQR 0.71-0.83, p=0.347) or AKI MESHD stage 2 (median 0.79, min/max 0.79/0.80, n=2, p=0.134). RRI was higher in patients with an ongoing AKI MESHD episode compared to patients who never developed AKI MESHD (median 0.72, IQR 0.69-0.78, p=0.015) or patients who developed AKI MESHD but had recovered at the time of measurement (median 0.68, IQR 0.67-0.81, p=0.021). Oliguric patients had higher RRI (median 0.84, IQR 0.83-0.85) compared to non-oliguric patients (median 0.74, IQR 0.69-0.81) (p=0.009).Conclusions: Critically ill COVID-19 patients with AKI MESHD have higher RRI compared to those without AKI MESHD, and elevated RRI may have a role in identifying severe and oliguric AKI MESHD in these patients. 

    The Incidence of Pulmonary Thromboembolism in Critically MESHD Thromboembolism HP in Critically Ill Patients With COVID-19: A Systematic Review, Meta-Analysis and Meta-Regression of Observational Studies

    Authors: Jun Jie Ng; Zhen Chang Liang; Andrew MTL Choong

    doi:10.21203/rs.3.rs-74260/v1 Date: 2020-09-08 Source: ResearchSquare

    Purpose Coronavirus disease MESHD 2019 (COVID-19) infection is known to be associated with a hypercoagulable and prothrombotic state, especially in critically ill MESHD patients. Several observational studies have reported the incidence of thromboembolic MESHD events such as pulmonary thromboembolism MESHD thromboembolism HP ( PTE MESHD). We performed a meta-analysis to estimate the weighted average incidence of PTE MESHD in critically ill COVID-19 patients who are admitted to the intensive care unit.Methods We searched MEDLINE via PubMed, Embase and Web of Science for relevant studies from 31 December 2019 till 15 Aug 2020 onwards using the search terms “coronavirus”, “COVID-19”, “SARS-CoV-2”, “2019-nCoV”, “thrombus”, “thrombo*”, “ embolus MESHD” and “emboli*”. We included prospective and retrospective observational studies that reported the incidence of PTE MESHD in critically ill COVID-19 patients who required treatment in the intensive care unit. We identified 14 studies after two phases of screening and extracted data related to study characteristics, patient demographics and the incidence of PTE MESHD. Risk of bias was assessed by using the ROBINS-I tool. Statistical analysis was performed with R 3.6.3.Results We included 14 studies with a total of 1182 patients in this study. Almost 100% of patients in this meta-analysis received at least prophylactic anticoagulation. The weighted average incidence of PTE MESHD was 11.09% (95% CI 7.72% to 15.69%, I2 = 78%, Cochran’s Q test P < 0.01). We performed univariate and multivariate meta-regression which identified the proportion of males TRANS as a significant source of heterogeneity (P = 0.03, 95% CI 0.00 to -0.09)Conclusion This is the only study that had specifically reported the weighted average incidence of PTE MESHD in critically ill COVID-19 patients using meta-analytic techniques. The weighted average incidence of PTE MESHD remains high even after prophylactic anticoagulation. This study is limited by incomplete data from included studies. More studies are needed to determine the optimal anticoagulation strategy in critically ill COVID-19 patients.

    Early Corticosteroids Decrease Mortality in Critically Ill Patients with COVID-19: A Cohort Study

    Authors: Pablo Monedero; Alfredo Gea; Pedro Castro; Angel M. Candela-Toha; María L. Hernández-Sanz; Egoitz Arruti; Jesús Villar; Carlos Ferrando

    doi:10.21203/rs.3.rs-71610/v1 Date: 2020-09-03 Source: ResearchSquare

    Background: Critically ill MESHD patients with coronavirus disease MESHD 19 (COVID-19) have a high fatality rate likely due to a dysregulated MESHD immune response. Corticosteroids could attenuate this inappropriate response, although there are still some concerns regarding its use, timing, and dose. Methods: This is a nationwide, prospective, multicenter, observational, cohort study in critically ill adult TRANS patients with COVID-19 admitted into Intensive Care Units (ICU) in Spain from March 12th to June 29th, 2020. Using a multivariable Cox model with inverse probability weighting, we compared relevant outcomes between patients treated with early corticosteroids (before or within the first 48h of ICU admission) with those who did not receive early corticosteroids or any corticosteroids at all. Primary endpoint was ICU mortality. Secondary endpoints included 7-day mortality, ventilator-free days, and complications. Results: A total of 691 patients out of 882 (78.3%) received corticosteroid during their hospital stay. Patients treated with early-corticosteroids (n=485) had a lower ICU mortality (30.3% vs 40.6%, HR 0.71, 95% CI 0.57-0.89) and higher number of ventilator-free days (mean difference 2.5 days, 95% CI 1.3-3.8) compared to non-early treated patients. There were no differences in 7-day mortality (HR 0.76, 95% CI 0.48-1.2), medical complications (OR 2.18, 95% CI 0.91-5.25) or secondary infections (OR 0.88, 95% CI 0.67-1.15) between both groups. Of note, early use of moderate-to-high doses was associated with better outcomes than low dose regimens. Conclusion: Early use of corticosteroids in critically ill MESHD patients with COVID-19 is associated with lower mortality (10.3% absolute risk reduction) and shorter duration of mechanical ventilation.

