Corpus overview


MeSH Disease

Obesity (34)

Disease (16)

Death (15)

Hypertension (14)

Infections (9)

Human Phenotype


    displaying 1 - 10 records in total 34
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    Outcomes of COVID-19 related hospitalisation among people with HIV in the ISARIC WHO Clinical Characterisation Protocol UK Protocol: prospective observational study

    Authors: Anna Maria Geretti; Alexander Stockdale; Sophie Kelly; Muge Cevik; Simon Collins; Laura Waters; Giovanni Villa; Annemarie B Docherty; Ewen M Harrison; Lance Turtle; Peter JM Openshaw; Kenneth Baillie; Caroline Sabin; Malcolm Gracie Semple

    doi:10.1101/2020.08.07.20170449 Date: 2020-08-11 Source: medRxiv

    Background. There is conflicting evidence about how HIV infection MESHD influences COVID-19. We compared the presentation characteristics and outcomes of people with and without HIV hospitalised with COVID-19 at 207 centres across the United Kingdom. Methods. We analysed data from people with laboratory confirmed or highly likely COVID-19 enrolled into the ISARIC CCP-UK study. The primary endpoint was day-28 mortality after presentation. We used Kaplan-Meier methods and Cox regression to describe the association with HIV status after adjustment for sex, ethnicity, age TRANS, indeterminate/probable hospital acquisition of COVID-19 (definite hospital acquisition excluded), presentation date, and presence/absence of ten comorbidities. We additionally adjusted for disease MESHD severity at presentation as defined by hypoxia MESHD/oxygen therapy. Findings. Among 47,539 patients, 115 (0.24%) had confirmed HIV-positive status and 103/115 (89.6%) had a record of antiretroviral therapy. At presentation, relative to the HIV-negative group, HIV-positive people were younger (median 55 versus 74 years; p<0.001), had a higher prevalence SERO of obesity MESHD obesity HP and moderate/severe liver disease MESHD, higher lymphocyte counts and C-reactive protein, and more systemic symptoms. The cumulative incidence of day-28 mortality was 25.2% in the HIV-positive group versus 32.1% in the HIV-negative group (p=0.12); however, stratification for age TRANS revealed a higher mortality among HIV-positive people aged TRANS below 60 years. The effect of HIV-positive status was confirmed in adjusted analyses (adjusted hazard ratio [HR] 1.49, 95% confidence interval [CI] 0.99-2.25; p=0.06). Following additional adjustment for disease MESHD severity at presentation, mortality was higher in HIV-positive people (adjusted HR 1.63; 95% CI 1.07-2.48; p=0.02). In the HIV-positive group, mortality was more common among those who were slightly older and among people with obesity MESHD obesity HP and diabetes with complications MESHD. Interpretation. HIV-positive status may be associated with an increased risk of day-28 mortality following a COVID-19 related hospitalisation.

    Comorbidities associated with regional variations in COVID-19 mortality revealed by population-level analysis

    Authors: Hongxing Yang; Fei Zhong

    doi:10.1101/2020.07.27.20158105 Date: 2020-07-29 Source: medRxiv

    Coronavirus disease MESHD 2019 (COVID-19), caused by severe acute respiratory syndrome MESHD coronavirus 2 (SARS-Cov-2), has developed into a global health crisis. Understanding the risk factors for poor outcomes of COVID-19 is thus important for successful management and control of the pandemic. However, the progress and severity of the epidemic across different regions show great differentiations. We hypothesized the origination of these differences are based on location-dependent variations in underlying population-wide health factors. Disease MESHD prevalence SERO or incidence data of states and counties of the United States were collected for a group of chronic diseases MESHD, including hypertension MESHD hypertension HP, diabetes, obesity MESHD obesity HP, stroke MESHD stroke HP, coronary heart disease MESHD, heart failure MESHD, physical inactivation, and common cancers (e.g., lung, colorectal, stomach, kidney and renal). Correlation and regression analysis identified the prevalence SERO of heart failure MESHD as a significant positive factor for region-level COVID-19 mortality. Similarly, the incidence of gastric cancer and thyroid cancer were also identified as significant factors contributing to regional variation in COVID-19 mortality. To explore the implications of these results, we re-analyzed the RNA-seq data for stomach adenocarcinoma MESHD (STAD) and colon carcinoma MESHD carcinoma HP (COAD) from The Cancer Genome Atlas (TCGA) project. We found that expression of genes in the immune response pathways were more severely disturbed in STAD than in COAD, implicating higher probability for STAD patients or individuals with precancerous chronic stomach diseases MESHD to develop cytokine storm once infected with COVID-19. Taken together, we conclude that location variations in particular chronic diseases MESHD and cancers contribute significantly to the regional variations in COVID-19 mortality.

