Corpus overview


MeSH Disease

Human Phenotype


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    Ocular findings and retinal involvement in COVID-19 pneumonia HP pneumonia MESHD patients: A cross-sectional study in an Italian referral centre

    Authors: Maria Pia Pirraglia; Giancarlo Ceccarelli; Alberto Cerini; Giacomo Visioli; Gabriella d'Ettorre; Claudio Maria Mastroianni; Francesco Pugliese; Alessandro Lambiase; Magda Gharbiya

    doi:10.21203/ Date: 2020-07-23 Source: ResearchSquare

    Background: changes in immune and coagulation systems and possible viral spread through blood SERO-brain barrier have been described in SARS-CoV-2 infection MESHD. In this study, we evaluate the possible retinal involvement and ocular findings in severe COVID-19 pneumonia HP pneumonia MESHD patients.  Methods: a cross sectional study was conducted on 46 patients affected by severe COVID-19 who were hospitalized in one Intensive Care Unit (ICU) and in two Infectious Diseases wards, including a bedside eye screening, corneal sensitivity SERO assessment and retinography. Results: a total of 43 SARS-CoV-2 positive pneumonia MESHD pneumonia HP patients affected with COVID-19 pneumonia HP pneumonia MESHD were included, 25 males TRANS and 18 females TRANS, with a median age TRANS of 70 [IQR 59-78]. Except for one patient with unilateral posterior chorioretinitis HP of opportunistic origin, of whom aqueous tap was negative for SARS-CoV-2, no further retinal manifestation related to COVID-19 infection MESHD was found in our cohort. We found 3 patients (7%) with bilateral conjunctivitis MESHD conjunctivitis HP in whom PCR analysis on conjunctival swab provided negative results for SARS-CoV-2. No alterations of corneal sensitivity SERO were found.Conclusion: we demonstrated the absence of retinal involvement in SARS-CoV-2 pneumonia MESHD pneumonia HP patients. Ophthalmologic evaluation in COVID-19, particularly in patients hospitalized in an ICU setting, may be useful to reveal systemic co-infections MESHD infections by opportunistic HP pathogens. 

    Optimized Laboratory Detection Strategy for COVID-19 Patients Reduces the Rate of Missed Diagnosis

    Authors: Wenjiao Chang; Yuru Shi; Yingjie Qi; Jiaxing Liu; Ting Liu; Zhaowu Chen; Dongfeng Liu; Ming Yin; Jing Xu; Yun Yang; Jing Ge; Shu Zhu; Yong Gao; Xiaoling Ma

    doi:10.21203/ Date: 2020-07-13 Source: ResearchSquare

    Background: Novel coronavirus pneumonia MESHD pneumonia HP (NCP) is an emerging, highly contagious community acquired pneumonia HP pneumonia MESHD (CAP) caused by severe acute SARS-CoV-2. Nucleic acid test currently played a crucial role in diagnosis of suspected COVID-19 patients. However, a high false-negative rate of this “gold standard” test has been reported and posed a major setback in blocking the spread of the virus. We here aim to describe an optimized laboratory detection strategy to reduce the false negative rate. Methods: Suspected NCP patients were asked to collect both coughed HP up specimen and pharyngeal swab. Samples from the same patient were mixed and tested at a single pool. SARS-CoV-2 was then detected by real-time RT-PCR using two different detection kits. Only if both results were negative was the test reported as negative. The patients will be excluded after two consecutive negative tests at 24 hour intervals. We also used multiplex PCR to detect 13 common respiratory tract pathogens (RTP). Results: Using this strategy, we confirmed 85 SARS-CoV-2 infections MESHD from 181 suspected patients, and 94.12% of patients were positive in the first test. The 96 excluded patients were followed up, and no additional NCP was found. We also found that 31.25% patients in 96 non-NCP patients were infected MESHD with at least one RTP that may cause CAP. Conclusion: Our studies suggest that dual reagents screening with pooled coughed HP up specimen and pharyngeal swab samples reduced the false negative rate of nucleic acid testing. During the epidemic of NCP in Anhui province, there was a certain proportion of infection and co-infection MESHD of other common pathogens of CAP. In comparison with SARS-CoV-2 detection alone, combining multiple pathogen detection reduces the rate of miss diagnosis.

