Corpus overview


MeSH Disease

Human Phenotype


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    Modeling the progression of SARS-CoV-2 infection MESHD in patients with COVID-19 risk factors through predictive analysis

    Authors: Juan Alonso Leon-Abarca

    doi:10.1101/2020.07.14.20154021 Date: 2020-07-19 Source: medRxiv

    With almost a third of adults TRANS being obese MESHD, another third hypertense MESHD and almost a tenth affected by diabetes MESHD, Latin American countries could see an elevated number of severe COVID-19 outcomes. We used the Open Dataset of Mexican patients with COVID-19 suspicion who had a definite RT-PCR result to develop a statistical model that evaluated the progression of SARS-CoV-2 infection MESHD in the population. We included patients of all ages TRANS with every risk factor provided by the dataset: asthma HP, chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD, smoking, diabetes MESHD, obesity HP obesity MESHD, hypertension HP hypertension MESHD, immunodeficiencies HP immunodeficiencies MESHD, chronic kidney disease HP chronic kidney disease MESHD, cardiovascular diseases MESHD, and pregnancy. The dataset also included an unspecified category for other risk factors that were not specified as a single variable. To avoid excluding potential patients at risk, that category was included in our analysis. Due to the nature of the dataset, the calculation of a standardized comorbidity index was not possible. Therefore, we treated risk factors as a categorical variable with two categories: absence of risk factors and the presence of at least one risk factor in accordance with previous epidemiological reports. Multiple logistic regressions were carried out to associate sex, risk factors, and age TRANS as a continuous variable (and the interaction that accounted for increasing diseases with older ages TRANS); and SARS-CoV-2 infection MESHD as the dependent zero-one binomial variable. Post estimation predictive marginal analysis was performed to generate probability trends along 95% confidence bands. This analysis was repeated several times through the course of the pandemic since the first record provided in their repository (April 12, 2020) to one month after the end of the state of sanitary emergency (the last date analyzed: June 27, 2020). After processing, the last measurement included 464,389 patients. The baseline analysis on April 12 revealed that people 35 years and older with at least one risk factor had a lower risk of SARS-CoV-2 infection MESHD in comparison to patients without risk factors (Figure 1). One month before the end of the nationwide state of emergency this age TRANS threshold was found at 50 years (May 2, 2020) and it shifted to 65 years on May 30. Two weeks after the end of the public emergency (June 13, 2020) the trends converged at 80 years and one week later (June 27, 2020) every male TRANS and female TRANS patient with at least one risk factor had a higher risk of SARS-CoV-2 infection MESHD compared to people without risk factors. Through the course of the COVID-19 pandemic, all four probability curves shifted upwards as a result of progressive disease spread TRANS. In conclusion, we found our model could monitor accurately the probability of SARS-CoV-2 infection MESHD in relation to age TRANS, sex, and the presence of at least one risk factor. Also, because the model can be applied to any particular political region within Mexico, it could help evaluate the contagion spread in specific vulnerable populations. Further studies are needed to determine the underlying nature of the mechanisms behind such observations.

    COVID-19 Inmate Risk Appraisal (CIRA): Development and validation of a screening tool to assess COVID-19 vulnerability in prisons

    Authors: Leonel C. Gonçalves; Stéphanie Baggio; Michael Weber; Laurent Gétaz; Hans Wolff; Jay P. Singh; Andreas Naegeli; Astrid Rossegger; Jérôme Endrass

    doi:10.21203/ Date: 2020-07-06 Source: ResearchSquare

    Objectives. To develop and validate a screening tool designed to identify detained people at increased risk for COVID-19 mortality, the COVID-19 Inmate Risk Appraisal (CIRA). Design. Cross-sectional study with a representative sample (development) and a case-control sample (validation).Setting. The two largest Swiss prisons.Participants. (1) Development sample: all male TRANS persons detained in Pöschwies, Zurich (n=365); (2) Validation sample: case-control sample of male TRANS persons detained in Champ-Dollon, Geneva (n=192, matching 1:3 for participants at risk for severe course of COVID-19 and participants without risk factors).Main outcome measures. The CIRA combined seven risk factors identified by the World Health Organization and the Swiss Federal Office of Public Health as prognosis of severe COVID-19 to derive an absolute risk increase in mortality rate: Age TRANS ≥60, cardiovascular disease MESHD, diabetes MESHD, hypertension HP hypertension MESHD, chronic respiratory disease MESHD, immunodeficiency HP immunodeficiency MESHD, and cancer MESHD. Results. Based on the development sample, we proposed a three-level classification: average (<3.7), elevated (3.7-5.7), and high (>5.7) risk. In the validation sample, the CIRA identified all individuals considered vulnerable by national recommendations (having at least one risk factor). The category “elevated risk” maximized sensitivity SERO (1) and specificity (.97). The CIRA had even higher capacity in discriminating vulnerable individuals according to clinical evaluation (a four-level risk categorization based on a consensus of medical staff). The category “elevated risk” maximized sensitivity SERO and specificity (both 1). When considering the individuals classified as extremely high risk by medical staff, the category “high risk” had a high discriminatory capacity (sensitivity=.89, specificity=.97). Conclusions. The CIRA scores have a high discriminative ability and will be important in custodial settings to support decisions and prioritize actions using a standardized valid assessment method. However, as knowledge on risk factors for COVID-19 mortality is still limited, the CIRA should be considered preliminary. Underlying data will be updated regularly on the website, where the CIRA algorithm is freely available.

