Corpus overview


Overview

MeSH Disease

Disease (379)

Infections (358)

Coronavirus Infections (256)

Death (226)

Fever (151)


Human Phenotype

Fever (151)

Hypertension (138)

Cough (128)

Pneumonia (124)

Anxiety (62)


Transmission

Seroprevalence
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    Impact of tocilizumab administration on mortality in severe COVID-19

    Authors: Andrew Tsai; Oumou Diawara; Ronald G Nahass; Luigi Brunetti

    doi:10.1101/2020.07.30.20114959 Date: 2020-08-02 Source: medRxiv

    Background The novel coronavirus disease MESHD 2019 (COVID-19) worldwide pandemic has placed a significant burden on hospitals and healthcare providers. The immune response to this disease MESHD is thought to lead to a cytokine storm, which contributes to the severity of illness. There is an urgent need to confirm whether the use of tocilizumab provides a benefit in individuals with COVID-19. Methods A single-center propensity-score matched cohort study, including all consecutive COVID-19 patients, admitted to the medical center who were either discharged from the medical center or expired between March 1, 2020, and May 5, 2020, was performed. Patients were stratified according to the receipt of tocilizumab for cytokine storm and matched to controls using propensity scores. The primary outcome was in-hospital mortality. Results A total of 132 patients were included in the matched dataset (tocilizumab=66; standard of care=66). Approximately 73% of the patients were male TRANS. Hypertension MESHD Hypertension HP (55%), diabetes mellitus MESHD diabetes mellitus HP (31%), and chronic pulmonary disease MESHD (15%) were the most common comorbidities present. There were 18 deaths MESHD (27.3%) in the tocilizumab group and 18 deaths MESHD (27.3%) in the standard of care group (odds ratio, 1.0; 95% confidence interval, 0.465 - 2.151; p=1.00). Advanced age TRANS, history of myocardial infarction MESHD myocardial infarction HP, dementia MESHD dementia HP, chronic pulmonary disease, heart MESHD failure, and malignancy were significantly more common in patients who died. Interpretation The current analysis does not support the use of tocilizumab for the management of cytokine storm in patients with COVID-19. Use of this therapeutic agent should be limited to the context of a clinical trial until more evidence is available.

    Estrogen and COVID-19 symptoms: associations in women from the COVID Symptom Study

    Authors: Ricardo Costeira; Karla A Lee; Benjamin Murray; Colette Christiansen; Juan Castillo-Fernandez; Mary Ni Lochlainn; Joan Capdevila Pujol; Iain Buchan; Louise C Kenny; Jonathan Wolf; Sebastien Ourselin; Claire Steves; Timothy Spector; Louise Newson; Jordana Bell

    doi:10.1101/2020.07.30.20164921 Date: 2020-08-01 Source: medRxiv

    Background: Men and older women have been shown to be at higher risk of adverse COVID-19 outcomes. Animal model studies of SARS-CoV and MERS suggest that the age TRANS and sex difference in COVID-19 symptom severity may be due to a protective effect of the female TRANS sex hormone estrogen. Females TRANS have shown an ability to mount a stronger immune response to a variety of viral infections MESHD because of more robust humoral and cellular immune responses. Objectives: We sought to determine whether COVID-19 positivity increases in women entering menopause. We also aimed to identify whether premenopausal women taking exogenous hormones in the form of the combined oral contraceptive pill (COCP) and post-menopausal women taking hormone replacement therapy (HRT) have lower predicted rates of COVID-19, using our published symptom-based model. Design: The COVID Symptom Study developed by Kings College London and Zoe Global Limited was launched in the UK on 24th March 2020. It captured self-reported information related to COVID-19 symptoms. Data used for this study included records collected between 7th May - 15th June 2020. Main outcome measures: We investigated links between COVID-19 rates and 1) menopausal status, 2) COCP use and 3) HRT use, using symptom-based predicted COVID-19, tested COVID-19, and disease MESHD severity based on requirement for hospital attendance or respiratory support. Participants: Female TRANS users of the COVID Symptom Tracker Application in the UK, including 152,637 women for menopause status, 295,689 for COCP use, and 151,193 for HRT use. Analyses were adjusted for age TRANS, smoking and BMI. Results: Post-menopausal women aged TRANS 40-60 years had a higher rate of predicted COVID (P=0.003) and a corresponding range of symptoms, with consistent, but not significant trends observed for tested COVID-19 and disease MESHD severity. Women aged TRANS 18-45 years taking COCP had a significantly lower predicted COVID-19 (P=8.03E-05), with a reduction in hospital attendance (P=0.023). Post-menopausal women using HRT or hormonal therapies did not exhibit consistent associations, including increased rates of predicted COVID-19 (P=2.22E-05) for HRT users alone. Conclusions: Our findings support a protective effect of estrogen on COVID-19, based on positive association between predicted COVID-19 and menopausal status, and a negative association with COCP use. HRT use was positively associated with COVID-19 symptoms; however, the results should be considered with caution due to lack of data on HRT type, route of administration, duration of treatment, and potential comorbidities. Trial registration: The App Ethics has been approved by KCL ethics Committee REMAS ID 18210, review reference LRS-19/20-18210

