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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Fighting COVID-19 spread among nursing home residents even in absence of molecular diagnosis: a retrospective cohort study.

    Authors: Alessio Strazzulla; Paul Tarteret; Maria Concetta Postorino; Marie Picque; Astrid de Pontfarcy; Nicolas Vignier; Catherine Chakvetadze; Coralie Noel; Cecile Drouin; Zine Eddine Benguerdi; Sylvain Diamantis

    doi:10.21203/rs.3.rs-51305/v1 Date: 2020-07-30 Source: ResearchSquare

    Background Access to molecular diagnosis was limited out-of-hospital in France during the 2020 coronavirus disease 2019 (COVID-19) epidemic. This study describes the evolution of COVID-19 outbreak in a nursing home in absence of molecular diagnosis. Methods A monocentric prospective study was conducted in a French nursing home from March 17th, 2020 to June 11th, 2020. Because of lack of molecular tests for severe acute respiratory syndrome 2 (SARS-Cov2) infection MESHD, probable COVID-19 cases were early identified considering only respiratory and not-respiratory symptoms and therefore preventing measures and treatments were enforced. Once available, serology tests were performed at the end of the study.A chronologic description of new cases and deaths MESHD was made together with a description of COVID-19 symptoms. Data about personal characteristics and treatments were collected and the following comparisons were performed: i) probable COVID-19 cases vs asymptomatic TRANS residents; ii) SARS-Cov2 seropositive residents vs seronegative residents. Results Overall, 32/66 (48.5%) residents and 19/39 (48.7%) members of health-care personnel were classified as probable COVID-19 cases. A total of 34/61 (55.7%) tested residents resulted seropositive. Death occurred in 4/66 (6%) residents. Diagnosis according to symptoms had 65% of sensitivity SERO, 78% of specificity, 79% of positive predictive value SERO and 64% of negative predictive value SERO.In resident population, the following symptoms were registered: 15/32 (46.8%) lymphopenia HP lymphopenia MESHD, 15/32 (46.8%) fever HP fever MESHD, 8/32 (25%) fatigue HP fatigue MESHD, 8/32 (25%) cough HP, 6/32 (18.8%) diarrhoea MESHD, 4/32 (12.5%) severe respiratory distress HP requiring oxygen therapy, 4/32 (12.5%) fall HP, 3/32 (9.4%) conjunctivitis HP conjunctivitis MESHD, 2/32 (6.3%) abnormal pulmonary noise at chest examination and 2/32 (6,25%) abdominal pain HP abdominal pain MESHD. Probable COVID-19 cases were older (81.3 vs 74.9; p=0.007) and they had higher prevalence SERO of atrial fibrillation HP atrial fibrillation MESHD (8/32, 25% vs 2/34, 12%; p=0.030); insulin treatment (4/34, 12% vs 0, 0%; p=0.033) and positive SARS-Cov2 serology (22/32, 69% vs 12/34, 35%; p=0.001) than asymptomatic TRANS residents. Seropositive residents had lower prevalence SERO of diabetes MESHD (4/34, 12% vs 9/27, 33%; p=0.041) and angiotensin-converting-enzyme inhibitors’ intake (1/34, 1% vs 5/27, 19%; p=0.042). Conclusions During SARS-Cov2 epidemic, early detection of respiratory and not-respiratory symptoms allowed to enforce extraordinary measures. They achieved limiting contagion and deaths among nursing home residents, even in absence of molecular diagnosis.

