Corpus overview


Overview

MeSH Disease

Obesity (103)

Disease (53)

Death (44)

Hypertension (43)

Infections (40)


Human Phenotype

Transmission

Seroprevalence
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    Outcomes of COVID-19 related hospitalisation among people with HIV in the ISARIC WHO Clinical Characterisation Protocol UK Protocol: prospective observational study

    Authors: Anna Maria Geretti; Alexander Stockdale; Sophie Kelly; Muge Cevik; Simon Collins; Laura Waters; Giovanni Villa; Annemarie B Docherty; Ewen M Harrison; Lance Turtle; Peter JM Openshaw; Kenneth Baillie; Caroline Sabin; Malcolm Gracie Semple

    doi:10.1101/2020.08.07.20170449 Date: 2020-08-11 Source: medRxiv

    Background. There is conflicting evidence about how HIV infection MESHD influences COVID-19. We compared the presentation characteristics and outcomes of people with and without HIV hospitalised with COVID-19 at 207 centres across the United Kingdom. Methods. We analysed data from people with laboratory confirmed or highly likely COVID-19 enrolled into the ISARIC CCP-UK study. The primary endpoint was day-28 mortality after presentation. We used Kaplan-Meier methods and Cox regression to describe the association with HIV status after adjustment for sex, ethnicity, age TRANS, indeterminate/probable hospital acquisition of COVID-19 (definite hospital acquisition excluded), presentation date, and presence/absence of ten comorbidities. We additionally adjusted for disease MESHD severity at presentation as defined by hypoxia MESHD/oxygen therapy. Findings. Among 47,539 patients, 115 (0.24%) had confirmed HIV-positive status and 103/115 (89.6%) had a record of antiretroviral therapy. At presentation, relative to the HIV-negative group, HIV-positive people were younger (median 55 versus 74 years; p<0.001), had a higher prevalence SERO of obesity MESHD obesity HP and moderate/severe liver disease MESHD, higher lymphocyte counts and C-reactive protein, and more systemic symptoms. The cumulative incidence of day-28 mortality was 25.2% in the HIV-positive group versus 32.1% in the HIV-negative group (p=0.12); however, stratification for age TRANS revealed a higher mortality among HIV-positive people aged TRANS below 60 years. The effect of HIV-positive status was confirmed in adjusted analyses (adjusted hazard ratio [HR] 1.49, 95% confidence interval [CI] 0.99-2.25; p=0.06). Following additional adjustment for disease MESHD severity at presentation, mortality was higher in HIV-positive people (adjusted HR 1.63; 95% CI 1.07-2.48; p=0.02). In the HIV-positive group, mortality was more common among those who were slightly older and among people with obesity MESHD obesity HP and diabetes with complications MESHD. Interpretation. HIV-positive status may be associated with an increased risk of day-28 mortality following a COVID-19 related hospitalisation.

    Clinical and intestinal histopathological findings in SARS-CoV-2/COVID-19 patients with hematochezia HP

    Authors: Margaret Cho; Weiguo Liu; Sophie Balzora; Yvelisse Suarez; Deepthi Hoskoppal; Neil D Theise; Wenqing Cao; Suparna A Sarkar