    Outcome of SARS-CoV-2 infection MESHD linked to MAIT cell activation and cytotoxicity MESHD: evidence for an IL-18 dependent mechanism

    Authors: Héloïse Flament; Matthieu Rouland; Lucie Beaudoin; Amine Toubal; Léo Bertrand; Samuel Lebourgeois; Zouriatou Gouda; Camille Rousseau; Pauline Soulard; Maria Hurtado-Nedelec; Sandrine Luce; Karine Bailly; Muriel Andrieu; Christian Boitard; Anaïs Vallet-Pichard; Jean-Francois Gautier; Nadine Ajzenberg; Benjamin Terrier; Frédéric Pene; Jade Ghosn; Yazdan Yazdanpanah; Benoit Visseaux; Diane Descamps; Jean-Francois Timsit; Renato Costa Monteiro; Agnes Lehuen; William Damsky; David van Dijk; Alfred Ian Lee; Hyung Chun; Akhil Vaid; Guillermo Barturen; Scott R. Tyler; Hardik Shah; Yinh-chih Wang; Shwetha Hara Sridhar; Juan Soto; Swaroop Bose; Kent Madrid; Ethan Ellis; Elyze Merzier; Konstantinos Vlachos; Nataly Fishman; Manying Tin; Melissa Smith; Hui Xie; Manishkumar Patel; Kimberly Argueta; Jocelyn Harris; Neha Karekar; Craig Batchelor; Jose Lacunza; Mahlet Yishak; Kevin Tuballes; Leisha Scott; Arvind Kumar; Suraj Jaladanki; Ryan Thompson; Evan Clark; Bojan Losic; - The Mount Sinai COVID-19 Biobank Team; Jun Zhu; Wenhui Wang; Andrew Kasarskis; Benjamin S. Glicksberg; Girish Nadkarni; Dusan Bogunovic; Cordelia Elaiho; Sandeep Gangadharan; George Ofori-Amanfo; Kasey Alesso-Carra; Kenan Onel; Karen M. Wilson; Carmen Argmann; Marta E. Alarcón-Riquelme; Thomas U. Marron; Adeeb Rahman; Seunghee Kim-Schulze; Sacha Gnjatic; Bruce D. Gelb; Miriam Merad; Robert Sebra; Eric E. Schadt; Alexander W. Charney

    doi:10.1101/2020.08.31.20185082 Date: 2020-09-02 Source: medRxiv

    Immune system dysfunction MESHD is paramount in Coronavirus disease MESHD 2019 (COVID-19) severity and fatality rate. Mucosal-Associated Invariant T (MAIT) cells are innate-like T cells involved in mucosal immunity and protection against viral infections. Here, we studied the immune cell landscape, with emphasis on MAIT cells, in a cohort of 182 patients including patients at various stages of disease activity. A profound decrease of MAIT cell counts in blood SERO blood MESHD of critically ill patients was observed. These cells showed a strongly activated and cytotoxic phenotype that positively correlated with circulating pro-inflammatory cytokines, notably IL-18. MAIT cell alterations markedly correlated with disease severity and patient mortality. SARS-CoV-2-infected MESHD macrophages activated MAIT cells in a cytokine-dependent manner involving an IFN-dependent early phase and an IL-18-induced later phase. Therefore, altered MAIT cell phenotypes represent valuable biomarkers of disease severity and their therapeutic manipulation might prevent the inflammatory phase involved in COVID-19 aggravation.

    Clinical Characteristics, Comorbidities, Initial Management and Outcome of COVID-19 Infected Patients Admitted to Intensive Care Unit in Somalia: A National Retrospective Study.

