Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    EARLY VIRAL CLEARANCE AMONG COVID-19 PATIENTS WHEN GARGLING WITH POVIDONE-IODINE AND ESSENTIAL OILS: A PILOT CLINICAL TRIAL

    Authors: NURUL AZMAWATI MOHAMED; NIZAM BAHAROM; WAN SHAHIDA WAN SULAIMAN; ZETTI ZAINOL RASHID; KON KEN WONG; UMI KALSOM ALI; SITI NORLIA OTHMAN; MUTTAQILLAH NAJIHAN ABD SAMAD; NAJMA KORI; PETRICK PERIYASAMY; NOR AZIZAN ZAKARIA; AGNI NHIRMAL KUMAR SUGUMAR; NUR EZZATY MOHAMMAD KAZMIN; XIONG KHEE CHEONG; SITI MARIYAM SANIMAN; ILINA ISAHAK; Kevin Wing; Peter Inglesby; Rohini Mathur; Henry Drysdale; Angel YS Wong; Helen I McDonald; Jonathan Cockburn; Harriet Forbes; John Parry; Frank Hester; Sam Harper; Liam Smeeth; Ian J Douglas; William G Dixon; Stephen JW Evans; Laurie Tomlinson; Ben Goldacre; Sacha Gnjatic; Noam Harpaz; Silvio Danese; Adeeb Rahman; Nikhil A Kumta; Alessio Aghemo; Francesca Petralia; Harm van Bakel; Adolfo Garcia-Sastre; Saurabh Mehandru

    doi:10.1101/2020.09.07.20180448 Date: 2020-09-09 Source: medRxiv

    Background: Gargling had been reported to have significant roles in the prevention and treatment of respiratory tract infections HP respiratory tract infections MESHD. The purpose of this study was to assess the ability of regular gargling to eliminate SARS-CoV-2 in the oropharynx and nasopharynx. Methodology: This pilot, open labeled, randomized, parallel study compared the effect of 30 seconds, 3 times/day gargling using 1% povidone-iodine (PVP-I), essential oils and tap water on SARS-CoV-2 viral clearance among COVID-19 patients in a tertiary hospital in Kuala Lumpur. Progress was monitored by day 4,6 and 12 PCR (Ct value), gargling and symptoms diary as well as clinical observations. Results: Five confirmed Stage 1 COVID-19 patients were recruited for each arm. The age TRANS range was from 22 to 56 years old. The majority were males TRANS. Two respondents had co-morbidities, which were asthma HP asthma MESHD and obesity HP obesity MESHD. Viral clearance was achieved at day 6 in 100%, 80%, 20% and 0% for 1% PVP-I, essential oils, tap water and control group respectively. Analysis of 1% PVP-I group versus control group showed significant p-value for comparison of PCR results on Day 4, Day 6 and Day 12. Conclusions: This preliminary study showed that gargling with 1% PVP-I and essential oils show great potential to be part of the treatment and management of Stage 1 COVID-19. Larger studies are required to ascertain the benefit of gargling for different stages of COVID-19 patients. This study was registered in clinicaltrial.gov (NCT04410159).

    COVID-19 hospitalizations in Brazil's Unified Health System (SUS)

    Authors: Carla Lourenço Tavares de Andrade; Claudia Cristina de Aguiar Pereira; Mônica Martins; Sheyla Maria Lemos Lima; Margareth Crisóstomo Portela; Tamar Plitt; Joseph Eggers; Ilaria Mogno; Ana Gonzalez-Reiche; Sophia Siu; Michael Tankelevich; Lauren Grinspan; Rebekah E Dixon; Divya Jha; Gustavo Martinez-Delgado; Fatima Amanat; Daisy A Hoagland; Benjamin tenOever; Marla C Dubinsky; Miriam Merad; Harm van Bakel; Florian Krammer; Gerold Bongers; Saurabh Mehandru; Jeremiah J Faith

