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    The major predictors of testing positive for COVID-19 among symptomatic hospitalized patients

    Authors: Samson Barasa; David Tarazona; Faviola Valdivia Guerrero; Nancy Rojas Serrano; Dennis Carhuaricra; Lenin Maturrano Hernandez; Ronnie Gavilan Chavez

    doi:10.1101/2020.09.11.20192963 Date: 2020-09-13 Source: medRxiv

    The major predictors of testing positive for COVID-19 among symptomatic hospitalized patients Samson Barasa,1 Amy Ballard,1 Josephine Kiage-Mokaya, 1 Michael Friedlander,1 Geraldine Luna,2 1PeaceHealth Sacred Heart 2University of Illinois at Chicago Introduction: Increasing corona virus disease MESHD 2019 (COVID-19) pre-test probability can minimize testing patients who are less likely to have COVID-19 and therefore reducing personal protective equipment and COVID-19 testing kit use. The aim of this study was to identify patients who were likely to test positive for COVID-19 among symptomatic patients suspected of having COVID-19 during hospitalization by comparing COVID-19 positive and negative patients. Method: We conducted a retrospective chart review of patients who were [≥]18 years old and underwent COVID-19 Polymerase chain reaction test because they presented with symptoms thought to be due to COVID-19. A Poisson regression analysis was conducted after clinical presentation, demographic, medical co-morbidities, laboratory and chest image data was retrieved from the medical records. Results: Charts of 277 and 18 COVID-19 negative and positive patients respectively were analyzed. Dyspnea HP Dyspnea MESHD (61%) was the most common symptom among COVID-19 negative patients, while 72% and 61% COVID-19 positive patients had cough HP cough MESHD and fever HP fever MESHD respectively. COVID-19 positive patients were more likely to present initially with cough HP [1.082 (1.022 - 1.145)], fever HP fever MESHD [1.066 (1.014 - 1.121)] and be 50 to 69 years old [1.094 (1.021 - 1.172)]. Dyspnea HP Dyspnea MESHD, weakness MESHD, lymphopenia HP lymphopenia MESHD and bilateral chest image abnormality were not associated with COVID-19 positivity. COVID-19 positive patients were less likely to have non-COVID-19 respiratory viral illness [1.068 (1.019 - 1.119)], human immunodeficiency HP immunodeficiency MESHD virus [0.849 (0.765 - 0.943)] and heart failure MESHD history [0.093 (0.891 - 0.978)]. Other chronic medical problems ( hypertension HP hypertension MESHD, diabetes mellitus HP diabetes mellitus MESHD, chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD and coronary artery disease MESHD) were not associated with testing positive for COVID-19. Conclusion: Cough HP, fever HP fever MESHD and being 50 to 69 years old are better predictors of symptomatic COVID-19 positivity during hospitalization. Despite published studies reporting a high prevalence SERO of lymphopenia HP lymphopenia MESHD among COVID-19 positive patients, lymphopenia HP lymphopenia MESHD is not associated with the risk of testing positive for COVID-19. Key Words: COVID-19, Predictors, Symptomatic, Hospitalized

    Red blood SERO cell distribution width (RDW) in Hospitalized COVID-19 Patients

    Authors: Preethi Ramachandran; Mahesh Gajendran; Abhilash Perisetti; Karim Osama Elkholy; Abhishek Chakraborti; Giuseppe Lippi; Hemant Goyal

