Corpus overview


MeSH Disease

Human Phenotype


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    Morbidity and Mortality Outcomes of Covid-19 Patients With and Without Hypertension HP Hypertension MESHD in Lagos, Nigeria: A Retrospective Cohort Study

    Authors: Akin Osibogun; Akin Abayomi; Oluchi Kanma-Okafor; Jide Idris; Abimbola Bowale; Ololade Wright; Bisola Adebayo; Segun Ogboye; Remi Adeseun; Ismael Abdus-Salam; Bamidele Mutiu; Babatunde Saka; Dayo Lajide; Sam Yenyi; Rotimi Agbolagorite; Oluwatosin Onasanya; Eniola Erinosho; Joshua Obasanya; Olu Adejumo; Sunday Adesola; Yewande Oshodi; IorhenE Akase; Shina Ogunbiyi; Adenike Omosun; Femi Erinoso; Hussein Abdur-Razzaq; Nike Osa; Kingsley Akinroye

    doi:10.21203/ Date: 2020-09-01 Source: ResearchSquare

    Background: The current pandemic of coronavirus disease MESHD (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) has shown epidemiological and clinical characteristics that appear worsened in hypertensive MESHD patients with COVID-19. The morbidity and mortality of the disease among hypertensive MESHD patients in Africa have yet to be well described.Methods: In this retrospective cohort study all confirmed COVID-19 adult TRANS patients (≥18 years of age TRANS) in Lagos between February 27 to July 6 2020 were included. Demographic, clinical and outcome data were extracted from electronic medical records of patients admitted at the COVID-19 isolation centers in Lagos. Outcomes included dying or being discharged by July 6, 2020. Variables were compared between hypertensive MESHD and non-hypertensives MESHD using univariable and multivariable logistic regression, cox regression and Kaplan Meier survival analysis methods to assess hypertension HP hypertension MESHD as a risk factor associated with worsened disease severity and death MESHD.Results: A total of 2075 adults TRANS with COVID-19 were included in this study. The prevalence SERO of hypertension HP hypertension MESHD was 17.8% and it was the most common comorbidity followed by diabetes MESHD (7.2%) and asthma HP asthma MESHD (2.0%). Overall mortality from COVID-19 was 4.2% while mortality among the hypertensives MESHD was 13.7%. Severe symptoms and mortality were significantly higher among the hypertensives MESHD and survival rates were significantly lowered by the presence of an additional comorbidity to 50% from 91% for those with hypertension HP hypertension MESHD alone and from 98% for all other patients (P<0.001). After adjustment for confounders, severe COVID-19 disease and death MESHD were higher for hypertensives MESHD (severe/critical illness: HR=2.41, P=0.001, 95%CI=1.4–4.0, death: HR=2.30, P=0.001, 95%CI=1.2–4.6, for those with hypertension HP hypertension MESHD only). Hypertension HP Hypertension MESHD posed an increased risk of severe morbidity and death MESHD from coronavirus disease MESHD in the presence of other comorbidities (severe/critical illness: HR=3.76, P=0.001, 95%CI=2.1–6.4, death: crude HR=6.63, P=0.001, 95%CI=3.4–1.6, for those with additional comorbidities).Conclusion: The potential morbidity and mortality risks of hypertension HP hypertension MESHD especially with other comorbidities in COVID-19 could help direct efforts towards prevention and prognostication. This provides the rationale for improving preventive caution for people with hypertension HP hypertension MESHD and other comorbidities and prioritizing them for future antiviral interventions.

