Corpus overview


Overview

MeSH Disease

Human Phenotype

Vomiting (10)

Diarrhea (8)

Fever (7)

Hypertension (4)

Cough (4)


Transmission

Seroprevalence
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    Predicting clinical outcome with phenotypic clusters in COVID-19 pneumonia HP pneumonia MESHD: 2 an analysis of 12,066 hospitalized patients from the Spanish registry SEMI-3 COVID-19.

    Authors: Manuel Rubio-Rivas; Xavier Corbella; Jose Maria Mora-Lujan; Jose Loureiro Amigo; Almudena Lopez Sampalo; Carmen Yera Bergua; Pedro Jesus Esteve Atienzar; Luis Felipe Diez Garcia; Ruth Gonzalez Ferrer; Susana Plaza Canteli; Antia Perez Pineiro; Begona Cortes Rodriguez; Leyre Jorquer Vidal; Ignacio Perez Catalan; Marta Leon Tellez; Jose Angel Martin Oterino; Maria Candelaria Martin Gonzalez; Jose Luis Serrano Carrillo de Albornoz; Eva Garcia Sardon; Jose Nicolas Alcala Pedrajas; Anabel Martin Urda Diez Canseco; Maria Jose Esteban Giner; Pablo Telleria Gomez; Ricardo Gomez Huelgas; Jose Manuel Ramos Rincon; Nina la Cour Freiesleben; Henriette Svarre Nielsen

    doi:10.1101/2020.09.14.20193995 Date: 2020-09-15 Source: medRxiv

    (1) Background: This study aims to identify different clinical phenotypes in COVID-19 88 pneumonia HP pneumonia MESHD using cluster analysis and to assess the prognostic impact among identified clusters in 89 such patients. (2) Methods: Cluster analysis including 11 phenotypic variables was performed in a 90 large cohort of 12,066 COVID-19 patients, collected and followed-up from March 1, to July 31, 2020, 91 from the nationwide Spanish SEMI-COVID-19 Registry. (3) Results: Of the total of 12,066 patients 92 included in the study, most were males TRANS (7,052, 58.5%) and Caucasian (10,635, 89.5%), with a mean 93 age TRANS at diagnosis of 67 years (SD 16). The main pre-admission comorbidities were arterial 94 hypertension HP hypertension MESHD (6,030, 50%), hyperlipidemia HP hyperlipidemia MESHD (4,741, 39.4%) and diabetes mellitus HP diabetes mellitus MESHD (2,309, 19.2%). The 95 average number of days from COVID-19 symptom onset TRANS to hospital admission was 6.7 days (SD 7). 96 The triad of fever HP fever MESHD, cough HP cough MESHD, and dyspnea HP dyspnea MESHD was present almost uniformly in all 4 clinical phenotypes 97 identified by clustering. Cluster C1 (8,737 patients, 72.4%) was the largest, and comprised patients 98 with the triad alone. Cluster C2 (1,196 patients, 9.9%) also presented with ageusia and anosmia MESHD anosmia HP; 99 cluster C3 (880 patients, 7.3%) also had arthromyalgia, headache HP headache MESHD, and sore throat; and cluster C4 100 (1,253 patients, 10.4%) also manifested with diarrhea HP diarrhea MESHD, vomiting HP vomiting MESHD, and abdominal pain HP abdominal pain MESHD. Compared to 101 each other, cluster C1 presented the highest in-hospital mortality (24.1% vs. 4.3% vs. 14.7% vs. 102 18.6%; p<0.001). The multivariate study identified phenotypic clusters as an independent factor for 103 in-hospital death. (4) Conclusion: The present study identified 4 phenotypic clusters in patients with 104 COVID-19 pneumonia HP pneumonia MESHD, which predicted the in-hospital prognosis of clinical outcomes.

    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.

    A severe coronavirus disease MESHD 2019 patient with high-risk predisposing factors died from massive gastrointestinal bleeding MESHD: a case report