    doi:10.1101/2020.07.29.20164558 Date: 2020-08-07 Source: medRxiv

    Gastrointestinal (GI) symptoms of SARS-CoV2/COVID-19 in the form of anorexia MESHD anorexia HP, nausea MESHD nausea, vomiting HP, vomiting MESHD, abdominal pain MESHD abdominal pain HP and diarrhea MESHD diarrhea HP are usually preceeded by respiratory manifestations and are associated with a poor prognosis. Hematochezia HP is an uncommon clinical presentation of COVID-19 disease MESHD and we hypothesize that older patients with significant comorbidites ( obesity MESHD obesity HP and cardiovascular) and prolonged hospitalization are suspectible to ischemic injury to the bowel. We reviewed the clinical course, key laboratory data including acute phase reactants, drug/medication history in two elderly TRANS male TRANS patients admitted for COVID-19 respiratory failure HP. Both patients had a complicated clinical course and suffered from hematochezia HP and acute blood SERO loss anemia MESHD anemia HP requiring blood SERO transfusion around day 40 of their hospitalization. Colonoscopic impressions were correlated with the histopathological findings in the colonic biopies and changes compatible with ischemia MESHD to nonspecific acute inflammation MESHD, edema MESHD edema HP and increased eosinophils in the lamina propria were noted.Both patients were on anticoagulants, multiple antibiotics and antifungal agents due to respiratory infections MESHD at the time of lower GI bleeding. Hematochezia HP resolved spontaneously with supportive care. Both patients eventually recovered and were discharged. Elderly TRANS patients with significant comorbid conditions are uniquely at risk for ischemic injury to the bowel. Hypoxic conditions due to COVID-19 pneumonia MESHD pneumonia HP and respiratory failure HP, compounded by preexisting cardiovascular complications, and/or cytokine storm orchestrated by the viral infection MESHD leading to alteration in coagulation profile and/or drug/medication injury can be difficult to distinguish in these critically ill patients. Presentation of hematochezia HP may further increase the mortality and morbidity of COVID-19 patients, and prompt consultation and management by gastroenterology is therefore warranted.

    Clinical course and severity outcome indicators among COVID 19 hospitalized patients in relation to comorbidities distribution Mexican cohort

    Authors: Genny Carrillo; Nina Mendez Dominguez; Kassandra D Santos Zaldivar; Andrea Rochel Perez; Mario Azuela Morales; Osman Cuevas Koh; Alberto Alvarez Baeza

    doi:10.1101/2020.07.31.20165480 Date: 2020-08-04 Source: medRxiv

    Introduction: COVID-19 affected worldwide, causing to date, around 500,000 deaths MESHD. In Mexico, by April 29, the general case fatality was 6.52%, with 11.1% confirmed case TRANS mortality and hospital recovery rate around 72%. Once hospitalized, the odds for recovery and hospital death MESHD rates depend mainly on the patients' comorbidities and age TRANS. In Mexico, triage guidelines use algorithms and risk estimation tools for severity assessment and decision-making. The study's objective is to analyze the underlying conditions of patients hospitalized for COVID-19 in Mexico concerning four severity outcomes. Materials and Methods: Retrospective cohort based on registries of all laboratory-confirmed patients with the COVID-19 infection MESHD that required hospitalization in Mexico. Independent variables were comorbidities and clinical manifestations. Dependent variables were four possible severity outcomes: (a) pneumonia MESHD pneumonia HP, (b) mechanical ventilation (c) intensive care unit, and (d) death MESHD; all of them were coded as binary Results: We included 69,334 hospitalizations of laboratory-confirmed and hospitalized patients to June 30, 2020. Patients were 55.29 years, and 62.61% were male TRANS. Hospital mortality among patients aged TRANS<15 was 9.11%, 51.99% of those aged TRANS >65 died. Male TRANS gender TRANS and increasing age TRANS predicted every severity outcome. Diabetes and hypertension MESHD hypertension HP predicted every severity outcome significantly. Obesity MESHD Obesity HP did not predict mortality, but CKD, respiratory diseases MESHD, cardiopathies were significant predictors. Conclusion: Obesity MESHD Obesity HP increased the risk for pneumonia MESHD pneumonia HP, mechanical ventilation, and intensive care admittance, but it was not a predictor of in-hospital death MESHD. Patients with respiratory diseases MESHD were less prone to develop pneumonia MESHD pneumonia HP, to receive mechanical ventilation and intensive care unit assistance, but they were at higher risk of in-hospital death MESHD.

