Corpus overview


Overview

MeSH Disease

Human Phenotype

Fever (36)

Cough (28)

Pneumonia (14)

Fatigue (10)

Lymphopenia (7)


Transmission

Seroprevalence
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    Phylogenomic analysis of SARS-CoV-2 genomes from western India reveals unique linked mutations

    Authors: Dhiraj Paul; Kunal Jani; Janesh Kumar; Radha Chauhan; Vasudevan Seshadri; Girdhari Lal; Rajesh Karyakarte; Suvarna Joshi; Murlidhar Tambe; Sourav Sen; Santosh Karade; Kavita Bala Anand; Shelinder Pal Singh Shergill; Rajiv Mohan Gupta; Manoj Kumar Bhat; Arvind Sahu; Yogesh S Shouche

    doi:10.1101/2020.07.30.228460 Date: 2020-07-31 Source: bioRxiv

    India has become the third worst-hit nation by the COVID-19 pandemic caused by the SARS-CoV-2 virus. Here, we investigated the molecular, phylogenomic, and evolutionary dynamics of SARS-CoV-2 in western India, the most affected region of the country. A total of 90 genomes were sequenced. Four nucleotide variants, namely C241T, C3037T, C14408T (Pro4715Leu), and A23403G (Asp614Gly), located at 5UTR, Orf1a, Orf1b, and Spike protein regions of the genome, respectively, were predominant and ubiquitous (90%). Phylogenetic analysis of the genomes revealed four distinct clusters, formed owing to different variants. The major cluster (cluster 4) is distinguished by mutations C313T, C5700A, G28881A are unique patterns and observed in 45% of samples. We thus report a newly emerging pattern of linked mutations. The predominance of these linked mutations suggests that they are likely a part of the viral fitness landscape. A novel and distinct pattern of mutations in the viral strains of each of the districts was observed. The Satara district viral strains showed mutations primarily at the 3' end of the genome, while Nashik district viral strains displayed mutations at the 5' end of the genome. Characterization of Pune strains showed that a novel variant has overtaken the other strains. Examination of the frequency of three mutations i.e., C313T, C5700A, G28881A in symptomatic versus asymptomatic TRANS patients indicated an increased occurrence in symptomatic cases, which is more prominent in females TRANS. The age TRANS-wise specific pattern of mutation is observed. Mutations C18877T, G20326A, G24794T, G25563T, G26152T, and C26735T are found in more than 30% study samples in the age group TRANS of 10-25. Intriguingly, these mutations are not detected in the higher age TRANS range 61-80. These findings portray the prevalence SERO of unique linked mutations in SARS-CoV-2 in western India and their prevalence SERO in symptomatic patients. ImportanceElucidation of the SARS-CoV-2 mutational landscape within a specific geographical location, and its relationship with age TRANS and symptoms, is essential to understand its local transmission TRANS dynamics and control. Here we present the first comprehensive study on genome and mutation pattern analysis of SARS-CoV-2 from the western part of India, the worst affected region by the pandemic. Our analysis revealed three unique linked mutations, which are prevalent in most of the sequences studied. These may serve as a molecular marker to track the spread of this viral variant to different places.

    Estimates of the rate of infection and asymptomatic MESHD asymptomatic TRANS COVID-19 disease MESHD in a population sample from SE England

    Authors: Philippa M Wells; Katie M Doores; Simon Couvreur; Rocio Martin Martinez; Jeffrey Seow; Carl Graham; Sam Acors; Neophytos Kouphou; Stuart Neil; Richard Tedder; Pedro Matos; Kate Poulton; Maria Jose Lista; Ruth Dickenson; Helin Sertkaya; Thomas Maguire; Edward Scourfield; Ruth Bowyer; Deborah Hart; Aoife O'Byrne; Kathryn Steele; Oliver Hemmings; Carolina Rosadas; Myra McClure; Joan Capedevila-Pujol; Jonathan wolf; Sebastien Ourseilin; Matthew Brown; Michael Malim; Timothy Spector; Claire Steves