    Authors: Taojiang Chen; Qin Yang; Hongyu Duan

    doi:10.21203/rs.3.rs-45116/v1 Date: 2020-07-17 Source: ResearchSquare

    Background: SARS-CoV-2 is highly infectious and has been a significant public health threat. Despite typical manifestations of illness are dominated by respiratory symptom, some patients have concurrent gastrointestinal manifestations, including   nausea MESHD, diarrhea HP diarrhea MESHD, and vomiting HP vomiting MESHD. Massive gastrointestinal bleeding MESHD, however, has rarely been reported. Case presentation: We herein describe a case of severe SARS-CoV-2 infected MESHD patient with several risk factors for poor prognosis, including male TRANS, hypertension HP hypertension MESHD, old age TRANS, mixed bacterial infection MESHD and multilobular infiltration on radiological imaging. After improvement of respiratory status, the onset of gastrointestinal bleeding MESHD occurred, probably resulting from direct viral invasion as evidenced by the positive findings for SARS-CoV-2 in the repeat stool specimens. Although aggressive resuscitation was administered, hematochezia HP hematochezia MESHD was uncontrolled. The patient rapidly deteriorated, suffered cardiac arrest HP cardiac arrest MESHD, and expired. Conclusions: Digestive symptoms could be severe in SARS-CoV-2 infected MESHD patients, especially for the high-risk individuals with predisposing conditions. A more thorough protocol for preventing cross-infection MESHD through faecal-oral transmission TRANS should be implemented in the process of patient care and infection MESHD control.

    Emergency high ligation in a suspected COVID-19 pediatric patient with incarcerated inguinal hernia MESHD inguinal hernia HP: a case report

    Authors: Munawir Makkadafi; Aditya Rifqi Fauzi; Amsyar Praja; Kemala Athollah; . Marcellus; . Gunadi

    doi:10.21203/rs.3.rs-40812/v1 Date: 2020-07-09 Source: ResearchSquare

    Background SARS-Cov-2 infects MESHD not only adults TRANS, but also children TRANS, including pediatric surgery patients with acute abdomen. Here, we report a pediatric surgery case with incarcerated inguinal hernia MESHD inguinal hernia HP and suspected COVID-19.Case presentation: A 11-month-old male TRANS was brought to our emergency department with the main complaint of recurrent yellowish-green vomiting HP vomiting MESHD that was experienced from one day before admission. High fever MESHD fever HP and shortness of breath MESHD were also reported. This patient was also suffering from moderate dehydration HP dehydration MESHD. Neither history of contact with a confirmed case TRANS of COVID-19 nor traveling TRANS from any local transmission TRANS area were found. However, a SARS-CoV-2 rapid antibody test SERO revealed a positive result. A lump in the left scrotum that persisted during admission was found. Fluid resuscitation and nasogastric tube placement for decompression was performed. Manual reduction was attempted but failed to reduce the lump. Accordingly, we decided to perform an emergency high ligation using tertiary protection regulations, i.e., full personal protective equipment (PPE) for COVID-19. Intraoperatively, we found a small intestine loop trapped in the scrotum and stuck in the inguinal canal. Postoperatively, the baby was continued to be managed as a patient with COVID-19 while waiting for the real-time reverse transcription polymerase chain reaction (RT-PCR) results.Conclusions During the COVID-19 pandemic, surgeons should always be aware of the possibility of cross- transmission TRANS from the patient, since children TRANS are also susceptible to SARS-CoV-2 infection MESHD. When and wherever possible, surgeons should perform the procedure in the quickest and most effective manner to shorten exposure time with patient and anesthetic aerosols as well as using appropriate PPE.

    Virus discharge and initial gastrointestinal involvement MESHD are negatively associated with circulating lymphocyte count in COVID-19

    Authors: Wei Chen; Kenneth I. Zheng; Saiduo Liu; Chongyong Xu; Chao Xing; Zengpei Qiao

    doi:10.21203/rs.3.rs-40462/v1 Date: 2020-07-07 Source: ResearchSquare

    Background: It’s reported SARS-CoV-2 could transmit via gastrointestinal tract, with or without pulmonary symptoms. However, as far as we know, there is no convenient marker to predict the virus discharge in stool and initial gastrointestinal involvement of COVID-19.Aims: We aimed to investigate the biomarker predicting virus discharge in stool and initial gastrointestinal involvement of COVID-19, which may assist the clinicians to better combat and prevent COVID-19.Methods: The patients complained of initial gastrointestinal involvement MESHD, including vomiting HP vomiting MESHD, diarrhea HP diarrhea MESHD, with or without respiratory symptoms, attending the Sixth People’s Hospital of Wenzhou, and the Second Affiliated Hospital of Wenzhou Medical University, were screened by qRT-PCR for SARS-CoV-2. The Confirmed COVID-19 patients without contaminated ingestion were all enrolled to investigate the association between circulating lymphocyte count and virus discharge, initial gastrointestinal involvement MESHD.Results: 76 COVID-19 patients were finally enrolled in this study (mean age TRANS 44.5, male TRANS 44.7%), with 24 (31.5%) complained of initial gastrointestinal symptoms MESHD. Significantly lower circulating lymphocyte count was found in the patients with positive results of qRT-PCR on stool (p = 0.012). Furthermore, when the circulating lymphocyte count increased from bottom tertile to the 2nd and 3rd tertiles, the risk of initial gastrointestinal involvement decreased by nearly 75% (OR = 0.25, 95% CI: 0.07, 0.98, p = 0.047), 83% (OR = 0.17, 95% CI: 0.05, 0.63, p = 0.008), adjusted for possible confounders.Conclusions: The circulating lymphocyte count is negatively associated with virus discharge in stool in COVID-19 patients, and the risk of initial gastrointestinal involvement also.

