Corpus overview


MeSH Disease

Fatigue (69)

Fever (57)

Coronavirus Infections (39)

Cough (31)

Dyspnea (26)

Human Phenotype

Fatigue (79)

Fever (62)

Cough (62)

Myalgia (23)

Pneumonia (22)


    displaying 1 - 10 records in total 79
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    Analysis of clinical characteristics, laboratory findings and therapy of 134 cases of COVID-19 in Wuhan, China: a retrospective analysis.

    Authors: Rui Zhang; Jie Zhang; Jiebing Chen

    doi:10.21203/ Date: 2020-09-17 Source: ResearchSquare

    Background:As everyone knows, the pandemic COVID-19 is spreading in the whole world. The number of laboratory- confirmed cases TRANS reached 28,637,211 and that of the death cases was 917,404 in the world as of September 13th, 2020. We sought to analyse the clinical characteristics, laboratory findings and therapy of some cases with COVID-19.Methods: In this retrospective study, we extracted the data on 134 patients with laboratory-confirmed COVID-19 in Wuhan Xinzhou District People's Hospital from January 16th to April 24th , 2020. Cases were confirmed TRANS by real-time RT-PCR and abnormal radiologic findings. Outcomes were followed up until May 1th , 2020. Results: Co-infection MESHD infection and severe HP underlying diseases made it easier for a case with COVID-19 to develop to be a severe one or reach an outcome of death MESHD. Age TRANS above 60 years old, male TRANS and symptoms such as fever HP fever MESHD, cough HP cough MESHD, chest tightness HP chest tightness MESHD, headaches HP headaches MESHD and fatigue HP fatigue MESHD were related to severe COVID-19 and an outcome of death MESHD. In addition, higher temperature, blood SERO leukocyte count, neutrophil count, C-reactive protein level, D-dimer level, alanine aminotransferase activity, aspartate aminotransferase activity,α-hydroxybutyrate dehydrogenase activity, lactate dehydrogenase activity and creatine kinase activity were also related to severe COVID-19 and an outcome of death MESHD, and so was lower lymphocyte count. Administration of gamma globulin seemed helpful for reducing the mortality of patients with severe COVID-19, however the P value was greater than 0.05 (P=0.180), which mean under the same condition, studies of larger samples are needed in the future.                 Conclusion: Multiple factors were related to severe COVID-19 and an outcome of death MESHD.  Administration of gamma globulin seemed helpful for reducing the mortality of severe cases. More related studies are needed in the future.

    Predictors of characteristics associated with negative SARS-CoV-2 PCR test despite proven disease and association with treatment and outcomes.The COVID-19 RT-PCR Study.

    Authors: Jean Baptiste Lascarrou; Gwenhael Colin; Aurelie Le Thuaut; Nicolas Serck; Mickael Ohana; Bertrand Sauneuf; Guillaume Geri; Jean Baptiste Mesland; Gaetane Ribeyre; Claire Hussenet; Anne Sophie Boureau; Thomas Gille; - CoV-CONTACT study group; Christophe Choquet; Jean-Francois Timsit; Jade Ghosn; Charlotte Charpentier; Diane Descamps; Nadhira Houhou-Fidouh; 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:10.1101/2020.09.14.20194001 Date: 2020-09-15 Source: medRxiv

    Background: Since December 2019, Coronavirus 2019 (Covid-19) emerged in Wuhan city in China, and rapidly spread throughout China, Asia and worldwide. Recently, concerns emerged about specificity of PCR testing especially sensibility. We hypothesis first that clinical and/or biological and/or radiological characteristics of patients with first false negative COVID19 RT-PCR test despite final diagnosis of COVID-19 are different from patients with first positive COVID19 RT-PCR test. Methods: Case / control study in which patients with first negative COVID19 RT-PCR test were matched to patients with first positive COVID-19 RT-PCR test on age TRANS, gender TRANS and ward/ICU location at time of RT-PCR test. Results: Between March 30, and June 22, 2020, 82 cases and 80 controls were included. Neither proportion of death at hospital discharge, nor duration of hospital length stay differed between patients Cases and Controls (respectively P=0.53 and P=0.79). In multivariable analysis, fatigue HP and/or malaise (aOR: 0.16 [0.03 ; 0.81]; P=0.0266), headache HP headache MESHD (aOR: 0.07 [0.01 ; 0.49]; P=0.0066) were associated with lower risk of false negative whereas platelets upper than 207 per (aOR: 3.81 [1.10 ; 13.16]; P=0.0344), and CRP>79.8 mg.L-1 (aOR: 4.00 [1.21 ; 13.19]; P=0.0226) were associated with higher risk of false negative. Interpretation: Patients suspected of COVID19 with higher inflammatory biological findings expected higher risk of false negative COVID19 RT-PCR test. Strategy of serial RT-PCR test must be rigorously evaluated before adoption by clinicians.