    doi:10.1101/2020.06.29.20143081 Date: 2020-07-03 Source: medRxiv

    Introduction: Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 MESHD (SARS-CoV-2), is causing dramatic morbidity and mortality worldwide. The Red Blood SERO Cell Distribution Width (RDW) has been strongly associated with increased morbidity and mortality in multiple diseases. Objective: To assess if elevated RDW is associated with unfavorable outcomes in hospitalized COVID-19. Methods: We retrospectively studied clinical outcomes of hospitalized COVID-19 patients for their RDW values. In-hospital mortality was defined as primary outcome, while septic shock MESHD shock HP, need for mechanical ventilation, and length of stay (LOS) were secondary outcomes. Results- A total of 294 COVID-19 patients were finally studied. Overall prevalence SERO of increased RDW was 49.7% (146/294). RDW was associated with increased risk of in-hospital mortality (aOR, 4.5; 95%CI, 1.4-14.3) and septic shock MESHD shock HP (aOR, 4.6; 95%CI, 1.4-15.1) after adjusting for anemia HP anemia MESHD, ferritin, and lactate. The association remained unchanged even after adjusting for other clinical confounders such as age TRANS, sex, body mass index, coronary artery disease MESHD, hypertension HP hypertension MESHD, diabetes mellitus HP diabetes mellitus MESHD, and chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD. No association was found instead with mechanical ventilation and median LOS. Conclusion: Elevated RDW in hospitalized COVID-19 patients is associated with a significantly increased risk of mortality and septic shock MESHD shock HP.

    Identification of pulmonary comorbid diseases network based repurposing effective drugs for COVID-19

    Authors: Jai Chand Patel; Rajkumar Tulswani; Pankaj Khurana; Yogendra Kumar Sharma; Lilly Ganju; Bhuvnesh Kumar; Ragumani Sugadev

    doi:10.21203/rs.3.rs-28148/v1 Date: 2020-05-08 Source: ResearchSquare

    The number of hospitalization of COVID-19 patients with one or more comorbid diseases is highly alarming. Despite the lack of large clinical data and incomplete understanding of virus pathology, identification of the COVID-19 associated diseases with clinical precision are highly limited. In this regard, our text mining of 6238 PubMed abstracts (as on 23 April 2020) successfully identified broad spectrum of COVID-19 comorbid diseases/disorders (54), and their prevalence SERO on the basis of the number of occurrence of disease terms in the abstracts. The disease ontology based semantic similarity network analysis revealed the six highly comorbid diseases of COVID-19 namely Viral Pneumonia HP, Pulmonary Fibrosis HP Pulmonary Fibrosis MESHD, Pulmonary Edema HP Pulmonary Edema MESHD, Acute Respiratory Distress Syndrome MESHD Respiratory Distress HP Syndrome ( ARDS MESHD), Chronic Obstructive Pulmonary Disease HP Chronic Obstructive Pulmonary Disease MESHD ( COPD MESHD) and Asthma HP. The disease gene bipartite network revealed 15 genes that were strongly associated with several viral pathways including the corona viruses may involve in the manifestation (mild to critical) of COVID-19. Our tripartite network- based repurposing of the approved drugs in the world market revealed six promising drugs namely resveratrol, dexamethasone, acetyl cysteine, Tretinoin, simvastatin and aspirin to treat comorbid symptoms of COVID-19 patients. Our animal studies in rats and literatures strongly supported that resveratrol is the most promising drug to possibly reduce several comorbid symptoms associated with COVID-19 including the severe hypoxemia HP hypoxemia MESHD induced vascular leakage. Overall, the anti-viral properties of resveratrol against corona virus could be readily exploited to effectively control the viral load at early stage of COVID-19 infection through nasal administration.

    Burden and prevalence SERO of prognostic factors for severe covid-19 disease in Sweden

    Authors: Katalin Gemes; Mats Talback; Karin Modig; Anders Ahlbom; Anita Berglund; Maria Feychting; Anthony Matthews