    doi:10.1101/2020.07.29.20162701 Date: 2020-07-30 Source: medRxiv

    Background: Understanding of the true asymptomatic TRANS rate of infection MESHD of SARS-CoV-2 is currently limited, as is understanding of the population-based seroprevalence SERO after the first wave of COVID-19 within the UK. The majority of data thus far come from hospitalised patients, with little focus on general population cases, or their symptoms. Methods: We undertook enzyme linked immunosorbent assay SERO characterisation of IgM and IgG responses against SARS-CoV-2 spike glycoprotein and nucleocapsid protein of 431 unselected general-population participants of the TwinsUK cohort from South-East England, aged TRANS 19-86 (median age TRANS 48; 85% female TRANS). 382 participants completed prospective logging of 14 COVID-19 related symptoms via the COVID Symptom Study App, allowing consideration of serology alongside individual symptoms, and a predictive algorithm for estimated COVID-19 previously modelled on PCR positive individuals from a dataset of over 2 million. Findings: We demonstrated a seroprevalence SERO of 12% (51participants of 431). Of 48 seropositive individuals with full symptom data, nine (19%) were fully asymptomatic TRANS, and 16 (27%) were asymptomatic TRANS for core COVID-19 symptoms: fever MESHD fever HP, cough MESHD cough HP or anosmia HP. Specificity of anosmia HP for seropositivity was 95%, compared to 88% for fever MESHD fever HP cough MESHD cough HP and anosmia HP combined. 34 individuals in the cohort were predicted to be Covid-19 positive using the App algorithm, and of those, 18 (52%) were seropositive. Interpretation: Seroprevalence SERO amongst adults TRANS from London and South-East England was 12%, and 19% of seropositive individuals with prospective symptom logging were fully asymptomatic TRANS throughout the study. Anosmia HP demonstrated the highest symptom specificity for SARS-CoV-2 antibody SERO response. Funding: NIHR BRC, CDRF, ZOE global LTD, RST-UKRI/MRC

    Early Clinical Factors Predicting the Development of Critical Disease MESHD in Japanese Patients with COVID-19: A Single-Center Retrospective, Observational Study

    Authors: Takatoshi Higuchi; Tsutomu Nishida; Hiromi Iwahashi; Osamu Morimura; Yasushi Otani; Yukiyoshi Okauchi; Masaru Yokoe; Norihiro Suzuki; Masami Inada; Kinya Abe

    doi:10.1101/2020.07.29.20159442 Date: 2020-07-30 Source: medRxiv

    Background: Insufficient evidence of factors predicting the COVID-19 progression from mild to moderate to critical has been established. We retrospectively evaluated risk factors for critical progression in Japanese COVID-19 patients. Method: Seventy-four laboratory-confirmed COVID-19 patients were hospitalized in our hospital between February 20, 2020, and June 10, 2020. We excluded asymptomatic TRANS, non-Japanese, and child TRANS patients. We divided patients into the stable group (SG) and the progression group (PG) (patients requiring mechanical ventilation). We compared the clinical factors in both groups. We established the cutoff values (COVs) for significantly different factors via receiver operating characteristic (ROC) curve analysis and evaluated risk factors by univariate regression. Results: We enrolled 57 COVID-19 patients (median age TRANS 52 years, 56.1% male TRANS). The median progression time from symptom onset TRANS was eight days. Seven patients developed critical disease MESHD (PG: 12.2%), two (3.5%) of whom died; 50 had stable disease MESHD. Univariate logistic analysis identified elevated lactate dehydrogenase (LDH) (COV: 309 U/l), decreased estimated glomerular filtration rate (eGFR) (COV: 68 ml/min), lymphocytopenia (COV: 980/l), and statin use as significantly associated with disease progression MESHD. However, in Cox proportional hazards analysis, lymphocytopenia at symptom onset TRANS was not significant. Conclusions: We identified three candidate risk factors for adult TRANS Japanese patients with mild to moderate COVID-19: statin use, elevated LDH level, and decreased eGFR.

    Prevalence SERO of Anosmia HP and Ageusia MESHD in Patients with COVID-19 at a Primary Health Center, Doha, Qatar