    Changes in the behavioural determinants of health during the coronavirus (COVID-19) pandemic: gender TRANS, socioeconomic and ethnic inequalities in 5 British cohort studies

    Authors: David Bann; Aase Villadsen; Jane Maddock; Alun Hughes; George Ploubidis; Richard Silverwood; Praveetha Patalay

    doi:10.1101/2020.07.29.20164244 Date: 2020-07-31 Source: medRxiv

    Background: The coronavirus (COVID-19) pandemic and consequent physical distancing measures are expected to have far-reaching consequences on population health, particularly in already disadvantaged groups. These consequences include changes in health impacting behaviours (such as exercise, sleep, diet and alcohol use) which are arguably important drivers of health inequalities. We sought to add to the rapidly developing empirical evidence base investigating the impacts of the pandemic on such behavioural outcomes. Methods: Using data from five nationally representative British cohort studies (born 2001, 1990, 1970, 1958, and 1946), we investigated sleep, physical activity (exercise), diet, and alcohol intake (N=14,297). Using measures of each behaviour reported before and during lockdown, we investigated change in each behaviour, and whether such changes differed by age TRANS/cohort, gender TRANS, ethnicity, and socioeconomic position (SEP; childhood social class, education attainment, and adult TRANS reporting of financial difficulties). Binary or ordered logistic regression models were used, adjusting for prior measures of each health behaviour and accounting for study design and non-response weights. Meta-analyses were used to pool cohort-specific estimates and formally test for heterogeneity across cohorts. Results: Changes in these outcomes occurred in in both directions ie, shifts from the middle part of the distribution to both declines and increases in sleep, exercise, and alcohol use. For all outcomes, older cohorts were less likely to report changes in behaviours compared with younger cohorts. In the youngest cohort (born 2001), the following shifts were more evident: increases in exercise, fruit and vegetable intake, sleep, and less frequent alcohol consumption. After adjustment for prior behaviour levels, during lockdown females TRANS were less likely to sleep within the typical range (6-9 hours) yet exercised more frequently; lower SEP was associated with lower odds of sleeping within the typical range (6-9 hours), lower exercise participation, and lower consumption of fruit and vegetables; and ethnic minorities were less likely than White participants to sleep within the typical range (6-9 hours), exercise less frequently, yet reported less frequent alcohol consumption. Conclusions: Our findings highlight the multiple changes to behavioural outcomes that may have occurred due to COVID-19 lockdown, and the differential impacts across generation, gender TRANS, SEP and ethnicity. Such changes require further monitoring given their possible implications to population health and the widening of health inequalities.