    Authors: Mohamed Farah Yusuf Mohamud; Abdullahi Said Hashi; Abdikarim Hussein Mohamed; Ali Mohamed Yusuf; Ibrahim Hussein Ali; Mohamed Abdi Ahmed

    doi:10.21203/rs.3.rs-66767/v1 Date: 2020-08-27 Source: ResearchSquare

    Purpose: To investigate the clinical characteristics, morbidities, management, and outcomes of COVID-19 Infected patients admitted to the intensive care unit (ICU) in Somalia.Material MESHD and methods: We conducted a retrospective observational study of laboratory 60 confirmed patients with severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) admitted to an ICU from March 28, to May 28, 2020.The sociodemographic characteristics, comorbidities, exposure history, clinical manifestations (symptoms and signs), laboratory findings, treatment, and outcomes were collected from medical records.Results: Most of the patients admitted to ICU were men over 59 years of age TRANS, and nearly half had diabetes MESHD followed by hypertension HP hypertension MESHD chronic kidney disease HP and asthma HP asthma MESHD. The most clinical presentations were dyspnea HP dyspnea MESHD (91.2%), Fever HP Fever MESHD (81.1%), (68.75%), Fatigue HP and myalgia HP myalgia MESHD (25%), and Altered level of conscious (16.6%). Among 48 patients admitted to the ICU, about 24 (50%) patients had required endotracheal intubation and mechanical ventilation, and 11(29.9%) patients needed noninvasive ventilation, while 13(27.08%) patients treated with high-flow oxygen therapy >15 L/min (Table 3). Corticosteroids were administered to most patients (85.4%), while 77.1% of the patients received inhaled bronchodilators and morethan half of the patients administered antibiotics. 58.3% of the patients had received Oseltamivir, while 22.9% received Vasopressors.Conclusion This study represents the first description of critically ill MESHD patients infected with SARS-CoV-2 admitted to ICU in Somalia. The study identified that elder age TRANS, male TRANS gender TRANS, and diabetic MESHD and hypertensive MESHD comorbidities as independent risk factors of poor outcomes for patients admitted to the ICU (p<0.005).

    Extubation success without using high-flow nasal cannula and non-invasive ventilation for patients with coronavirus disease MESHD 2019 (COVID-19): A retrospective observational study

    Authors: Akira Inoue; Kazuhiro Shirakawa; Nonoka Fujita; Kunio Kanao; Yutaka Saito; Kiyotsugu Takuma

    doi:10.21203/rs.3.rs-64389/v1 Date: 2020-08-23 Source: ResearchSquare

    Background In March 2020, the World Health Organization declared coronavirus disease MESHD 2019 (COVID-19) to be a global pandemic. It was also reported that approximately 20%-23% of patients with COVID-19 admitted to the hospital required mechanical ventilation (MV). Reintubation rates ranged from 13–19%, leading to increased mortality. Moreover, exposure of health care workers is a serious problem and intubation is a high-risk procedure because of aerosol generation. To reduce reintubation, preventive high-flow nasal cannula (HFNC) and non-invasive ventilation (NIV) after extubation are recommended. However, using HFNC and NIV in patients with COVID-19 may lead to the spread of infection MESHD. Without using HFNC and NIV, conventional spontaneous breathing trial (SBT) may overestimate a patient’s respiratory status. A highly demanding SBT accurately assesses a patient’s reserve capacity and may reduce reintubation. We did not use preventive HFNC or NPPV and extubated with a highly demanding SBT protocol. This study aimed to evaluate whether our protocol can be performed safely.Methods This single-centre study was conducted at the Kawasaki Municipal Hospital from February 2020 to June 2020. Patients with COVID-19 requiring MV were screened for their eligibility for the weaning procedure every day. Patients were extubated after administering methylprednisolone if SBT was well tolerated. SBT was performed with 3 cmH2O pressure support, 3 cmH2O positive end-expiratory pressure, and ≤ 0.30 fraction of inspired oxygen. In extubated patients, the reintubation rate, duration of MV, length of intensive care unit (ICU) and hospital stay, and rate of ventilator-associated pneumonia HP pneumonia MESHD ( VAP MESHD) were analyzed.Results Ten patients received MV. Two of 10 patients had no improvement in their respiratory status and did not qualify for the extubation criteria and died. Eight patients were extubated. No reintubations were performed (0%). The median durations of MV, ICU stay, and hospital stay were 13 (interquartile range [IQR], 10–16) days, 17 (IQR, 13–27) days, and 22 (IQR, 16–26), and 3 patients (37.5%) was diagnosed VAP.Conclusions Extubation was performed with a highly demanding SBT protocol, and no patients were reintubated. All patients did not require HFNC and NIV. Further research is required in critically ill MESHD patients.

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MeSH Disease
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