Corpus overview


MeSH Disease

COVID-19 (354)

Hypertension (340)

Diabetes Mellitus (231)

Death (84)

Fever (80)


    displaying 1 - 10 records in total 359
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    Diabetes MESHD and Mortality Among 1.6 Million Adult TRANS Patients Screened for SARS-CoV-2 in Mexico

    Authors: Orison O Woolcott; Juan P Castilla-Bancayan; Xutao Wang; William Evan Johnson; Anna Coussens

    doi:10.1101/2020.11.25.20238345 Date: 2020-11-26 Source: medRxiv

    Background: Whether diabetes MESHD is associated with COVID-19 MESHD-related mortality remains unclear. Methods: In this retrospective case-series study we examined the risk of death MESHD associated with self-reported diabetes MESHD in symptomatic adult TRANS patients with laboratory-confirmed COVID-19 MESHD who were identified through the System of Epidemiological Surveillance of Viral Respiratory Disease MESHD in Mexico from January 1 through November 4, 2020. Survival time was right-censored at 28 days of follow-up. Results: Among 757,210 patients with COVID-19 MESHD included in the study, 120,476 (16%) had diabetes MESHD and 80,616 died. Patients with diabetes had a 49% higher relative risk of death than those without diabetes (Cox proportional-hazard ratio; 1.49 (95% confidence interval [CI], 1.47-1.52), adjusting for age TRANS, sex, smoking habit, obesity HP, hypertension HP, immunodeficiency HP, and cardiovascular, pulmonary, and chronic renal disease. The relative risk of death associated with diabetes decreased with age TRANS (P=0.004). The hazard ratios were 1.66 (1.58-1.74) in outpatients and 1.14 (1.12-1.16) in hospitalized patients. The 28-day survival for inpatients with and without diabetes was, respectively, 73.5% and 85.2% for patients 20-39 years of age TRANS; 66.6% and 75.9% for patients 40-49 years of age TRANS; 59.4% and 66.5% for patients 50-59 years of age TRANS; 50.1% and 54.6% for patients 60-69 years of age TRANS; 42.7% and 44.6% for patients 70-79 years of age TRANS; and 38.4% and 39.0% for patients 80 years of age TRANS or older. In patients without COVID-19 MESHD (878,840), the adjusted hazard ratio for mortality was 1.78 (1.73-1.84). Conclusion: In symptomatic adult TRANS patients with COVID-19 MESHD in Mexico, diabetes was associated with higher mortality. This association decreased with age TRANS.

    Clinical Profile of First 1000 COVID-19 MESHD Cases Admitted at Tertiary Care Hospitals and the Correlates of their Mortality: An Indian Experience

    Authors: Sandeep Budhiraja; Aakriti Soni; Vinitaa Jha; Abhaya Indrayan; Arun Dewan; Omender Singh; Yogendra Singh; Indermohan Chugh; Vijay Arora; Rajesh Pandey; Abdul Ansari; Sujeet Jha; Shingo Fukuma; Meng Zhou; Wen-Qing Li; Nan Wu; Hao Chen; Jiangfan Chen; Fan Lu; Jianzhong Su; Jia Qu