    A Bayesian Framework for Estimating the Risk Ratio of Hospitalization for People with Comorbidity Infected by the SARS-CoV-2 Virus

    Authors: Xiang Gao; Qunfeng Dong

    doi:10.1101/2020.07.25.20162131 Date: 2020-07-28 Source: medRxiv

    Estimating the hospitalization risk for people with certain comorbidities infected by the SARS-CoV-2 virus is important for developing public health policies and guidance based on risk stratification. Traditional biostatistical methods require knowing both the number of infected people who were hospitalized and the number of infected people who were not hospitalized. However, the latter may be undercounted, as it is limited to only those who were tested for viral infection MESHD. In addition, comorbidity information for people not hospitalized may not always be readily available for traditional biostatistical analyses. To overcome these limitations, we developed a Bayesian approach that only requires the observed frequency of comorbidities in COVID-19 patients in hospitals and the prevalence SERO of comorbidities in the general population. By applying our approach to two different large-scale datasets in the U.S., our results consistently indicated that cardiovascular diseases MESHD carried the highest hospitalization risk for COVID-19 patients, followed by diabetes, chronic respiratory disease MESHD, hypertension MESHD hypertension HP, and obesity MESHD obesity HP, respectively.

    The impact of COVID-19 on patients with asthma MESHD asthma HP: A Big Data analysis

    Authors: Jose Luis Izquierdo; Carlos Almonacid; Yolanda Gonzalez; Carlos Del Rio-Bermudez; Julio Ancochea; Remedios Cardenas; Joan B Soriano

    doi:10.1101/2020.07.24.20161596 Date: 2020-07-24 Source: medRxiv

    Background: From the onset of the COVID-19 pandemic, an association between the severity of COVID-19 and the presence of certain medical chronic conditions has been suggested. However, unlike influenza and other viruses, the burden of the disease MESHD in patients with asthma MESHD asthma HP has been less evident. Objective: This study aims at a better understanding of the burden of COVID-19 in patients with asthma MESHD asthma HP and the impact of asthma MESHD asthma HP, its related comorbidities, and treatment on the prognosis of COVID-19. Methods: We analyzed clinical data from patients with asthma MESHD asthma HP from January 1st to May 10th, 2020 using big data analytics and artificial intelligence through the SAVANA Manager clinical platform. Results: Out of 71,192 patients with asthma MESHD asthma HP, 1,006 (1.41%) suffered from COVID-19. Compared to asthmatic individuals without COVID-19, patients with asthma MESHD asthma HP and COVID-19 were significantly older (55 vs. 42 years), predominantly female TRANS (66% vs. 59%), had higher prevalence SERO of hypertension MESHD hypertension HP, dyslipidemias MESHD, diabetes, and obesity MESHD obesity HP, and smoked more frequently. Contrarily, allergy HP-related factors such as rhinitis MESHD rhinitis HP and eczema MESHD eczema HP were less frequent in asthmatic patients with COVID-19 (P < .001). Higher prevalence SERO of hypertension MESHD hypertension HP, dyslipidemia, diabetes, and obesity MESHD obesity HP was also confirmed in those patients with asthma MESHD asthma HP and COVID-19 who required hospital admission. The percentage of individuals using inhaled corticosteroids (ICS) was lower in patients who required hospitalization due to COVID-19, as compared to non-hospitalized patients (48.3% vs. 61.5%; OR: 0.58: 95% CI 0.44-0.77). During the study period, 865 (1.21%) patients with asthma MESHD asthma HP were being treated with biologics. Although these patients showed increased severity and more comorbidities at the ear, nose, and throat (ENT) level, their hospital admission rates due to COVID-19 were relatively low (0.23%). COVID-19 increased inpatient mortality in asthmatic patients (2.29% vs 0.54%; OR 2.29: 95% CI 4.35-6.66). Conclusion: Our results indicate that the number of COVID-19 cases in patients with asthma MESHD asthma HP has been low, although higher than the observed in the general population. Patients with asthma MESHD asthma HP and COVID-19 were older and were at increased risk due to comorbidity-related factors. ICS and biologics are generally safe and may be associated with a protective effect against severe COVID-19 infection MESHD.

