Corpus overview


MeSH Disease

Human Phenotype


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    Clinical Characteristics and Outcomes of COVID-19 Positive Acute Coronary Syndrome MESHD Patients; a multisource Electronic Healthcare Records Study from England

    Authors: Muhammad Rashid; Jianhua Wu; Adam Timmis; Nick Curzen; Azfar Zaman; Sarah Clarke; James Nolan; Ahmad Shoiab; Mohamed O Mohamed; Mark De Belder; John Deanfield; Chris Gale; Mamas Mamas; Ian Reckless; Tim Brooks; Andre Charlett; Matthew Hickman; Isabel Oliver; David Wyllie

    doi:10.1101/2020.08.20.20175091 Date: 2020-08-22 Source: medRxiv

    Background: Patients with underlying cardiovascular disease MESHD and Coronavirus disease MESHD 2019 (COVID-19) infection MESHD are at increased risk of morbidity and mortality. However, there is limited information on management and outcomes of patients presenting with acute coronary syndrome MESHD ( ACS MESHD) and concomitant COVID19 infection MESHD. Objectives: This multisource national analysis of live data from England was designed to characterise the presenting profile and outcomes of patients hospitalized with ACS MESHD and COVID-19 infection MESHD. Methods: Multisource data from all acute NHS hospital in England was linked to study the characteristics and outcomes of patients hospitalized with COVID-19 ACS MESHD compared to non COVID-19 ACS MESHD patients. Hierarchical multilevel models were constructed to study the association between COVID19 ACS MESHD and in-hospital and 30-day mortality. Results: Between 1st March 2020 and 31st May 2020, 517 (4.0%) were admitted with COVID- 19 ACS MESHD from a total of 12,958 ACS MESHD patients. COVID-19 ACS MESHD patients were generally older, BAME ethnicity, more comorbid and had unfavourable presenting characteristics compared to non-COVID-19 ACS MESHD patients. They were less likely to receive invasive coronary strategy in the form of coronary angiography (67.7% vs 81.0%), PCI (30.2% vs 53.9%), dual antiplatelet medication 76.3% vs 88.0%), and other important secondary medication. Patients with COVID-19 ACS MESHD had higher in-hospital (aOR 3.27 95%CI 2.41-4.42) and 30-day mortality (aOR 6.53 95%CI 5.1-8.36) compared to non COVID-19 ACS MESHD group. Conclusion: COVID-19 infection MESHD is prevalent but less frequent in the patients hospitalized with ACS MESHD in England. Presence of COVID-19 infection MESHD in patients with ACS MESHD is associated with significant mortality hazard.

    The Impact of the COVID-19 Pandemic on the Emergency Department Visits: A Retrospective Analysis in Shanghai, China

    Authors: Wei Long; Jiudong Hu; Lijuan Li; Sheng Zuo; Qian Yang; Zenghua Ren

    doi:10.21203/ Date: 2020-07-27 Source: ResearchSquare

    BackgroundThe novel coronavirus diseases MESHD (COVID-19) has led to a pandemic and affected people's lives greatly, including their health seeking behavior. We aimed to evaluate the impact of the current COVID-19 pandemic on characteristics and trends of emergency department (ED) visits in Shanghai, China.MethodsThis was a retrospective observational study using medical record databases from the Shanghai Sixth People's Hospital (East Campus) for years 2016 through 2020. All the patients referred to the ED between January 2016 and June 2020 were retrospectively reviewed. January 1, 2020, was chosen as the cutoff date for the statistical analysis and data of January and February in 2020 was compared with the same period of 2019.ResultsDuring the first two months of 2020, there was a 60.9% decline in ED visits when compared with the same period of 2019 (9,904 vs. 25,316, respectively), and the waiting time in ED has been greatly reduced correspondingly (12±4 vs. 66±19 min, p < 0.001); ED visits for acute ischemic stroke MESHD ischemic stroke HP ( AIS MESHD) and acute coronary syndrome MESHD(ACS) decreased by 53.9% and 41.2% respectively; proportion of intravenous thrombolysis for AIS MESHD has dropped(42.1% vs. 11.4%, p = 0.003), and percutaneous coronary intervention for ACS was similar (70.6% vs. 63.3%, p = 0.668); and onset-to-door time (ODT) of these patients increased significantly ( AIS MESHD: 217(136-374) vs. 378(260-510)min, ACS: 135(85-195) vs. 226(155-368)min, all p < 0.001).ConclusionThe outbreak of COVID-19 pandemic was correlated with a significant decline in the number of ED visits including AIS MESHD and ACS patients when compared to the pre-COVID-19 period. ODT of AIS MESHD and ACS patients increased significantly. Raising public awareness is necessary to avoid serious healthcare and economic consequences of undiagnosed and untreated stroke HP stroke MESHD and myocardial infarction HP myocardial infarction MESHD attack.