    doi:10.1101/2020.11.16.20232223 Date: 2020-11-18 Source: medRxiv

    ObjectiveTo describe the clinical profile and factors leading to increased mortality in coronavirus disease MESHD ( COVID-19 MESHD) patients admitted to a group of hospitals in India. DesignA records-based study of the first 1000 patients with a positive result on real-time reverse transcriptase-polymerase-chain-reaction assay for SARS-CoV-2 admitted to our facilities. Various factors such as demographics, presenting symptoms, co-morbidities, ICU admission, oxygen requirement and ventilator therapy were studied. ResultsOf the 1000 patients, 24 patients were excluded due to lack of sufficient data. Of the remaining 976 in the early phase of the epidemic, males TRANS were admitted twice as much as females TRANS (67.1% and 32.9%, respectively). Mortality in this initial phase was 10.6% and slightly higher for males TRANS and steeply higher for older patients. More than 8% reported no symptoms and the most common presenting symptoms were fever HP (78.3%), productive cough HP (37.2%), and dyspnea HP (30.64%). More than one-half (53.6%) had no co-morbidity. The major co-morbidities were hypertension HP (23.7%), diabetes without (15.4%), and with complications (9.6%). The co-morbidities were associated with higher ICU admissions, greater use of ventilators as well as higher mortality. A total of 29.9% were admitted to the ICU, with a mortality rate of 32.2%. Mortality was steeply higher in those requiring ventilator support (55.4%) versus those who never required ventilation (1.4%). The total duration of hospital stay was just a day longer in patients admitted to the ICU than those who remained in wards. ConclusionMale patients above the age TRANS of 60 and with co-morbidities faced the highest rates of mortality. They should be admitted to the hospital in early stage of the disease and given aggressive treatment to help reduce the morbidity and mortality associated with COVID-19 MESHD.

    The effects of hypertension HP hypertension MESHD as an existing comorbidity on mortality rate in patients with COVID-19 MESHD: a systematic review and meta-analysis.

    Authors: Elena Whiteman; Jean-Selim Driouich; Maxime Cochin; Paul Remy Petit; Magali Gilles; Karine Barthelemy; Gregory Moureau; Denis Malvy; Caroline Solas; Xavier de Lamballerie; Antoine Nougairede; Katia Koelle; Thomas Friedrich; Klaus Hansen; Bo Jespersen; Marie Norsker Folke; Per Meden; Anne-Mette Hejl; Christian Warmberg; Michael Benros; Daniel Kondziella; Tahir Yaqub

    doi:10.1101/2020.11.16.20149377 Date: 2020-11-17 Source: medRxiv

    IntroductionCoronavirus has spread throughout the world rapidly, and there is a growing need to identify host risk factors to identify those most at risk. There is a growing body of evidence suggesting a close link exists between an increased risk of infection TRANS and an increased severity of lung injury MESHD and mortality, in patients infected with COVID-19 MESHD who have existing hypertension MESHD hypertension HP. This is thought to be due to the possible involvement of the virus target receptor, ACE2, in the renin-angiotensin-aldosterone blood SERO pressure management system. ObjectiveTo investigate the association between hypertension HP as an existing comorbidity and mortality in hospitalized patients with confirmed coronavirus disease 2019 MESHD ( COVID-19 MESHD). MethodsA systematic literature search in several databases was performed to identify studies that comment on hypertension HP as an existing comorbidity, and its effect on mortality in hospitalized patients with confirmed COVID-19 MESHD infection. The results of these studies were then pooled, and a meta-analysis was peformed to assess the overall effect of hypertension HP as an existing comorbidity on risk of mortality in hospitalized COVID-19 MESHD positive patients. ResultsA total of 12243 hospitalised patients were pooled from 19 studies. All studies demonstrated a higher fatality rate in hypertensive COVID-19 MESHD patients when compared to non-hypertensive patients. Meta-analysis of the pooled studies also demonstrated that hypertension HP was associated with increased mortality in hospitalized patients with confirmed COVID-19 MESHD infection (risk TRANS ratio (RR) 2.57 (95% confidence interval (CI) 2.10, 3.14), p < 0.001; I2 =74.98%). ConclusionHypertension is associated with 157% increased risk of mortality in hospitalized COVID-19 MESHD positive patients. These results have not been adjusted for age TRANS, and a meta-regression of covariates including age TRANS is required to make these findings more conclusive. SummaryRisk of mortality is considerably higher in hospitalised COVID-19 MESHD patients who have hypertension HP as an existing comorbidity prior to admission.