    Authors: Raid Muhmid Al-Ani; DEBASHIS ACHARYA

    doi:10.21203/rs.3.rs-48737/v1 Date: 2020-07-25 Source: ResearchSquare

    Background: Loss of smell and taste are common complaints in patients with the COVID-19 disease MESHD. These symptoms may present alone or with other symptoms. It is of utmost importance to know their rates of occurrence for better controlling of the infection MESHD. Objectives: To detect the prevalence SERO of anosmia HP and ageusia MESHD in individuals with COVID-19 in Al-Wajbah Primary Health Center, Doha, Qatar.Materials and methods: This retrospective study was conducted at Al-Wajbah Primary Health Center, Doha, Qatar. The study covered the two-month period -May and June 2020. The proven cases of COVID-19 by real-time PCR (Polymerase Chain Reaction) were enrolled in the study. Data regarding the age TRANS, gender TRANS, symptomatology including anosmia HP and ageusia MESHD, history of recent travel TRANS, smoking, past history of nasal and paranasal diseases MESHD (NPND), and severity of the disease MESHD were taken from the patients’ records. IBM- SPSS version 22 statistical software was used for the analysis of the data.Results: Out of 141, 35 (24.82%) subject presented with anosmia HP, ageusia MESHD or both. Most of the patients were from age group TRANS >30 year (n=104, 73.76%) with nearly equal gender TRANS. The majority of the individuals were without history of recent travel TRANS (92.2%) and smoking (80.14%). Three-quarters of the patients were asymptomatic TRANS, and 51.06% with a past history of NPND. The male TRANS sex, history of recent travel TRANS, smoking, and severe course of the disease MESHD were positive, highly significant association with anosmia HP or ageusia MESHD. All patients returned to their normal smell and taste sensations within a mean duration of 6.89 days.Conclusion: Loss of taste and smell were common symptomatology of COVID-19 disease MESHD. The males TRANS, recent travel TRANS, smoking, and severe course of the disease MESHD were risk factors of the anosmia HP and ageusia MESHD in COVID-19 cases.

    COVID-19 infection MESHD among healthcare workers: a cross-sectional study in southwest Iran

    Authors: Golnar Sabetian; Mohsen Moghadami; Leila Hashemizadeh Fard Haghighi; Mohammad Javad Fallahi; Reza Shahriarirad; Naeimehossadat Asmarian; Yalda Sadat Moeini

    doi:10.21203/rs.3.rs-47641/v1 Date: 2020-07-22 Source: ResearchSquare

    Objective: With the novel coronavirus pandemic, the impact on the healthcare system and workers cannot be overlooked.  However, studies on the infection MESHD status of medical personnel are still lacking. It is imperative to ensure the safety of health-care workers (HCWs) not only to safeguard continuous patient care but also to ensure they do not transmit the virus, therefore evaluation infection MESHD rates in these groups are indicated.Methods: Demographic and clinical data regarding infected cases among HCWs of Fars, Iran with positive SARS‐CoV‐2 PCR tests were obtained from 10th March to 16th May.Results: Our data demonstrated a rate of 5.62% (273 out of 4854 cases) infection MESHD among HCW, with a mean age TRANS of 35 years and a dominance of female TRANS cases (146 cases: 53.5%). The majority of infected cases were among nurses (51.3%) while the most case infection MESHD rate (CIR) was among physicians (27 out of 842 performed test (3.2%)). Also, the highest rate of infection MESHD was in the emergency MESHD rooms (30.6%). Also, 35.5% of the patients were asymptomatic TRANS and the most frequent clinical features among symptomatic patients were myalgia MESHD myalgia HP (46%) and cough MESHD cough HP (45.5%). Although 5.5% were admitted to hospitals, there were no reports of ICU admission. Furthermore, 10.3% of the cases reported transmitting the infection MESHD to family and friends TRANS. Regarding safety precautions, 1.6% didn't wear masks and 18.7% didn't use gloves in work environments. Conclusion: HCWs are among the highest groups at risk of infection TRANS risk of infection TRANS infection MESHD during the COVID-19 pandemic; therefore, analysis of the infection MESHD status of these groups is vital to maintain enough attention from the public, provide effective suggestions for government agencies and expanding protective measures is essential to decrease infection MESHD rates.

    Initial experience in Mexico with convalescent plasma SERO in COVID-19 patients with severe respiratory failure HP, a retrospective case series

    Authors: Michel F. Martinez-Resendez; Fernando Castilleja-Leal; Alejandro Torres-Quintanilla; Augusto Rojas-Martinez; Gerardo Garcia-Rivas; Rocio Ortiz-Lopez; Victor Trevino; Reynaldo Lara-Medrano; Hiram Villanueva-Lozano; Teresa Ramirez-Elizondo; Victor Sanchez-Nava; Francisco Moreno-Hoyos; Alfonso Martinez-Thomae; Martin Hernandez-Torre; Carlos Diaz-Olachea; Servando Cardona-Huerta; Sylvia de la Rosa-Pacheco; Carlos Diaz-Garza; Paola Reynoso-Lobo; Alma R. Marroquin-Escamilla; Jessica G. Herrera-Gamboa; Fatima M. Alvarado-Monroy; Claudia D. Aguayo-Millan; Francisco F. Villegas-Macedo; Jesus E. Flores-Osorio; Daniel Davila-Gonzalez; Maria E. Diaz-Sanchez; Guillermo Torre-Amione