    Cardiovascular Implications of Coronavirus Disease MESHD 2019 (COVID-19): A Systematic Review

    Authors: Ravi Ranjan Pradhan; Ajay Kumar Yadav; Shobha Mandal

    doi:10.21203/ Date: 2020-07-02 Source: ResearchSquare

    Background: World Health Organization has declared Coronavirus disease MESHD (COVID-19) as a Public Health Emergency of International Concern. It has killed thousands and millions are infected worldwide. Though COVID-19 is supposed to be primarily a disease of respiratory system, it also has widespread implications on other systems as well. The aim of this systematic review is to summarize the cardiovascular implications of COVID-19. Methods: PubMed, PubMed Central, EMBASE, and Google Scholar were searched for peer-reviewed articles which aimed to delineate the cardiovascular implications of COVID-19.Results: A total of six articles (five original articles and one case report) were included. We found diverse cardiovascular implications of COVID-19 ranging from acute cardiac injury to death MESHD. New onset abnormalities in electrocardiogram or echocardiogragram, elevated plasma SERO levels of cardiac troponin, NT-proBNP, and D-dimer have role in early identification of acute cardiac injury MESHD in such patients. Additionally, cardiac troponin and NT-proBNP can be used to evaluate prognosis and possible need for intensive care in these patients.Conclusion: Acute cardiac injury MESHD is common in patients with COVID-19. Aggressive supportive management based on prognostic indicators along with management of heart failure MESHD, arrhythmias HP arrhythmias MESHD, acute coronary syndrome MESHD and thrombosis MESHD can improve clinical outcomes in such patients.

    Decline of emergency admissions for cardiovascular and cerebrovascular events after the outbreak of COVID-19

    Authors: Viktoria Schwarz; Felix Mahfoud; Lucas Lauder; Wolfgang Reith; Stefanie Behnke; Sigrun Smola; Jürgen Rissland; Thorsten Pfuhl; Bruno Scheller; Michael Böhm; Sebastian Ewen