    Bronchoscopy in critically ill COVID-19 Patients: microbiological profile and factors related to nosocomial respiratory infection MESHD

    Authors: Pere Serra Mitja; Carmen Centeno Clemente; Ignasi Garcia-Olive; Adria Antuori Torres; Maria Casadella Fontdevila; Rachid Tazi Mezalek; Fernando Armestar; Esther Fernandez Araujo; Felipe Andreo Garcia; Antoni Rosell Gratacos

    doi:10.1101/2020.07.01.20144683 Date: 2020-07-03 Source: medRxiv

    Background: Nosocomial co-infections MESHD are a cause of morbidity and mortality in Intensive Care Units (ICU). Objectives: Our aim was to describe bronchoscopy findings and analyse co-infection MESHD through bronchial aspirate (BA) samples in patients with COVID-19 pneumonia HP pneumonia MESHD requiring ICU admission. Methods: We conducted a retrospective observational study, analysing the BA samples collected from intubated patients with COVID-19 to diagnose nosocomial respiratory infection MESHD. Results: One-hundred and fifty-five consecutive BA samples were collected from 75 patients. Of them, 90 (58%) were positive cultures for different microorganisms, 11 (7.1%) were polymicrobial, and 37 (23.7%) contained resistant microorganisms. There was a statistically significant association between increased days of orotracheal intubation (OTI) and positive BA (18.9 days versus 10.9 days, p<0.01), polymicrobial infection MESHD (22.11 versus 13.54, p<0.01) and isolation of resistant microorganisms (18.88 versus 10.94, p<0.01). In 88% of the cases a change in antibiotic treatment was made. Conclusion: Nosocomial respiratory infection MESHD in intubated COVID-19 patients seems to be higher than in non-epidemic periods. The longer the intubation period, the greater the probability of co-infection MESHD, isolation of resistant microorganisms and polymicrobial infection MESHD. Microbiological sampling through BA is an essential tool to manage these patients appropriately

    Organisms causing secondary pneumonias HP pneumonias MESHD in COVID-19 patients at 5 UK ICUs as detected with the FilmArray test

    Authors: Zaneeta Dhesi; Virve I Enne; David Brealey; David M Livermore; Juliet High; Charlotte Russell; Antony Colles; Hala Kandil; Damien Mack; Daniel Martin; Valerie Page; Robert Parker; Kerry Roulston; Suveer Singh; Emmanuel Wey; Ann Marie Swart; Susan Stirling; Julie A Barber; Justin O'Grady; Vanya A Gant