    Phylogenomic analysis of SARS-CoV-2 genomes from western India reveals unique linked mutations

    Authors: Dhiraj Paul; Kunal Jani; Janesh Kumar; Radha Chauhan; Vasudevan Seshadri; Girdhari Lal; Rajesh Karyakarte; Suvarna Joshi; Murlidhar Tambe; Sourav Sen; Santosh Karade; Kavita Bala Anand; Shelinder Pal Singh Shergill; Rajiv Mohan Gupta; Manoj Kumar Bhat; Arvind Sahu; Yogesh S Shouche

    doi:10.1101/2020.07.30.228460 Date: 2020-07-31 Source: bioRxiv

    India has become the third worst-hit nation by the COVID-19 pandemic caused by the SARS-CoV-2 virus. Here, we investigated the molecular, phylogenomic, and evolutionary dynamics of SARS-CoV-2 in western India, the most affected region of the country. A total of 90 genomes were sequenced. Four nucleotide variants, namely C241T, C3037T, C14408T (Pro4715Leu), and A23403G (Asp614Gly), located at 5UTR, Orf1a, Orf1b, and Spike protein regions of the genome, respectively, were predominant and ubiquitous (90%). Phylogenetic analysis of the genomes revealed four distinct clusters, formed owing to different variants. The major cluster (cluster 4) is distinguished by mutations C313T, C5700A, G28881A are unique patterns and observed in 45% of samples. We thus report a newly emerging pattern of linked mutations. The predominance of these linked mutations suggests that they are likely a part of the viral fitness landscape. A novel and distinct pattern of mutations in the viral strains of each of the districts was observed. The Satara district viral strains showed mutations primarily at the 3' end of the genome, while Nashik district viral strains displayed mutations at the 5' end of the genome. Characterization of Pune strains showed that a novel variant has overtaken the other strains. Examination of the frequency of three mutations i.e., C313T, C5700A, G28881A in symptomatic versus asymptomatic TRANS patients indicated an increased occurrence in symptomatic cases, which is more prominent in females TRANS. The age TRANS-wise specific pattern of mutation is observed. Mutations C18877T, G20326A, G24794T, G25563T, G26152T, and C26735T are found in more than 30% study samples in the age group TRANS of 10-25. Intriguingly, these mutations are not detected in the higher age TRANS range 61-80. These findings portray the prevalence SERO of unique linked mutations in SARS-CoV-2 in western India and their prevalence SERO in symptomatic patients. ImportanceElucidation of the SARS-CoV-2 mutational landscape within a specific geographical location, and its relationship with age TRANS and symptoms, is essential to understand its local transmission TRANS dynamics and control. Here we present the first comprehensive study on genome and mutation pattern analysis of SARS-CoV-2 from the western part of India, the worst affected region by the pandemic. Our analysis revealed three unique linked mutations, which are prevalent in most of the sequences studied. These may serve as a molecular marker to track the spread of this viral variant to different places.

    Regional now- and forecasting for data reported with delay: A case study in COVID-19 infections MESHD

    Authors: Giacomo De Nicola; Marc Schneble; Göran Kauermann; Ursula Berger

    id:2007.16058v1 Date: 2020-07-31 Source: arXiv

    Governments around the world continue to act to contain and mitigate the spread of COVID-19. The rapidly evolving situation compels officials and executives to continuously adapt policies and social distancing measures depending on the current state of the spread of the disease TRANS disease MESHD. In this context, it is crucial for policymakers to have a firm grasp on what the current state of the pandemic is as well as to have an idea of how the infective situation is going to unfold in the next days. However, as in many other situations of compulsorily-notifiable diseases MESHD and beyond, cases are reported with delay to a central register, with this delay deferring an up-to-date view of the state of things. We provide a stable tool for monitoring current infection MESHD levels as well as predicting infection MESHD numbers in the immediate future at the regional level. We accomplish this through nowcasting of cases that have not yet been reported as well as through forecasting of future infections MESHD. The two steps are also combined in forenowcasting. We apply our model to German data, for which our focus lies in explaining and predicting infectious behaviour by district, age group TRANS and gender TRANS.