    Municipality- level predictors of COVID-19 mortality in Mexico: a cautionary tale

    Authors: Alejandra Contreras-Manzano; Carlos M Guerrero-Lopez; Mercedes Aguerrebere; Ana Cristina Sedas; Hector Lamadrid-Figueroa

    doi:10.1101/2020.07.11.20151522 Date: 2020-07-14 Source: medRxiv

    Background. Inequalities and burden of comorbidities of the Coronavirus disease MESHD 2019 (COVID-19) vary importantly inside the countries. We aimed to analyze the Municipality-level factors associated with a high COVID-19 mortality rate of in Mexico. Methods. We retrieved information from 142,643 cumulative confirmed symptomatic cases and 18,886 deaths MESHD of COVID-19 as of June 20th, 2020 from the publicly available database of the Ministry of Health of Mexico. Public official data of the most recent census and surveys of the country were used to adjust a negative binomial regression model with the quintiles (Q) of the distribution of sociodemographic and health outcomes among 2,457 Municipality-level. Expected Mortality Rates (EMR), Incidence Rate Ratios (IRR) and 95% Confidence Intervals are reported. Results. Factors associated with high MR of COVID-19, relative to Quintile 1 (Q1), were; diabetes prevalence SERO (Q4, IRR=2.60), obesity MESHD obesity HP prevalence SERO (Q5, IRR=1.93), diabetes mortality rate (Q5, IRR=1.58), proportion of indigenous population (Q2, IRR=1.68), proportion of economically active population (Q5, IRR=1.50), density of economic units that operate essential activities (Q4, IRR=1.54) and population density (Q5, IRR=2.12). We identified 1,351 Municipality-level without confirmed COVID-19 deaths MESHD, of which, 202 had nevertheless high (Q4, Mean EMR= 8.0 deaths MESHD per 100,000) and 82 very high expected COVID-19 mortality (Q5, Mean EMR= 13.8 deaths MESHD per 100,000). Conclusion. This study identified 1,351 Municipality-level of Mexico that, in spite of not having confirmed COVID-19 deaths MESHD yet, share characteristics that could eventually lead to a high mortality scenario later in the epidemic and warn against premature easing of mobility restrictions. Local information should be used to reinforce strategies of prevention and control of outbreaks in communities vulnerable to COVID-19. Keywords: COVID-19; risk factors; social determinants; health determinants; Municipality-level; counties.

    The COVID-19 mortality effects of underlying health conditions in India: a modelling study

    Authors: Paul Novosad; Radhika Jain; Alison Campion; Sam Asher

    doi:10.1101/2020.07.05.20140343 Date: 2020-07-08 Source: medRxiv

    Objective: To model how known COVID-19 comorbidities will affect mortality rates and the age TRANS distribution of mortality in a large lower middle income country (India), as compared with a high income country (England), and to identify which health conditions drive any differences. Design: Modelling study. Setting: England and India. Participants: 1,375,548 respondents aged TRANS 18 to 99 to the District Level Household Survey-4 and Annual Health Survey in India. Additional information on health condition prevalence SERO on individuals aged TRANS 18 to 99 was obtained from the Health Survey for England and the Global Burden of Diseases MESHD, Risk Factors, and Injuries Studies (GBD). Main outcome measures: The primary outcome was the proportional increase in age TRANS-specific mortality in each country due to the prevalence SERO of each COVID-19 mortality risk factor (diabetes, hypertension MESHD hypertension HP, obesity MESHD obesity HP, chronic heart disease MESHD, respiratory illness, kidney disease MESHD, liver disease MESHD, and cancer, among others). The combined change in overall mortality and the share of deaths MESHD under 60 from the combination of risk factors was estimated in each country. Results: Relative to England, Indians have higher rates of diabetes (10.6% vs. 8.5%), chronic respiratory disease MESHD (4.8% vs. 2.5%), and kidney disease MESHD (9.7% vs. 5.6%), and lower rates of obesity MESHD obesity HP (4.4% vs. 27.9%), chronic heart disease MESHD (4.4% vs. 5.9%), and cancer (0.3% vs. 2.8%). Population COVID-19 mortality in India relative to England is most increased by diabetes (+5.4%) and chronic respiratory disease MESHD (+2.3%), and most reduced by obesity MESHD obesity HP (-9.7%), cancer (-3.2%), and chronic heart disease MESHD (-1.9%). Overall, comorbidities lower mortality in India relative to England by 9.7%. Accounting for demographics and population health explains a third of the difference in share of deaths MESHD under age TRANS 60 between the two countries. Conclusions: Known COVID-19 health risk factors are not expected to have a large effect on aggregate mortality or its age TRANS distribution in India relative to England. The high share of COVID-19 deaths MESHD from people under 60 in low- and middle-income countries (LMICs) remains unexplained. Understanding mortality risk associated with health conditions prevalent in LMICs, such as malnutrition MESHD malnutrition HP and HIV/AIDS, is essential for understanding differential mortality. Keywords: COVID-19, India, low- and middle-income countries, comorbidity

