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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Cardiometabolic Risk Factors for COVID-19 Susceptibility and Severity: A Mendelian Randomization Analysis

    Authors: Aaron Leong; Joanne Cole; Laura N. Brenner; James B. Meigs; Jose C. Florez; Josep M. Mercader; Fernando Bozza; Carlo Palmieri; Daniel Munblit; Jan Cato Holter; Anders Benjamin Kildal; Clark D Russell; Antonia Ho; Lance Turtle; Thomas M Drake; Anna Beltrame; Katrina Hann; Ibrahim Richard Bangura; Rob Fowler; Sulaiman Lakoh; Colin Berry; David J Lowe; Joanne McPeake; Madiha Hashmi; Anne Margarita Dyrhol-Riise; Chloe Donohue; Daniel R Plotkin; Hayley Hardwick; Natalie Elkheir; Nazir Lone; Annemarie B Docherty; Ewen M Harrison; Kenneth J Baille; Gail Carson; Malcolm G Semple; Janet T Scott

    doi:10.1101/2020.08.26.20182709 Date: 2020-09-01 Source: medRxiv

    Importance: Early epidemiological studies report associations of diverse cardiometabolic conditions especially body mass index (BMI), with COVID-19 susceptibility and severity, but causality has not been established. Identifying causal risk factors is critical to inform preventive strategies aimed at modifying disease risk. Objective: We sought to evaluate the causal associations of cardiometabolic conditions with COVID-19 susceptibility and severity. Design: Two-sample Mendelian Randomization (MR) Study. Setting: Population-based cohorts that contributed to the genome-wide association study (GWAS) meta-analysis by the COVID-19 Host Genetics Initiative. Participants: Patients hospitalized with COVID-19 diagnosed by RNA PCR, serologic testing SERO, or clinician diagnosis. Population controls defined as anyone who was not a case in the cohorts. Exposures: Selected genetic variants associated with 17 cardiometabolic diseases MESHD, including diabetes MESHD, coronary artery disease MESHD, stroke HP stroke MESHD, chronic kidney disease HP chronic kidney disease MESHD, and BMI, at p<5 x 10-8 from published largescale GWAS. Main outcomes: We performed an inverse-variance weighted averages of variant-specific causal estimates for susceptibility, defined as people who tested positive for COVID-19 vs. population controls, and severity, defined as patients hospitalized with COVID-19 vs. population controls, and repeated the analysis for BMI using effect estimates from UKBB. To estimate direct and indirect causal effects of BMI through obesity HP obesity MESHD-related cardiometabolic diseases, we performed pairwise multivariable MR. We used p<0.05/17 exposure/2 outcomes=0.0015 to declare statistical significance. Results: Genetically increased BMI was causally associated with testing positive for COVID-19 [6,696 cases / 1,073,072 controls; p=6.7 x 10-4, odds ratio and 95% confidence interval 1.08 (1.03, 1.13) per kg/m2] and a higher risk of COVID-19 hospitalization [3,199 cases/897,488 controls; p=8.7 x 10-4, 1.12 (1.04, 1.21) per kg/m2]. In the multivariable MR, the direct effect of BMI was abolished upon conditioning on the effect on type 2 diabetes MESHD but persisted when conditioning on the effects on coronary artery disease MESHD, stroke HP stroke MESHD, chronic kidney disease HP chronic kidney disease MESHD, and c-reactive protein. No other cardiometabolic exposures tested were associated with a higher risk of poorer COVID-19 outcomes. Conclusions and Relevance: Genetic evidence supports BMI as a causal risk factor for COVID-19 susceptibility and severity. This relationship may be mediated via type 2 diabetes MESHD. Obesity HP may have amplified the disease burden of the COVID-19 pandemic either single-handedly or through its metabolic consequences.

    The 2019 novel coronavirus disease MESHD with secondary ischemic stroke HP ischemic stroke MESHD: two cases report

    Authors: Bin Fu; Yun Chen; Ping Li

    doi:10.21203/rs.3.rs-20943/v2 Date: 2020-04-02 Source: ResearchSquare

    Background: The 2019 novel coronavirus disease MESHD is an outbreak of respiratory illness MESHD first detected in Wuhan, China in the end of Dec, 2019. The older patients complicated with underlying diseases MESHD are reported more likely to have clinical symptoms. But its secondary lesion is rarely reported. Case presentation: We reported two cases of coronavirus infected pneumonia MESHD pneumonia HP with acute ischemic stroke MESHD ischemic stroke HP in patients at their middle- age TRANS. In both 2019 coronavirus diseases MESHD cases, neurological physical examination are normal before infection MESHD. Lymphocytopenia MESHD and high expression of cytokines and D-dimer were found from serum SERO clinical laboratory test at admission. The dysarthria HP dysarthria MESHD and limb muscle weakness HP muscle weakness MESHD are initial manifestations in one week after 2019 novel coronavirus infection MESHD. The head CT and head/neck arterial CTA showed small-vessel occlusion MESHD. The patients were diagnosed with coronavirus diseases MESHD with secondary acute ischemic stroke HP ischemic stroke MESHD. They were treated with tirofiban and followed up with daily aspirin and atorvastatin. Conclusion: The present cases suggested that secondary ischemic stroke HP ischemic stroke MESHD, which mainly manifested as small-vessel occlusion MESHD, should be considered for coronavirus disease MESHD patients with prompt diagnosis and treatment. 

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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