    doi:10.1101/2020.07.14.20144469 Date: 2020-07-20 Source: medRxiv

    Introduction: Hospital mortality due to COVID-19 in Mexico is high (32%) and as of today, effective treatment options are limited. More effective treatments that shorten hospital stay and reduce mortality are needed. Initial reports for the use of convalescent plasma SERO (CP) therapy for COVID-19 appear promising. We describe a case series of eight patients with impending respiratory failure HP, who underwent CP therapy. Methods: Six male TRANS and two female TRANS ( ages TRANS 31 to 79) patients that were admitted to the intensive-care unit for severe COVID-19 were transfused with two doses of CP (250 mL per dose, anti-SARS-CoV-2 IgG titers > 1:100). Donors were six SARS-CoV-2 infected males TRANS who remained asymptomatic TRANS for > 7 days and were negative for two nasopharyngeal RT-PCR tests. Clinical characteristics, inflammatory and cellular injury markers, chest X-ray findings and viral loads were analyzed before and after CP administration. Viral load association to disease MESHD severity was further analyzed on a separate cohort of asymptomatic TRANS vs hospitalized patients with COVID-19. Results: Eight patients with respiratory failure HP were successfully discharged with a median length of stay of 22.5 (IQR 18.25-29.00). After CP therapy, we observed a reduction of C-reactive protein (CRP) (median, 22.80 mg/dL vs. 1.63 mg/dL), and of procalcitonin (median, 0.27 ng/mL vs. 0.13 ng/mL). High- Sensitivity SERO Cardiac Troponin I (hs-cTnI), Brain Natriuretic Peptide (BNP) and Lactate Dehydrogenase (LDH) were lower, and a mild reduction of pulmonary infiltrates HP by chest X-ray was observed. Lastly, a reduction of viral load was after CP therapy was found. (log, median [IQR], 1.2 [0.70-2.20] vs. 0.25 [0.00-1.78]). We observed no adverse effects. Conclusions: CP could potentially be an effective therapeutic option for patients with severe COVID-19. Clinical benefit needs to be studied further through randomized controlled trials.

    Joint CBC-ICT Interpretation for the pre-surgical screening of COVID 19 asymptomatic TRANS cases: A cross-sectional study

    Authors: Tanzeel Imran; Humera Altaf Naz; Hamza Khan; Ali Haider Bangash; Laraib Bakhtiar Khan; Haroon Khan

    doi:10.1101/2020.07.16.20138354 Date: 2020-07-17 Source: medRxiv

    Background On 26th, February 2020, first cases of COVID 19 were confirmed in Pakistan. Since then, surgeries were halted in a bid to prevent transmission TRANS. However, since such a long halt is infeasible, a general protocol of screening the carriers TRANS, especially asymptomatic TRANS carries, is a dire need of time. The objective of our study is to propose an economically feasible protocol of COVID 19 screening. Simple but effective screening strategies can help to restore the workings of hospital surgical departments. Methods We analyzed the clinical data of patients turning up for elective surgeries at the Rawal General Hospital (RGH), Islamabad from the 24th of March to the 15th of May, 2020. Asymptomatic TRANS patients with negative COVID 19 contact and travel TRANS histories were screened with COVID 19 Immunochromatography (ICT) IgM / IgG Ab Test. Complete blood SERO count (CBC) was done and interpreted in conjunction with the ICT results. Results 39 patients with a mean age TRANS of 49 years were studied. The result of ICT for COVID-19 was positive in 9 cases (23%). The entire positive ICT patients population expressed significantly lower lymphocyte count (p<0.01); 8 patients had high monocyte count (p<0.05) whereas only 4 patients had a combined high neutrophil and monocyte count (P<0.05). All of these four patients with high neutrophil count were females TRANS. The combined interpretation of CBC and ICT IgM / IgG Ab Test had a high accuracy in diagnosing asymptomatic TRANS COVID-19 carriers TRANS that were later confirmed by real-time reverse transcriptase-polymerase chain reaction (rRT-PCR). Conclusion We propose that joint CBC-ICT interpretation should be adopted on a large scale to help in the diagnoses of asymptomatic TRANS carriers TRANS as both tests are simple and inexpensive and thus suit the developing countries limited health budget. Future research projects should be adopted in order to assess the accuracy of the proposed protocol on a large scale. Keywords: COVID-19, Surgery, Asymptomatic TRANS carriers TRANS, ICT, CBC.