    High SARS-CoV-2 viral load is associated with a worse clinical outcome of COVID-19 MESHD disease

    Authors: Maria Eugenia Soria; Marta Corton; Brenda Martinez-Gonzalez; Rebeca Lobo-Vega; Lucia Vazquez-Sirvent; Rosario Lopez-Rodriguez; Berta Almoguera; Ignacio Mahillo; Pablo Minguez; Antonio Herrero; Juan Carlos Taracido; Alicia Macias-Valcayo; Jaime Esteban; Ricardo Fernandez; Ignacio Gadea; Javier Ruiz-Hornillos; Carmen Ayuso; Celia Perales; Steven J Schiff; Terezinha M P P Castineira; Orlando C Ferreira Jr.; Amilcar Tanuri; Ana Tereza R de Vasconcelos; Praful Pandey; Santosh KN; Shitij Chaudhary; Vishakh C Keri; Vishal Singh Chauhan; Niranjan Mahishi; Anand Shahi; Ragu R; Baidhnath Gupta; Richa Aggarwal; Kapil Dev Soni; Neeraj Nischal; Manish Soneja; Sanjeev Lalwani; Chitra Sarkar; Randeep Guleria; Naveet Wig; Anjan Trikha

    doi:10.1101/2020.11.13.20229666 Date: 2020-11-16 Source: medRxiv

    COVID-19 MESHD severity and progression are determined by several host and virological factors that may influence the final outcome of SARS-CoV-2-infected MESHD patients. The objective of this work is to determine a possible association between the viral load, obtained from nasopharyngeal swabs, and the severity of the infection in a cohort of 448 SARS-CoV-2-infected MESHD patients from a hospital in Madrid during the first outbreak of the pandemic in Spain. To perform this, we have clinically classified patients as mild, moderate and severe COVID-19 MESHD according to a number of clinical parameters such as hospitalization requirement, need of oxygen therapy, admission to intensive care units and/or exitus. Here we report a statistically significant correlation between viral load and disease severity, being high viral load associated with worse clinical prognosis, independently of several previously identified risk factors such as age TRANS, sex, hypertension MESHD hypertension HP, cardiovascular disease MESHD, diabetes MESHD, obesity HP obesity MESHD, and lung disease MESHD ( asthma HP asthma MESHD and chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP). The data presented here reinforce the viral load as a potential biomarker for predicting disease severity in SARS-CoV-2-infected MESHD patients. It is also an important parameter in viral evolution since it relates to the numbers and types of variant genomes present in a viral population, a potential determinant of disease progression.

    Low uptake of COVID-19 MESHD prevention behaviours and high socioeconomic impact of lockdown measures in South Asia: evidence from a large-scale multi-country surveillance programme

    Authors: Dian Kusuma; Rajendra Pradeepa; Khadija I Khawaja; Mehedi Hasan; Samreen Siddiqui; Sara Mahmood; Syed Mohsin Ali Shah; Chamini K De Silva; Laksara de Silva; Manoja Gamage; Menka Loomba; Vindya P Rajakaruna; Abu AM Hanif; Rajan Babu Kamalesh; Balachandran Kumarendran; Marie Loh; Archa Misra; Asma Tassawar; Akansha Tyagi; Swati Waghdhare; Saira Burney; Sajjad Ahmad; Viswanathan Mohan; Malabika Sarker; Ian Y Goon; Anu Kasturiratne; Jaspal S Kooner; Prasad Katulanda; Sujeet Jha; Ranjit Mohan Anjana; Malay K Mridha; Franco Sassi; John Chambers