    doi:10.1101/2020.09.03.20187617 Date: 2020-09-05 Source: medRxiv

    Objective: To study the profile of hospitalizations due to COVID-19 in the Unified Health System (SUS) in Brazil and to identify factors associated with hospital mortality related to the disease. Methods: Cross-sectional study, based on secondary data on COVID-19 hospitalizations that occurred in SUS, between the last days of February and June. Patients aged TRANS 18 years or older, with primary or secondary diagnoses indicative of COVID-19 were included. Bivariate analyses were performed and generalized linear mixed models (GLMM) were estimated with random effects intercept. The modeling followed three steps, including: attributes of the patients; elements of the care process; and characteristics of the hospital and place of hospitalization. Results: 89,405 hospitalizations were observed, of which 24.4% resulted in death MESHD. COVID-19 patients hospitalized in SUS were predominantly male TRANS (56.5%), with a mean age TRANS of 58.9 years. The length of stay ranged from less than 24 hours to 114 days, with a mean of 6.9 (STD=6.5) days. Of the total number of hospitalizations, 22.6% reported ICU use. The chances of hospital death MESHD among men were 16.8% higher than among women and increased with age TRANS. Black individuals had a higher chance of death MESHD. The behavior of the Charlson and Elixhauser indices was consistent with the hypothesis of a higher risk of death MESHD among patients with comorbidities, and obesity HP obesity MESHD had an independent effect on increasing this risk. Some states had a higher risk of hospital death from COVID-19, such as Amazonas and Rio de Janeiro. The chances of hospital death MESHD were 72.1% higher in municipalities with at least 100,000 inhabitants and being hospitalized in the municipality of residence was a protective factor. Conclusion: There was wide variation in hospital COVID-19 mortality in the SUS, associated with demographic and clinical factors, social inequality and differences in the structure of services and quality of health care.

    Characteristics and outcomes of 627 044 COVID-19 patients with and without obesity HP obesity MESHD in the United States, Spain, and the United Kingdom

    Authors: Martina Recalde; Elena Roel; Andrea Pistillo; Anthony G Sena; Albert Prats-Uribe; Waheed Ul-Rahman Ahmed; Heba Alghoul; Thamir M Alshammari; Osaid Alser; Carlos Areia; Edward Burn; Paula Casajust; Dalia Dawoud; Scott L DuVall; Thomas Falconer; Sergio Fernandez-Bertolin; Asieh Golozar; Mengchun Gong; Lana Yin Hui Lai; Jennifer C.E Lane; Kristine E Lynch; Michael E Matheny; Paras P Mehta; Daniel R Morales; Karthik Natarjan; Fredrik Nyberg; Jose D Posada; Christian G Reich; Lisa M Schilling; Karishma Shah; Nigham H Shah; Vignesh Subbian; Lin Zhang; Hong Zhu; Patrick Ryan; Daniel Prieto-Alhambra; Kristin Kostka; Talita Duarte-Salles

    doi:10.1101/2020.09.02.20185173 Date: 2020-09-03 Source: medRxiv

    Background: COVID-19 may differentially impact people with obesity HP obesity MESHD. We aimed to describe and compare the demographics, comorbidities, and outcomes of obese MESHD patients with COVID-19 to those of non-obese MESHD patients with COVID-19, or obese MESHD patients with seasonal influenza. Methods: We conducted a cohort study based on outpatient/inpatient care, and claims data from January to June 2020 from the US, Spain, and the UK. We used six databases standardized to the OMOP common data model. We defined two cohorts of patients diagnosed and/or hospitalized with COVID-19. We created corresponding cohorts for patients with influenza in 2017-2018. We followed patients from index date to 30 days or death MESHD. We report the frequency of socio-demographics, prior comorbidities, and 30-days outcomes (hospitalization, events, and death MESHD) by obesity HP obesity MESHD status. Findings: We included 627 044 COVID-19 (US: 502 650, Spain: 122 058, UK: 2336) and 4 549 568 influenza (US: 4 431 801, Spain: 115 224, UK: 2543) patients. The prevalence SERO of obesity HP obesity MESHD was higher among hospitalized COVID-19 (range: 38% to 54%) than diagnosed COVID-19 (30% to 47%), or diagnosed/hospitalized influenza (15% to 48%) patients. Obese MESHD hospitalized COVID-19 patients were more often female TRANS and younger than non- obese MESHD COVID-19 patients or obese MESHD influenza patients. Obese COVID-19 patients were more likely to have prior comorbidities, present with cardiovascular and respiratory events during hospitalization, require intensive services, or die compared to non- obese MESHD COVID-19 patients. Obese COVID-19 patients were also more likely to require intensive services or die compared to obese MESHD influenza patients, despite presenting with fewer comorbidities. Interpretation: We show that obesity HP obesity MESHD is more common among COVID-19 than influenza patients, and that obese MESHD patients present with more severe forms of COVID-19 with higher hospitalization, intensive services, and fatality than non- obese MESHD patients. These data are instrumental for guiding preventive strategies of COVID-19 infection MESHD and complications

    Non-alcoholic fatty liver disease MESHD ( NAFLD MESHD) and risk of hospitalization for Covid-19.

