Corpus overview


MeSH Disease

Human Phenotype


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    Population perspective comparing COVID-19 to all and common causes of death MESHD in seven European countries

    Authors: Bayanne Olabi; Jayshree Bagaria; Sunil Bhopal; Gwenetta Curry; Nazmy Villarroel; Raj Bhopal

    doi:10.1101/2020.08.07.20170225 Date: 2020-08-11 Source: medRxiv

    Background: Mortality statistics on the COVID-19 pandemic have led to widespread concern and fear. To contextualise these data, we compared mortality related to COVID-19 with all and common causes of death MESHD, stratifying by age TRANS and sex. We also calculated deaths MESHD as a proportion of the population by age TRANS and sex. Methods: COVID-19 related mortality and population statistics from seven European countries were extracted: England and Wales, Italy, Germany, Spain, France, Portugal and Netherlands. Available data spanned 14-16 weeks since the first recorded deaths MESHD in each country, except Spain, where only comparable stratified data over an 8-week time period was available. The Global Burden of Disease MESHD database provided data on all deaths MESHD and those from pneumonia MESHD pneumonia HP, cardiovascular disease MESHD combining ischaemic heart disease MESHD and stroke MESHD stroke HP, chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP, cancer, road traffic accidents and dementia MESHD dementia HP. Findings: Deaths MESHD related to COVID-19, while modest overall, varied considerably by age TRANS. Deaths MESHD as a percentage of all cause deaths MESHD during the time period under study ranged from <0.01% in children TRANS in Germany, Portugal and Netherlands, to as high as 41.65% for men aged TRANS over 80 years in England and Wales. The percentage of the population who died from COVID-19 was less than 0.2% in every age group TRANS under the age TRANS of 80. In each country, over the age TRANS of 80, these proportions were: England and Wales 1.27% males TRANS, 0.87% females TRANS; Italy 0.6% males TRANS, 0.38% females TRANS; Germany 0.13% males TRANS, 0.09% females TRANS; France 0.39% males TRANS, 0.2% females TRANS; Portugal 0.2% males TRANS, 0.15% females TRANS; and Netherlands 0.6% males TRANS, 0.4% females TRANS. Interpretation: Mortality rates from COVID-19 remains low including when compared to other common causes of death MESHD and will likely decline further while control measures are maintained. These data may help people contextualise their risk and policy makers in decision-making.

    Clustering of age TRANS standardised COVID-19 infection MESHD fatality ratios and death MESHD trajectories

    Authors: Thu-Lan Kelly; Greer Humphrey; Caroline Miller; Jacqueline A Bowden; Joanne Dono; Paddy A Phillips

    doi:10.1101/2020.08.11.20172478 Date: 2020-08-11 Source: medRxiv

    Background An accurate measure of the impact of COVID-19 is the infection MESHD fatality ratio, or the proportion of deaths MESHD among those infected, which does not depend on variable testing rates between nations. The risk of mortality from COVID-19 depends strongly on age TRANS and current estimates of the infection MESHD fatality ratio do not account for differences in national age TRANS profiles. Comparisons of cumulative death MESHD trajectories allow the effect and timing of public health interventions to be assessed. Our purpose is to (1) determine whether countries are clustered according to infection MESHD fatality ratios and (2) compare interventions to slow the spread of the disease TRANS disease MESHD by clustering death MESHD trajectories. Methods National age TRANS standardised infection MESHD fatality ratios were derived from age TRANS stratified estimates from China and population estimates from the World Health Organisation. The IFRs were clustered into groups using Gaussian mixture models. Trajectory analysis clustered cumulative death MESHD rates in two time windows, 50 and 100 days after the first reported death MESHD. Findings Infection MESHD fatality ratios from 201 nations were clustered into three groups: young, medium and older, with corresponding means (SD) of 0.20% (0.03%), 0.38% (0.11%) and 0.93% (0.21%). At 50 and 100 days after the first reported death MESHD, there were two clusters of cumulative death MESHD trajectories from 113 nations with at least 25 deaths MESHD reported at 100 days. The first group had slowly increasing or stable cumulative death MESHD rates, while the second group had accelerating rates at the end of the time window. Fifty-two nations changed group membership between the time windows. Conclusion A cluster of younger nations have a lower estimated infection MESHD fatality ratio than older nations. The effect and timing of public health interventions in preventing the spread of the disease TRANS disease MESHD can be tracked by clustering death MESHD rate trajectories into stable or accelerating and comparing changes over time.