    Awake Prone Positioning Does Not Reduce the Risk of Intubation in COVID-19 Treated with High-Flow Nasal Oxygen Therapy. A Multicenter, Adjusted Cohort Study

    Authors: Carlos Ferrando; Ricard Mellado-Artigas; Alfredo Gea; Egoitz Arruti; César Aldecoa; Ramón Adalia; Fernando Ramasco; Pablo Monedero; Emilio Maseda; Gonzalo Tamayo; María L. Hernández-Sanz; Jordi Mercadal; Ascensión Martín-Grande; Robert M. Kacmarek; Jesús Villar; Fernando Suárez-Sipmann

    doi:10.21203/rs.3.rs-53558/v1 Date: 2020-08-04 Source: ResearchSquare

    Background: Awake prone positioning (awake-PP) in non-intubated coronavirus disease MESHD 2019 (COVID-19) patients could avoid endotracheal intubation, reduce the use of critical care resources, and improve survival. We aimed to examine whether the combination of high-flow nasal oxygen therapy (HFNO) with awake-PP prevents the need for intubation when compared to HFNO alone.Methods: Prospective, multicentre, adjusted observational cohort study in consecutive COVID-19 patients with acute respiratory failure HP (ARF) receiving respiratory support with HFNO from 12 March to 9 June, 2020. Patients were classified as HFNO with or without awake-PP. Logistic models were fitted to predict treatment at baseline using the following variables: age TRANS, sex, obesity MESHD obesity HP, non-respiratory sequential organ failure assessment score, APACHE-II, C-reactive protein, days from symptoms onset TRANS to HFNO initiation, respiratory rate and peripheral oxyhemoglobin saturation. We compared data on demographics, vital signs, laboratory markers, need for invasive mechanical ventilation, days to intubation, ICU length of stay, and ICU mortality between HFNO patients with and without awake-PP.Results: A total of 1076 patients with COVID-19 ARF were admitted, of which 199 patients received HFNO and were analyzed. Fifty-five (27.6%) were pronated during HFNO; 60 (41%) and 22 (40%) patients from the HFNO and HFNO+awake-PP groups were intubated. The use of awake-PP as an adjunctive therapy to HFNO did not reduce the risk of intubation [RR 0.87 (95%CI: 0.53–1.43), p=0.60]. Patients treated with HFNO+awake-PP showed a trend for delay in intubation compared to HFNO alone [median 1 (interquartile range, IQR 1.0-2.5) vs 2 IQR 1.0-3.0] days, (p=0.055), but awake-PP did not affect 28-day mortality [RR 1.04 (95%CI: 0.40–2.72), p=0.92].Conclusion: In patients with COVID-19 ARF treated with HFNO, the use of awake-PP did not reduce the need for intubation or affect mortality.

    METFORMIN USE IS ASSOCIATED WITH REDUCED MORTALITY IN A DIVERSE POPULATION WITH COVID-19 AND DIABETES

    Authors: Andrew Crouse; Tiffany Grimes; Peng Li; Matthew Might; Fernando Ovalle; Anath Shalev

    doi:10.1101/2020.07.29.20164020 Date: 2020-07-31 Source: medRxiv

    BACKGROUND: Coronavirus disease MESHD-2019 (COVID-19) is a growing pandemic with an increasing death MESHD toll that has been linked to various comorbidities as well as racial disparity. However, the specific characteristics of these at-risk populations are still not known and approaches to lower mortality are lacking. METHODS: We conducted a retrospective electronic health record data analysis of 25,326 subjects tested for COVID-19 between 2/25/20 and 6/22/20 at the University of Alabama at Birmingham Hospital, a tertiary health care center in the racially diverse Southern U.S. The primary outcome was mortality in COVID-19-positive subjects and the association with subject characteristics and comorbidities was analyzed using simple and multiple linear logistic regression. RESULTS: The odds ratio of contracting COVID-19 was disproportionately high in Blacks/African-Americans (OR 2.6; 95%CI 2.19-3.10; p<0.0001) and in subjects with obesity MESHD obesity HP (OR 1.93; 95%CI 1.64-2.28; p<0.0001), hypertension MESHD hypertension HP (OR 2.46; 95%CI 2.07-2.93; p<0.0001), and diabetes (OR 2.11; 95%CI 1.78-2.48; p<0.0001). Diabetes was also associated with a dramatic increase in mortality (OR 3.62; 95%CI 2.11-6.2; p<0.0001) and emerged as an independent risk factor in this diverse population even after correcting for age TRANS, race, sex, obesity MESHD obesity HP and hypertension MESHD hypertension HP. Interestingly, we found that metformin treatment was independently associated with a significant reduction in mortality in subjects with diabetes and COVID-19 (OR 0.33; 95%CI 0.13-0.84; p=0.0210). CONCLUSION: Thus, these results suggest that while diabetes is an independent risk factor for COVID-19-related mortality, this risk is dramatically reduced in subjects taking metformin, raising the possibility that metformin may provide a protective approach in this high risk population.