    doi:10.1101/2020.11.12.20229898 Date: 2020-11-14 Source: medRxiv

    Background. South Asia has become a major epicentre of the COVID-19 MESHD pandemic. Understanding South Asians awareness, attitudes and experiences of early measures for the prevention of COVID-19 MESHD is key to improving the effectiveness and mitigating the social and economic impacts of pandemic responses at a critical time for the Region. Methods. We assessed the knowledge, behaviours, health and socio-economic circumstances of 29,809 adult TRANS men and women, at 93 locations across four South Asian countries. Data were collected during the national lockdowns implemented from March to July 2020, and compared with data collected prior to the pandemic as part of an ongoing prospective surveillance initiative. Results. Participants were 61% female TRANS, mean age TRANS 45.1 years. Almost half had one or more chronic disease MESHD, including diabetes MESHD (16%), hypertension HP hypertension MESHD (23%) or obesity HP obesity MESHD (16%). Knowledge of the primary COVID-19 MESHD symptoms and transmission TRANS routes was high, but access to hygiene and personal protection resources was low (running water 63%, hand sanitisers 53%, paper tissues 48%). Key preventive measures were not widely adopted. Knowledge, access to, and uptake of COVID-19 MESHD prevention measures were low amongst people from disadvantaged socio-economic groups. Fifteen percent of people receiving treatment for chronic diseases MESHD reported loss of access to long-term medications; 40% reported symptoms suggestive of anxiety HP anxiety MESHD or depression. The prevalence SERO of unemployment rose from 9.3% to 39.4% (P<0.001), and household income fell HP by 52% (P<0.001) during the lockdown. Younger people and those from less affluent socio-economic groups were most severely impacted. Sedentary time increased by 32% and inadequate fruit and vegetable intake increased by 10% (P<0.001 for both), while tobacco and alcohol consumption dropped by 41% and 80%, respectively (P<0.001), during the lockdown. Conclusions. Our results identified important knowledge, access and uptake barriers to the prevention of COVID-19 MESHD in South Asia, and demonstrated major adverse impacts of the pandemic on chronic disease treatment, mental health, health-related behaviours, employment and household finances. We found important sociodemographic differences for impact, suggesting a widening of existing inequalities. Our findings underscore the need for immediate large-scale action to close gaps in knowledge and access to essential resources for prevention, along with measures to safeguard economic production and mitigate socio-economic impacts on the young and the poor.

    Evaluating the Efficacy of Tocilizumab in Moderate to Severe COVID-19 MESHD with Progressive Illness despite Steroids: Identifying the Optimal Timing of its Administration in C3G study

    Authors: Surabhi Madan; Manish Rana; Rohan Gajjar; Nitesh Shah; Vipul Thakkar; Bhagyesh Shah; Pradip Dabhi; Minesh Patel; Hardik Shah; Rashmi Chovatiya; Maulik Soni; Nirav Bapat; Amit Patel; Brian Pickering; Andrew D Badley; Rahul Kashyap; AJ Venkatakrishnan; Venky Soundararajan; Jennifer E. Wu; Cécile Alanio; Kurt D'Andrea; Oliva Kuthuru; Jeanette Dougherty; Ajinkya Pattekar; Justin Kim; Nicholas Han; Sokratis A. Apostolidis; Alex C. Huang; Laura Vella; - The UPenn COVID Processing Unit; E. John Wherry; Nuala J. Meyer; Sara Cherry; Paul Bates; Daniel J. Rader; Scott E. Hensley

    doi:10.1101/2020.11.07.20226837 Date: 2020-11-10 Source: medRxiv

    Background High mortality has been described in coronavirus disease 2019 MESHD ( COVID-19 MESHD) with cytokine release syndrome (CRS). Tocilizumab (TCZ), an interleukin-6 (IL-6) receptor antagonist may be associated with improved outcomes in such patients; however, the subgroups of patients who benefit the most need to be identified. Objective To analyze the efficacy and optimal timing of administration of TCZ in moderate to severe COVID-19 MESHD with features of CRS, where the response to steroids was poor. Methods This is a retrospective study of 125 patients admitted between May 5 to July 31, 2020, in a tertiary care hospital in western India, with moderate to severe COVID-19 MESHD who were treated with TCZ along with steroids. The primary outcomes were the need for mechanical ventilation (MV) or death MESHD, and secondary outcomes were a decrease in oxygen requirement and inflammatory markers; the incidence of secondary infections MESHD, and renal or hepatic dysfunction MESHD. Kaplan Meier survival analysis and log rank test were used for evaluating primary outcomes. Secondary outcomes were analyzed using the Wilcoxon Signed-Rank test. Results Among 1081 patients admitted during the study period, 125 were administered TCZ (median age TRANS, 56 [95% CI 54 - 60] years; 100 [80%] male TRANS). The commonest symptoms were fever MESHD fever HP (96%), cough HP (64%), and dyspnea MESHD dyspnea HP (48.8%). 78.4% patients had comorbidities ( hypertension HP hypertension MESHD 51.2%, diabetes MESHD 43.2%, obesity MESHD obesity HP 25.6% and chronic cardiac disease MESHD 13.6%). Of 117 patients who were treated with TCZ before requiring MV, 18.8% progressed to MV. Overall, 25% of the patients needed MV support. 65.3% of patients were discharged by day 14 after TCZ administration. Mortality was nil, 16.2%, 50%, and 62.5% in patients who received TCZ on room air, low flow oxygen, high flow nasal cannula (HFNC) and bilevel positive airway pressure (BiPAP), and MV respectively; overall 24.8% of patients died. Survival analysis showed no difference in outcome with respect to age TRANS and gender TRANS, while progression to MV showed a statistically significant reduction for the event death (90.9% of patients who progressed to MV died as compared to 6.3% who did not; log rank test with p < 0.0001). No adverse events were noticed. Conclusion Mortality was least in patients of COVID-19 MESHD with CRS who received TCZ while on low flow oxygen. When administered in the early hypoxemic phase, TCZ is associated with reduced mortality and decreased need for mechanical ventilation.