    Outcomes and Cardiovascular Comorbidities MESHD in a Predominantly African-American Population with COVID-19

    Authors: Ann B. Nguyen; Gaurav A. Upadhyay; Ben Chung; Bryan Smith; Stephanie A. Besser; Julie A. Johnson; John Blair; R. Parker Ward; Jeanne DeCara; Tamar Polonsky; Amit R. Patel; Jonathan Grinstein; Luise Holzhauser; Rohan Kalathiya; Atman P. Shah; Jonathan Paul; Sandeep Nathan; James Liao; Roberto M. Lang; Krysta Wolfe; Ayodeji Adegunsoye; David Wu; Bhakti Patel; Monica E. Peek; Doriane Miller; Dinesh J. Kurian; Stephen R. Estime; Allison Dalton; Avery Tung; Michael F. O'Connor; John P. Kress; Francis J. Alenghat; Roderick Tung

    doi:10.1101/2020.06.28.20141929 Date: 2020-06-29 Source: medRxiv

    Importance: Racial disparities in COVID-19 outcomes have been amplified during this pandemic and reports on outcomes in African-American (AA) populations, known to have higher rates of cardiovascular (CV) comorbidities, remain limited. Objective: To examine prevalence SERO of comorbidities, rates of hospitalization and survival, and incidence of CV manifestations of COVID-19 in a predominantly AA population in south metropolitan Chicago. Design, Setting, Participants: This was an observational cohort study of COVID-19 patients encountered from March 16 to April 16, 2020 at the University of Chicago. Deidentified data were obtained from an institutional data warehouse. Group comparisons and logistic regression modeling based on baseline demographics, clinical characteristics, laboratory and diagnostic testing was performed. Exposures: COVID-19 was diagnosed by nasopharyngeal swab testing and clinical management was at the discretion of treating physicians. Main Outcomes and Measures: Primary outcomes were hospitalization and in-hospital mortality, and secondary outcomes included incident CV manifestations of COVID-19 in the context of overall cardiology service utilization. Results: During the 30 day study period, 1008 patients tested positive for COVID-19 and 689 had available encounter data. Of these, 596 (87%) were AA and 356 (52%) were hospitalized, of which 319 (90%) were AA. Age TRANS > 60 years, tobacco use, BMI >40 kg/m2, diabetes mellitus HP diabetes mellitus MESHD ( DM MESHD), insulin use, hypertension HP hypertension MESHD, chronic kidney disease HP chronic kidney disease MESHD, coronary artery disease MESHD ( CAD MESHD), and atrial fibrillation HP atrial fibrillation MESHD ( AF MESHD) were more common in hospitalized patients. Age TRANS > 60 years, tobacco use, CAD MESHD, and AF MESHD were associated with greater risk of in-hospital mortality along with several elevated initial laboratory markers including troponin, NT-proBNP, blood SERO urea nitrogen, and ferritin. Despite this, cardiac manifestations of COVID-19 were uncommon, coincident with a 69% decrease in cardiology service utilization. For hospitalized patients, median length of stay was 6.2 days (3.4-11.9 days) and mortality was 13%. AA patients were more commonly hospitalized, but without increased mortality. Conclusions and Relevance: In this AA-predominant experience from south metropolitan Chicago, CV comorbidities and chronic diseases MESHD were highly prevalent and associated with increased hospitalization and mortality. Insulin-requiring DM MESHD and CKD emerged as novel predictors for hospitalization. Despite the highest rate of comorbidities reported to date, CV manifestations of COVID-19 and mortality were relatively low. The unexpectedly low rate of mortality merits further study.

    PREEXISTING COMORBIDITIES PREDICTING SEVERE COVID-19 IN OLDER ADULTS TRANS IN THE UK BIOBANK COMMUNITY COHORT

    Authors: Janice L Atkins; Jane AH Masoli; Joao Delgado; Luke C Pilling; Chia-Ling C Kuo; George Kuchel; David Melzer