    A phenome-wide association study (PheWAS) of COVID-19 outcomes by race using the electronic health records data in Michigan Medicine

    Authors: Maxwell Salvatore; Tian Gu; Jasmine A. Mack; Swaraaj Prabhu Sankar; Snehal Patil; Thomas S. Valley; Karandeep Singh; Brahmajee K. Nallamothu; Sachin Kheterpal; Lynda Lisabeth; Lars G. Fritsche; Bhramar Mukherjee

    doi:10.1101/2020.06.29.20141564 Date: 2020-07-01 Source: medRxiv

    Blacks/African Americans are overrepresented in the number of hospitalizations and deaths MESHD from COVID-19 in the United States, which could be explained through differences in the prevalence SERO of existing comorbidities. We performed a disease MESHD- disease MESHD phenome-wide association study (PheWAS) using data representing 5,698 COVID-19 patients from a large academic medical center, stratified by race. We explore the association of 1,043 pre-occurring conditions with several COVID-19 outcomes: testing positive, hospitalization, ICU admission, and mortality. Obesity MESHD Obesity HP, iron deficiency anemia MESHD iron deficiency anemia HP and type II diabetes were associated with susceptibility in the full cohort, while ill-defined descriptions/complications of heart disease MESHD and stage III chronic kidney disease HP kidney disease MESHD were associated among non-Hispanic White (NHW) and non-Hispanic Black/African American (NHAA) patients, respectively. The top phenotype hits in the full, NHW, and NHAA cohorts for hospitalization were acute renal failure, hypertension MESHD hypertension HP, and insufficiency/ arrest respiratory HP failure, respectively. Suggestive relationships between respiratory issues and COVID-19-related ICU admission and mortality were observed, while circulatory system diseases MESHD showed stronger association in NHAA patients. We were able to replicate some known comorbidities related to COVID-19 outcomes while discovering potentially unknown associations, such as endocrine/metabolic conditions related to hospitalization and mental disorders related to mortality, for future validation. We provide interactive PheWAS visualization for broader exploration.

    Why Has COVID-19 Mortality Been Higher in Certain Countries Than Others? An Ecological Analysis of 204 Countries

    Authors: Chris Kenyon

    id:10.20944/preprints202006.0246.v1 Date: 2020-06-21 Source:

    Background: It is unclear why certain countries have been more severely affected by COVID-19 than other countries. Methods: In this ecological study we compared COVID-19 mortality and incidence/100,000 as well as 4 putative explanatory factors by WHO world region. Linear regression was then used to assess the country-level predictors of COVID-19 mortality/100,000 and incidence/100,000 in 204 countries with available data. Results: COVID-19 incidence and mortality/capita were greater in Europe than other regions. This was despite a higher testing rate in Europe than other regions. Europe had an older population than all other regions and a higher prevalence SERO of obesity MESHD obesity HP than Africa, South East Asia and the Eastern Mediterranean. Country level multiple linear regression revealed positive associations between mortality/capita and testing rate, percent of the population 65 years or older, and Europe compared to Western Pacific and South East Asia (all P<0.005). Results for the analyses with cases/100,000 as outcome variable were similar. Conclusion: Our results suggest that older populations as well as other undefined regional and national factors, possibly related to efficacy of control efforts, are responsible for differences in national severity COVID-19 epidemics.