    doi:10.1101/2020.06.22.20131573 Date: 2020-06-23 Source: medRxiv

    ABSTRACT Introduction. Several viral respiratory infections - notably influenza - are associated with secondary bacterial infection MESHD and additional pathology. The extent to which this applies for COVID-19 is unknown. Accordingly, we aimed to define the bacteria causing secondary pneumonias HP pneumonias MESHD in COVID-19 ICU patients using the FilmArray Pneumonia HP Panel, and to determine this tests potential in COVID-19 management. Methods. COVID-19 ICU patients with clinically-suspected secondary infection at 5 UK hospitals were tested with the FilmArray at point of care. We collected patient demographic data and compared FilmArray results with routine culture. Results. We report results of 110 FilmArray tests on 94 patients (16 had 2 tests): 69 patients (73%) were male TRANS, the median age TRANS was 59 yrs; 92 were ventilated. Median hospital stay before testing was 14 days (range 1-38). Fifty-nine (54%) tests were positive, with 141 bacteria detected. Most were Enterobacterales (n=55, including Klebsiella spp MESHD. [n= 35]) or Staphylococcus aureus (n=13), as is typical of hospital and ventilator pneumonia HP pneumonia MESHD. Community pathogens, including Haemophilus influenzae (n=8) and Streptococcus pneumoniae HP (n=1), were rarer. FilmArray detected one additional virus (Rhinovirus/Enterovirus) and no atypical bacteria. Fewer samples (28 % vs. 54%) were positive by routine culture, and fewer species were reported per sample; Klebsiella species remained the most prevalent pathogens. Conclusion. FilmArray had a higher diagnostic yield than culture for ICU COVID-19 patients with suspected secondary pneumonias HP pneumonias MESHD. The bacteria found mostly were Enterobacterales, S. aureus and P. aeruginosa, as in typical HAP/VAP, but with Klebsiella spp MESHD. more prominent. We found almost no viral co-infection MESHD. Turnaround from sample to results is around 1h 15 min compared with the usual 72h for culture, giving prescribers earlier data to inform antimicrobial decisions.

    Non-coronavirus Genome Sequences Identified from Metagenomic Analysis of Clinical Samples from COVID-19 Infected Patients: An Evidence for Co-infection MESHD

    Authors: Mohamed Abouelkhair

    id:10.20944/preprints202005.0505.v2 Date: 2020-06-18 Source:

    In December 2019, pneumonia HP pneumonia MESHD caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD emerged in Wuhan City, Hubei Province, China. Early in 2020, the World Health Organization (WHO) announced a new name for the 2019-nCoV-caused epidemic disease MESHD: coronavirus disease MESHD 2019 (COVID-19) and declared COVID-19 to be the sixth international public health emergency. Cellular co-infection MESHD is a critical determinant of both viral fitness and infection MESHD outcome and plays a crucial role in shaping the host immune response to infections. In this study, sixty-eight public next-generation sequencing libraries from SARS-CoV-2 infected MESHD patients were retrieved from the NCBI Sequence Read Archive database using SRA-Toolkit. Using an alignment-free method based on K-mer mapping and extension, SARS-CoV-2 was identified in all except three patients. Influenza A H7N9 (3/68), Human immunodeficiency virus MESHD immunodeficiency HP virus 1 (1/68), rhabdovirus isolate (3/68), Human metapneumovirus (1/68), coronaviruses NL63 (1/68), Parvovirus (1/68), Simian virus 40 (1/68), and hepatitis HP hepatitis MESHD virus (1/68) genome sequences were detected in SARS-CoV-2 infected MESHD patients.

    Limited Role for Antibiotics in COVID-19: Scarce Evidence of Bacterial Coinfection

    Authors: Wenjing Wei; Jessica K Ortwine; Norman S Mang; Christopher Joseph; Brenton C Hall; Bonnie Chase Prokesch

    doi:10.1101/2020.06.16.20133181 Date: 2020-06-18 Source: medRxiv

    Background: There is currently a paucity of data describing bacterial coinfections, related antibiotic prescribing patterns, and the potential role of antimicrobial stewardship in the care of patients infected with SARS-CoV-2. Methods: This prospective, observational study was conducted from March 10, 2020 to April 21, 2020 in admitted patients with confirmed COVID-19. Patients were included if [≥] 18 years old and admitted to the hospital for further treatment. Data was collected via chart review from the enterprise electronic health record database. Data collected include factors driving antibiotic choice, indication, and duration of therapy as well as microbiological data. Findings: Antibiotics were initiated on admission in 87/147 (59%) patients. Of these, 85/87 (98%) prescriptions were empiric. The most common indication for empiric antibiotics was concern for community-acquired pneumonia HP pneumonia MESHD (76/85, 89%) with the most prescribed antibiotics being ceftriaxone and azithromycin. The median duration of antibiotic therapy was two days (interquartile range 1-5). No patients had a community-acquired bacterial respiratory coinfection MESHD, but 10/147 (7%) of patients were found to have concurrent bacterial infections MESHD from a non-respiratory source, and one patient was diagnosed with active pulmonary tuberculosis HP pulmonary tuberculosis MESHD at the time of admission for COVID-19. Interpretation: Bacterial coinfection in patients with COVID-19 was infrequent. Antibiotics are likely unnecessary in patients with mild symptoms. There is little role for broad-spectrum antibiotics to empirically treat multidrug resistant organisms in patients with COVID-19, regardless of disease severity. Antimicrobial stewardship remains important in patients infected with SARS-CoV-2.