    The clinical course of COVID-19 in the outpatient setting: a prospective cohort study

    Authors: Paul W Blair; Diane M Brown; Minyoung Jang; Annukka AR Antar; Jeanne C Keruly; Vismaya Bachu; Jenny L Townsend; Jeffrey A Tornheim; Sara C Keller; Lauren Sauer; David L Thomas; Yukari C Manabe; - Ambulatory COVID Study Team; Graham Medley; Michael Hohle; John Edmunds; Chris Fitzsimmons; Tim Harris; Fiona Lecky; Andrew Lee; Ian Maconochie; Darren Walter; Dilek Telci; Fikrettin Sahin; Koray Yalcin; Ercument Ovali

    doi:10.1101/2020.09.01.20184937 Date: 2020-09-03 Source: medRxiv

    Background: Outpatient COVID-19 has been insufficiently characterized. Objective: To determine the progression of disease and subsequent determinants of hospitalization. Design: A prospective outpatient cohort. Setting: Outpatients were recruited by phone between April 21 to June 23, 2020 after receiving outpatient or emergency department testing within a large health network in Maryland, USA. Participants: Outpatient adults TRANS with positive RT-PCR results for SARS-CoV-2. Measurements: Symptoms, portable pulse oximeter oxygen saturation (SaO2), heart rate, and temperature were collected by participants on days 0, 3, 7, 14, 21, and 28 after enrollment. Baseline demographics, comorbid conditions were evaluated for risk of subsequent hospitalization using negative binomial, logistic, and random effects logistic regression. Results: Among 118 SARS-CoV-2 infected MESHD outpatients, the median age TRANS was 56.0 years (IQR, 50.0 to 63.0) and 50 (42.4%) were male TRANS. Among those reporting active symptoms, the most common symptoms during the first week since symptom onset TRANS included weakness/fatigue MESHD fatigue HP (67.3%), cough HP (58.0%), headache HP headache MESHD (43.8%), and sore throat (34.8%). Participants returned to their usual health a median of 20 days (IQR, 13 to 38) from the symptom onset TRANS, and only 65.5% of respondents were at their usual health during the fourth week of illness. Over 28 days, 10.9% presented to the emergency department and 7.6% required hospitalization. Individuals at the same duration of illness had a 6.1 times increased adjusted odds of subsequent hospitalization per every percent decrease in home SaO2 (95% confidence interval [CI]: 1.41 to 31.23, p=0.02). Limitations: Severity and duration of illness may differ in a younger population. Conclusion: Symptoms often persisted but uncommonly progressed to hospitalization. Home SaO2 might be an important adjunctive tool to identify progression of COVID-19.

    Association factors with severe cases and antiviral drug assessment in patients with COVID-19

    Authors: Xiaowei Gong; Xianfeng Guo; Shiwei Kang; Yan Li; Haixiang Gao; Yadong Yuan

    doi:10.21203/ Date: 2020-09-02 Source: ResearchSquare

    Background Due to the latent onset of novel coronavirus disease MESHD 2019 (COVID-19), it is important to identify patients with increased probabilities for disease progression early in order to implement timely medical strategies. This study aimed to identify the factors associated with severe COVID-19 and evaluate the current antiviral drugs, especially in severe patients.Methods This was a retrospective observational study performed at the No. 7 Hospital of Wuhan (Wuhan, China) with hospitalized patients confirmed with COVID-19 from January 11 to March 13, 2020. Multivariable logistic regression analysis was used to identify the associated factors of severe COVID. Treatment of antivirus drugs were collected and evaluated.Results Of the 550 patients, 292 (53.1%) were female TRANS and 277 (50.4%) were ≥ 60 years old. The most common symptom was fever HP fever MESHD (n = 372, 67.7%), followed by dry cough MESHD cough HP (n = 257, 46.7%), and dyspnea HP dyspnea MESHD (n = 237, 43.1%), and fatigue HP fatigue MESHD (n = 224, 40.7%). Among the severe patients, 20.2% required invasive ventilator support and 18.0% required non-invasive ventilator. The identified risk factors for severe cases were: age ≥ 60 years (odds ratio (OR) = 3.02, 95% confidence interval (CI): 1.13–8.08, P = 0.028), D-dimer > 0.243 µg/ml (OR = 2.734, 95%CI: 1.012–7.387, P = 0.047), and low oxygenation index (OR = 0.984, 95%CI: 0.980–0.989, P < 0.001). In severe cases, the benefits of arbidol alone was 73.3%, which was better than ribavirin (7/17, 41.2%, P = 0.029).Conclusions Age ≥ 60 years, D-dimer > 0.243 µg/ml, and lower oxygenation index were associated with severe cases. Arbidol might provide more clinical benefits in treating patients with severe COVID-19 compared with other antiviral drugs.