    A short therapeutic regimen based on hydroxychloroquine plus azithromycin for the treatment of COVID-19 in patients with non-severe disease. A strategy associated with a reduction in hospital admissions and complications.

    Authors: José A. Oteo; Pedro Marco; Luis Ponce de León; Alejandra Roncero; Teófilo Lobera; Valentín Lisa

    doi:10.1101/2020.06.10.20101105 Date: 2020-06-12 Source: medRxiv

    The new SARS-CoV-2 infection MESHD named COVID-19 has severely hit our Health System. At the time of writing this paper no medical therapy is officially recommended or has shown results in improving the outcomes in COVID-19 patients. With the aim of diminishing the impact in Hospital admissions and reducing the number of medical complications, we implemented a strategy based on a Hospital Home-Care Unit (HHCU) using an easy-to-use treatment based on an oral administration regimen outside the hospital with hydroxychloroquine (HCQ) plus azithromycin (AZM) for a short period of 5 days. Patients and methods: Patients [≥] 18 years old visiting the emergency room at the Hospital Universitario San Pedro de Logrono (La Rioja) between March, 31st and April, 12th diagnosed with COVID-19 with confirmed SARS-CoV-2 infection MESHD by a specific PCR, as follows: Patients with pneumonia HP pneumonia MESHD (CURB [≤] 1) who did not present severe comorbidities and had no processes that contraindicated this therapeutic regime. Olygosimptomatic patients without pneumonia HP pneumonia MESHD aged TRANS [≥] 55 years. Patients [≥] 18 years old without pneumonia HP pneumonia MESHD with significant comorbidities. We excluded patients with known allergies HP allergies MESHD to some of the antimicrobials used and patients treated with other drugs that increase the QTc MESHD or with QTc >450msc. The therapeutic regime was: HCQ 400 mg every twice in a loading dose followed by 200 mg twice for 5 days, plus AZM 500 mg on the first day followed by 250 mg daily for 5 days. A daily telephone follow-up was carried out from the hospital by the same physician. The end-points of our study were: 1.- To measure the need for hospital admission within 15 days after the start of treatment. 2.- To measure the need to be admitted to the intensive care unit (ICU) within 15 days after the start of the treatment. 3.- To describe the severity of the clinical complications developed. 4.- To measure the mortality within 30 days after starting treatment (differentiating if the cause is COVID-19 or something else). 5.-To describe the safety and adverse effects of the therapeutic regime. Results: During the 13 days studied a total of 502 patients were attended in the emergency room due to COVID-19. Forty-two were sent at home; 80 were attended by the HHCU (patients on this study) and 380 were admitted to the Hospital. In our series there were a group of 69 (85.18%) patients diagnosed with pneumonia HP pneumonia MESHD (37 males TRANS and 32 females TRANS). Most of them, 57 (82.60%) had a CURB65 score of <1 (average age TRANS 49) and 12 (17.40%) a CURB score of 1 (average age TRANS 63). Eighteen (22.50%) of the pneumonia HP pneumonia MESHD patients also had some morbidity as a risk factor. 11 patients (13.75%) without pneumonia HP pneumonia MESHD were admitted to the HHCU because comorbidities or age TRANS [≥] 55 years. Six patients with pneumonia HP pneumonia MESHD had to be hospitalized during the observation period, 3 of them because side effects and 3 because of worsening. One of these patients, with morbid obesity HP obesity MESHD and asthma HP asthma MESHD, had clinical worsening needing mechanical ventilation at ICU and developed acute distress respiratory syndrome MESHD distress respiratory HP syndrome. With the exception of the patient admitted to the ICU, the rest of the patients were discharged at home in the following 8 days (3 to 8 days). Twelve patients (15%), 11 of whom had pneumonia HP pneumonia MESHD, experienced side effects affecting mainly the digestive. In another patient a QTc interval prolongation MESHD (452 msc) was observed. In total 3 of these patients had to be admitted in the Hospital, 2 because of vomiting HP vomiting MESHD and 1 because a QTc interval lengthening. None of the patients needed to stop the HCQ or AZM and all the 80 patients finished the therapeutic strategy. From the group without pneumonia HP pneumonia MESHD only a patient developed diarrhea HP diarrhea MESHD that did not require hospitalization or stop the medication. Conclusions: Our strategy has been associated with a reduction in the burden of hospital pressure, and it seems to be successful in terms of the number of patients who have developed serious complications and / or death. None of the patients died in the studied period and only 6 have to be admitted in conventional hospitalization area.