    National Smoking Rates Correlate Inversely with COVID-19 Mortality

    Authors: Michael J Norden; David H. Avery; Justin G Norden; David R Haynor

    doi:10.1101/2020.06.12.20129825 Date: 2020-06-14 Source: medRxiv

    ABSTRACT Introduction: Recent studies show cigarette smokers are markedly under-represented among patients hospitalized for COVID-19 in over a dozen countries. It is unclear if this may be related to confounding factors such as age TRANS distribution, access to care, and inaccurate records. We hypothesized that these concerns could be avoided by studying smoking prevalence SERO in relation to COVID-19 mortality. Since climate has been identified as a factor in COVID-19, we studied groups of countries with relatively comparable temperatures. Methods: The 20 hottest and 20 coldest countries in the Johns Hopkins Mortality Analysis database with a minimum mortality rate of .3 deaths MESHD/100,000 were selected on the basis of the average temperatures of their largest city. Mortality rates were determined as of May 1, 2020 and correlated with national smoking rate adjusting for sex ratio, obesity MESHD obesity HP, temperature, and elderly TRANS population. Results: A highly significant inverse correlation between current daily smoking prevalence SERO and COVID-19 mortality rate was noted for the group of hot countries (R=-.718, p = .0002), cold countries (R=-.567, p=.0046), and the combined group (R=-.324, p=.0207). However, after adjustments only the regression for hot countries and the combined group remained significant. In hot countries, for each percentage point increase in smoking rate mortality decreased by .147 per 100,000 population (95% CI .102- 192, p=.0066). This resulted in mortality rates several-fold elevated in the countries with the lowest smoking rates relative to the highest smoking rates. In the combined group, mortality decreased by .257 per 100,000 population (95% CI .175-.339, p=.0034). Discussion: These findings add support to the finding of an inverse relationship between current smoking and seriously symptomatic COVID-19. However, we conclude that the difference in mortality between the highest and lowest smoking countries appears too large to be due primarily to the effects of smoking per se. A potentially beneficial effect of smoking is surprising, but compatible with a number of hypothetical mechanisms which deserve exploration: 1) Studies show smoking alters ACE2 expression which may affect COVID-19 infection MESHD or its progression to serious lung pathology. 2) Nicotine has anti-inflammatory activity and also appears to alter ACE2 expression. 3) Nitric oxide in cigarette smoke is known to be effective in treating pulmonary hypertension MESHD hypertension HP and has shown in vitro antiviral effects including against SARS-CoV-2. 4) Smoking has complicated effects on the immune system involving both up and down regulation, any of which might alone or in concert antagonize progression of COVID-19. 5) Smokers are exposed to hot vapors which may stimulate immunity in the respiratory tract by various heat-related mechanisms (e.g. heat shock MESHD shock HP proteins). Studies of steam and sauna treatments have shown efficacy in other viral respiratory conditions. At this time there is no clear evidence that smoking is protective against COVID-19, so the established recommendations to avoid smoking should be emphasized. The interaction of smoking and COVID-19 will only be reliably determined by carefully designed prospective study, and there is reason to believe that there are unknown confounds that may be spuriously suggesting a protective effect of smoking. However, the magnitude of the apparent inverse association of COVID-19 and smoking and its myriad clinical implications suggest the importance of further investigation.

    Does COVID-19 Change Dietary Habits and Lifestyle Behaviours in Kuwait?

    Authors: Wafaa Husain; Fatemah Ashkanani

    id:10.20944/preprints202006.0154.v1 Date: 2020-06-12 Source:

    Aim: This study was designed to understand the changes in dietary and lifestyle behaviours that are major determinants of health during the COVID-19 outbreak. Methods: A cross-sectional study was conducted through an online questionnaire using a convenience sample of 415 adults TRANS living in Kuwait ( age TRANS range 18-73 years). Results: The overall prevalence SERO of being overweight MESHD overweight HP and obesity MESHD obesity HP among participants was 37.2% and 33.1% respectively. The study identified significant changes in the dietary habits and lifestyle behaviours of participants during COVID-19. In general, there was an increase in the percentage of participants that consumed four or more meals a day, skipped breakfast, and engaged in frequent late night snacking. Moreover, there was a drastic decrease in the frequency of fast food consumption and an increase in the percentage of participants who had their main meal freshly made. Furthermore, there was a great reduction in physical activity and an increase in the amount of screen time and sedentary behaviours. A notable increase was detected in day-time sleep and a decrease in night-time sleep among participants. Conclusion: This study indicates that due to the increased prevalence SERO of habits conducive to increased rates of being overweight MESHD overweight HP and obesity MESHD obesity HP during the COVID-19 outbreak, there is a high likelihood that the pandemic will further exacerbate the already widespread problem of obesity MESHD obesity HP and being overweight MESHD overweight HP in Kuwait.

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MeSH Disease
Human Phenotype

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