    doi:10.1101/2020.04.08.20057919 Date: 2020-04-11 Source: medRxiv

    Objectives: Describe the burden and prevalence SERO of prognostic factors of severe COVID-19 disease at national and county level in Sweden. Design: Cross sectional study Setting: Sweden Participants: 9,624,428 individuals living in Sweden on 31st December 2014 and alive on 1st January 2016 Main outcome measures: Burden and prevalence SERO of prognostic factors for severe COVID-19 based on the guidelines from the World Health Organization and European Centre for Disease Prevention and Control, which are age TRANS 70 years and older, cardiovascular disease MESHD, cancer MESHD, chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD, severe asthma HP asthma MESHD, and diabetes MESHD. Prognostic factors were identified based on records for three years before 1st January 2016 from the Swedish National Inpatient and Outpatient Specialist Care Register, Prescribed Drug Register, and Cancer MESHD Register. Results: 22.1% of the study population had at least one prognostic factor for severe COVID-19 (2,131,319 individuals), and 1.6% had at least three factors (154,746 individuals). The prevalence SERO of underlying medical conditions in the whole study population ranged from 0.8% with chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD (78,516 individuals) to 7.4% with cardiovascular disease MESHD (708,090 individuals), and the county specific prevalence SERO of at least one prognostic factor ranged from 19.2% in Stockholm (416,988 individuals) to 25.9% in Kalmar (60,005 individuals). Conclusions: The prevalence SERO of prognostic factors for severe COVID-19 disease will aid authorities in optimally planning healthcare resources during the ongoing pandemic. Results can also be applied to underlying assumptions of disease burden in modelling efforts to support COVID-19 planning. This information is crucial when deciding appropriate strategies to mitigate the pandemic and reduce both the direct mortality burden from the disease itself, and the indirect mortality burden from potentially overwhelmed health systems.

    Prevalence SERO, Severity and Mortality associated with COPD MESHD and Smoking in patients with COVID-19: A Rapid Systematic Review and Meta-Analysis

    Authors: Jaber S Alqahtani; Tope Oyelade; Abdulelah M Aldhahir; Saeed M Alghamdi; Mater Almehmadi; Abdullah S Alqahtani; Shumonta Quaderi; Swapna Mandal; John Hurst

    doi:10.1101/2020.03.25.20043745 Date: 2020-03-27 Source: medRxiv

    Background: Coronavirus disease 2019 (COVID-19) is an evolving infectious disease MESHD that dramatically spread all over the world in the early part of 2020. No studies have yet summarised the potential severity and mortality risks caused by COVID-19 in patients with chronic obstructive pulmonary disease HP chronic obstructive pulmonary disease MESHD ( COPD MESHD), and we update information in smokers. Methods: We systematically searched electronic databases from inception to March 24, 2020. Data were extracted by two independent authors in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Study quality was assessed using a modified version of the Newcastle Ottawa Scale. We synthesised a narrative from eligible studies and conducted a meta-analysis using a random-effects model to calculate pooled prevalence SERO rates and 95% confidence intervals (95%CI). Results: In total, 123 abstracts were screened and 61 full-text manuscripts were reviewed. A total of 15 studies met the inclusion criteria, which included a total of 2473 confirmed COVID-19 patients. All studies were included in the meta-analysis. The crude case fatality rate of COVID-19 was 6.4%. The pooled prevalence SERO rates of COPD MESHD patients and smokers in COVID-19 cases were 2% (95% CI, 1%-3%) and 9% (95% CI, 4%-14%) respectively. COPD patients were at a higher risk of more severe disease (risk of severity = 63%, (22/35) compared to patients without COPD 33.4% (409/1224) [calculated RR, 1.88 (95% CI, 1.4-2.4)]. This was associated with higher mortality (60%). Our results showed that 22% (31/139) of current smokers and 46% (13/28) of ex-smokers had severe complications. The calculated RR showed that current smokers were 1.45 times more likely [95% CI: 1.03-2.04] to have severe complications compared to former and never smokers. Current smokers also had a higher mortality rate of 38.5%. Conclusion: Although COPD prevalence SERO in COVID-19 cases was low in current reports, COVID-19 infection was associated with substantial severity and mortality rates in COPD. Compared to former and never smokers, current smokers were at greater risk of severe complications and higher mortality rate. Effective preventive measures are required to reduce COVID-19 risk in COPD patients and current smokers.