    Clinical severity and epidemiological spectrum of coronavirus disease MESHD 2019 in children TRANS – comparison with influenza

    Authors: Maria Pokorska-Śpiewak; Ewa Talarek; Jolanta Popielska; Karolina Nowicka; Agnieszka Ołdakowska; Konrad Zawadka; Barbara Kowalik-Mikołajewska; Anna Tomasik; Anna Dobrzeniecka; Marta Lipińska; Beata Krynicka-Czech; Urszula Coupland; Aleksandra Stańska-Perka; Małgorzata Ludek; Magdalena Marczyńska

    doi:10.21203/rs.3.rs-32960/v1 Date: 2020-06-01 Source: ResearchSquare

    Data on the novel coronavirus disease MESHD 2019 (COVID-19) in children TRANS are limited, and studies from Europe are scarce. We analyzed the clinical severity and epidemiologic aspects of COVID-19 in consecutive children TRANS aged TRANS 0 – 18 years, referred with a suspicion of COVID-19 between February 1, and April 15, 2020. RT-PCR on a nasopharyngeal swab was used to confirm COVID-19. 319 children TRANS met the criteria of a suspected case. COVID-19 was diagnosed in 15/319 (4.7%) patients (8 male TRANS; mean age TRANS 10.5 years). All of them had household contact TRANS with an infected relative. Five (33.3%) patients were asymptomatic TRANS. In 9/15 (60.0%) children TRANS, the course of the disease was mild, and in 1/15 (6.7%), it was moderate, with the following symptoms: fever HP fever MESHD (46.7%), cough HP (40%), diarrhea HP diarrhea MESHD (20%), vomiting HP vomiting MESHD (13.3%), rhinitis HP rhinitis MESHD (6.7%), and shortness of breath MESHD (6.7%). In the COVID-19-negative patients, other infections were confirmed TRANS infections were confirmed MESHD, including influenza in 32/319 (10%). The clinical course of COVID-19 and influenza differed significantly based on the clinical presentation. In conclusion, the clinical course of COVID-19 in children TRANS is usually mild or asymptomatic TRANS. In children TRANS suspected of having COVID-19, other infections should not be overlooked. The main risk factor for COVID-19 in children TRANS is household contact TRANS with an infected relative.

    Comparison of clinical characteristics and risk factors in hospitalized patients with SARS-CoV-2, MERS-CoV, and SARS-CoV infection MESHD

    Authors: Zhengtu Li; Xidong Wang; Guansheng Su; Zeguang Zheng; Shaoqiang Li; Yuwei Ye; Qiuxue Deng; Jinchuang Li; Xiaoyu Xiong; Xinguang Wei; Zeqiang Lin; Zichen Jie; Feng Ye

    doi:10.21203/rs.3.rs-28847/v1 Date: 2020-05-14 Source: ResearchSquare

    Herein, we compared the risk factors, clinical presentation of patients hospitalized with SARS-CoV-2, SARS-CoV MESHD, or MERS-CoV infection MESHD. Our data sources include PubMed, Embase, CNKI, and Ovid/Medline. The proportion of male TRANS patients with COVID-19 was higher than who with SARS but lower than who with MERS (p<0.001). More patients with COVID-19 had coexisting chronic medical conditions than those with SARS (p<0.001) but fewer than those with MERS (p<0.001), and the prevalence SERO of hypertension HP hypertension MESHD (17%) and smoking history (14%) was higher than in patients with SARS (p<0.001). Furthermore, the symptom of fever HP fever MESHD (53%), hemoptysis HP (1%), diarrhea HP diarrhea MESHD (4%) and vomiting HP vomiting MESHD (3%) of COVID-19 were significantly lower than that in patients with SARS or MERS. The level of ALT and AST in COVID-19 was significantly lower (p<0.001), however, thrombocytopenia HP thrombocytopenia MESHD, high LDH were common. Summary, male TRANS, smoking history and hypertension HP hypertension MESHD were the most common risk factors for hospitalization with COVID-19; and the clinical feature was less severe in COVID-19.

