Corpus overview


MeSH Disease

Human Phenotype


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    SARS-CoV-2 Infection Reaches MESHD the Human Nervous System: How?

    Authors: Vladimir N. Uversky; Fatma Elrashdy; Abdullah Aljadawi; Syed Moasfar Ali; Rizwan Hasan Khan; Elrashdy M. Redwan

    id:10.20944/preprints202008.0696.v1 Date: 2020-08-31 Source:

    Without protective and/or therapeutic agents the SARS-CoV-2 infection MESHD known as coronavirus disease MESHD 2019 (COVID-19) is quickly spreading worldwide. It has surprising transmissibility TRANS potential, since it could infect MESHD all ages TRANS, gender TRANS, and human sectors. It attacks respiratory, gastrointestinal, urinary, hepatic, and endovascular systems and can reach the peripheral nervous system (PNS) and central nervous system (CNS) through known and unknown mechanisms. The reports on the neurological manifestations and complications of the SARS-CoV-2 infection MESHD are increasing exponentially. Herein, we enumerate seven candidate routes, which the mature or immature SARS-CoV-2 components could use to reach the CNS and PNS, utilizing the within-body crosstalk between organs. The majority of SARS-CoV-2 infected MESHD patients suffer from some neurological manifestations (e.g., confusion HP confusion MESHD, anosmia HP anosmia MESHD, and ageusia MESHD). It seems that although the mature virus did not reach the CNS or PNS of the majority of patients, its unassembled components and/or the accompanying immune-mediated responses may be responsible for the observed neurological symptoms. The viral particles and/or its components have been specifically documented in endothelial cells of lung, kidney, skin, and CNS. This means that the blood SERO-endothelial-barrier may be considered as the main route for SARS-CoV-2 entry into the nervous system, with the barrier disruption being more logical than barrier permeability, as evidenced by postmortem analyses.

    Clinical features and inpatient trajectories of older inpatients with COVID-19: a retrospective observational study.

    Authors: Christopher N Osuafor; Catriona Davidson; Alistair J Mackett; Marie Goujon; Lelane Van Der Poel; Vince Taylor; Jacobus Preller; Robert J B Goudie; Victoria L Keevil

    doi:10.21203/ Date: 2020-08-17 Source: ResearchSquare

    Background: A comprehensive description of the clinical characteristics, inpatient trajectory and relationship with frailty of older inpatients admitted with COVID-19 is essential in the management of older adults TRANS during the COVID-19 pandemic. The aim of this study was to describe the clinical features and inpatient trajectory of older inpatients with confirmed COVID -19.Methods: This was a retrospective observational study of hospitalised older adults TRANS. Subjects include unscheduled medical admissions of older inpatients to a University Hospital with laboratory and clinically confirmed COVID-19. The primary outcome was death MESHD during the inpatient stay or within 14 days of discharge after a maximum follow up time of 45 days. The characteristics of the cohort were described in detail as a whole and by frailty status.Results: 214 patients were included in this study with a mean length of stay of 11 days (Range 6 to 18 days), of whom 140 (65.4%) patients were discharged and 74 (34.6%) patients died in hospital. 142 (66.4%) patients were frail with median Clinical Frailty Scale (CFS) score of 6. Frail patients were more likely to present with atypical symptoms including new or worsening confusion HP confusion MESHD compared to non-frail patients (20.8% vs 45.1%, p<0.001) and were more likely to die in hospital or within 14 days of discharge (66% vs 16%, p=0.001). Older age TRANS, being male TRANS, presenting with high illness acuity and high frailty were all independently associated with higher risk of death MESHD and a dose response association between higher frailty and higher mortality was observed.Conclusions: Older adult TRANS inpatients with COVID-19 infection MESHD are likely to present with atypical symptoms, experience delirium HP delirium MESHD and have a high mortality, especially if they are also living with frailty. Clinicians should have a low threshold for testing for COVID-19 in older and frail patients presenting to hospital as an emergency during periods when there is community transmission TRANS of COVID-19 and, when diagnosed, this should prompt early advanced care planning with the patient and family. 