    Seroprevalence SERO of Hospital Staff in Province with Zero COVID-19 cases

    Authors: Tanawin Nopsopon; Krit Pongpirul; Korn Chotirosniramit; Wutichai Jakaew; Chuenkhwan Kaewwijit; Sawan Kanchana; Narin Hiransuthikul

    doi:10.1101/2020.07.13.20151944 Date: 2020-07-17 Source: medRxiv

    BACKGROUND. COVID-19 seroprevalence SERO data has been scarce, especially in less developed countries with a relatively low infection MESHD rate. METHODS. A locally developed rapid IgM/IgG test SERO kit was used for screening hospital staff in Ranong hospital which located in a province with zero COVID-19 prevalence SERO in Thailand from April 17 to May 17, 2020. A total of 844 participants were tested; 82 of which were tested twice with one month apart. (Thai Clinical Trials Registry: TCTR20200426002) RESULTS. Overall, 0.8% of the participants (7 of 844) had positive immunoglobulin M (IgM), none had positive immunoglobulin G (IgG). Female TRANS staffs seemed to have higher IgM seropositive than male TRANS staffs (1.0% vs. 0.5%). None of the participants with a history of travel TRANS to the high-risk area or a history of close contact TRANS with PCR-confirmed COVID-19 case had developed antibodies SERO against SARS-CoV-2. Among 844 staff, 811 had no symptom and six of them developed IgM seropositive (0.7%) while 33 had minor symptoms and only one of them developed IgM seropositive (3.0%). No association between IgM antibody SERO against SARS-CoV-2 status and gender TRANS, history of travel TRANS to a high-risk area, history of close contact TRANS with PCR-confirmed COVID-19 case, history of close contact TRANS with suspected COVID-19 case, presence of symptoms within 14 days, or previous PCR status was found. None of the hospital staff developed IgG against SARS-CoV-2. CONCLUSION. COVID-19 antibody test SERO could detect a substantial number of hospital staffs who could be potential silent spreaders in a province with zero COVID-19 case. Antibody testing SERO should be encouraged for mass screening, especially in asymptomatic TRANS healthcare workers.

    Characterization of the SARS-CoV-2 outbreak in the State of Qatar, February 28-April 18, 2020

    Authors: Hanan M Al Kuwari; Hanan F Abdul Rahim; Laith J Abu Raddad; Abdul-Badi Abou-Samra; Zaina Al Kanaani; Abdullatif Al Khal; Einas Al Kuwari; Salih Al Marri; Muna Al Masalmani; Hamad Eid Al Romaihi; Sheikh M Al Thani; Peter Coyle; Ali N Latif; Robert Owen; Roberto Bertollini; Adeel A Butt

    doi:10.1101/2020.07.15.20154211 Date: 2020-07-16 Source: medRxiv

    Objective To define the epidemiologic curve of COVID-19 in Qatar, determine factors associated with severe or critical illness MESHD, and study the temporal relation between public health measures and case finding Design Epidemiologic investigation Setting and Participants All confirmed COVID-19 cases in the State of Qatar between February 28 and April 18, 2020 Main Outcome Measures Number of total and daily new COVID-19 infections MESHD; demographic characteristics and comorbidity burden and severity of infection MESHD; factors associated with severe or critical illness MESHD Results Between February 28 and April 18, 2020 (11:00AM local time), 5,685 cases of COVID-19 were identified. Mean age TRANS (SD) was 35.8(12.0) years, 88.9% were male TRANS and 8.7% were Qatari nationals. Overall, 83.6% had no concomitant comorbidity, and 3.0% had 3 or more comorbidities. The overwhelming majority (90.9%) were asymptomatic TRANS or with minimal symptoms, with 2.0% having severe or critical illness MESHD. Presence of hypertension MESHD hypertension HP or diabetes were associated with a higher risk of severe or critical illness MESHD. Seven deaths MESHD were observed during the time interval studied. The epidemiologic curve indicated two distinct patterns of infection MESHD, a larger cluster among expatriate craft and manual workers, and a smaller one among Qatari nationals returning from abroad during the epidemic. Conclusion COVID-19 infections MESHD in Qatar started in two distinct clusters, but then became more widespread in the population through community transmission TRANS. Infections were mostly asymptomatic MESHD asymptomatic TRANS or with minimal symptoms and associated with very low mortality. Severe/ critical illness MESHD was associated with presence of hypertension MESHD hypertension HP or diabetes.