    High viral load suggests increased COVID-19 severity in a longitudinal cohort

    Authors: Yuanlin He; Xin Xu; Qun Lu; Zhiliang Hu; Yue Jiang; Ci Song; Wei Chen; Peipei Li; Weixiao Wang; Chuanjun Xu; Yuting Ma; Yuan Lin; Zhibin Hu; Yongxiang Yi; Hongbing Shen

    doi:10.21203/ Date: 2020-06-08 Source: ResearchSquare

    Background: An outbreak caused by the 2019 novel coronavirus (2019-nCoV) has spread globally. However, the viral dynamics, co-infection MESHD and their associations with clinical severity, have not been well explored.Methods: We longitudinally enrolled 23 (Five severe-type, ten common-type and eight asymptomatic TRANS-type patients) hospitalized 2019-nCov-infected patients in Jiangsu between January 21 and February 11, 2020. Medical records and pharyngeal swab specimens, were collected to analyze the association between viral dynamic and disease severity.Results: Five severe-type, ten common-type and eight asymptomatic TRANS-type patients were enrolled. Linear mixed effects models revealed that the common and severe-type patients had a higher level of viral load (3.08 points, 95% CI, 0.51-5.65, P = 0.019; 6.07 points, 95% CI, 2.79-9.35, P < 0.001) and maintained a higher peak viral load ( P = 0.066 and 0.022, respectively), when compared with the asymptomatic TRANS group. Viral load shedding among older patients ( aged TRANS ≥ 60) processed slower than that among younger patients ( P = 0.047). RNA virome sequencing identified two co-infected MESHD RNA viruses, Human endogenous retrovirus H (HERV) and Human picobirnavirus (HPBV). Of note, HPBV was detected in one severe-type and two common-type patients, while was not detected in all the asymptomatic TRANS cases.Conclusion: Higher viral load was positively associated with disease severity. This finding highlights the importance of monitoring the viral kinetics to identify patients at greater risk of progressing to severe pneumonia HP pneumonia MESHD.

    Co-infection of COVID-19 and Influenza A in A Hemodialysis Patient: A Case Report

    Authors: Ran Jing; Rama R Vunnam; Elizabeth Schnaubelt; Chad Vokoun; Allison Cushman-Vokoun; David Goldner; Srinivas R Vunnam