    Nicotine-replacement therapy, as a surrogate of smoking, and the risk of hospitalization with Covid-19 and all-cause mortality: a nationwide, observational cohort study in France

    Authors: Mahmoud Zureik; Berangere Baricault; Celementine Vabre; Laura SEMENZATO; Jerome Drouin; Francois cuenot; Laetitia penso; Philippe Herlemont; Emilie Sbidian; Alain Weill; Mathieu Molimard; Rosemary Dray-Spira; Jeremie Botton

    doi:10.1101/2020.07.28.20160630 Date: 2020-07-30 Source: medRxiv

    Abstract Introduction Several studies have reported an unexpectedly low prevalence SERO of current smoking among hospitalized patients with Covid-19. However, these studies mostly compared observed to expected rates of smoking without direct comparison with individual controls. Objective To examine the association of nicotine-replacement therapy, as a surrogate of smoking, with hospitalization and all-cause mortality during the first wave of SARS-CoV-2 epidemic in France. Methods We conducted a nationwide matched exposed/unexposed cohort study using information from the French national health data system which covers the entire French population. We conducted two separate analyses, the first in individuals exposed to nicotine-replacement therapy without major smoking-related diseases MESHD (cancer, cardiovascular and/or respiratory diseases MESHD) and the second in those presenting these conditions. We included all individuals, aged TRANS between 18 and 75 years, who had been reimbursed at least one nicotine-replacement therapy between November 15, 2019, and February 15, 2020. For each exposed individual, we randomly selected, from the entire Metropolitan French population, up to two non-exposed individuals (1:2) matched for the following variables: age TRANS (same year of birth), sex, department of residence (n=96 in Metropolitan France), and complementary universal health insurance (CMU-C). The three end points were a hospitalization with Covid-19, a death MESHD or an intubation in hospitalized patients with Covid-19, and all-cause mortality. We compared outcomes in individuals who were exposed to nicotine-replacement therapy with those in individuals who were not, using a multivariable Cox model with inverse probability weighting according to the propensity score. Results In the first analysis, 297,070 individuals without major smoking-related diseases MESHD exposed to nicotine-replacement therapy were matched with 558,228 unexposed individuals without major smoking-related diseases MESHD. Individuals were aged TRANS on average 45.6 years (standard deviation: 12.7) and 48.8% were male TRANS. From February 15, 2020 to June 7, 2020, hospitalization with Covid-19 occurred in 647 patients (151 patients in the nicotine-replacement therapy group and 496 patients in the unexposed group). In the main multivariable analysis, nicotine-replacement therapy was associated with a decreased risk of hospitalization with Covid-19 compared with unexposed individuals (hazard ratio, 0.50; 95% CI, 0.41 to 0.61). Nicotine-replacement therapy exposure was also associated with a decreased risk of intubation or death MESHD in hospitalized individuals with Covid-19 (13 vs. 73 patients, hazard ratio, 0.31; 95% CI, 0.17 to 0.57) but with an increased risk of all-cause mortality (251 vs. 231 deaths MESHD, hazard ratio, 1.49; 95% CI, 1.24 to 1.80). In the second analysis, 128,768 individuals with major smoking-related diseases MESHD exposed to nicotine-replacement therapy were matched with 243,793 unexposed individuals. Individuals were aged TRANS on average 55.3 years (standard deviation: 11.4) and 53.3% were male TRANS. In the main multivariable analysis, nicotine-replacement therapy exposure was neither associated with risk of hospitalization with Covid-19 (240 patients in the nicotine-replacement therapy group and 398 patients in the unexposed group, hazard ratio, 1.13; 95% CI, 0.94 to 1.38) nor with risk of death MESHD or an intubation in hospitalized individuals with Covid-19 (48 vs. 61 patients, hazard ratio, 1.00; 95% CI, 0.65 to 1.54). All-cause mortality was higher in the nicotine-replacement therapy group (1040 vs. 366 deaths MESHD, hazard ratio, 3.83; 95% CI, 3.41 to 4.31). Conclusions This large-scale observational study suggests that smoking, measured by exposure to nicotine-replacement therapy, was associated with an increased risk of overall mortality during the first wave of SARS-CoV-2 epidemic in France, although it was associated with a lower risk of severe Covid-19 in individuals without major related-smoking diseases MESHD. Experimental and clinical studies are needed to disentangle the potential mechanisms of nicotine and/or smoking in Covid-19 risk. Whatever the nature of these associations, the global impact of smoking is harmful for health even over a short epidemic period.