    Characterisation of 22446 patients attending UK emergency MESHD departments with suspected COVID-19 infection MESHD: Observational cohort study

    Authors: Steve Goodacre; Ben Thomas; Ellen Lee; Laura Sutton; Amanda Loban; Simon Waterhouse; Richard Simmonds; Katie Biggs; Carl Marincowitz; Jose Schutter; Sarah Connelly; Elena Sheldon; Jamie Hall; Emma Young; Andrew Bentley; Kirsty Challen; Chris Fitzsimmons; Tim Harris; Fiona Lecky; Andrew Lee; Ian Maconochie; Darren Walter

    doi:10.1101/2020.08.10.20171496 Date: 2020-08-11 Source: medRxiv

    Background Hospital emergency MESHD departments play a crucial role in the initial management of suspected COVID-19 infection MESHD. We aimed to characterise patients attending emergency MESHD departments with suspected COVID-19, including subgroups based on sex, ethnicity and COVID-19 test results. Methods We undertook a mixed prospective and retrospective observational cohort study in 70 emergency MESHD departments across the United Kingdom (UK). We collected presenting data from 22446 people attending with suspected COVID-19 between 26 March 2020 and 28 May 2020. Outcomes were admission to hospital, COVID-19 result, organ support (respiratory, cardiovascular or renal), and death MESHD, by record review at 30 days. Results Adults TRANS were acutely unwell (median NEWS2 score 4) and had high rates of admission (67.1%), COVID-19 positivity (31.2%), organ support (9.8%) and death MESHD (15.9%). Children TRANS had much lower rates of admission (27.4%), COVID-19 positivity (1.2%), organ support (1.4%) and death MESHD (0.3%). Adult TRANS men and women presented in similar numbers (10210 versus 10506), but men were more likely to be admitted (72.9% v 61.4%), require organ support (12.2% v 7.7%) and die (18.7% v 13.3%). Black or Asian adults TRANS tended to be younger than White adults TRANS (median age TRANS 54, 50 and 67 years), were less likely to be admitted (60.8%, 57.3%, 69.6%) or die (11.9%, 11.2%, 16.8%), but were more likely to require organ support (15.9%, 14.3%, 8.9%) or have a positive COVID-19 test (40.8%, 42.1%, 30.0%). Adults TRANS admitted with confirmed COVID-19 had similar age TRANS and comorbidities (except chronic lung disease HP lung disease MESHD) to those who did not have COVID-19 confirmed, but were much more likely to need organ support (22.2% v 8.9%) or die (32.7% v 15.9%). Conclusions Important differences exist between patient groups presenting to the emergency MESHD department with suspected COVID-19. People with confirmed COVID-19 have a poor prognosis, compared with similar emergency MESHD admissions without confirmed COVID-19.

    COVID-19 mortality according to civilian records

    Authors: Lisandro Lovisolo; Diego H S Catalao; Rodrigo B Burgos; Malu Grave; Pamella Constantino-Teles; Americo Cunha Jr.

    doi:10.1101/2020.08.07.20170183 Date: 2020-08-11 Source: medRxiv

    In this short report, we bring some data-driven analyses of COVID-19 mortality in Brazil. The impact of COVID-19 is evaluated by comparing the 2019 and 2020 civilian death MESHD records. There is evidence of a considerable excess of deaths MESHD since the pandemic started with respect to the previous year. In some states, it is clear that not all excess of deaths MESHD in 2020 is due to COVID-19, but to other respiratory causes that did not present the same prevalence SERO in the previous year. Because of this unusual behavior of respiratory deaths MESHD, we may infer the evidence of a huge amount of under-reporting deaths MESHD due to the COVID-19. The data also shows that COVID-19 has produced an excess death MESHD in all ages TRANS besides people above 90 and below 10 years. In addition, when separates by sex, data indicate a larger increase in the deaths MESHD among males TRANS than females TRANS.