    Authors: Carolyn Bramante; Christopher J. Tignanelli; Nirjhar Dutta; Emma Jones; Leonardo Tamariz; Jeanne M Clark; Michael Usher; Genevieve Metlon-Meaux; Sayeed Ikramuddin; Ravi Prakash Madaiah; Peter Hart; Hemant Kulkarni

    doi:10.1101/2020.09.01.20185850 Date: 2020-09-02 Source: medRxiv

    Background: Covid-19 disease causes significant morbidity and mortality through increase inflammation MESHD and thrombosis MESHD. Non-alcoholic fatty liver disease MESHD and non-alcoholic steatohepatitis MESHD are states of chronic inflammation MESHD and indicate advanced metabolic disease MESHD. We sought to understand the risk of hospitalization for Covid-19 associated with NAFLD MESHD/NASH. Methods: Retrospective analysis of electronic medical record data of 6,700 adults TRANS with a positive SARS-CoV-2 PCR from March 1, 2020 to Aug 25, 2020. Logistic regression and competing risk were used to assess odds of being hospitalized. Additional adjustment was added to assess risk of hospitalization among patients with a prescription for metformin use within the 3 months prior to the SARS-CoV-2 PCR result, history of home glucagon-like-peptide 1 receptor agonist (GLP-1 RA MESHD) use, and history of metabolic and bariatric surgery (MBS). Interactions were assessed by gender TRANS and race. Results: A history of NAFLD MESHD/NASH was associated with increased odds of admission for Covid-19: logistic regression OR 2.04 (1.55, 2.96, p<0.01), competing risks OR 1.43 (1.09-1.88, p<0.01); and each additional year of having NAFLD MESHD/NASH was associated with a significant increased risk of being hospitalized for Covid-19, OR 1.86 (1.43-2.42, p<0.01). After controlling for NAFLD MESHD/NASH, persons with obesity HP obesity MESHD had decreased odds of hospitalization for Covid-19, OR 0.41 (0.34-0.49, p<0.01). NAFLD MESHD/NASH increased risk of hospitalization in men and women, and in all racial/ethnic subgroups. Mediation treatments for metabolic syndrome MESHD were associated with non-significant reduced risk of admission: OR 0.42 (0.18-1.01, p=0.05) for home metformin use and OR 0.40 (0.14-1.17, p=0.10) for home GLP-1RA use. MBS MESHD was associated with a significant decreased risk of admission: OR 0.22 (0.05-0.98, p<0.05). Conclusions: NAFLD MESHD/NASH is a significant risk factor for hospitalization for Covid-19, and appears to account for risk attributed to obesity HP obesity MESHD. Treatments for metabolic disease mitigated risks from NAFLD MESHD/NASH. More research is needed to confirm risk associated with visceral adiposity, and patients should be screened for and informed of treatments for metabolic syndrome MESHD.

    Risk factors for SARS-CoV-2 infection MESHD, hospitalisation, and death in Catalonia MESHD, Spain: a population-based cross-sectional study

    Authors: Judit Villar-Garcia; Rosa Maria Vivanco-Hidalgo; Montserrat Cleries; Elisenda Martinez; David Monterde; Pol Perez-Sust; Luis Garcia-Eroles; Carol Sais; Montserrat Moharra; Emili Vela; Jochen Lennerz; Hetal Desai Marble; Lauren L. Ritterhouse; Julie Batten; N. Zeke Georgantas; Rebecca Pellerin; Sylvia Signorelli; Julia Thierauf; Molly Kemball; Christian Happi; Donald S. Grant; Daouda Ndiaye; Katherine J. Siddle; Samar B Mehta; Jason B. Harris; Edward T Ryan; Virginia M. Pierce; Regina C LaRocque; Jacob Lemieux; Pardis Sabeti; Eric Rosenberg; John Branda; Sarah E Turbett; Gail Carson; Malcolm G Semple; Janet T Scott