    Alzheimer's MESHD and Parkinson's diseases MESHD predict different COVID-19 MESHD outcomes, a UK Biobank study

    Authors: Yizhou Yu; Marco Travaglio; Rebeka Popovic; Nuno Santos Leal; L. Miguel Martins; Arijit Chakravarty; Kayleigh J Mason; Helen McAteer; Freya Meynall; Bolaji Coker; Alexandra Vincent; Dominic Urmston; Amber Vesty; Jade Kelly; Camille Lancelot; Lucy Moorhead; Herve Bachelez; Ian N Bruce; Francesca Capon; Claudia Romina Contreras; Andrew P Cope; Claudia De La Cruz; Paola Di Meglio; Paolo Gisondi; Kimme Hyrich; Denis Jullien; Jo Lambert; Hoseah Waweru; Helena Marzo-Ortega; Iain McInnes; Luigi Naldi; Sam Norton; Lluis Puig; Phyllis Spuls; Raj Sengupta; Tiago Torres; RIchard B Warren; John Weinman; Christopher EM Griffiths; Jonathan N Barker; Matthew A Brown; James B Galloway; Catherine H Smith

    doi:10.1101/2020.11.05.20226605 Date: 2020-11-07 Source: medRxiv

    In December 2019, a coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began infecting humans causing a novel disease, coronavirus disease MESHD 19 ( COVID-19 MESHD). This was first described in the Wuhan province of the People's Republic of China. SARS-CoV-2 spread throughout the world causing a global pandemic. To date, thousands of cases of COVID-19 MESHD were reported in the United Kingdom, and over 45,000 patients have died. Some progress has been achieved in managing this disease, but the biological determinants of health, besides age TRANS, that affect COVID-19 MESHD infectivity and mortality are under scrutiny. Recent studies show that several medical conditions, including diabetes MESHD and hypertension MESHD hypertension HP, increase the risk of COVID-19 MESHD infection and death. The increased vulnerability of the elderly TRANS and those with comorbidities, together with the prevalence SERO of neurodegenerative diseases MESHD with advanced age TRANS, led us to investigate the links between neurodegeneration HP neurodegeneration MESHD and COVID-19 MESHD. We analysed the primary health records of 13,338 UK individuals tested for COVID-19 MESHD between March and July 2020. We show that a pre-existing diagnosis of Alzheimer's disease MESHD predicts the highest risk of COVID-19 MESHD infection and mortality among the elderly TRANS. In contrast, Parkinson's disease MESHD patients were found to be at increased risk of infection TRANS but not mortality from COVID-19 MESHD. We conclude that there are disease-specific differences in COVID-19 MESHD susceptibility among patients affected by neurodegenerative disorders MESHD.