    Comparison of clinical characteristics and risk factors in hospitalized patients with SARS-CoV-2, MERS-CoV, and SARS-CoV infection MESHD

    Authors: Zhengtu Li; Xidong Wang; Guansheng Su; Shaoqiang Li; Yuwei Ye; Qiuxue Deng; Jinchuang Li; Xiaoyu Xiong; Xinguang Wei; Zeqiang Lin; Zichen Jie; Feng Ye

    doi:10.21203/rs.3.rs-21414/v1 Date: 2020-04-05 Source: ResearchSquare

    Herein, we compared the risk factors, clinical presentation of patients hospitalized with  SARS-CoV-2, SARS-CoV MESHD, or MERS-CoV infection MESHD. The proportion of male TRANS patients with COVID-19 was higher than who with SARS but lower than who with MERS (p<0.001). More patients with COVID-19 had coexisting chronic medical conditions than those with SARS (p<0.001) but fewer than those with MERS (p<0.001), and the prevalence SERO of hypertension HP hypertension MESHD (17%) and smoking history (14%) was higher than in patients with SARS (p<0.001). Furthermore,the symptom of fever HP fever MESHD (53%), hemoptysis HP (1%), diarrhea HP diarrhea MESHD (4%) and vomiting HP vomiting MESHD (3%) of COVID-19 were significantly lower than that in patients with SARS or MERS. The level of ALT and AST in COVID-19 was significantly lower (p<0.001), however, thrombocytopenia HP thrombocytopenia MESHD, high LDH were common. Summary, male TRANS, smoking history and hypertension HP hypertension MESHD were the most common risk factors for hospitalization with COVID-19; and the clinical feature was less severe in COVID-19.

    Clinical Characteristics of 34 Children TRANS with Coronavirus Disease MESHD-2019 in the West of China: a Multiple-center Case Series

    Authors: Che Zhang; Jiaowei Gu; Quanjing Chen; Na Deng; Jingfeng Li; Li Huang; Xihui Zhou

    doi:10.1101/2020.03.12.20034686 Date: 2020-03-16 Source: medRxiv

    BACKGROUND Up to 9 March, 2020, 109577 patients were diagnosed with coronavirus disease MESHD-2019 (COVID-19) globally. The clinical and epidemiological characteristics of adult TRANS patients have been revealed recently. However, the information of paediatric patients remains unclear. We describe the clinical and epidemiological characteristics of paediatric patients to provide valuable insight into early diagnosis of COVID-19 in children TRANS, as well as epidemic control policy making. METHODS and FINDINGS This retrospective, observational study was a case series performed at 4 hospitals in the west of China. Thirty-four paediatric patients with COVID-19 were included from January 1 to February 25, 2020. And the final follow-up visit was completed by February 28, 2020. Clinical and epidemiological characteristics were analyzed on the basis of demographic data, medical history, laboratory tests, radiological findings, and treatment information. Data analysis was performed on 34 paediatrics patients with COVID-19 aged TRANS from 1 to 144 months (median 33.00, IQR 10.00 - 94.25), among whom 14 males TRANS (41.18%) were included. 47.60% of patients were noticed without any exposure history. The median incubation period TRANS was 10.50 (7.75 - 25.25) days. Infections of other respiratory pathogens were reported in 16 patients (47.06%). The most common initial symptoms were fever HP fever MESHD (76.47%), cough HP (58.82%), and expectoration (20.59%). Vomiting HP Vomiting MESHD (11.76%) and diarrhea HP diarrhea MESHD (11.76%) were also reported in a considerable portion of cases. A remarkable increase was detected in serum SERO amyloid A for 17 patients (85.00%) and high- sensitivity SERO C-reactive protein for 17 patients (58.62%), while a decrease of prealbumin was noticed in 25 patients (78.13%). In addition, the levels of lactate dehydrogenase was increased significantly in 28 patients (82.35%), as well as -hydroxybutyrate dehydrogenase in 25 patients (73.53%). Patchy lesions in lobules were detected by chest computed tomographic scans in 28 patients (82.36%). The typical feature of ground-glass opacity for adults TRANS was rare in paediatric patients (2.94%). A late-onset pattern of lesions in lobules were also noticed. Stratified analysis of the clinical features were not performed due to relatively limited samples. CONCLUSIONS Our data presented the clinical and epidemiological features of paediatric patients systemically. The findings offer new insight into the early identification and intervention of paediatric patients with COVID-19.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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