    Association of Smoking Status with Outcomes in Hospitalized COVID-19 Patients

    Authors: Muhammad Adrish; Sridhar Chilimuri; Nikhitha Mantri; Haozhe Sun; Maleeha Zahid; Sudharsan Gongati; Ked Fortuzi; Abhishrut Pramod Jog; Pravish Purmessur; Ravish Singhal

    doi:10.21203/ Date: 2020-07-01 Source: ResearchSquare

    Introduction: Smoking causes inflammation of the lung MESHD epithelium by releasing cytokines and impairing muco-ciliary clearance. Some studies have linked smoking with severity of illness of COVID-19 whereas others have found no such association.Methods: This was a retrospective analysis of all adults TRANS hospitalized with COVID-19 from March 09 to May 18, 2020. Results: 1173 patients met the study criteria. 837 patients never smoked and 336 patients were either current smokers or past smoker and were grouped together in smokers group. Patients in smokers group were more likely to be male TRANS and had higher incidence of underlying COPD MESHD (19% vs. 6%, p<0.001), human immunodeficiency HP immunodeficiency MESHD virus infection (11% vs. 5%,p<0.001), cancer MESHD (11% vs. 6%, p=0.005), congestive heart failure HP congestive heart failure MESHD (15% vs. 8%, p<0.001), coronary artery disease MESHD (15% vs. 9%, p=0.027), chronic kidney disease HP chronic kidney disease MESHD (11% vs. 8%, p=0.037), and end-stage renal disease MESHD (10% vs. 6%, p=0.009) compared to non-smokers. Smokers were more likely to develop critical illness requiring mechanical ventilation (47% vs. 37% p=0.005). Univariate Cox model for survival analysis by smoking status showed that smokers only current smokers had higher risk of death MESHD compared to never-smokers (HR 1.61, 95% confidence interval 1.22–2.12, p<0.001). In the multivariate approach Cox model for the survival, female TRANS sex, age TRANS, LDH and systemic steroid use were associated with overall survival.Conclusion: In our large single center retrospective database of patients hospitalized with COVID-19, smoking was associated with development of critical illness MESHD and higher likelihood of death MESHD

    The impact of SARS-CoV-2 transmission TRANS fear and COVID-19 pandemic on the mental health of patients with primary immunodeficiency disorders MESHD immunodeficiency HP disorders, severe asthma HP asthma MESHD, and other high-risk groups

    Authors: Fatih Colkesen; Oguzhan Kilincel; Mehmet Sozen; Eray Yildiz; Sengul Beyaz; Fatma Colkesen; Gokhan Aytekin; Mehmet Zahit Kocak; Yakup Alsancak; Murat Araz; Sevket Arslan

    doi:10.1101/2020.06.26.20140616 Date: 2020-06-28 Source: medRxiv

    Background: The adverse effects of COVID-19 pandemic on the mental health of high-risk group patients for morbidity and mortality and its impact on public health in the long term have not been clearly determined. Objective: To determine the level of COVID-19 related transmission TRANS fear and anxiety HP anxiety MESHD in healthcare workers and patients with primary immunodeficiency disorder MESHD immunodeficiency HP disorder ( PID MESHD), severe asthma HP asthma MESHD, and the ones with other comorbidities. Methods: The healthcare workers and patients with PID MESHD, severe asthma HP asthma MESHD (all patients receiving biological agent treatment), malignancy MESHD, cardiovascular disease MESHD, hypertension HP hypertension MESHD (90% of patients receiving ACEI or ARB therapy), diabetes mellitus HP diabetes mellitus MESHD (42 % of patients receiving DPP-4 inhibitor therapy) were included in the study. A total of 560 participants, 80 individuals in each group, were provided. The hospital anxiety HP anxiety MESHD and depression MESHD scale ( HADS ) and Fear of illness and virus evaluation (FIVE ) scales were applied to the groups with face to face interview methods. Results: The mean age TRANS was 49.30 years and 306 (55 %) were female TRANS. The FIVE Scale and HADS-A scale scores of health care workers were significantly higher than other groups' scores (p = 0.001 and 0.006). The second-highest scores belonged to patients with PID MESHD. There was no significant difference between the groups for the HADS-D score (p=0.07). The lowest score in all scales was observed in patients with hypertension HP hypertension MESHD. Conclusions: This study demonstrated that in the pandemic process, patients with primary immunodeficiency MESHD immunodeficiency HP, asthma HP asthma MESHD patients, and other comorbid patients, especially healthcare workers, should be referred to the centers for the detection and treatment of mental health conditions.