    Early Clinical Factors Predicting the Development of Critical Disease MESHD in Japanese Patients with COVID-19: A Single-Center Retrospective, Observational Study

    Authors: Takatoshi Higuchi; Tsutomu Nishida; Hiromi Iwahashi; Osamu Morimura; Yasushi Otani; Yukiyoshi Okauchi; Masaru Yokoe; Norihiro Suzuki; Masami Inada; Kinya Abe

    doi:10.1101/2020.07.29.20159442 Date: 2020-07-30 Source: medRxiv

    Background: Insufficient evidence of factors predicting the COVID-19 progression from mild to moderate to critical has been established. We retrospectively evaluated risk factors for critical progression in Japanese COVID-19 patients. Method: Seventy-four laboratory-confirmed COVID-19 patients were hospitalized in our hospital between February 20, 2020, and June 10, 2020. We excluded asymptomatic TRANS, non-Japanese, and child TRANS patients. We divided patients into the stable group (SG) and the progression group (PG) (patients requiring mechanical ventilation). We compared the clinical factors in both groups. We established the cutoff values (COVs) for significantly different factors via receiver operating characteristic (ROC) curve analysis and evaluated risk factors by univariate regression. Results: We enrolled 57 COVID-19 patients (median age TRANS 52 years, 56.1% male TRANS). The median progression time from symptom onset TRANS was eight days. Seven patients developed critical disease MESHD (PG: 12.2%), two (3.5%) of whom died; 50 had stable disease MESHD. Univariate logistic analysis identified elevated lactate dehydrogenase (LDH) (COV: 309 U/l), decreased estimated glomerular filtration rate (eGFR) (COV: 68 ml/min), lymphocytopenia (COV: 980/l), and statin use as significantly associated with disease progression MESHD. However, in Cox proportional hazards analysis, lymphocytopenia at symptom onset TRANS was not significant. Conclusions: We identified three candidate risk factors for adult TRANS Japanese patients with mild to moderate COVID-19: statin use, elevated LDH level, and decreased eGFR.

    Estimates of the rate of infection and asymptomatic MESHD asymptomatic TRANS COVID-19 disease MESHD in a population sample from SE England

    Authors: Philippa M Wells; Katie M Doores; Simon Couvreur; Rocio Martin Martinez; Jeffrey Seow; Carl Graham; Sam Acors; Neophytos Kouphou; Stuart Neil; Richard Tedder; Pedro Matos; Kate Poulton; Maria Jose Lista; Ruth Dickenson; Helin Sertkaya; Thomas Maguire; Edward Scourfield; Ruth Bowyer; Deborah Hart; Aoife O'Byrne; Kathryn Steele; Oliver Hemmings; Carolina Rosadas; Myra McClure; Joan Capedevila-Pujol; Jonathan wolf; Sebastien Ourseilin; Matthew Brown; Michael Malim; Timothy Spector; Claire Steves

    doi:10.1101/2020.07.29.20162701 Date: 2020-07-30 Source: medRxiv

    Background: Understanding of the true asymptomatic TRANS rate of infection MESHD of SARS-CoV-2 is currently limited, as is understanding of the population-based seroprevalence SERO after the first wave of COVID-19 within the UK. The majority of data thus far come from hospitalised patients, with little focus on general population cases, or their symptoms. Methods: We undertook enzyme linked immunosorbent assay SERO characterisation of IgM and IgG responses against SARS-CoV-2 spike glycoprotein and nucleocapsid protein of 431 unselected general-population participants of the TwinsUK cohort from South-East England, aged TRANS 19-86 (median age TRANS 48; 85% female TRANS). 382 participants completed prospective logging of 14 COVID-19 related symptoms via the COVID Symptom Study App, allowing consideration of serology alongside individual symptoms, and a predictive algorithm for estimated COVID-19 previously modelled on PCR positive individuals from a dataset of over 2 million. Findings: We demonstrated a seroprevalence SERO of 12% (51participants of 431). Of 48 seropositive individuals with full symptom data, nine (19%) were fully asymptomatic TRANS, and 16 (27%) were asymptomatic TRANS for core COVID-19 symptoms: fever MESHD fever HP, cough MESHD cough HP or anosmia HP. Specificity of anosmia HP for seropositivity was 95%, compared to 88% for fever MESHD fever HP cough MESHD cough HP and anosmia HP combined. 34 individuals in the cohort were predicted to be Covid-19 positive using the App algorithm, and of those, 18 (52%) were seropositive. Interpretation: Seroprevalence SERO amongst adults TRANS from London and South-East England was 12%, and 19% of seropositive individuals with prospective symptom logging were fully asymptomatic TRANS throughout the study. Anosmia HP demonstrated the highest symptom specificity for SARS-CoV-2 antibody SERO response. Funding: NIHR BRC, CDRF, ZOE global LTD, RST-UKRI/MRC