    Robust, reproducible clinical patterns in hospitalised patients with COVID-19

    Authors: Jonathan E Millar; Lucile Neyton; Sohan Seth; Jake Dunning; Laura Merson; Srinivas Murthy; Clark D Russell; Sean Keating; Maaike Swets; Carole H Sudre; Timothy D Spector; Sebastien Ourselin; Claire J Steves; Jonathan Wolf; - ISARIC4C Investigators; Annemarie B Docherty; Ewen M Harrison; Peter JM Openshaw; Malcolm G Semple; J Kenneth Baillie

    doi:10.1101/2020.08.14.20168088 Date: 2020-08-16 Source: medRxiv

    Severe COVID-19 is characterised by fever HP fever MESHD, cough HP cough MESHD, and dyspnoea MESHD. Symptoms affecting other organ systems have been reported. The clinical associations of different patterns of symptoms can influence diagnostic and therapeutic decision-making: for example, significant differential therapeutic effects in sub-groups of patients with different severities of respiratory failure HP respiratory failure MESHD have already been reported for the only treatment so far shown to reduce mortality in COVID-19, dexamethasone. We obtained structured clinical data on 68914 patients in the UK (the ISARIC Coronavirus Clinical Characterisation Consortium, 4C) and used a principled, unsupervised clustering approach to partition the first 33468 cases according to symptoms reported at recruitment. We validated our findings in a second group of 35446 cases recruited to ISARIC-4C, and in separate cohort of community cases. A core symptom set of fever HP fever MESHD, cough HP cough MESHD, and dyspnoea co MESHD-occurred with additional symptoms in three patterns: fatigue HP fatigue MESHD and confusion HP confusion MESHD, diarrhoea and vomiting MESHD vomiting HP, or productive cough HP. Presentations with a single reported symptom of dyspnoea MESHD or confusion HP confusion MESHD were common, and a subgroup of patients reported few or no symptoms. Patients presenting with gastrointestinal symptoms MESHD were more commonly female TRANS, had a longer duration of symptoms before presentation, and had lower 30-day mortality. Patients presenting with confusion HP confusion MESHD, with or without core symptoms, were older and had a higher unadjusted mortality. Symptom clusters were highly consistent in replication analysis using a further 35446 individuals subsequently recruited to ISARIC-4C. Similar patterns were externally verified in 4445 patients from a study of self-reported symptoms of mild disease. The large scale of ISARIC-4C study enabled robust, granular discovery and replication of patient clusters. Clinical interpretation is necessary to determine which of these observations have practical utility. We propose that four patterns are usefully distinct from the core symptom groups: gastro-intestinal disease MESHD, productive cough HP, confusion HP confusion MESHD, and pauci-symptomatic presentations. Importantly, each is associated with an in-hospital mortality which differs from that of patients with core symptoms. These observations deepen our understanding of COVID-19 and will influence clinical diagnosis, risk prediction, and future mechanistic and clinical studies.

    Clinical features and disease severity in an Iranian population of COVID-19 patients

    Authors: Shima Nabavi; Zahra Javidarabshahi; Abolghasem Allahyari; Mohammad Ramezani; Mohsen Seddigh-Shamsi; Sahar Ravanshad; Mina AkbariRad; Farnoosh Ebrahimzadeh; Shohre Khatami; Maryam Emadzadeh; Neda Saeedian; Ahmadreza Zarifian; Maryam Miri; Fariba Rezaeetalab; Sepide Hejazi; Reza Basiri; Mahnaz Mozdourian

    doi:10.21203/ Date: 2020-07-31 Source: ResearchSquare

    Objectives: Coronavirus disease 2019 (COVID-19) can present with a variety of symptoms. Severity of the disease may be associated with several factors. Here, we review clinical features of COVID-19 patients with different severities.Methods: This cross-sectional study was performed in Imam Reza hospital, Mashhad, Iran, during February-April 2020. COVID-19 patients with typical computed tomography (CT) patterns and/or positive reverse-transcriptase polymerase chain reaction (RT-PCR) were included. The patients were classified into three groups of moderate, severe, and critical based on disease severity. Demographic, clinical, laboratory, and radiologic findings were collected and compared. P<0.05 was considered statistically significant.Results: Overall, 200 patients with mean age TRANS of 69.75±6.39 years, of whom 82 (41%) were female TRANS were studied. Disease was severe/critical in the majority of patients (167, 83.5%). Disease severity was significantly associated with age TRANS, malignant comorbidities, dyspnea HP dyspnea MESHD, nausea/vomiting HP nausea/vomiting MESHD, confusion HP confusion MESHD, respiratory rate, pulse rate, O2 saturation, extent of CT involvement, serum SERO C-reactive protein (CRP), pH, pO2, and aspartate transaminase (P<0.05). Moreover, complications including shock HP, coagulopathy MESHD, acidosis HP acidosis MESHD, sepsis HP sepsis MESHD, acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD), intensive care unit (ICU) admission, and intubation were significantly higher in patients with higher severities. O2 saturation, nausea/vomiting HP nausea/vomiting MESHD, and extent of lung CT involvement were independent predictors of severe/critical COVID-19 (OR=0.342, 45.93, and 25.48, respectively; P<0.05).Conclusions: Our results indicate O2 saturation, nausea/vomiting HP nausea/vomiting MESHD, and extent of lung CT involvement as independent predictors of severe COVID-19 conditions. Serum SERO CRP levels and pO2 were also considerably higher patients with higher severity and can be used along with other factors as possible predictors of severe disease in COVID-19 patients.