    doi:10.21203/ Date: 2020-05-22 Source: ResearchSquare

    Background: Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2, a novel coronavirus that was first discovered in Wuhan, China in December 2019. With the growing numbers of community spread cases worldwide, the World Health Organization (WHO) declared the COVID-19 outbreak as a pandemic on March 11. Like influenza viruses, SARS-CoV-2 is thought to be transmitted by contact, droplets, and fomites, and COVID-19 has a similar disease presentation to influenza. Here we present a case of influenza A and COVID-19 co-infection MESHD in a 60-year-old man with end-stage renal disease MESHD ( ESRD MESHD) on hemodialysis.Case presentation: A 60-year-old man with ESRD MESHD on hemodialysis (HD) presented for worsening cough HP cough MESHD, shortness of breath MESHD, and diarrhea HP diarrhea MESHD. The patient first developed a mild fever HP fever MESHD (100 °F) during hemodialysis three days prior to presentation and has been experiencing worsening flu-like symptoms, including fever HP of up to 101.6 °F, non- productive cough HP, generalized abdominal pain HP abdominal pain MESHD, nausea, vomiting HP nausea, vomiting MESHD vomiting MESHD, and liquid green diarrhea HP diarrhea MESHD. He lives alone at home with no known sick contacts and denies any recent travel TRANS or visits to healthcare facilities other than the local dialysis center. Rapid flu test was positive for influenza A. Procalcitonin was elevated at 5.21 ng/mL with a normal white blood SERO cell (WBC) count. Computed tomography (CT) chest demonstrated multifocal areas of consolidation and extensive mediastinal and hilar adenopathy MESHD concerning for pneumonia HP pneumonia MESHD. He was admitted to the biocontainment unit of Nebraska Medicine for concerns of possible COVID-19 and was started on oseltamivir for influenza and vancomycin/cefepime for the probable bacterial cause of his pneumonia HP pneumonia MESHD and diarrhea HP diarrhea MESHD. GI MESHD pathogen panel and C. diff toxin assay were negative. On the second day of admission, initial nasopharyngeal swab came back positive for SARS-CoV-2 by RT-PCR. The patient received supportive care and resumed bedside hemodialysis in strict isolation, and eventually fully recovered from COVID-19.Conclusions: Our case demonstrated that co-infection of influenza and SARS-CoV-2 can occur in patients with no known direct exposure to COVID-19. The possibility of SARS-CoV-2 co-infection MESHD should not be overlooked even when other viruses including influenza can explain the clinical symptoms.

    Pregnancy outcomes, Newborn complications and Maternal-Fetal Transmission TRANS of SARS-CoV-2 in women with COVID-19: A systematic review

    Authors: Rahul Gajbhiye; Deepak Modi; Smita Mahale

    doi:10.1101/2020.04.11.20062356 Date: 2020-04-15 Source: medRxiv

    Abstract Objective: The aim of this systematic review was to examine published and preprint reports for maternal and fetal outcomes in pregnant women with COVID-19 and also assess the incidence of maternal-fetal transmission TRANS of SARS CO-V-2 infection MESHD. Design : Systematic review Data sources:We searched PUMBED. Medline, Embase, MedRxiv and bioRxiv databases upto 31st March 2020 utilizing combinations of word variants for " coronavirus " or " COVID-19 " or " severe acute respiratory syndrome MESHD " or " SARS-COV-2 " and " pregnancy " . We also included data from preprint articles. Study selection : Original case reports and case series on pregnant women with a confirmed diagnosis of SARS-CoV-2 infection MESHD. Data extraction : We included 23 studies [China (20), USA (01), Republic of Korea (01) and Honduras, Central America (01) reporting the information on 172 pregnant women and 162 neonates. The primary outcome measures were maternal health characteristics and adverse pregnancy outcomes, neonatal outcomes and SARS-CoV-2 infection MESHD in neonates was extracted. Treatments given to pregnant women with COVID-19 were also recorded. Results: Out of 172 women affected by COVID-19 in pregnancy, 160 women had delivered 162 newborns (2 set of twins, 12 ongoing pregnancies). In pregnant women with COVID-19, the most common symptoms were fever HP fever MESHD (54%), cough HP (35%), myalgia HP myalgia MESHD (17%), dyspnea HP dyspnea MESHD (12%) and diarrhea HP diarrhea MESHD (4%). Pneumonia HP was diagnosed by CT scan imaging in 100 % of COVID-19 pregnant women. Pregnancy complications included delivery by cesarean section (89%), preterm labor MESHD (21%), fetal distress HP (9%) and premature rupture of membranes HP (8%). The most common co-morbidities associated with pregnant women with COVID-19 were diabetes MESHD (11%), hypertensive disorders MESHD (9%), placental disorders MESHD (5%), co-infections MESHD (6%), scarred HP uterus (5%), hypothyroidism HP hypothyroidism MESHD (5%) and anemia HP anemia MESHD (4%). Amongst the neonates of COVID-19 mothers, preterm birth (23%), respiratory distress HP respiratory distress MESHD syndrome (14%), pneumonia HP pneumonia MESHD (14%) low birth weight (11%), small for gestational age HP age TRANS (3%) were reported. There was one still birth and one neonatal death MESHD reported. Vertical transmission TRANS rate of SARS-CoV-2 is estimated to be 11%. Conclusion In pregnant women with COVID-19, diabetes MESHD and hypertensive disorders MESHD are common co-morbidities and there is a risk of preterm delivery. Amongst the neonates born to mothers with COVID-19, respiratory distress HP respiratory distress MESHD syndrome and pneumonia HP pneumonia MESHD are common occurrence. There is an evidence of vertical transmission TRANS of SARS-CoV-2 infection MESHD in women with COVID-19.