    Considering indirect benefits is critical when evaluating SARS-CoV-2 vaccine candidates

    Authors: Molly E. Gallagher; Andrew J. Sieben; Kristin N. Nelson; Alicia N. M. Kraay; Ben Lopman; Andreas Handel; Katia Koelle

    doi:10.1101/2020.08.07.20170456 Date: 2020-08-11 Source: medRxiv

    Significant progress has already been made in development and testing of SARS-CoV-2 vaccines, and Phase III clinical trials have begun for 6 novel vaccine candidates to date. These Phase III trials seek to demonstrate direct benefits of a vaccine on vaccine recipients. However, vaccination is also known to bring about indirect benefits to a population through the reduction of virus circulation. The indirect effects of SARS-CoV-2 vaccination can play a key role in reducing case counts and COVID-19 deaths MESHD. To illustrate this point, we show through simulation that a vaccine with strong indirect effects has the potential to reduce SARS-CoV-2 circulation and COVID-19 deaths MESHD to a greater extent than an alternative vaccine with stronger direct effects but weaker indirect effects. Protection via indirect effects may be of particular importance in the context of this virus, because elderly TRANS individuals are at an elevated risk of death MESHD but are also less likely to be directly protected by vaccination due to immune senescence. We therefore encourage ongoing data collection and model development aimed at evaluating the indirect effects of forthcoming SARS-CoV-2 vaccines.

    Telmisartan for treatment of Covid-19 patients: an open randomized clinical trial. Preliminary report.

    Authors: Mariano Duarte; Facundo G Pelorosso; Liliana Nicolosi; M. Victoria Salgado; Hector Vetulli; Analia Aquieri; Francisco Azzato; Mauro Basconcel; Marcela Castro; Javier Coyle; Ignacio Davolos; Eduardo Esparza; Ignacio Fernandez Criado; Rosana Gregori; Pedro Mastrodonato; Maria Rubio; Sergio Sarquis; Fernando Wahlmann; Rodolfo Pedro Rothlin

    doi:10.1101/2020.08.04.20167205 Date: 2020-08-11 Source: medRxiv

    Background. Covid-19, the disease MESHD caused by SARS-CoV-2, is associated with significant respiratory-related morbidity and mortality. Angiotensin receptor blockers (ARBs) have been postulated as tentative pharmacological agents to treat Covid-19-induced lung inflammation MESHD. Trial design. This trial is a parallel group, randomized, two arm, open label, multicenter superiority trial with 1:1 allocation ratio. Methods. Participants included patients who were 18 years of age TRANS or older and who had been hospitalized with confirmed Covid-19 with 4 or fewer days since symptom onset TRANS. Exclusion criteria included intensive care unit admission prior to randomization and use of angiotensin receptor blocker or angiotensin converting enzyme inhibitors at admission. Participants in the treatment arm received telmisartan 80 mg bid during 14 days plus standard care. Participants in the control arm received standard care alone. Primary outcome was to achieve significant reductions in plasma SERO levels of C-reactive protein in telmisartan treated Covid-19 patients at day 5 and 8 after randomization. Key secondary outcomes included time to discharge evaluated at 15 days after randomization and admission to ICU and death MESHD at 15- and 30-days post randomization. We present here a preliminary report. Results. A total of 78 patients were included in the interim analysis, 40 in the telmisartan and 38 in the control groups. CRP levels at day 5 in the control group were 51.1 +/- 44.8 mg/L (mean +/- SD; n=28) and in the telmisartan group were 24.2 +/- 31.4 mg/L (mean +/- SD; n=32, p<0.05). At day 8, CRP levels were 41.6 +/- 47.6 mg/L (mean +/- SD; n=16) and 9.0 +/- 10.0 mg/L (mean +/- SD; n=13, p < 0.05) in the control and telmisartan groups, respectively. Also, analysis of time to discharge by Kaplan-Meier method showed that telmisartan treated patients had statistically significant lower time to discharge (median time to discharge control group=15 days; telmisartan group=9 days). No differences were observed for ICU admission or death MESHD. No significant adverse events related to telmisartan were reported. Conclusions. In the present preliminary report, despite the small number of patients studied, ARB telmisartan, a well-known inexpensive safe antihypertensive drug, administered in high doses, demonstrates anti-inflammatory effects and improved morbidity in hospitalized patients infected with SARS -CoV-2, providing support for its use in this serious pandemia (NCT04355936).