    doi:10.1101/2020.05.06.20092700 Date: 2020-05-08 Source: medRxiv

    Background: Older COVID-19 hospitalized patients frequently have hypertension HP hypertension MESHD, diabetes MESHD or coronary heart disease MESHD ( CHD MESHD), but whether these are more common than in the population is unclear. During the initial epidemic in England, virus testing for older adults TRANS was restricted to symptomatic hospitalized patients. We aimed to estimate associations between pre-existing diagnoses and COVID-19 status, in a large community cohort. Methods: UK Biobank (England) participants assessed 2006 to 2010, followed in hospital discharge records to 2017. Demographic and pre-existing common diagnoses association tested with COVID-19 status (16th March to 14th April 2020) in logistic models, adjusted for demographics, study site and other diagnoses. Results: There were 274,356 participants aged TRANS 65+, including 448 (0.16%) hospitalized COVID-19 patients. Common co-morbidities in patients were hypertension HP hypertension MESHD (58.5%), coronary heart disease MESHD ( CHD MESHD, 21.1%), history of fall HP or fragility fractures MESHD (30.6%), and type 2 diabetes MESHD (19.6%). However, in adjusted models, COVID-19 patients were more likely than other participants to have pre-existing dementia HP dementia MESHD (OR=3.07 95% CI 1.71 to 5.50), COPD MESHD (OR= 1.82 CI 1.33 to 2.49), depression MESHD (OR=1.81 CI 1.36 to 2.40), type 2 diabetes MESHD (OR=1.70 CI 1.30 to 2.21), chronic kidney disease HP chronic kidney disease MESHD and atrial fibrillation HP atrial fibrillation MESHD. Hypertension HP Hypertension MESHD was modestly associated (OR=1.29 CI 1.04 to 1.59), but CHD MESHD (OR=0.92 CI 0.71 to 1.20) prevalence SERO was similar in COVID-19 patients and other participants. Conclusion: Specific co-morbidities are disproportionally common in older adults TRANS who develop severe COVID-19. Tailored interventions may be needed, as these results do not support simple age TRANS-based targeting to prevent severe COVID-19 infection MESHD.

    Prevalence SERO and Impact of Myocardial Injury MESHD in Patients Hospitalized with COVID-19 Infection

    Authors: Anuradha Lala; Kipp W Johnson; Adam J Russak; Ishan Paranjpe; Shan Zhao; Sulaiman Solani; Akhil Vaid; Fayzan Chaudhry; Jessica K De Freitas; Zahi A Fayad; Sean P Pinney; Matthew Levin; Alexander Charney; Emilia Bagiella; Jagat Narula; Benjamin S Glicksberg; Girish Nadkarni; James Januzzi; Donna M Mancini; Valentin Fuster

    doi:10.1101/2020.04.20.20072702 Date: 2020-04-24 Source: medRxiv

    Background: The degree of myocardial injury MESHD, reflected by troponin elevation, and associated outcomes among hospitalized patients with Coronavirus Disease MESHD (COVID-19) in the US are unknown. Objectives: To describe the degree of myocardial injury MESHD and associated outcomes in a large hospitalized cohort with laboratory-confirmed COVID-19. Methods: Patients with COVID-19 admitted to one of five Mount Sinai Health System hospitals in New York City between February 27th and April 12th, 2020 with troponin-I (normal value <0.03ng/mL) measured within 24 hours of admission were included (n=2,736). Demographics, medical history, admission labs, and outcomes were captured from the hospital EHR. Results: The median age TRANS was 66.4 years, with 59.6% men. Cardiovascular disease MESHD ( CVD MESHD) including coronary artery disease MESHD, atrial fibrillation HP atrial fibrillation MESHD, and heart failure MESHD, was more prevalent in patients with higher troponin concentrations, as were hypertension HP hypertension MESHD and diabetes MESHD. A total of 506 (18.5%) patients died during hospitalization. Even small amounts of myocardial injury MESHD (e.g. troponin I 0.03-0.09ng/mL, n=455, 16.6%) were associated with death MESHD (adjusted HR: 1.77, 95% CI 1.39-2.26; P<0.001) while greater amounts (e.g. troponin I>0.09 ng/dL, n=530, 19.4%) were associated with more pronounced risk (adjusted HR 3.23, 95% CI 2.59-4.02). Conclusions: Myocardial injury MESHD is prevalent among patients hospitalized with COVID-19, and is associated with higher risk of mortality. Patients with CVD MESHD are more likely to have myocardial injury MESHD than patients without CVD MESHD. Troponin elevation likely reflects non- ischemic MESHD or secondary myocardial injury MESHD.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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