    doi:10.1101/2020.08.26.20182303 Date: 2020-09-01 Source: medRxiv

    OBJECTIVE To identify the different subpopulations that are susceptible for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection MESHD and hospitalisation or death MESHD due to coronavirus disease MESHD 2019 (COVID-19) in Catalonia, Spain. DESIGN Cross-sectional study. SETTING Data collected from the Catalan Health Surveillance System (CatSalut) in Catalonia, a region of Spain. PARTICIPANTS Using data collected between 1 March and 1 June 2020, we conducted the following comparative analyses: people infected by SARS-CoV-2 (328 892) vs Catalonia's entire population (7 699 568); COVID-19 cases who required hospitalisation (37 638) vs cases who did not require hospitalisation (291 254); and COVID-19 cases who died during the study period vs cases who did not die during the study period (12 287). MAIN OUTCOME MEASURES Three clinical outcomes related to COVID-19 ( infection MESHD, hospitalisation, or death MESHD). We analysed sociodemographic and environment variables (such as residing in a nursing home) and the presence of previous comorbidities. RESULTS A total of 328 892 cases were considered to be infected with SARS-CoV-2 (4.27% of total population). The main risk factors for the diagnostic were: female TRANS gender TRANS (risk ratio [RR] =1.49; 95% confidence interval [95% CI] =1.48-1.50), age TRANS (45-64 years old; RR=1.02; 95% CI=1.01-1.03), high comorbidity burden (GMA index) (RR=3.03; 95% CI=2.97-3.09), reside in a nursing home (RR=11.82; 95% CI=11.66-11.99), and smoking (RR=1.06; 95% CI=1.05-1.07). During the study period, there were 37 638 (11.4 %) hospitalisations due to COVID-19, and the risk factors were: male TRANS gender TRANS (RR=1.45; 95% CI=1.43-1.48), age TRANS > 65 (RR=2.38; 95% CI=2.28-2.48), very low individual income (RR=1.03; 95% CI=0.97-1.08), and high burden of comorbidities (GMA index) (RR=5.15; 95% CI=4.89-5.42). The individual comorbidities with higher burden were obesity HP obesity MESHD (RR=1.23; 95% CI=1.20-1.25), chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD (RR=1.19; 95% CI=1.15-1.22), heart failure MESHD (RR=1.19; 95% CI=1.16-1.22), diabetes mellitus HP diabetes mellitus MESHD (RR=1.07; 95% CI=1.04-1.10), and neuro-psychiatric MESHD comorbidities (RR=1.06; 95% CI=1.03-1.10). A total of 12 287 deaths (3.73%) were attributed to COVID-19, and the main risk factors were: male TRANS gender TRANS (RR=1.73; 95% CI=1.67-1.81), age TRANS > 65 (RR=37.45; 95% CI=29.23-47.93), residing in a nursing home (RR=9.22; 95% CI=8.81-9.65), and high burden of comorbidities (GMA index) (RR=5.25; 95% CI=4.60-6.00). The individual comorbidities with higher burden were: heart failure MESHD (RR=1.21; 95% CI=1.16-1.22), chronic kidney disease HP chronic kidney disease MESHD (RR=1.17; 95% CI=1.13-1.22), and diabetes mellitus HP diabetes mellitus MESHD (RR=1.10; 95% CI=1.06-1.14). These results did not change significantly when we considered only PCR-positive patients. CONCLUSIONS Female TRANS gender TRANS, age TRANS between 45 to 64 years old, high burden of comorbidities, and factors related to environment (nursing home) play a relevant role in SARS-CoV-2 infection MESHD and transmission TRANS. In addition, we found risk factors for hospitalisation and death MESHD due to COVID-19 that had not been described to date, including comorbidity burden, neuro-psychiatric disorders MESHD, and very low individual income. This study supports interventions for transmission TRANS control beyond stratify-and-shield strategies focused only on protecting those at risk of death. Future COVID-19 studies should examine the role of gender TRANS, the burden of comorbidities, and socioeconomic status in disease transmission TRANS, and should determine its relationship to workplaces, especially healthcare centres and nursing homes.