    Social Determinants Associated with COVID-19 Mortality in the United States

    Authors: Shayom Debopadhaya; Ariella D Sprague; Hongxi Mou; Tiburon L Benavides; Sarah M Ahn; Cole A Reschke; John S Erickson; Kristin P Bennett; Bruno Luciano Carneiro Alves de Oliveira; Carolina Abreu de Carvalho; Érika Bárbara Abreu Fonseca Thomaz; Eudes Alves Simões Neto; Jamesson Ferreira Leite Júnior; Lécia Maria Sousa Santos Cosme; Marcos Adriano Garcia Campos; Rejane Christine de Sousa Queiroz; Sérgio Souza Costa; Vitória Abreu de Carvalho; Vanda Maria Ferreira Simóes; Maria Teresa Seabra Soares de Britto e Alves; Alcione Miranda dos Santos; Alberto Pasqualetto; Maylin Koo; Virginia Esteve; Arnau Antoli; Rafael Moreno; Sergi Yun; Pau Cerda; Mariona Llaberia; Francesc Formiga; Marta Fanlo; Abelardo Montero; David Chivite; Olga Capdevila; Ferran Bolao; Xavier Pinto; Josep Llop; Antoni Sabate; Jordi Guardiola; Josep M Cruzado; Josep Comin-Colet; Salud Santos; Ramon Jodar; Xavier Corbella

    doi:10.1101/2020.08.28.20183848 Date: 2020-09-01 Source: medRxiv

    This study examines social determinants associated with disparities in COVID-19 mortality rates in the United States.Using county-level data, 42 negative binomial mixed models were used to evaluate the impact of social determinants on COVID-19 outcome. First, to identify proper controls, the effect of 24 high-risk factors on COVID-19 mortality rate was quantified. Then, the high-risk terms found to be significant were controlled for in an association study between 41 social determinants and COVID-19 mortality rates. The results describe that ethnic minorities, immigrants, socioeconomic inequalities, and early exposure to COVID-19 are associated with increased COVID-19 mortality, while the prevalence SERO of asthma HP asthma MESHD, suicide, and excessive drinking is associated with decreased mortality. Overall, we recognize that social inequality places disadvantaged groups at risk, which must be addressed through future policies and pro-grams. Additionally, we reveal possible relationships between lung disease MESHD, mental health, and COVID-19 that need to be explored on a clinical level.

    UK prevalence SERO of underlying conditions which increase the risk of severe COVID-19 disease: a point prevalence SERO study using electronic health records

    Authors: Jemma L Walker; Daniel J Grint; Helen Strongman; Rosalind M Eggo; Maria Peppa; Caroline Minassian; Kathryn E Mansfield; Christopher T. Rentsch; Ian J Douglas; Rohini Mathur; Angel Wong; Jennifer K Quint; Nick Andrews; Jamie Lopez Bernal; J Anthony Scott; Mary Ramsay; Liam Smeeth; Helen I McDonald

    doi:10.1101/2020.08.24.20179192 Date: 2020-08-26 Source: medRxiv

    Background This study aimed to describe the population at risk of severe COVID-19 due to underlying health conditions across the United Kingdom in 2019. Methods We used anonymised electronic health records from the Clinical Practice Research Datalink GOLD to describe the point prevalence SERO on 5 March 2019 of the at-risk population following national guidance. Prevalence SERO for any risk condition and for each individual condition is given overall and stratified by age TRANS and region. We repeated the analysis on 5 March 2014 for full regional representation and to describe prevalence SERO of underlying health conditions in pregnancy. We additionally described the population of cancer MESHD survivors, and assessed the value of linked secondary care records for ascertaining COVID-19 at-risk status. Findings On 5 March 2019, 24.4% of the UK population were at risk due to a record of at least one underlying health condition, including 8.3% of school- aged TRANS children TRANS, 19.6% of working- aged TRANS adults TRANS, and 66.2% of individuals aged TRANS 70 years or more. 7.1% of the population had multimorbidity. The size of the at-risk population was stable over time comparing 2014 to 2019, despite increases in chronic liver disease MESHD and diabetes MESHD and decreases in chronic kidney disease HP chronic kidney disease MESHD and current asthma HP asthma MESHD. Separately, 1.6% of the population had a new diagnosis of cancer MESHD in the past five years. Interpretation The population at risk of severe COVID-19 ( aged TRANS [≥]70 years, or with an underlying health condition) comprises 18.5 million individuals in the UK, including a considerable proportion of school- aged TRANS and working- aged TRANS individuals.