    A Mini Review on Current Clinical and Research Findings for Children TRANS Suffering from COVID-19

    Authors: Xiao Li; Kun Qian; Ling-ling Xie; Xiu-juan Li; Min Cheng; Li Jiang; Bjoern W. Schuller

    doi:10.1101/2020.03.30.20044545 Date: 2020-04-04 Source: medRxiv

    Background: As the novel coronavirus triggering COVID-19 has broken out in Wuhan, China and spread rapidly worldwide, it threatens the lives of thousands of people and poses a global threat on the economies of the entire world. However, infection MESHD with COVID-19 is currently rare in children TRANS. Objective To discuss the latest findings and research focus on the basis of characteristics of children TRANS confirmed with COVID-19, and provide an insight into the future treatment and research direction. Methods: We searched the terms "COVID-19 OR coronavirus OR SARS-CoV-2" MESHD AND "Pediatric OR children TRANS" on PubMed, Embase, Cochrane library, NIH, CDC, and CNKI. The authors also reviewed the guidelines published on Chinese CDC and Chinese NHC. Results: We included 25 published literature references related to the epidemiology, clinical manifestation, accessary examination, treatment, and prognosis of pediatric patients with COVID-19. Conclusion: The numbers of children TRANS with COVID-19 pneumonia HP pneumonia MESHD infection are small, and most of them come from family aggregation. Symptoms are mainly mild or even asymptomatic TRANS, which allow children TRANS to be a risk factor for transmission TRANS. Thus, strict epidemiological history screening is needed for early diagnosis and segregation. This holds especially for infants, who are more susceptible to infection MESHD than other age groups TRANS in pediatric age TRANS, but have most likely subtle and unspecific symptoms. They need to be paid more attention to. CT examination is a necessity for screening the suspected cases, because most of the pediatric patients are mild cases, and plain chest X-ray do not usually show the lesions or the detailed features. Therefore, early chest CT examination combined with pathogenic detection is a recommended clinical diagnosis scheme in children TRANS. The risk factors which may suggest severe or critical progress for children TRANS are: Fast respiratory rate and/or; lethargy HP and drowsiness HP mental state and/or; lactate progressively increasing and/or; imaging showed bilateral or multi lobed infiltration, pleural effusion HP pleural effusion MESHD or rapidly expending of lesions in a short period of time and/or; less than 3 months old or those who underly diseases. For those critical pediatric patients with positive SARS-CoV-2 diagnosis, polypnea may be the most common symptom. For treatment, the elevated PCT seen in children TRANS in contrast to adults TRANS suggests that the underlying coinfection/ secondary infection MESHD may be more common in pediatric patients and appropriate antibacterial treatment should be considered. Once cytokine storm is found in these patients, anti-autoimmune or blood SERO-purifying therapy should be given in time. Furthermore, effective isolation measures and appropriate psychological comfort need to be provided timely.

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MeSH Disease
Human Phenotype

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