    Clinical Course and Risk Factors for severe Disease MESHD and Death of Adult Critically MESHD Adult TRANS Critically Ill Inpatients with COVID-19 in Toulouse, France: A Retrospective Cohort Study

    Authors: William Buffières; Benjamine Sarton; Charline Zadro; Fanny Vardon Bounes; Vincent Minville; Bernard Georges; Thierry Seguin; Jean Marie Conil; Stephanie Ruiz; Samia Collot; Guillaume Ducos; Marie Virtos; Diane Osinski; David Rousset; Thomas Geeraerts; Thomas Filleron; Benoit Bataille; Jacques Izopet; Jean Ruiz; Veronique Ramonda; Olivier Fourcade; Beatrice Riu; Damien Guinault; Stein Silva

    doi:10.21203/rs.3.rs-66770/v1 Date: 2020-08-27 Source: ResearchSquare

    BackgroundTo explore risk factors for unfavorable outcome ( death MESHD or requiring invasive mechanical ventilation at 28 days from ICU admission) of critically ill COVID-19 patients hospitalized in the Toulouse regionMethodsRetrospective cohort of critically ill COVID-19 patients sequentially admitted to 12 ICUs in Toulouse region (March 9, 2020, to April 8, 2020). All patients had laboratory confirmed SARS-CoV-2 infection MESHD and required invasive mechanical ventilation. Baseline characteristics, pathophysiological respiratory data, clinical outcomes, viral shredding, and chest CT scan were collected.ResultsA total of 150 patients were included (median age TRANS, 68 years (interquartile range, (IQR), 58-72; 81% male TRANS). The most common comorbidities were hypertension HP (77, 51%) and obesity HP (42, 28%). At ICU admission, the median PaO2/FiO2 ratio was 138 (IQR,112-178). During hospitalization, the rate of ventilator-acquired pneumonia HP (VAP) was 61% and 51 (34%) patients had acute kidney injury HP (AKI) with a Kidney Disease Improving Global Outcomes (KDIGO) score > 1. The 28-day mortality was 15.3%, and 50 (33%) patients had unfavorable outcome. We found that VAP (5.91; 2.10-10.03; p value = 0.002) and AKI with a KDIGO score > 1 (4.71; 1.69-14.41; p value = 0.004) were associated with increased odds of unfavorable outcome. Neither, chest CT scan data on admission, nor pathophysiological respiratory data during ICU stay were associated to patient’s outcome.ConclusionThe potential risk factors of AKI and VAP could help clinicians to identify patients with poor prognosis at an early stage. Targeted care of these factors might have a significant impact on COVID-19 patient’s outcome.

    Multisystem inflammatory syndrome MESHD in children TRANS related to COVID-19: A systematic review

    Authors: Levi Hoste; Ruben Van Paemel; Filomeen Haerynck; Jacob J. Mansfield; Pranav Mellacheruvu; Pablo Monsivais; Lasse Lehtonen; Ahmed Geneid; Aruni Bhatnager; Pedro A Piedra; Larry R Ellingsworth; Gregory Glenn; Gale Smith; Joseph Torresi; Weisan Chen; Linda Wakim; Allen Cheng; Jan Petersen; Jamie Rossjohn; Adam K Wheatley; Stephen Kent; Louise Rowntree; Katherine Kedzierska; Mengge Lyu; Guixiang Xiao; Xia Xu; Weigang Ge; Jiale He; Jun Fan; Junhua Wu; Meng Luo; Xiaona Chang; Huaxiong Pan; Xue Cai; Junjie Zhou; Jing Yu; Huanhuan Gao; Mingxing Xie; Sihua Wang; Guan Ruan; Hao Chen; Hua Su; Heng Mei; Danju Luo; Dashi Zhao; Fei Xu; Yan Li; Yi Zhu; Jiahong Xia; Yu Hu; Tiannan Guo