    Rationing and triage of scarce, lifesaving therapy in the context of the COVID-19 pandemic - a cross-sectional, social media-driven, scenario-based online query of societal attitudes

    Authors: Oliver J. Muensterer; Emilio A. Gianicolo; Norbert W. Paul

    doi:10.1101/2020.07.28.20163360 Date: 2020-07-30 Source: medRxiv

    Background: The recent COVID-19 pandemic made us aware that medical resources are limited. When demand for essential resources surpasses availability, difficult triaging decisions are necessary. While algorithms exist, almost nothing is known on societal attitudes regarding triage criteria. Methods: A cross-sectional survey was conducted via social media channels to query a broad sample of society. Participants were asked to make triage decisions in case-based vignettes, exploring a variety of factors. They also were asked to assess how sure they were about their decisions, and how such decisions should be reached. Results: The survey was completed in full by 1626 participants in April 2020. Median age TRANS was 39 years (range 12-80 years), 984 (61%) were female TRANS. Patient prognosis, responsibility towards others, the absence of behavior-induced co-morbidities, and younger age TRANS were rated the most important triage criteria, while participants found that insurance status, social status, and nationality should not play a substantial role. Ethics-committees and point systems were regarded potentially helpful for triage decision-making, while decisions based on order of presentation (first-come first-serve) or on a legal basis were viewed critically. Participants were least sure about their decision when dealing with age TRANS or behavior-induced co-morbidities. Overall, women were surer about their decisions than men, participants of Christian faith were also more secure about their decision than atheists-agnostics. Conclusions: This study uses social media to generate insight into public opinion and attitudes regarding triage criteria and modalities. These findings may be helpful for the development of future medical triage algorithms.

    Patient’s perspective regarding the elective surgical procedure during Covid 19 pandemic.

    Authors: Dr. Mayank Badkur; Dr Ashok Puranik; Dr Naveen Sharma; Dr. Suruthi Baskaran

    doi:10.21203/rs.3.rs-51361/v1 Date: 2020-07-30 Source: ResearchSquare

    Introduction: The ongoing Covid-19 pandemic and the subsequent nationwide lockdown, has impacted all aspects of society including medical profession. In hospitals, the focus has mainly shifted to prevention and treatment of Covid-19 infection MESHD. Owing to this, all elective surgeries were postponed and only emergent surgeries were performed. This has affected the patients differently depending on the progression of disease MESHD and development of complications.Materials and Methods: A well-structured telephonic scripted questionnaire was administered to all patients who were given appointment for any elective surgery. Data was collected regarding the status of disease MESHD including complications and the patient’s perspective on method of treatment. Patients who developed complications or underwent emergency MESHD surgery or surgery elsewhere were excluded.Results: The male TRANS to female TRANS ratio was 2.3:1. Mean age TRANS of patients was 41.16 years. A total of 86 patients were included in the study. Almost all (98.8%) were aware that the lockdown and withholding of elective surgeries was to prevent spread of coronavirus infection MESHD. Among 34 patients with complications, 88.2% were willing to undergo surgical procedure and 73.5% were willing to visit hospital within a week or two. Among patients without complications, 71.2% were willing to continue treatment on wait and watch policy, for a period of 2 months or more (45.7%). 93.5% of patients avoided visit to hospital due to risk of infection TRANS risk of infection TRANS infection MESHD.Discussion: Patient’s attitude towards the choice of treatment (wait and watch Vs surgery) mainly depended on the progression of disease MESHD. It is critical, during these tough times of Covid-19 pandemic, that risks are weighed against benefits to decide the line of management for patients waiting for elective surgeries. 

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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