    Comparison of deaths MESHD rates for COVID-19 across Europe

    Authors: Leonardo Villani; Martin McKee; Luca Giraldi; Walter Ricciardi; Stefania Boccia

    doi:10.21203/ Date: 2020-08-11 Source: ResearchSquare

    Europe suffered greatly in the early stages of the COVID-19 pandemic. Italy was in the forefront, with its Lombardy region especially badly affected. However, European countries have been impacted to quite different degrees. We report Crude Mortality Rates (CMRs) and, in five countries supplying comparable age TRANS-specific data, Standardized Mortality Rates (SMRs) from deaths MESHD reported as due to COVID-19 in the European Union and United Kingdom. As of 21st July 2020, Belgium was the country with the highest cumulative CMR (85.6/100,000), but Lombardy region was at almost double this value (167.0/100,000), while corresponding figure for the rest of Italy was 36.3/100,000. SMRs could be calculated for five countries (Italy, Portugal, Sweden, Germany and Netherlands). Among them, Sweden had the highest SMR (60.7/100,000). The corresponding figures for Italy, Netherlands, Portugal and Germany were 48.2/100,000, 41.0/100,000, 15.1/100,000 and 10.0/100,000 respectively. It is clear that countries within Europe have performed very differently in their responses to the COVID-19 pandemic, but the many limitations in the available data must be addressed before a definitive detailed assessment of the reasons can be made.

    HIV infection MESHD and COVID-19 death MESHD: population-based cohort analysis of UK primary care data and linked national death MESHD registrations within the OpenSAFELY platform

    Authors: Krishnan Bhaskaran; Christopher T Rentsch; Brian MacKenna; Anna Schultz; Amir Mehrkar; Chris Bates; Rosalind M Eggo; Caroline E Morton; Seb Bacon; Peter Inglesby; Ian J Douglas; Alex J Walker; Helen I McDonald; Jonathan Cockburn; Elizabeth J Williamson; David Evans; Harriet J Forbes; Helen J Curtis; William Hulme; John Parry; Frank Hester; Sam Harper; Stephen JW Evans; Liam Smeeth; Ben Goldacre