    Placental SARS-CoV-2 in a patient with mild COVID-19 disease MESHD

    Authors: Albert L. Hsu; Minhui Guan; Eric Johannesen; Amanda J. Stephens; Nabila Khaleel; Nikki Kagan; Breanna C. Tuhlei; Xiu-Feng Wan

    doi:10.1101/2020.07.11.20149344 Date: 2020-07-14 Source: medRxiv

    Background: The full impact of COVID-19 on pregnancy remains uncharacterized. Current literature suggests minimal maternal, fetal, and neonatal morbidity and mortality,1 and COVID-19 manifestations appear similar between pregnant and non-pregnant women.2 We present a case of placental SARS-CoV-2 virus in a woman with an uncomplicated pregnancy and mild COVID-19 disease MESHD. Methods: A pregnant woman was evaluated at University of Missouri Women and Childrens Hospital. Institutional review board approval was obtained; information was obtained from medical records. Reverse transcriptase-polymerase chain reaction (RT-PCR) was performed to detect SARS-CoV-2. A gynecological pathologist examined the placenta and performed histolopathology. Sections were formalin-fixed and paraffin-embedded; slides were cut and subjected to hematoxylin-and-eosin or immunohistochemistry (IHC) staining. IHC was performed with specific monoclonal antibodies SERO to detect SARS-CoV-2 antigen or to identify trophoblasts. Findings: A 29 year-old multigravida presented at 40-4/7 weeks for labor induction. With myalgias MESHD myalgias HP two days prior, she tested positive for SARS-CoV-2. Her parents TRANS were in self-isolation for COVID-19 positivity; husband was asymptomatic TRANS and tested negative for COVID-19, but exposed to a workplace (meatpacking facility) outbreak. Prenatal course was uncomplicated, with no gestational hypertension MESHD hypertension HP. She was afebrile and asymptomatic TRANS with normal vital signs throughout hospitalization. Her myalgias MESHD myalgias HP improved prior to admission. A liveborn male TRANS infant was delivered vaginally. Newborn course was uneventful; he was appropriate for gestational age TRANS, physical was unremarkable, and he was discharged home at 36 hours. COVID-19 RT-PCR test was negative at 24 hours. At one-week follow-up, newborn was breastfeeding well, with no fevers MESHD fevers HP or respiratory distress HP. Overall placental histology is consistent with acute uterine hypoxia MESHD (subchorionic laminar necrosis MESHD) superimposed on chronic uterine hypoxia MESHD (extra-villous trophoblasts and focal chronic villitis). IHC using SARS-CoV-2 nucleocapsid-specific monoclonal antibody SERO demonstrated SARS-CoV-2 antigens throughout the placenta in chorionic villi endothelial cells, and rarely in CK7-expressing trophoblasts. Negative control placenta (November 2019 delivery) and ferret nasal turbinate tissues (not shown) were negative for SARS-CoV-2. Interpretation: In this report, SARS-CoV-2 was found in the placenta, but newborn was COVID-19 negative. Our case shows maternal vascular malperfusion, with no features of fetal vascular malperfusion. To our knowledge, this is the first report of placental COVID-19 despite mild COVID-19 disease MESHD in pregnancy (with no symptoms of COVID-19 aside from myalgias MESHD myalgias HP); specifically, this patient had no fever MESHD fever HP, cough MESHD cough HP, or shortness of breath, but only myalgias MESHD myalgias HP and sick contacts. Despite her having mild COVID-19 disease MESHD in pregnancy, we demonstrate placental vasculopathy and presence of SARS-CoV-2 virus across the placenta. Evidence of placental COVID-19 raises concern for possible placental vasculopathy (potentially leading to fetal growth restriction, pre-eclampsia MESHD eclampsia HP, and other pregnancy complications MESHD) as well as for potential vertical transmission TRANS -- especially for pregnant women who may be exposed to COVID-19 in early pregnancy. Further studies are urgently needed, to determine whether women with mild, pre-symptomatic, or asymptomatic TRANS COVID-19 may have SARS-CoV-2 virus that can cross the placenta, cause fetal vascular malperfusion, and possibly affect the fetus. This raises important public health and public policy questions of whether future pregnancy guidance should include stricter pandemic precautions, such as screening for a wider array of COVID-19 symptoms, increased antenatal surveillance, and possibly routine COVID-19 testing on a regular basis throughout pregnancy.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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