    Estimating excess 1- year mortality from COVID-19 according to underlying conditions and age TRANS in England: a rapid analysis using NHS health records in 3.8 million adults TRANS

    Authors: Amitava Banerjee; Laura Pasea; Steve Harris; Arturo Gonzalez-Izquierdo; Ana Torralbo; Laura Shallcross; Mahdad Noursadeghi; Deenan Pillay; Christina Pagel; Wai Keong Wong; Claudia Langenberg; Bryan Williams; Spiros Denaxas; Harry Hemingway

    doi:10.1101/2020.03.22.20040287 Date: 2020-03-24 Source: medRxiv

    RAPID COMMUNICATION 22 March 2020 Estimating excess 1- year mortality from COVID-19 according to underlying conditions and age TRANS in England: a rapid analysis using NHS health records in 3.8 million adults TRANS Background: The medical, health service, societal and economic impact of the COVID-19 emergency has unknown effects on overall population mortality. Previous models of population mortality are based on death MESHD over days among infected people MESHD, nearly all of whom (to date at least) have underlying conditions. Models have not incorporated information on high risk conditions or their longer term background (pre-COVID-19) mortality. We estimated the excess number of deaths over 1 year under different COVID-19 incidence rates and differing mortality impacts. Methods: Using population based linked primary and secondary care electronic health records in England (HDR UK - CALIBER), we report the prevalence SERO of underlying conditions defined by UK Public Health England COVID-19 guidelines (16 March 2020) in 3,862,012 individuals aged TRANS [≥]30 years from 1997-2017. We used previously validated phenotypes, openly available (https://caliberresearch.org/portal), for each condition using ICD-10 diagnosis, Read, procedure and medication codes. We estimated the 1-year mortality in each condition, and developed simple models of excess COVID-19-related deaths assuming relative risk (RR) of the impact of the emergency (compared to background mortality) of 1.2, 1.5 and 2.0. Findings: 20.0% of the population are at risk according to current PHE guidelines, of which; 13.7% were age TRANS>70 years and 6.3% aged TRANS [≤]70 years with [≥]1 underlying condition (cardiovascular disease (2.3%), diabetes (2.2%), steroid therapy (1.9%), severe obesity HP (0.9%), chronic kidney disease HP (0.6%) and chronic obstructive pulmonary disease HP, COPD (0.5%). Multimorbidity (co-occurrence of [≥]2 conditions in an individual) was common (10.1%). The 1-year mortality in the at-risk population was 4.46%, and age TRANS and underlying conditions combine to influence background risk, varying markedly across conditions (5.9% in age TRANS>70 years, 8.6% for COPD and 13.1% in those with [≥]3 or more conditions). In a suppression scenario (at SARS CoV2 rates of 0.001% of the UK population), there would be minimal excess deaths (3 and 7 excess deaths at relative risk, RR, 1.5 and 2.0 respectively). At SARS CoV2 rates of 10% of the UK population (mitigation) the model estimates the numbers of excess deaths as: 13791, 34479 and 68957 (at RR 1.2, 1.5 and 2.0 respectively). At SARS CoV2 rates of 80% in the UK population (do-nothing), the model estimates the number of excess deaths as 110332, 275,830 and 551,659 (at RR 1.2, 1.5 and 2.0) respectively. Interpretation: We provide the public, researchers and policy makers a simple model to estimate the excess mortality over 1 year from COVID-19, based on underlying conditions at different ages TRANS. If the relative mortality impact of COVID-19 were to be about 20% (similar magnitude as the established winter vs summer mortality excess), then the excess deaths would be 0 when 1 in 100 000 (suppression), 13791 when 1 in 10 (mitigation) and 110332 when 8 in 10 are infected (do nothing) scenario. However, the relative impact of COVID-19 is unknown. If the emergency were to double the mortality risk, then we estimate 7, 68957 and 551,659 excess deaths in the same scenarios. These results may inform the need for more stringent suppression measures as well as efforts to target those at highest risk for a range of preventive interventions.

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