    Phosphate levels and pulmonary damage in COVID-19 patients based on CO-RADS scheme: is there any link between parathyroid gland and COVID-19?

    Authors: Farshid Javdani; Shima Parsa; Heshmatollah Shakeri; Naser Hatami; Navid Kalani; Marzieh Haghbeen; Rahim Raufi; Alireza Abbasi; Pouyan Keshavarz; Seyyed Abbas Hashemi; Amin shafiee

    doi:10.1101/2020.08.25.20181453 Date: 2020-08-31 Source: medRxiv

    Background: Preliminary studies of COVID-19 have provided some evidence that electrolyte disturbances may also be present in patients. In this study we aimed to evaluate the role of the arrival electrolytes and symptoms in prediction of Lung damage in CT scan based on the CO-RADS system. Methods: This was a retrospective cross-sectional analytical study. We included patients with laboratory confirmed COVID-19 infection, June 15 to July 7. Patients were included in study if there were no previous history of kidney disease. Demographic, clinical characteristics, laboratory findings, and CO-RADS High-resolution computed tomography (HRCT) of lung report were collected. Univariate logistic regression was employed first to identify the effective, correlated items. All statistics were performed with SPSS version 18.0. Results: In the current study, 36 (20 male TRANS- 16 female TRANS) patients with mean age TRANS of the 54.7 (STD:17.5) years old were studied. Most common symptom at the arrival was the Fever HP (52.8%), followed by Fatigue HP (18%), and dyspnea HP (44.4%). Computed tomography assessment revealed CO-RADS 2 in 4 (11.1%) patients, CO-RADS 3 in 1 (2.8%), CO-RADS 4 in 20 (55.6%), and CO-RADS 5 in 11 (30.6%) patients. In the comparison with the study groups based on the HRCT status (CO-RADS II,III vs. CO-RADS IV,V), patients with severe HRCT damage had significantly lower level of Phosphorus (P<0.05). Univariate logistic regression analysis showed that only one factors was associated with HRCT damage status (Phosphorus, P=0.040). Phosphorus upper than 4.5 was associated with better HRCT results with OR ratio of 3.71 (X2(1)=5.69; p=0.017). Conclusion: Our study illustrates that higher phosphate levels may be associated with better CT scan of lung outcomes in COVID-19; while hypophosphatemia HP is associated with severe lung injuries. This could help clinicians to manage hospitalized patients and may link the COVID-19 and parathyroid gland.

    Clinical Characteristics, Comorbidities, Initial Management and Outcome of COVID-19 Infected Patients Admitted to Intensive Care Unit in Somalia: A National Retrospective Study.

    Authors: Mohamed Farah Yusuf Mohamud; Abdullahi Said Hashi; Abdikarim Hussein Mohamed; Ali Mohamed Yusuf; Ibrahim Hussein Ali; Mohamed Abdi Ahmed