    doi:10.1101/2020.08.17.20173641 Date: 2020-08-18 Source: medRxiv

    Importance. In April 2020, multiple reports of an association between a hyperinflammatory, Kawasaki-like condition and SARS-CoV-2 were published and termed as pediatric inflammatory multisystem syndrome MESHD ( PIMS MESHD) or multisystem inflammatory syndrome MESHD ( MIS MESHD). A thorough characterization of this syndrome (demographics, presentation, diagnosis, and outcome) is currently lacking. Objective. We aimed to perform a systematic review of published cases of this novel multisystem inflammatory syndrome MESHD in children TRANS associated with COVID-19. Evidence review. A literature search of Pubmed, Embase, BioRxiv, MedRxiv and COVID-19 specific research repositories (Cochrane COVID-19 Study Register and the World Health Organization (WHO) COVID-19 Global Research Database) was conducted from December 30th, 2019 to June 30th, 2020. Publications describing inflammatory syndromes associated with COVID-19 were included. Of 333 unique publications, 229 records were excluded based on title and abstract. After screening the full text, 40 observational studies and case reports were included, comprising 687 cases (published between May 9th, 2020 and June 30th, 2020). Findings. In contrast to classic Kawasaki disease MESHD, epidemiological enrichment for adolescents (median age TRANS 9 [6.0-12.3]) and ethnic minorities (35.8% black and 24.5% Hispanic/Latino) was observed. There was a male TRANS predominance (59.1%). Apart from obesity HP obesity MESHD (24.4%), pre-existing conditions were infrequent. The majority suffered from gastrointestinal (87.2%) and cardiocirculatory (79.2%) manifestations. Respiratory symptoms (51.2%) were less frequent. Over half of patients (56.3%) presented with hemodynamic shock HP, and critical care interventions were often necessary (inotropics (56.5%), mechanical ventilation (22.9%), non-invasive ventilation (30.6%), extracorporal membrane oxygenation (ECMO;4.5%)). Anti-SARS-CoV-2 IgG and RT-PCR were positive in respectively 69.4% and 36.7%. Eleven deaths MESHD were reported (1.6%). The RCPCH case definition proved to be most comprehensive comprising all single cases. In contrast, WHO and CDC MIS MESHD definitions are more stringent, with the CDC case definition often missing severe cases requiring intensive care (n = 33 out of 95 cases). Conclusions and Relevance. This novel pediatric multisystem hyperinflammatory condition MESHD, associated with COVID-19, is characterized by a severe and heterogeneous disease spectrum. Despite frequent intensive care interventions, mortality rate was low and short-term outcome favorable. Long-term follow-up of possible chronic complications and additional clinical research, to elucidate the underlying immunological pathogenesis and possible genetic predisposition is crucial.

    Obesity HP, old age TRANS and frailty are the true risk factors for COVID-19 mortality and not chronic disease MESHD or ethnicity in Croydon.

    Authors: Zinu Philipose; Nadia Smati; Chun Shing Jefferson Wong; Karen Aspey; Michael Anthony Mendall; Christopher Thouvenel; Kennidy K Takehara; Julie Eggenberger; Emily A Hemann; Hayley R Waterman; Mitchell L Fahning; Yu Chen; Jennifer Rathe; Caleb Stokes; Samuel Wrenn; Brooke Fiala; Lauren P Carter; Jessica A Hamerman; Neil P King; Michael Gale; Daniel J Campbell; David Rawlings; Marion Pepper

    doi:10.1101/2020.08.12.20156257 Date: 2020-08-14 Source: medRxiv

    Background: Coronavirus-19 (COVID-19) mortality in hospitalised patients is strongly associated with old age TRANS, nursing home residence, male TRANS sex and obesity HP obesity MESHD, with a more controversial association with ethnicity and chronic diseases MESHD, in particular diabetes mellitus MESHD diabetes mellitus HP. Further complicating the evaluation of the independent impacts of these risk factors is the failure to control for frailty in the published studies thus far. Aim: To determine the true risk factors for mortality in patients confirmed to have COVID-19 in Croydon needing hospital admission and to evaluate the independence of these risk factors in this group after adjusting for body mass index (BMI) and frailty. Methods: This observational study retrospectively reviewed hospital electronic medical records of 466 consecutive patients who were admitted to Croydon University Hospital confirmed positive by rapid PCR test from 11th March 2020 to 9th April 2020. Statistical analysis was performed by multiple unconditional and univariate logistic regression. Results: After multivariate analysis, male TRANS sex [OR 1.44 (CI 0.92-2.40)], age TRANS (per year) [OR 1.07 (CI 1.05-1.09)], morbid obesity HP obesity MESHD (BMI > 40 kg/m2 vs reference BMI 18.5-24.9 kg/m2 ) [OR 14.8 (CI 5.25-41.8)], and nursing home residence (OR 3.01 (CI 1.56-5.79) were independently associated with COVID-19 mortality with no statistically significant association found with chronic diseases MESHD or ethnicity. In the non-nursing home population, after adjusting for age TRANS and sex, the odds ratio for type 2 diabetes mellitus MESHD diabetes mellitus HP ( T2DM MESHD) as a risk factor was 1.64 (CI 1.03-2.61, p = 0.03) and was and was attenuated to 1.30 (CI 0.78-2.18)) after controlling for BMI; the association of mortality with male TRANS sex was strengthened [OR 1.66 (CI 0.96-2.87)] and that for ethnic minority patients was weakened [South Asians [from OR 1.30 (CI 0.67-2.53)) to OR 1.21 (CI 0.60-2.46)]; African Caribbeans [from OR 1.24 (CI 0.65-2.34) to OR 1.16 (CI 0.58-2.30)]. There was a borderline but potentially large protective effect (p= 0.09) in patients who were on anticoagulation drugs prior to admission [OR 0.56 (CI 0.28-1.11)]. Conclusion: Our study found no significant effect of ethnicity and chronic diseases as independent risk factors on COVID-19 mortality in Croydon population whereas male TRANS sex, high BMI, old age TRANS and frailty were found to be independent risk factors. Routine prophylactic treatment with anticoagulant drugs in the high-risk COVID-19 population warrants further prompt investigation.