    Level of Knowledge, Attitude and Perception About COVID-19 Pandemic and Infection Control: A Cross-Sectional Study Among Veterinarians in Nigeria MESHD

    Authors: Olubukola Adenubi; Oluwawemimo Adebowale; Abimbola Oloye; Noah Bankole; Hezekiah Adesokan; Oladotun Fadipe; Patience Ayo-Ajayi; Adebayo Akinloye

    id:10.20944/preprints202007.0337.v1 Date: 2020-07-15 Source:

    Coronavirus disease (COVID-19) has caused mankind serious confusion HP confusion MESHD, economic havoc and psychological distress. This study evaluated the level of knowledge, attitude and perception about COVID-19 pandemic, infection control and impact among veterinarians in Nigeria. A cross-sectional online survey was used to collect data from consenting respondents during implementation of lockdown in the country (April 23 - May 31, 2020). Purposive and chain referral sampling techniques were used to recruit 368 respondents from various sectors of the profession. The proportion of respondents surveyed 197/368 (53.5 %) were from the public sector, 35.3 % from private sector, 1.1 % were unemployed and 0.8 % retired. Majority of the respondents were males TRANS (72.8 %), within 30 – 39 years (39.7 %) and had 1 – 10 years work experience. Respondents displayed good level of knowledge about COVID-19 (72.4 % ± 9.9 %, range 44.1-91.2 %), with information mostly derived from TV/Radio (81.5%) and social media (81.0 %). The overall attitude level was poor and various determinants for good attitude among respondents were if they were above 60 years (p = 0.013), possessed postgraduate qualification ( p = 0.031), worked over 30 years post DVM (p = 0.001), had household members between 5 and 10 (p = 0.012), and were resident in states on total lockdown (p = 0.024). There was no correlation between the knowledge level score and respondents’ attitude towards the pandemic (p = 0.12). With increasing rate of COVID-19 transmission TRANS, research data are needed to develop evidence-driven strategies, policies and effective risk mitigations to reduce the pandemic’s adverse impacts.

    More than privacy: Australians' concerns and misconceptions about the COVIDSafe App: a short report

    Authors: Rae Thomas; Zoe Michaleff; Hannah Greenwood; Eman Abukmail; Paul Glasziou

    doi:10.1101/2020.06.09.20126110 Date: 2020-06-09 Source: medRxiv

    Background: Timely and effective contact tracing TRANS is an essential public health role to curb the transmission TRANS of COVID-19. App- based contact TRANS tracing TRANS has the potential to optimise the resources of overstretched public health departments. However, its efficiency is dependent on wide-spread adoption. We aimed to identify the proportion of people who had downloaded the Australian Government COVIDSafe app and examine the reasons why some did not. Method: An online national survey with representative quotas for age TRANS and gender TRANS was conducted between May 8 and May 11 2020. Participants were excluded if they were a healthcare professional or had been tested for COVID-19. Results: Of the 1802 potential participants contacted, 289 were excluded, 13 declined, and 1500 participated in the survey (response rate 83%). Of survey participants, 37% had downloaded the COVIDSafe app, 19% intended to, 28% refused, and 16% were undecided. Equally proportioned reasons for not downloading the app included privacy (25%) and technical concerns (24%). Other reasons included a belief that social distancing was sufficient and the app is unnecessary (16%), distrust in the Government (11%), and apathy HP (11%). In addition, COVIDSafe knowledge varied with confusion HP confusion MESHD about its purpose and capabilities. Conclusion: For the COVIDSafe app to be accepted by the public and used correctly, public health messages need to address the concerns of its citizens, specifically in regards to privacy, data storage, and technical capabilities. Understanding the specific barriers preventing the uptake of tracing TRANS apps provides the opportunity to design targeted communication strategies aimed at strengthening public health initiatives such as download and correct use.