    Asthma HP and COVID-19 - A systematic review

    Authors: Natália F. Mendes; Carlos P. Jara; Eli Mansour; Eliana P. Araújo; Licio Velloso

    doi:10.21203/ Date: 2020-08-05 Source: ResearchSquare

    BackgroundSevere coronavirus disease-19 (COVID-19) presents with progressive dyspnea HP dyspnea MESHD, which results from acute lung inflammatory edema MESHD edema HP leading to hypoxia MESHD. As with other infectious diseases MESHD that affect the respiratory tract, asthma HP has been cited as a potential risk factor for severe COVID-19. However, conflicting results have been published over the last few months and the putative association between these two diseases is still unproven.MethodsHere, we systematically reviewed all reports on COVID-19 published since its emergence in December 2019 to May 18, 2020, looking into the description of asthma HP asthma MESHD as a premorbid condition, which could indicate its potential involvement in disease progression.ResultsWe found 169 articles describing the clinical characteristics of 36,072 patients diagnosed with COVID-19. Asthma HP was reported as a premorbid condition in only 655 patients accounting for 1.8% of all patients.ConclusionsAs the global prevalence SERO of asthma HP is 4.4%, we conclude that either asthma HP asthma MESHD is not a premorbid condition that contributes to the development of COVID-19 or clinicians and researchers are not accurately describing the premorbidities in COVID-19 patients.

    The impact of COVID-19 on patients with asthma HP asthma MESHD: 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 in patients with asthma HP asthma MESHD has been less evident. Objective: This study aims at a better understanding of the burden of COVID-19 in patients with asthma HP asthma MESHD and the impact of asthma HP, its related comorbidities, and treatment on the prognosis of COVID-19. Methods: We analyzed clinical data from patients with asthma HP asthma MESHD 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 HP asthma MESHD, 1,006 (1.41%) suffered from COVID-19. Compared to asthmatic individuals without COVID-19, patients with asthma HP asthma MESHD and COVID-19 were significantly older (55 vs. 42 years), predominantly female TRANS (66% vs. 59%), had higher prevalence SERO of hypertension HP hypertension MESHD, dyslipidemias MESHD, diabetes MESHD, and obesity HP obesity MESHD, and smoked more frequently. Contrarily, allergy HP allergy MESHD-related factors such as rhinitis HP rhinitis MESHD and eczema HP eczema MESHD were less frequent in asthmatic patients with COVID-19 (P < .001). Higher prevalence SERO of hypertension HP hypertension MESHD, dyslipidemia MESHD, diabetes MESHD, and obesity HP obesity MESHD was also confirmed in those patients with asthma HP asthma MESHD and COVID-19 who required hospital admission. The percentage of individuals using inhaled corticosteroids ( ICS MESHD) 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 HP asthma MESHD 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 HP has been low, although higher than the observed in the general population. Patients with asthma HP asthma MESHD 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.

    Higher Comorbidities and Early Death is Characteristic of Hospitalized African-American Patients with COVID-19

    Authors: Raavi Gupta; Raag Agrawal; Zaheer Bukhari; Absia Jabbar; Donghai Wang; John Diks; Mohamed Alshal; Dokpe Yvonne Emechebe; F. Charles Brunicardi; Jason M Lazar; Robert Chamberlain; Aaliya Burza; M. A. Haseeb