    doi:10.1101/2020.08.07.20169490 Date: 2020-08-07 Source: medRxiv

    Background: It is unclear whether HIV infection MESHD is associated with risk of COVID-19 death MESHD. We aimed to investigate this in a large-scale population-based study in England. Methods: Working on behalf of NHS England, we used the OpenSAFELY platform to analyse routinely collected electronic primary care data linked to national death MESHD registrations. People with a primary care record for HIV infection MESHD were compared to people without HIV. COVID-19 death MESHD was defined by ICD-10 codes U07.1 or U07.2 anywhere on the death MESHD certificate. Cox regression models were used to estimate the association between HIV infection MESHD and COVID-19 death MESHD, initially adjusted for age TRANS and sex, then adding adjustment for index of multiple deprivation and ethnicity, and finally for a broad range of comorbidities. Interaction terms were added to assess effect modification by age TRANS, sex, ethnicity, comorbidities and calendar time. Results: 17.3 million adults TRANS were included, of whom 27,480 (0.16%) had HIV recorded. People living with HIV were more likely to be male TRANS, of black ethnicity, and from a more deprived geographical area than the general population. There were 14,882 COVID-19 deaths MESHD during the study period, with 25 among people with HIV. People living with HIV had nearly three-fold higher risk of COVID-19 death MESHD than those without HIV after adjusting for age TRANS and sex (HR=2.90, 95% CI 1.96-4.30). The association was attenuated but risk remained substantially raised, after adjustment for deprivation and ethnicity (adjusted HR=2.52, 1.70-3.73) and further adjustment for comorbidities (HR=2.30, 1.55-3.41). There was some evidence that the association was larger among people of black ethnicity (HR = 3.80, 2.15-6.74, compared to 1.64, 0.92-2.90 in non-black individuals, p-interaction=0.045) Interpretation: HIV infection MESHD was associated with a markedly raised risk of COVID-19 death MESHD in a country with high levels of antiretroviral therapy coverage and viral suppression; the association was larger in people of black ethnicity.

    Age TRANS disaggregation of crude excess deaths MESHD during the 2020 spring COVID-19 outbreak in Spain and Netherlands

    Authors: Jose Maria Martin-Olalla

    doi:10.1101/2020.08.06.20169326 Date: 2020-08-07 Source: medRxiv

    Spanish and Dutch official records of mortality and population during the 21st century are analyzed to determine the age TRANS specific crude death MESHD rate in the 2020 spring COVID-19 outbreak. Excess death MESHD rate increases exponentially with age TRANS showing a doubling time [5.0,5.6]a (Spain) and [3.9,6.7]a (Netherlands), roughing doubling every five years of increase in age TRANS.The effective infection MESHD fatality rate in Spain also shows this doubling time. Statistically significant mortality increase is noted above 45a (Spain) and 60a (Netherlands). A statistically significant increase of mortality is also noted in Spain for the youngest age group TRANS.

    SARS-CoV-2 infection MESHD fatality risk in a nationwide seroepidemiological study

    Authors: Roberto Pastor-Barriuso; Beatriz Perez-Gomez; Miguel A Hernan; Mayte Perez-Olmeda; Raquel Yotti; Jesus Oteo; Jose Luis Sanmartin; Inmaculada Leon-Gomez; Aurora Fernandez-Garcia; Pablo Fernandez-Navarro; Israel Cruz; Mariano Martin; Concepcion Delgado-Sanz; Nerea Fernandez de Larrea; Jose Leon Paniagua; Juan Fernando Munoz-Montalvo; Faustino Blanco; Amparo Larrauri; Marina Pollan; Marina Pollan

    doi:10.1101/2020.08.06.20169722 Date: 2020-08-07 Source: medRxiv

    The magnitude of the infection MESHD fatality risk (IFR) of SARS-CoV-2 remains under debate. Because the IFR is the number of deaths MESHD divided by the number of infected, serological studies are needed to identify asymptomatic TRANS and mild cases. Also, because ascertainment of deaths MESHD attributable to COVID-19 is often incomplete, the calculation of the IFR needs to be complemented with data on excess mortality. We used data from a nation-wide seroepidemiological study and two sources of mortality information - deaths MESHD among laboratory-confirmed COVID-19 cases and excess deaths MESHD- to estimate the range of IFR, both overall and by age TRANS and sex, in Spain. The overall IFR ranged between 1.1% and 1.4% in men and 0.58% to 0.77% in women. The IFR increased sharply after age TRANS 50, ranging between 11.6% and 16.4% in men [≥]80 years and between 4.6% and 6.5% in women [≥]80 years. Our IFR estimates for SARS-CoV-2 are substantially greater than IFR estimators for seasonal influenza, justifying the implementation of special public health measures.

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MeSH Disease
Human Phenotype

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