    Obesity MESHD Obesity HP and Severity in Patients with COVID-19: A Scoping Review Protocol

    Authors: Marcela Larissa Costa; Carlos Adriano Santos Souza; Ana Caroline Cardoso Silva; Dayane Franciely Conceição Santos; Edilene Fernandes Nonato; Francismayne Batista Santana; Giselle dos Santos Dias; Jessyca Teles Barreto; Laís Santos Costa; Maria Carolina Barros Costa; Tamila das Neves Ferreira; Jeniffer Santos Santana; Raquel Simões Mendes Netto; Tereza Virgínia Silva Bezerra do Nascimento; Marco Antônio Prado Nunes; Márcia Ferreira Cândido de Souza

    doi:10.21203/rs.3.rs-51197/v1 Date: 2020-07-30 Source: ResearchSquare

    Background: Coronavirus disease MESHD (COVID-19), caused by the SARS-CoV-2 strain, was first identified in late 2019, in China. A greater number of countries were affected in 2020, with a consequent increase in the disease MESHD's epidemiological curve. The outcomes of patients affected by the virus can worsen, developing acute respiratory failure HP and other serious complications, especially when related to older individuals and people of all ages TRANS with obesity MESHD obesity HP and comorbidities. Some studies have shown that obese infected with COVID-19 had a high frequency risk of hospitalization in the Intensive Care Unit and the need to use Invasive Mechanical Ventilation, in addition to the association between a higher death MESHD rate. Thus, obese patients tend to have a more severe course of COVID-19. In this sense, this review aims to synthesize the evidence in the literature that associates COVID-19 and the severity of the prognosis in infected obese patients. Methods: This protocol will include all study articles that can be used as instruments to assess the severity of clinical outcomes in obese patients infected by 2019-nCoV. There will be no time limitation when searching for articles. Studies in any environment or country for inclusion will be considered.Discussion: There are still not enough studies to characterize the evidence and its strength in the prognosis of the disease MESHD. Therefore, given the need for early detection of the possible implications and treatment for patients with obesity MESHD obesity HP, the evidence will be useful for directing the conduct and optimization of therapies in these patients by the multiprofessional teams.Scoping review registration: Open Science Framework: https://osf.io/xrkec

    Risk Factors for COVID-19-associated hospitalization: COVID-19-Associated Hospitalization Surveillance Network and Behavioral Risk Factor Surveillance System

    Authors: Jean Y. Ko; Melissa L. Danielson; Machell Town; Gordana Derado; Kurt J. Greenland; Pam Daily Kirley; Nisha B. Alden; Kimberly Yousey-Hindes; Evan J. Anderson; Patricia A. Ryan; Sue Kim; Ruth Lynfield; Salina M. Torres; Grant R. Barney; Nancy M. Bennett; Melissa Sutton; H. Keipp Talbot; Mary Hill; Aron J. Hall; Alicia M. Fry; Shikha Garg; Lindsay Kim; - COVID-NET Investigation Group