    Epidemiological and clinical features of 2019-nCoV acute respiratory disease cases in Chongqing municipality, China: a retrospective, descriptive, multiple-center study

    Authors: Di Qi; Xiaofeng Yan; Xumao Tang; Junnan Peng; Qian Yu; Longhua Feng; Guodan Yuan; An Zhang; Yaokai Chen; Jing Yuan; Xia Huang; Xianxiang Zhang; Peng Hu; Yuyan Song; Chunfang Qian; Qiangzhong Sun; Daoxin Wang; Jin Tong; Jianglin Xiang

    doi:10.1101/2020.03.01.20029397 Date: 2020-03-03 Source: medRxiv

    BackgroundIn January 19, 2020, first case of 2019 novel coronavirus (2019-nCoV) pneumonia HP (COVID-19) was confirmed in Chongqing municipality, China. MethodsIn this retrospective, descriptive, multiple-center study, total of 267 patients with COVID-19 confirmed by real-time RT-PCR in Chongqing from Jan 19 to Feb 16, 2020 were recruited. Epidemiological, demographic, clinical, radiological characteristics, laboratory examinations, and treatment regimens were collected on admission. Clinical outcomes were followed up until Feb 16, 2020. Results267 laboratory-confirmed COVID-19 patients admitted to 3 designated-hospitals in Chongqing provincial municipality from January 19 to February 16, 2020 were enrolled and categorized on admission. 217 (81.27%) and 50 (18.73%) patients were categorized into non-severe and severe subgroups, respectively. The median age TRANS of patients was 48.0 years (IQR, 35.0-65.0), with 129 (48.3%) of the patients were more than 50 years of age TRANS. 149 (55.8%) patients were men. Severe patients were significantly older (median age TRANS, 71.5 years [IQR, 65.8-77.0] vs 43.0 years [IQR, 32.5-57.0]) and more likely to be male TRANS (110 [50.7%] vs 39 [78.0%]) and have coexisting disorders (15 [30.0%] vs 26 [12.0%]). 41 (15.4%) patients had a recent travel TRANS to Hubei province, and 139 (52.1%) patients had a history of contact with patients from Hubei. On admission, the most common symptoms of COVID-19 were fever HP 225(84.3%), fatigue HP (208 [77.9%]), dry cough HP (189 [70.8%]), myalgia HP or arthralgia HP (136 [50.9%]). Severe patients were more likely to present dyspnea HP (17 [34.0%] vs 26 [12.0%]) and confusion HP (10 [20.0%] vs 15 [6.9%]). Rales (32 [12.0%]) and wheezes (20 [7.5%]) are not common noted for COVID-19 patients, especially for the non-severe (11 [5.1%], 10 [4.6%]). 118 (44.2%). Most severe patients demonstrated more laboratory abnormalities. 231 (86.5%), 61 (22.8%) patients had lymphopenia HP, leukopenia HP and thrombocytopenia HP, respectively. CD4+ T cell counts decrease HP was observed in 77.1 % of cases, especially in the severe patients (45, 100%). 53.1% patients had decreased CD+3 T cell counts, count of CD8+T cells was lower than the normal range in part of patients (34.4%). More severe patients had lower level of CD4+ T cells and CD+3 T cells (45 [100.0%] vs 29[56.9%], 31 [68.9%] vs 20 [39.2%]). Most patients had normal level of IL-2, IL-4, TNF- and INF-{gamma}, while high level of IL-6 and IL-17A was common in COVID-19 patients (47 [70.1%], 35 [52.2%]). Level of IL-6, IL-17A and TNF- was remarkably elevated in severe patients (32 [84.2%] vs 15 [51.7%], 25 [65.8%] vs 10 [34.5%], 17 [44.7%] vs 5 [17.2%]). All patients received antiviral therapy (267, 100%). A portion of severe patients (38, 76.0%) received systemic corticosteroid therapy. Invasive mechanical ventilation in prone position, non-invasive mechanical ventilation, high-flow nasal cannula oxygen therapy was adopted only in severe patients with respiratory failure HP (5[10.0%], 35[70.0%], 12[24.0%]). Traditional Chinese medicine was adopted to most of severe patients (43,86.0%). Conclusion:Our study firstly demonstrated the regional disparity of COVID-19 in Chongqing municipality and further thoroughly compared the differences between severe and non-severe patients. The 28-day mortality of COVID-19 patients from 3 designed hospitals of Chongqing is 1.5%, lower than that of Hubei province and mainland China including Hubei province. However, the 28-mortality of severe patients was relatively high, with much higher when complications occurred. Notably, the 28-mortality of critically severe patients complicated with severe ARDS is considerably as high as 44.4%. Therefore, early diagnosis and intensive care of critically severe COVID-19 cases, especially those combined with ARDS, will be considerably essential to reduce mortality.

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MeSH Disease
Human Phenotype

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