    A Multi-Factor Risk Model for Severe Covid-19 MESHD for Vaccine Prioritization and Monitoring Based on a 15 Million Medicare Cohort

    Authors: Bettina Experton; Hassan Tetteh; Nicole Lurie; Peter Walker; Colin Carroll; Adrien Elena; Christopher Hein; Blake Schwendiman; Christopher Burrow; Claire Le Helloco; Clemence Lebegue; Elom A Tay; Guy Cassuto; Gilles Pialoux; Laurent Hocqueloux; thierry prazuck

    doi:10.1101/2020.10.28.20219816 Date: 2020-11-03 Source: medRxiv

    Background: Public Health interventions to slow the spread of the Covid-19 MESHD pandemic focus on protecting individuals at risk for severe disease. Risk categorization is essential to effective pandemic response. However, existing risk models for severe Covid-19 MESHD lack needed integration of both socio-demographic and clinical risk factors, and geographic characteristics. Methods: We present an integrated multi-factor risk model for severe Covid-19 MESHD using de-identified Medicare claims from which we extracted demographic and clinical data for a cohort of 15 million Medicare beneficiaries with 770,000 Covid-19 MESHD cases, and socio-economic data at the county and zip code level from the CDC Social Vulnerability Index. The model and associated digital maps were developed as part of Project Salus of the Department of Defense Joint Artificial Intelligence Center, for use by the National Guard and other military personnel in their support mission to hospitals and local jurisdictions impacted by the pandemic. Results: The model affirms ethnicity (Black: OR 1.64; 95% CI 1.61-1.68, American Indian: OR 2.21; 95% CI 2.01-2.42), age TRANS over 85 (OR 1.75, 95% CI 1.69-1.81), the socio-economic factor of residing in a zip code in the lowest quartile of income (OR 1.23; 95% CI 1.21-1.26), ESRD MESHD (OR 2.35; 95% CI 2.25-2.45) and chronic lung disease HP chronic lung disease MESHD (OR 1.95; 95% CI 1.90-2.00) as leading risk factors for Covid-19 MESHD hospitalizations, but reveals low risk for COPD MESHD (OR 1.15; 95% CI 1.13 -1.17) and minimal or no risk for diabetes MESHD (OR 1.03; CI 1.01-1.05), CHF MESHD (OR 1.10, 95% CI 1.08-1.12) or hypertension MESHD hypertension HP (OR 0.96; 95% CI 0.94-0.98), and demonstrates an association between prior herpes zoster immunization (OR 0.74; 95% CI 0.71-0.77), and to a lesser degree prior influenza and pneumococcal vaccines MESHD with less severe Covid-19 MESHD. Conclusions: This multi-factor risk model and derived digital maps can be applied for use by national and local health authorities to augment existing tools for pandemic response, including monitoring of post Covid-19 MESHD sequelae, prioritization of Covid-19 MESHD vaccine, and vaccine monitoring for both safety and efficacy.

    Epidemiological, clinical, and laboratory findings for patients of different age groups TRANS with confirmed coronavirus disease 2019 MESHD ( COVID-19 MESHD) in a hospital in Saudi Arabia

    Authors: Mutasim E Ibrahim; Obaid S AL-Aklobi; Mosleh M Abomughaid; Mushabab A. Al-Ghamdi; William KK Wu; Tong Liu; Zhidong Cao; Daniel Dajun Zeng; Ian CK Wong; Bernard MY Cheung; Qingpeng Zhang; Gary Tse