    doi:10.1101/2020.07.27.20161810 Date: 2020-07-29 Source: medRxiv

    Background: Identification of risk factors for COVID-19-associated hospitalization is needed to guide prevention and clinical care. Objective: To examine if age TRANS, sex, race/ethnicity, and underlying medical conditions is independently associated with COVID-19-associated hospitalizations. Design: Cross-sectional. Setting: 70 counties within 12 states participating in the Coronavirus Disease MESHD 2019-Associated Hospitalization Surveillance Network (COVID-NET) and a population-based sample of non-hospitalized adults TRANS residing in the COVID-NET catchment area from the Behavioral Risk Factor Surveillance System. Participants: U.S. community-dwelling adults TRANS ([≥]18 years) with laboratory-confirmed COVID-19-associated hospitalizations, March 1- June 23, 2020. Measurements: Adjusted rate ratios (aRR) of hospitalization by age TRANS, sex, race/ethnicity and underlying medical conditions ( hypertension MESHD hypertension HP, coronary artery disease MESHD, history of stroke MESHD stroke HP, diabetes, obesity MESHD obesity HP [BMI [≥]30 kg/m2], severe obesity MESHD obesity HP [BMI[≥]40 kg/m2], chronic kidney disease HP kidney disease MESHD, asthma MESHD asthma HP, and chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP). Results: Our sample included 5,416 adults TRANS with COVID-19-associated hospitalizations. Adults TRANS with (versus without) severe obesity MESHD obesity HP (aRR:4.4; 95%CI: 3.4, 5.7), chronic kidney disease HP kidney disease MESHD (aRR:4.0; 95%CI: 3.0, 5.2), diabetes (aRR:3.2; 95%CI: 2.5, 4.1), obesity MESHD obesity HP (aRR:2.9; 95%CI: 2.3, 3.5), hypertension MESHD hypertension HP (aRR:2.8; 95%CI: 2.3, 3.4), and asthma MESHD asthma HP (aRR:1.4; 95%CI: 1.1, 1.7) had higher rates of hospitalization, after adjusting for age TRANS, sex, and race/ethnicity. In models adjusting for the presence of an individual underlying medical condition, higher hospitalization rates were observed for adults TRANS [≥]65 years, 45-64 years (versus 18-44 years), males TRANS (versus females TRANS), and non-Hispanic black and other race/ethnicities (versus non-Hispanic whites). Limitations: Interim analysis limited to hospitalizations with underlying medical condition data. Conclusion: Our findings elucidate groups with higher hospitalization risk that may benefit from targeted preventive and therapeutic interventions.

    COVID-19 pandemic: Nigerians’ knowledge, perception and adherence to preventive measures

    Authors: Oyetunde Oyeyemi; Victoria Oladoyin; Oluyemi Okunlola; Akinola Mosobalaje; Ifeoluwa Oyeyemi; Wasiu Adebimpe; Roseangela Nwuba; Iyadunni Anuoluwa; Adebisi Tiamiyu; Oghale Ovuakporie-uvo; Isaac Adesina; Babawale Olatunji; Jennifer Kone; Yinka Oluwafemi; Caleb Obajaja; Abiodun Ajiboye

    doi:10.21203/rs.3.rs-49707/v1 Date: 2020-07-27 Source: ResearchSquare

    Aims: One of the ways to manage the current coronavirus disease MESHD 2019 (COVID-19) pandemic is monitoring of public knowledge, risk perceptions, adherence to preventive measures and preparedness behaviors. This is of utmost importance in resource limited countries. This study determined the knowledge and perception about COVID-19; adherence to COVID-19 preventive measures; as well as predictors of self-perceived risk of contracting COVID-19 among Nigerian adults TRANS.Methods: A cross-sectional study was conducted among Nigerian adults TRANS ≥ 18 years using an online survey. Participants were recruited using the authors’ social networks. Data was analysed using descriptive and inferential statistics at 5% level of statistical significance.Results: Generally, a high proportion of respondents had correct knowledge about COVID-19. However, only about half (49.8% and 49.9%) had correct knowledge that obesity MESHD obesity HP was a risk factor for COVID-19 and that antibiotics cannot be used to treat COVID-19. Most (84.1%) did not have a self-perceived risk of contracting COVID-19. Most (81.0%) have been avoiding crowded places and 61.3% washed their hands very often. Predictors of self-perceived risk of COVID-19 were age TRANS 40-59 years (OR 2.05, CI 1.217-3.435), ≥ 60 years (OR 4.68, CI 1.888-11.583) and visiting crowded places (OR 2.27, CI 1.499-3.448).Conclusion: Our study recommends more rigorous public health education aimed at improving COVID-19 outbreak response in Nigerian. Also, physical and social distancing should be emphasized across all age groups TRANS with additional focus on the older population.   