    Obesity HP Obesity MESHD and Smoking as Risk Factors for Invasive Mechanical Ventilation in COVID-19: a Retrospective, Observational Cohort Study

    Authors: Ana Carolina Costa Monteiro; Rajat Suri; Ileanacho Obi Emeruwa; Robert J Stretch; Roxana Y Cortes Lopez; Alexander Sherman; Catherine C Lindsay; Jennifer A Fulcher; David Goodman-Meza; Anil Sapru; Russell G Buhr; Steven Y Chang; Tisha Wang; Nida Qadir; Rachel Vreeman; Joseph Masci; Nick A Maskell; Shaney Barratt

    doi:10.1101/2020.08.12.20173849 Date: 2020-08-14 Source: medRxiv

    Purpose: To describe the trajectory of respiratory failure HP respiratory failure MESHD in COVID-19 and explore factors associated with risk of invasive mechanical ventilation (IMV). Materials and Methods: A retrospective, observational cohort study of 112 inpatient adults TRANS diagnosed with COVID-19 between March 12 and April 16, 2020. Data were manually extracted from electronic medical records. Multivariable and Univariable regression were used to evaluate association between baseline characteristics, initial serum SERO markers and the outcome of IMV. Results: Our cohort had median age TRANS of 61 (IQR 45-74) and was 66% male TRANS. In-hospital mortality was 6% (7/112). ICU mortality was 12.8% (6/47), and 18% (5/28) for those requiring IMV. Obesity HP (OR 5.82, CI 1.74-19.48), former (OR 8.06, CI 1.51-43.06) and current smoking status (OR 10.33, CI 1.43-74.67) were associated with IMV after adjusting for age TRANS, sex, and high prevalence SERO comorbidities by multivariable analysis. Initial absolute lymphocyte count (OR 0.33, CI 0.11-0.96), procalcitonin (OR 1.27, CI 1.02-1.57), IL-6 (OR 1.17, CI 1.03-1.33), ferritin (OR 1.05, CI 1.005-1.11), LDH (OR 1.57, 95% CI 1.13-2.17) and CRP (OR 1.13, CI 1.06-1.21), were associated with IMV by univariate analysis. Conclusions: Obesity HP, smoking history, and elevated inflammatory markers were associated with increased need for IMV in patients with COVID-19.

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

    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 MESHD) symptoms of SARS-CoV2/COVID-19 in the form of anorexia HP anorexia MESHD, nausea, vomiting HP nausea, vomiting MESHD vomiting MESHD, abdominal pain HP abdominal pain MESHD and diarrhea HP diarrhea MESHD are usually preceeded by respiratory manifestations and are associated with a poor prognosis. Hematochezia HP Hematochezia MESHD is an uncommon clinical presentation of COVID-19 disease and we hypothesize that older patients with significant comorbidites ( obesity HP obesity MESHD and cardiovascular) and prolonged hospitalization are suspectible to ischemic injury MESHD 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 respiratory failure MESHD. Both patients had a complicated clinical course and suffered from hematochezia HP hematochezia MESHD and acute blood SERO blood MESHD loss 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 HP edema MESHD 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 MESHD. Hematochezia HP Hematochezia MESHD 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 MESHD to the bowel. Hypoxic conditions MESHD due to COVID-19 pneumonia HP pneumonia MESHD and respiratory failure HP respiratory failure MESHD, compounded by preexisting cardiovascular complications, and/or cytokine storm orchestrated by the viral infection 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 hematochezia MESHD may further increase the mortality and morbidity of COVID-19 patients, and prompt consultation and management by gastroenterology is therefore warranted.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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