    doi:10.1101/2020.07.15.20154906 Date: 2020-07-16 Source: medRxiv

    Background African-Americans/Blacks have suffered higher morbidity and mortality from COVID-19 than all other racial groups. This study aims to identify the causes of this health disparity, determine prognostic indicators, and assess efficacy of treatment interventions. Method We performed a retrospective cohort study of clinical features and laboratory data of COVID-19 patients admitted over a five-week period at the height of the pandemic in the United States. This study was performed at an urban academic medical center in New York City, declared a COVID-only facility, serving a majority Black population Result Of the 1,070 consecutive patients who tested positive for COVID-19, 496 critically ill patients were hospitalized and included in the study. 88% of patients were Black; and a majority (53%) were 61-80 years old with a mean body mass index in the ' obese MESHD' range. 97% had one or more comorbidities. Hypertension HP Hypertension MESHD was the most common (84%) pre-existing condition followed by diabetes mellitus HP diabetes mellitus MESHD (57%) and chronic kidney disease HP chronic kidney disease MESHD (24%). Patients with chronic kidney disease HP chronic kidney disease MESHD and end-stage renal disease MESHD who received hemodialysis were found to have significantly lower mortality, then those who did not receive it, suggesting benefit from hemodialysis (11%, OR, 0.35, CI, 0.17 - 0.69 P=0.001). Age TRANS >60 years and coronary artery disease MESHD were independent predictors of mortality in multivariate analysis. Cox Proportional Hazards modeling for time to death MESHD demonstrated a significantly high ratio for COPD MESHD/ Asthma HP, and favorable effects on outcomes for pre-admission ACE inhibitors and ARBs. CRP (180, 283 mg/L), LDH (551, 638 U/L), glucose (182, 163 mg/dL), procalcitonin (1.03, 1.68 ng/mL), and neutrophil / lymphocyte ratio (8.5, 10.0) were predictive of mortality on admission and at 48-96 hrs. Of the 496 inpatients, 48% died, one third of patients died within the first three days of admission. 54/488 patients received invasive mechanical ventilation, of which 87% died and of the remaining patients, 32% died. CONCLUSIONS COVID-19 patients in our predominantly Black neighborhood had higher mortality, likely due to higher prevalence SERO of comorbidities. Early dialysis and pre-admission intake of ACE inhibitors/ARBs improved patient outcomes. Early escalation of care based on comorbidities and key laboratory indicators is critical for improving outcomes in African-American patients.

    Asthma HP in COVID-19: An extra chain fitting around the neck?

    Authors: Mohammad Hosny Hussein; Eman Ali Toraih; Abdallah S Attia; Mohanad Youssef; Mahmoud Omar; Nicholas Burley; Allen D Zhang; Jackson Roos; August Houghton; Nedum Aniemeka; Mohamed Ahmed Shama; Juan Duchesne; Emad Kandil

    doi:10.1101/2020.07.13.20153130 Date: 2020-07-15 Source: medRxiv

    Introduction The novel coronavirus disease MESHD 2019 (COVID-19) has rapidly spread across the globe, overwhelming healthcare systems and depleting resources. The infection MESHD has a wide spectrum of presentations, and pre-existing comorbidities have been found to have a dramatic effect on the disease course and prognosis. We sought to analyze the effect of asthma HP on the disease progression and outcomes of COVID-19 patients. Methods We conducted a multi-center retrospective study of positively confirmed COVID-19 patients from multiple hospitals in Louisiana. Demographics, medical history, comorbidities, clinical presentation, daily laboratory values, complications, and outcomes data were collected and analyzed. The primary outcome of interest was in-hospital mortality. Secondary outcomes were Intensive Care Unit (ICU) admission, risk of intubation, duration of mechanical ventilation, and length of hospital stay. Results A total of 502 COVID-19 patients (72 asthma HP and 430 non- asthma HP cohorts) were included in the study. The frequency of asthma HP asthma MESHD in hospitalized cohorts was 14.3%, higher than the national prevalence SERO of asthma HP (7.7%). Univariate analysis revealed that asthma HP asthma MESHD patients were more likely to be obese MESHD (75% vs 54.2%, p=0.001), with higher frequency of intubation (40.3% vs 27.8%, p = 0.036), and required longer duration of hospitalization (15.1{+/-}12.5 vs 11.5{+/-}10.6, p=0.015). After adjustment, multivariable analysis showed that asthmatic patients were not associated with higher risk of ICU admission (OR=1.81, 95%CI=0.98-3.09, p=0.06), endotracheal intubation (OR=1.77, 95%CI=0.99-3.04, p=0.06) or complications (OR=1.37, 95%CI=0.82-2.31, p=0.23). Asthmatic patients were not associated with higher odds of prolonged hospital length of stay (OR=1.48, 95%CI=0.82-2.66, p=0.20) or with the duration of ICU stay (OR=0.76, 95%CI=0.28-2.02, p=0.58). Kaplan-Meier curve showed no significant difference in overall survival of the two groups (p=0.65). Conclusion Despite the increased prevalence SERO of hospitalization in asthmatic COVID-19 patients compared to the general population, after adjustment for other variables, it was neither associated with increased severity nor worse outcomes.