    COVID-19 :Determinants of Hospitalization, ICU and Death among 20,293 reported cases in Portugal

    Authors: Vasco Ricoca Peixoto; Andre Vieira; Pedro Aguiar; Paulo Sousa; Carlos Carvalho; Daniel Rhys Thomas; Alexandre Abrantes; Carla Nunes

    doi:10.1101/2020.05.29.20115824 Date: 2020-05-30 Source: medRxiv

    Introduction Determinants of hospitalization, intensive care unit (ICU) admission and death MESHD are still unclear for Covid-19 and only a few studies have adjusted for confounding for different clinical outcomes including all reported cases in a country in the analysis. We used routine surveillance data from Portugal to identify risk factors for COVID-19 outcomes, in order to support risk stratification, clinical and public health interventions, and to improve scenarios to plan health care resources. Methods We conducted a retrospective cohort study including 20,293 laboratory confirmed cases TRANS of COVID-19 in Portugal to 28 April 2020, electronically through the National Epidemic Surveillance System of the Directorate-General of Health( DGS MESHD). We calculated absolute risks, relative risks (RR) and adjusted relative risks (aRR) to identify demographic and clinical factors associated with hospitalization, admission to ICU and death MESHD using Poisson regressions. Results Increasing age TRANS after 60 years was the greatest determinant for all outcomes. Assuming 0-50 years as reference, being aged TRANS 80-89 years was the strongest determinant of hospital admission (aRR-5.7), 70-79 years for ICU(aRR-10.4) and >90 years for death MESHD(aRR-226.8) with an aRR of 112.7 in those 70-79 . Among comorbidites, Immunodeficiency HP Immunodeficiency MESHD, cardiac disease MESHD, kidney disease MESHD, and neurologic disease MESHD were independent risk factors for hospitalization (aRR 1.83, 1.79, 1.56, 1.82), for ICU these were cardiac, Immunodeficiency HP Immunodeficiency MESHD, kidney and lung disease (aRR 4.33, 2.76, 2.43, 2.04), and for death MESHD they were kidney, cardiac and chronic neurological disease MESHD (aRR: 2.9, 2.6, 2.0) Male TRANS gender TRANS was a risk factor for all outcomes. There were statistically significant differences for the 3 outcomes between regions. Discussion and Conclusions Older age TRANS stands out as the strongest risk factor for all outcomes specially for death MESHD as absolute is risk was small for those younger than 50. These findings have implications in terms of risk stratified public health measures that should prioritize protecting older people. Epidemiologic scenarios and clinical guidelines may consider the estimated risks, even though under-ascertainment of mild and asymptomatic TRANS cases should be considered in different age groups TRANS.

    Association between rRT-PCR test results upon admission and outcome in hospitalized chest CT-Positive COVID-19 patients; a provincial retrospective cohort with active follow-up

    Authors: Saeed Nemati; Hamid Reza Najari; Anita Eftekharzadeh; Amir Mohammad Kazemifar; Ali Qandian; Pedram Fattahi; Maedeh Zokaei Nikoo; Shiva Leghaei; Mohammad Reza Rouhollahi

    doi:10.1101/2020.04.21.20074641 Date: 2020-04-25 Source: medRxiv

    Background - The Covid-19 pandemic imposed the most devastating challenge on healthcare systems worldwide. Iran was among the first countries that had to confront serious shortages in RT-PCR testing for SARS-CoV-2 and ventilators availabilities throughout the COVID-19 outbreak. This study aimed to investigate the clinical course of hospitalized COVID-19 patients with different rRT-PCR test results during the first 3 weeks of the outbreak in Qazvin province, Iran. Methods -For this retrospective cohort study, data of hospitalized patients primarily diagnosed as having COVID-19 in all 12 centers across the whole Qazvin province during Feb 20-Mar 11, 2020 was analyzed. A multivariate logistic regression model was applied to assess the independent associates of death among COVID-19 patients. Results - 998 patients (57% male TRANS, median age TRANS 54 years) with positive chest CT-scan changes were included in this study. Among them, 558 patients were examined with rRT-PCR test and 73.8% tested positive. Case fatality rate was 20.68% and 7.53% among test-positive and test negative hospitalized patients, respectively. While only 5.2% of patients were ICU admitted, case fatality rates outside ICU were 17.70% and 4.65% in test-positive and test-negative non-ICU admitted patients, correspondingly. The independent associates of death MESHD were age TRANS [≥] 70 years, testing positive with rRT-PCR test, having immunodeficiency HP immunodeficiency MESHD disorders and ICU admission. Conclusions - Hospitalized COVID-19 patients with mild symptoms despite positive chest CT changes and major comorbidities were more probable to have negative rRT-PCR test result, hence lower case fatality rate and a more favorable outcome.