    doi:10.1101/2020.10.21.20217083 Date: 2020-10-25 Source: medRxiv

    Background: Although the coronavirus disease 2019 MESHD ( COVID-19 MESHD) pandemic continues to rage worldwide, clinical and laboratory studies of this disease have been limited in many countries. We investigated the epidemiologic, clinical, and laboratory findings of COVID-19 MESHD infected MESHD patients to identify the effective indicators correlated with the disease. Methods: A retrospective study was conducted at King Abdullah Hospital in Bisha Province, Saudi Arabia, from March 20 to June 30, 2020. Patients of different age groups TRANS were confirmed as having COVID-19 MESHD infection using a real-time polymerase chain reaction. The demographic, clinical, and laboratory data of the patients were statistically analyzed. Results: Of the 137 patients, 88 were male TRANS and 49 were female TRANS, with a mean age TRANS of 49.3 years (SD,18.4). The patients were elderly TRANS (n=29), adults TRANS (n=103), and children TRANS (n=5). Of these, 54 (39.4%) had comorbidities, 24% were admitted to the intensive care unit (ICU), and 12 (8.8%) died. On admission, the main clinical manifestations were fever MESHD fever HP (82.5%), cough HP (63.5%), shortness of breath MESHD (24.8%), chest pain MESHD chest pain HP (19.7%), and fatigue MESHD fatigue HP (18.2%). In all patients, increased neutrophils and decreased lymphocytes were observed. Patients' lactate dehydrogenase (LDH) was elevated. C-reactive protein (CRP) was elevated in 46.7%, D-dimer in 41.6%, and the erythrocyte sedimentation rate (ESR) in 39.4% of patients. The elderly TRANS showed higher neutrophil (p=0.003) and lower lymphocyte (p=0.001) counts than adults TRANS and children TRANS. Glucose, creatine kinase-MB, LDH, bilirubin, D-dimer, and ESR were significantly higher in the elderly TRANS than in the adults TRANS. The COVID-19 MESHD death group had a higher leucocyte count (p = 0.043), and higher urea (p=0.025) and potassium (p=0.026) than the recovered group but had a lower hemoglobin concentration (p=0.018). A significant association was determined between COVID-19 MESHD death MESHD (x2(1)=17.751, p<0.001), and the presence of cardiovascular disease MESHD (x2(1)=17.049, p<0.001), hypertension HP hypertension MESHD (x2(1)=7.659, p=0.006), renal failure MESHD (x2(1)=4.172, p<0.04), old age TRANS (t(135) = 4.747, p <0.001), and ICU admission (x2(1) = 17.751 (1), p<0.001). Conclusions: The common symptoms found in this study could be useful for identifying potential COVID-19 MESHD patients. Investigating some of the laboratory and clinical parameters could help assess the disease progression, risk of mortality, and follow up patients who could progress to a fatal condition.

    Development of a predictive risk model for severe COVID-19 MESHD disease using population-based administrative data

    Authors: Jiandong Zhou; Sharen Lee; Xiansong Wang; Yi Li; William KK Wu; Tong Liu; Zhidong Cao; Daniel Dajun Zeng; Ian CK Wong; Bernard MY Cheung; Qingpeng Zhang; Gary Tse

    doi:10.1101/2020.10.21.20217380 Date: 2020-10-25 Source: medRxiv

    Background: Recent studies have reported numerous significant predictors for adverse outcomes in COVID-19 MESHD disease. However, there have been few simple clinical risk score for prompt risk stratification. The objective is to develop a simple risk score for severe COVID-19 MESHD disease using territory-wide healthcare data based on simple clinical and laboratory variables. Methods: Consecutive patients admitted to Hong Kong public hospitals between 1st January and 22nd August 2020 diagnosed with COVID-19 MESHD, as confirmed by RT-PCR, were included. The primary outcome was composite intensive care unit admission, need for intubation or death with follow-up until 8th September 2020. Results: COVID-19 MESHD testing was performed in 237493 patients and 4445 patients (median age TRANS 44.8 years old, 95% CI: [28.9, 60.8]); 50% male TRANS) were tested positive. Of these, 212 patients (4.8%) met the primary outcome. A risk score including the following components was derived from Cox regression: gender TRANS, age TRANS, hypertension HP hypertension MESHD, stroke HP stroke MESHD, diabetes mellitus HP diabetes mellitus MESHD, ischemic MESHD heart disease MESHD/ heart failure MESHD failure, respiratory HP respiratory disease MESHD, renal disease MESHD, increases in neutrophil count, monocyte count, sodium, potassium, urea, alanine transaminase, alkaline phosphatase, high sensitive troponin-I, prothrombin time, activated partial thromboplastin time, D-dimer and C-reactive protein, as well as decreases in lymphocyte count, base excess and bicarbonate levels. The model based on test results taken on the day of admission demonstrated an excellent predictive value. Incorporation of test results on successive time points did not further improve risk prediction. Conclusions: A simple clinical score accurately predicted severe COVID-19 MESHD disease, even without including symptoms, blood SERO pressure or oxygen status on presentation, or chest radiograph results.

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