    Trends in Angiotensin Receptor Blocker Use Among those at Risk for COVID-19 Morbidity and Mortality in the United States

    Authors: Alexandra Perez; Robert Speth; Juan Saavedra

    doi:10.1101/2020.07.24.20161851 Date: 2020-07-27 Source: medRxiv

    Importance: Assessment of the use of angiotensin receptor blockers (ARBs) in the United States provides insight into prescribing practices, and may inform guidelines, policy measures and research during the COVID-19 pandemic. Objective: To evaluate trends in ARB use among adults TRANS in the United States who have preexisting conditions and sociodemographic risk factors that put them at a higher risk of SARS-CoV-2 infection MESHD and COVID-19-related complications and mortality. Design, setting and participants: This study uses the nationally representative cross-sectional data from the 2005-2018 National Health and Nutrition Examination Survey (NHANES). Participants included 39,749 non-institutionalized U.S. civilian adults TRANS who were 20 years and older and those with the most common preexisting conditions and risk factors reported among patients with COVID-19. Main outcomes and measures: Use of ARBs in the prior 30 days from survey interview. Results: ARB use ranged from 7.4% [95% CI, 6.5%-8.4%] to 26.2% [95% CI, 19.4%-34.4%] among those with one or two metabolic, renal, respiratory, and/or cardiovascular diseases MESHD. Among individuals with the three most common preexisting conditions in patients with COVID-19 including hypertension MESHD hypertension HP, diabetes and obesity MESHD obesity HP, ARB use was higher among the elderly TRANS, females TRANS, non-Hispanic whites, and those with health insurance coverage. Conclusions and relevance: In this nationally representative survey, ARB use was found to be widespread, but unevenly distributed among individuals with conditions and sociodemographic risk factors that place them at a higher risk of COVID-19 morbidity and mortality.

    The impact of previous history of bariatric surgery on outcome of Covid-19: A nationwide medico-administrative French study.

    Authors: Antonio Iannelli; Samir Bouam; Anne-Sophie Schneck; Sébastien Frey; Jean Gugenheim; Marco Alifano

    doi:10.21203/rs.3.rs-48313/v1 Date: 2020-07-24 Source: ResearchSquare

    Purpose: To determine the risk of invasive mechanical ventilation and death MESHD in obese individuals with history of bariatric surgery compared to standard ones admitted for Covid-19 infection MESHD.Methods: Nationwide retrospective observational study based on electronic health data. 4 248 253 individuals aged TRANS 15 to 75 years with a diagnosis of obesity MESHD obesity HP were included. All obese inpatients, undergoing bariatric surgery or not, recorded during a hospital stay by the French National Health Insurance were followed, during a mean observation time of 5.43 ± 2.93 years. This exposition was bariatric surgery (n=389,671) including adjustable gastric banding, sleeve gastrectomy, gastric bypass versus no bariatric surgery (n=3,858,582). The primary outcome was Covid-19 related death MESHD and the secondary outcome was the need for invasive mechanical ventilation.Results: 8 286 (0.2%) obese individuals were admitted for Covid-19 infection MESHD between January 1st and May 15th 2020 with a diagnosis of Covid-19 infection MESHD. 541 (0.14%) had a history of bariatric surgery and 7,745 (0.2%) did not. Invasive mechanical ventilation was necessary in 14.54% of patients and death MESHD occurred in 13.58% of cases. The need for an invasive mechanical ventilation and death MESHD occurred in 7% and 3.5% in the bariatric surgery group versus 15% and 14.2% in the non-bariatric surgery group, respectively (both p<0.0001). After a logistic regression, the risk of invasive mechanical ventilation significantly increased with age TRANS being higher in the age TRANS class 61-75, male TRANS gender TRANS, and hypertension MESHD hypertension HP, whereas bariatric surgery showed an independent protective effect. Mortality was independently associated with increasing age TRANS, male TRANS gender TRANS, known history of heart failure MESHD, cancer, and diabetes, whereas BS was in favor with a protective effect. Conclusion: This nationwide administrative study showed that bariatric surgery is independently associated with a reduced risk of death MESHD and invasive mechanical ventilation in obese individuals with Covid-19 infection MESHD.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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