    Comorbidity and its impact on 1,590 patients with COVID-19 in China: A Nationwide Analysis

    Authors: Wei-jie Guan; Wen-hua Liang; Yi Zhao; Heng-rui Liang; Zi-sheng Chen; Yi-min Li; Xiao-qing Liu; Ru-chong Chen; Chun-li Tang; Tao Wang; Chun-quan Ou; Li Li; Ping-yan Chen; Ling Sang; Wei Wang; Jian-fu Li; Cai-chen Li; Li-min Ou; Bo Cheng; Shan Xiong; Zheng-yi Ni; Yu Hu; Jie Xiang; Lei Liu; Hong Shan; Chun-liang Lei; Yi-xiang Peng; Li Wei; Yong Liu; Ya-hua Hu; Peng Peng; Jian-ming Wang; Ji-yang Liu; Zhong Chen; Gang Li; Zhi-jian Zheng; Shao-qin Qiu; Jie Luo; Chang-jiang Ye; Shao-yong Zhu; Lin-ling Cheng; Feng Ye; Shi-yue Li; Jin-ping Zheng; Nuo-fu Zhang; Nan-shan Zhong; Jian-xing He

    doi:10.1101/2020.02.25.20027664 Date: 2020-02-27 Source: medRxiv

    Objective: To evaluate the spectrum of comorbidities and its impact on the clinical outcome in patients with coronavirus disease MESHD 2019 (COVID-19). Design: Retrospective case studies Setting: 575 hospitals in 31 province/autonomous regions/provincial municipalities across China Participants: 1,590 laboratory-confirmed hospitalized patients. Data were collected from November 21st, 2019 to January 31st, 2020. Main outcomes and measures: Epidemiological and clinical variables (in particular, comorbidities) were extracted from medical charts. The disease severity was categorized based on the American Thoracic Society guidelines for community-acquired pneumonia HP pneumonia MESHD. The primary endpoint was the composite endpoints, which consisted of the admission to intensive care unit (ICU), or invasive ventilation, or death MESHD. The risk of reaching to the composite endpoints was compared among patients with COVID-19 according to the presence and number of comorbidities. Results: Of the 1,590 cases, the mean age TRANS was 48.9 years. 686 patients (42.7%) were females TRANS. 647 (40.7%) patients were managed inside Hubei province, and 1,334 (83.9%) patients had a contact history of Wuhan city. Severe cases accounted for 16.0% of the study population. 131 (8.2%) patients reached to the composite endpoints. 399 (25.1%) reported having at least one comorbidity. 269 (16.9%), 59 (3.7%), 30 (1.9%), 130 (8.2%), 28 (1.8%), 24 (1.5%), 21 (1.3%), 18 (1.1%) and 3 (0.2%) patients reported having hypertension HP hypertension MESHD, cardiovascular diseases MESHD, cerebrovascular diseases MESHD, diabetes MESHD, hepatitis HP hepatitis MESHD B infections, chronic HP chronic obstructive pulmonary disease MESHD obstructive pulmonary disease, chronic HP chronic kidney diseases MESHD, malignancy and immunodeficiency MESHD immunodeficiency HP, respectively. 130 (8.2%) patients reported having two or more comorbidities. Patients with two or more comorbidities had significantly escalated risks of reaching to the composite endpoint compared with those who had a single comorbidity, and even more so as compared with those without (all P<0.05). After adjusting for age TRANS and smoking status, patients with COPD MESHD (HR 2.681, 95%CI 1.424-5.048), diabetes MESHD (HR 1.59, 95%CI 1.03-2.45), hypertension HP hypertension MESHD (HR 1.58, 95%CI 1.07-2.32) and malignancy MESHD (HR 3.50, 95%CI 1.60-7.64) were more likely to reach to the composite endpoints than those without. As compared with patients without comorbidity, the HR (95%CI) was 1.79 (95%CI 1.16-2.77) among patients with at least one comorbidity and 2.59 (95%CI 1.61-4.17) among patients with two or more comorbidities. Conclusion: Comorbidities are present in around one fourth of patients with COVID-19 in China, and predispose to poorer clinical outcomes.

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MeSH Disease
Human Phenotype

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