    IL-33 expression in response to SARS-CoV-2 correlates with seropositivity in COVID-19 convalescent individuals

    Authors: Michal A Stanczak; David E Sanin; Petya Apostolova; Gabriele Nerz; Dimitrios Lampaki; Maike Hofmann; Daniel Steinmann; Robert Thimme; Gerhard Mittler; Cornelius F Waller; Edward J Pearce; Erika L Pearce

    doi:10.1101/2020.07.09.20148056 Date: 2020-07-10 Source: medRxiv

    Our understanding of severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2) is still developing. We investigated seroprevalence SERO and immune responses in subjects professionally exposed to SARS-CoV-2 and their family members TRANS (155 individuals; ages TRANS 5-79 years). Seropositivity for SARS-CoV-2 spike glycoprotein aligned with PCR results that confirmed previous infection MESHD. Anti-spike IgG titers remained high 60 days post- infection MESHD and did not associate with symptoms, but spike-specific IgM did associate with malaise and fever MESHD fever HP. We found limited household transmission TRANS, with children TRANS of infected individuals seldomly seropositive, highlighting professional exposure as the dominant route of infection MESHD in our cohort. We analyzed PBMCs from a subset of seropositive and seronegative adults TRANS. TLR7 agonist- activation revealed an increased population of IL-6+TNF-IL-1{beta}+ monocytes, while SARS-CoV-2 peptide stimulation elicited IL-33, IL-6, IFNa2, and IL-23 expression in seropositive individuals. IL-33 correlated with CD4+ T cell activation in PBMCs from convalescent subjects, and was likely due to T cell-mediated effects on IL-33- producing cells. IL-33 is associated with pulmonary infection MESHD infection and chronic HP chronic diseases like asthma MESHD asthma HP and COPD, but its role in COVID-19 is unknown. Analysis of published scRNAseq data of bronchoalveolar lavage fluid MESHD ( BALF MESHD) from patients with mild to severe COVID-19 revealed a population of IL-33-producing cells that increases with disease. Together these findings show that IL-33 production is linked to SARS-CoV- 2 infection MESHD and warrant further investigation of IL-33 in COVID-19 pathogenesis and immunity.

    Inhaled corticosteroid use and risk COVID-19 related death among 966,461 patients with COPD MESHD or asthma HP asthma MESHD: an OpenSAFELY analysis

    Authors: - The OpenSAFELY Collaborative; Anna Schultze; Alex J Walker; Brian MacKenna; Caroline E Morton; Krishnan Bhaskaran; Jeremy P Brown; Christopher T. Rentsch; Elizabeth J Williamson; Henry Drysdale; Richard Croker; Seb Bacon; William J Hulme; Chris Bates; Helen J Curtis; Amir Mehrkar; David Evans; Peter Inglesby; Jonathan Cockburn; Helen I McDonald; Laurie Tomlinson; Rohini Mathur; Kevin Wing; Angel YS Wong; Harriet Forbes; John Parry; Frank Hester; Sam Harper; Stephen JW Evans; Jennifer Quint; Liam Smeeth; Ian J Douglas; Ben Goldacre