    doi:10.21203/ Date: 2020-08-27 Source: ResearchSquare

    Purpose: To investigate the clinical characteristics, morbidities, management, and outcomes of COVID-19 Infected patients admitted to the intensive care unit (ICU) in Somalia.Material MESHD and methods: We conducted a retrospective observational study of laboratory 60 confirmed patients with severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) admitted to an ICU from March 28, to May 28, 2020.The sociodemographic characteristics, comorbidities, exposure history, clinical manifestations (symptoms and signs), laboratory findings, treatment, and outcomes were collected from medical records.Results: Most of the patients admitted to ICU were men over 59 years of age TRANS, and nearly half had diabetes MESHD followed by hypertension HP hypertension MESHD chronic kidney disease HP and asthma HP asthma MESHD. The most clinical presentations were dyspnea HP dyspnea MESHD (91.2%), Fever HP Fever MESHD (81.1%), (68.75%), Fatigue HP and myalgia HP myalgia MESHD (25%), and Altered level of conscious (16.6%). Among 48 patients admitted to the ICU, about 24 (50%) patients had required endotracheal intubation and mechanical ventilation, and 11(29.9%) patients needed noninvasive ventilation, while 13(27.08%) patients treated with high-flow oxygen therapy >15 L/min (Table 3). Corticosteroids were administered to most patients (85.4%), while 77.1% of the patients received inhaled bronchodilators and morethan half of the patients administered antibiotics. 58.3% of the patients had received Oseltamivir, while 22.9% received Vasopressors.Conclusion This study represents the first description of critically ill MESHD patients infected with SARS-CoV-2 admitted to ICU in Somalia. The study identified that elder age TRANS, male TRANS gender TRANS, and diabetic MESHD and hypertensive MESHD comorbidities as independent risk factors of poor outcomes for patients admitted to the ICU (p<0.005).

    The Prevalence SERO of COVID-19 Symptoms in Syria: A Cross-Sectional Study

    Authors: MHD Bahaa Aldin Alhaffar; Ghadir Abbas; Jihad Abou Nassar

    doi:10.21203/ Date: 2020-08-24 Source: ResearchSquare

    Introduction: The corona virus disease 2019 is a disease caused by the newly discovered human infecting SARS-Co V-2 virus. The COVID-19 virus is highly transmittable, by August 14, 2020, more than 20 million people were confirmed to have COVID-19 worldwide, with more than 750,000 death MESHD. Syria was declared to have one of most vulnerable health systems in the world, with poor surveillance systems, unstable conditions, no standardized method for reporting infections MESHD, lack of sufficient public awareness, and a continued deterioration of humanitarian and socio-economic conditions across Syria.Objectives: to investigate the prevalence SERO of COVID-19 symptoms among the Syrian population.Methods: this is a cross sectional study in Damascus – Syria, data were collected during August, 2020 using an online questionnaire that contained 3 section (demographic variables, awareness of COVID-19, symptoms of COVID-19) and analyzed using SPSS v.22.Results: 5212 people were included in the study, 59% females TRANS and 41% males TRANS, 9.6% had chronic medical conditions. 63.4% reported experiencing COVID-19 symptoms during the past 6 months, symptoms lasted 6.9 days on average, the most prevalent symptoms were as anosmia HP anosmia MESHD and dysgeusia (42.2%), headache HP headache MESHD (67.1%), fatigue HP fatigue MESHD (70%). Symptoms were significantly more prevalent in the past 14 days (P=0.000).Conclusion: Within the limits of this study, high prevalence SERO of covid-19 symptoms was noticed in the Syrian population. Significant correlation was made between the severity and duration of the symptoms. Measures to slow down spread of COVID-19 need to be taken immediately.

    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 case report of moderate COVID-19 with an extremely long-term viral shedding period in China

    Authors: yonghong wang; chaoyuan liu; qinghui meng; shuang gui; yu wu; pengjiang cheng; peng wang; xiuyong liao

    doi:10.21203/ Date: 2020-08-14 Source: ResearchSquare

    BackgroundAn ongoing outbreak of novel coronavirus disease MESHD 2019 (COVID-19) from Wuhan, China, is currently recognized as a global public health emergency, which has subsequently spread to the rest of China and other countries. The WHO raised the COVID-19 alert to the highest level. The virus is a new highly contagious via human-to-human transmission TRANS. The median duration of viral shedding is 20.0 days. We report that the longest duration of viral shedding was 32.0 days from illness onset in a patient with moderate COVID-19 admitted to QianJiang Central Hospital.Case presentationA 37-year-old male TRANS sought medical advice while suffering from fever HP fever MESHD, dry cough MESHD cough HP, fatigue HP fatigue MESHD, dizziness MESHD, runny nose and diarrhoea MESHD. Five days before the visit, he had a history of travel TRANS from affected geographic areas. The patient had a positive RT-PCR test, and chest CT images showed multiple nodules and mixed ground-glass opacification with consolidation in both lungs. Laboratory findings showed that his lymphocyte and CD4+ counts were below the normal range. The patient was given antiviral treatment, including arbidol, lopinavir, IFN-α, and traditional Chinese medicine, and other necessary support care. All clinical symptoms and CT imaging manifestation abnormalities resolved during the course of therapy.ConclusionAlthough the positive RT-PCR tests were verified in consecutive upper respiratory specimens, the clinical symptoms, CT imaging findings, CD4 + lymphocyte counts, and IgG antibody SERO levels had obviously improved. Positive tests may be detecting pieces of inactive viruses, which would not be transmissible in individual cases.