    doi:10.21203/ Date: 2020-05-19 Source: ResearchSquare

    Background The spread of the novel coronavirus SARS-CoV-2 and the guidance from authorities for social distancing and media reporting lead to significant uncertainty in Germany. As concerns have been expressed regarding the underdiagnosing of harmful diseases. We explored the rates of emergency presentations for acute coronary syndrome MESHD ( ACS MESHD) and acute cerebrovascular events (ACVE) before and after spread of SARS-CoV-2. Methods We analyzed all-cause visits at a tertiary university emergency department and admissions for ACS MESHD and ACVE before (calendar weeks 1 to 9, 2020) and after (calendar weeks 10 to 16, 2020) the first coronavirus disease MESHD (COVID-19) case in the region of the Saarland, Germany. The data were compared with the same period of the previous year. Results In 2020 an average of 346 patients per week presented at the emergency department whereas in 2019 an average of 400 patients presented up to calendar week 16 (p=0.018; whole year 2019 = 395 patients per week). After the first COVID-19 diagnosis in the region, emergency department visit volume decreased by 30% compared with the same period in 2019 (p=0.0012). Admissions due to ACS MESHD decreased by 41% (p=0.0023 for all; Δ -71% (p=0.007) for unstable angina MESHD, Δ -25% (p=0.42) for myocardial infarction HP myocardial infarction MESHD with ST-elevation and Δ -17% (p=0.28) without ST-elevation) compared with the same period in 2019 and decreased from 142 patients in calendar weeks 1 to 9 to 62 patients in calendar weeks 10 to 16. ACVE decreased numerically by 20% (p=0.25 for all; transient ischemic attack HP ischemic MESHD attack: Δ -32% (p=0.18), ischemic stroke HP ischemic stroke MESHD: Δ -23% (p=0.48), intracerebral haemorrhage MESHD: Δ +57% (p=0.4)). There was no significant change in ACVE per week (p=0.7) comparing calendar weeks 1 to 9 (213 patients) and weeks 10 to 16 (147 patients). Testing of 3756 samples was performed to detect 58 SARS-CoV-2 positive patients ( prevalence SERO 1,54%, thereof one patient with myocardial and two with cerebral ischemia HP cerebral ischemia MESHD) up to calendar week 16 in 2020. Conclusions The COVID-19 pandemic was associated with a significant decrease in all-cause admission and admissions due to cardiovascular events MESHD in the emergency department. Regarding acute cerebrovascular events there was a numerical decrease but no significant difference.

    A Rapid Decrease in Stroke HP Stroke MESHD, Acute Coronary Syndrome MESHD, and Corresponding Interventions at 65 United States Hospitals Following Emergence of COVID-19

    Authors: Adam de Havenon; John Ney; Brian Callaghan; Alen Delic; Sam Hohmann; Ernie Shippey; Shadi Yaghi; Mohammad Anadani; Gregory Esper; Jennifer Majersik

    doi:10.1101/2020.05.07.20083386 Date: 2020-05-11 Source: medRxiv

    Background Following the emergence of coronavirus disease MESHD 2019 (COVID-19), early reports suggested a decrease in stroke HP stroke MESHD and acute coronary syndrome MESHD ( ACS MESHD). We sought to provide descriptive statistics for stroke HP stroke MESHD and ACS MESHD from a sample of hospitals throughout the United States, comparing data from March 2020 to similar months pre-COVID. Methods We performed a retrospective analysis of 65 academic and community hospitals in the Vizient Clinical Data Base. The primary outcome is monthly count of stroke HP stroke MESHD and ACS MESHD, and acute procedures for both, from February and March in 2020 compared to the same months in 2018 and 2019. Results are aggregated for all hospitals and reported by Census Region. Results We identified 51,246 strokes HP strokes MESHD (42,780 ischemic MESHD, 8,466 hemorrhagic MESHD), 1,043 mechanical thrombectomies (MT), 836 tissue plasminogen activator (tPA) administrations, 36,551 ACS MESHD, and 3,925 percutaneous coronary interventions (PCI) for ACS MESHD. In February 2020, relative to February 2018 and 2019, hospitalizations with any discharge diagnosis of stroke HP stroke MESHD and ACS MESHD increased by 9.8% and 12.1%, respectively, while in March 2020 they decreased 18.5% and 7.5%, relative to March 2018 and 2019. When only including hospitalizations with the primary discharge diagnosis of stroke HP stroke MESHD or ACS MESHD, in March 2020 they decreased 17.6% and 25.7%, respectively. In March 2020, tPA decreased 3.3%, MT increased 18.8%, although in February 2020 it had increased 36.8%, and PCI decreased 14.7%. These decreases were observed in all Census regions. Conclusions Following greater recognition of the risks of COVID-19, hospitalizations with stroke HP stroke MESHD and ACS MESHD were markedly diminished in a geographically diverse sample of United States hospitals. Because the most likely explanation is that some patients with stroke HP stroke MESHD and ACS MESHD did not seek medical care, the underlying reasons for this decrease warrant additional study to inform public health efforts and clinical care during this and future pandemics.

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MeSH Disease
Human Phenotype

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