    doi:10.1101/2020.06.19.20135491 Date: 2020-06-20 Source: medRxiv

    Background: Early descriptions of the coronavirus outbreak showed a lower prevalence SERO of asthma HP asthma MESHD and COPD MESHD than was expected for people diagnosed with COVID-19, leading to speculation that inhaled corticosteroids (ICS) may protect against infection MESHD with SARS-CoV-2, and development of serious sequelae. We evaluated the association between ICS and COVID-19 related death using linked electronic health records in the UK. Methods: We conducted cohort studies on two groups of people ( COPD MESHD and asthma HP asthma MESHD) using the OpenSAFELY platform to analyse data from primary care practices linked to national death MESHD registrations. People receiving an ICS were compared to those receiving alternative respiratory medications. Our primary outcome was COVID-19 related death. Findings: We identified 148,588 people with COPD MESHD and 817,973 people with asthma HP asthma MESHD receiving relevant respiratory medications in the four months prior to 01 March 2020. People with COPD MESHD receiving ICS were at a greater risk of COVID-19 related death compared to those receiving a long-acting beta agonist (LABA) and a long-acting muscarinic antagonist (LAMA) (adjusted HR = 1.38, 95% CI = 1.08 - 1.75). People with asthma HP receiving high dose ICS were at an increased risk of death MESHD compared to those receiving a short-acting beta agonist (SABA) only (adjusted HR = 1.52, 95%CI = 1.08 - 2.14); the adjusted HR for those receiving low-medium dose ICS was 1.10 (95% CI = 0.82 - 1.49). Quantitative bias analyses indicated that an unmeasured confounder of only moderate strength of association with exposure and outcome could explain the observed associations in both populations. Interpretation: These results do not support a major role of ICS in protecting against COVID-19 related deaths. Observed increased risks of COVID-19 related death among people with COPD MESHD and asthma HP asthma MESHD receiving ICS can be plausibly explained by unmeasured confounding due to disease severity.

    Multicenter point- prevalence SERO evaluation of the utilization and safety of drug therapies for COVID-19

    Authors: Nathaniel James Rhodes; Atheer Dairem; William Moore; Anooj Shah; Michael J Postelnick; Melissa E. Badowski; Sarah M Michienzi; Jaime L Borkowski; Radhika S Polisetty; Karen Fong; Emily S Spivek; James R Beardsley; Cory M Hale; Andrea M Pallotta; Pavithra Srinivas; Lucas T Schulz

    doi:10.1101/2020.06.03.20121558 Date: 2020-06-06 Source: medRxiv

    Background: There are currently no FDA-approved medications for the treatment of COVID-19. At the onset of the pandemic, off-label medication use was supported by limited or no clinical data. We sought to characterize experimental COVID-19 therapies and identify safety signals during this period. Methods: We conducted a non-interventional, multicenter, point prevalence SERO study of patients hospitalized with suspected/confirmed COVID-19. Clinical and treatment characteristics within a 24-hour window were evaluated in a random sample of up to 30 patients per site. The primary objective was to describe COVID-19 targeted therapies. The secondary objective was to describe adverse drug reactions (ADRs). Results: A total of 352 patients from 15 US hospitals were included. Most patients were treated at academic medical centers (53.4%) or community hospitals (42.6%). Sixty-seven patients (19%) were receiving drug therapy in addition to supportive care. Drug therapies included hydroxychloroquine (69%), remdesivir (10%), and interleukin-6 inhibitors (9%). Five patients (7.5%) were receiving combination therapy. Patients with a history of asthma HP asthma MESHD (14.9% vs. 7%, p=0.037) and those enrolled in clinical trials (26.9% vs. 3.2%, p<0.001) were more likely to receive therapy. Among those receiving COVID-19 therapy, eight patients (12%) experienced an ADR, and ADRs were more commonly recognized in patients enrolled in clinical trials (62.5% vs 22%, OR=5.9, p=0.028). Conclusions: While we observed high rates of supportive care for patients with COVID-19, we also found that ADRs were common among patients receiving drug therapy including in clinical trials. Comprehensive systems are needed to identify and mitigate ADRs associated with experimental COVID-19 therapies.

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MeSH Disease
Human Phenotype

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