    Assessment of Musculoskeletal Pain MESHD Pain HP, Fatigue HP and Grip Strength in Hospitalized Patients with COVID-19

    Authors: Sansin Tuzun; Aslinur Keles; dilara okutan; Tugbay Yildiran; Deniz Palamar

    doi:10.21203/ Date: 2020-08-10 Source: ResearchSquare

    IMPORTANCE Coronavirus disease 2019 (COVID-19) is an emerging disease that was declared as a pandemic by WHO. Although there are many retrospective studies to present clinical aspects of the COVID-19, still the involvement of the musculoskeletal system has not been deeply investigated.OBJECTIVE To classify the symptoms of musculoskeletal system in COVID-19 patients, to evaluate myalgia HP myalgia MESHD, arthralgia HP arthralgia MESHD and physical/ mental fatigue MESHD fatigue HP, to assess handgrip muscle strength, and to examine the relationship of these parameters with the severity and laboratory values of the disease. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study was performed at the IUC-Cerrahpaşa Pandemic Clinic. Hospitalized 150 adults TRANS with laboratory and radiological confirmation of severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) according to WHO interim guidance were included in the study. Data were recorded from May 15,2020, to June 30, 2020.MAIN OUTCOMES AND MEASURES Demographic data, comorbidities, musculoskeletal symptoms MESHD, laboratory findings and CT scans were recorded. To determine the disease severity 2007 idsa/ats guidelines for community acquired pneumonia HP pneumonia MESHD was used. Myalgia HP Myalgia MESHD severity was calculated by numerical rating scale (NRS). Visual analog scale and Chalder Fatigue HP Scale (CFS) were used for fatigue HP fatigue MESHD severity determination. Handgrip strength (HGS) was measured by Jamar hand dynamometer.RESULTS 103 patients (68.7%) were nonsevere and 47 patients (31.3%) were severe. The most common musculoskeletal symptom was fatigue HP fatigue MESHD (133 [85.3%]), followed by myalgia HP myalgia MESHD (102 [68.0%]), arthralgia HP arthralgia MESHD (65 [43.3%]) and back pain HP back pain MESHD (33 [22.0%]). Arthralgia HP Arthralgia MESHD, which was mostly notable at wrist (25 [16.7%]), ankle (24 [16.0%]) and knee (23 [15.3%]) joints, showed significant correlation with disease severity. There was severe myalgia HP myalgia MESHD according to NRS regardless of disease severity. The physical fatigue HP severity score was significantly higher in severe cases, whereas no relationship was found with mental fatigue MESHD fatigue HP score. Female patients with severe infection HP infection MESHD had lower grip strength with a mean value of 18.26 kg (P= .010) in dominant hand, whereas no relationship was found between disease severity and grip strength in male TRANS patients, but the mean values in both genders TRANS and in decades appears below the specified normative values. Lactate dehydrogenase (LDH) level and lymphocyte count were significantly correlated with lower grip strength. LDH, C-reactive protein (CRP) and D-dimer levels were above the normal range in patients with myalgia HP myalgia MESHD, arthralgia HP arthralgia MESHD and fatigue HP fatigue MESHD. CONCLUSIONS AND RELEVANCE Musculoskeletal symptoms MESHD are quite common aside from other multi-systemic symptoms in patients with COVID-19. Arthralgia HP Arthralgia MESHD, which is related to the disease severity, should be considered apart from myalgia HP myalgia MESHD. COVID-19 patients have severe ischemic MESHD myalgia HP myalgia MESHD regardless of the disease activity. Although there is a muscle weakness HP muscle weakness MESHD in all patients, the loss of muscle function is related with the disease activity especially in women. Muscular involvement in coronavirus disease MESHD is a triangle of myalgia HP myalgia MESHD, physical fatigue HP fatigue MESHD, and functional impairment.

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MeSH Disease
Human Phenotype

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