### Overview

MeSH Disease

Death (181)

Infections (94)

Disease (75)

Hypertension (21)

Human Phenotype

Hypertension (22)

Obesity (15)

Fever (9)

Cough (9)

Pneumonia (9)

Transmission

Seroprevalence
displaying 1 - 10 records in total 182
records per page

### Oncologic Immunomodulatory Agents in Patients with Cancer and COVID-19

Authors: Justin Jee; Aaron J Stonestrom; Sean Devlin; Teresa Nguyentran; Beatriz Wills; Varun Narendra; Michael B Foote; Melissa Lumish; Santosha Vardhana; Stephen Pastores; Neha Korde; Dhwani Patel; Steven Horwitz; Michael Scordo; Anthony Daniyan

doi:10.1101/2020.08.11.20145458 Date: 2020-08-12 Source: medRxiv

Background Corticosteroids, anti-CD20 agents, immunotherapies, and cytotoxic chemotherapy are commonly used in the treatment of patients with cancer. How these agents impact patients with cancer who are infected with SARS-CoV-2 remains unclear. Methods We retrospectively investigated associations between SARS-CoV-2-associated respiratory failure HP or death MESHD with receipt of the aforementioned medications and with pre-COVID-19 neutropenia MESHD neutropenia HP. The study included all cancer patients diagnosed with SARS-CoV-2 at Memorial Sloan Kettering Cancer Center until June 2, 2020 (N=820). We controlled for cancer-related characteristics known to predispose to worse COVID-19. To address that more acutely ill patients receive therapeutic corticosteroids, we examined patient subsets based on different levels of respiratory support: <=2 L/min supplemental oxygen, >2L/min supplemental oxygen, and advanced respiratory support prior to death MESHD. Results Corticosteroid administration was associated with worse outcomes in the pre-2L supplemental oxygen cohort; no statistically significant difference was observed in the >2L/min supplemental oxygen and post-critical cohorts. Interleukin-6 (IL-6) and C-reactive protein (CRP) levels were lower, and ferritin levels were higher, after corticosteroid administration. In patients with metastatic thoracic cancer, 9 of 25 (36%) and 10 of 31 (32%) had respiratory failure HP or death MESHD among those who did and did not receive immunotherapy, respectively. Seven of 23 (30%) and 52 of 187 (28%) patients with hematologic cancer had respiratory failure HP or death MESHD among those who did and did not receive anti-CD20 therapy, respectively. Chemotherapy itself was not associated with worse outcomes, but pre-COVID-19 neutropenia MESHD neutropenia HP was associated with worse COVID-19 course. Relative prevalence SERO of chemotherapy-associated neutropenia MESHD neutropenia HP in previous studies may account for different conclusions regarding the risks of chemotherapy in patients with COVID-19. In the absence of prospective studies and evidence-based guidelines, our data may aid providers looking to assess the risks and benefits of these agents in caring for cancer patients in the COVID-19 era.

### COVID-19 mortality according to civilian records

Authors: Lisandro Lovisolo; Diego H S Catalao; Rodrigo B Burgos; Malu Grave; Pamella Constantino-Teles; Americo Cunha Jr.

doi:10.1101/2020.08.07.20170183 Date: 2020-08-11 Source: medRxiv

In this short report, we bring some data-driven analyses of COVID-19 mortality in Brazil. The impact of COVID-19 is evaluated by comparing the 2019 and 2020 civilian death MESHD records. There is evidence of a considerable excess of deaths MESHD since the pandemic started with respect to the previous year. In some states, it is clear that not all excess of deaths MESHD in 2020 is due to COVID-19, but to other respiratory causes that did not present the same prevalence SERO in the previous year. Because of this unusual behavior of respiratory deaths MESHD, we may infer the evidence of a huge amount of under-reporting deaths MESHD due to the COVID-19. The data also shows that COVID-19 has produced an excess death MESHD in all ages TRANS besides people above 90 and below 10 years. In addition, when separates by sex, data indicate a larger increase in the deaths MESHD among males TRANS than females TRANS.

### A Monte Carlo approach to model COVID-19 deaths MESHD and infections MESHD using Gompertz functions

Authors: Tulio Rodrigues; Otaviano Helene

id:2008.04989v1 Date: 2020-08-11 Source: arXiv

This study describes the dynamics of COVID-19 deaths MESHD and infections MESHD via a Monte Carlo approach. The analyses include death MESHD's data from USA, Brazil, Mexico, UK, India and Russia, which comprise the four countries with the highest number of deaths MESHD/ confirmed cases TRANS, as of Aug 07, 2020, according to the WHO. The Gompertz functions were fitted to the data of weekly averaged confirmed deaths MESHD per day by mapping the $\chi^2$ values. The uncertainties, variances and covariances of the model parameters were calculated by propagation. The fitted functions for the average deaths MESHD per day for USA and India have an upward trend, with the former having a higher growth rate and quite huge uncertainties. For Mexico, UK and Russia, the fits are consistent with a slope down pattern. For Brazil we found a subtle trend down, but with significant uncertainties. The USA, UK and India data shown a first peak with a higher growth rate when compared to the second one, demonstrating the benefits of non-pharmaceutical interventions of sanitary measures and social distance flattening the curve. For USA, a third peak seems quite plausible, most likely related with the recent relaxation policies. Brazil's data are satisfactorily described by two highly overlapped Gompertz functions with similar growth rates, suggesting a two-steps process for the pandemic spreading. The 95% CI for the total number of deaths MESHD ($\times 10^3$) predicted by the model for Aug 31, 2020 are 160 to 220, 110 to 130, 59 to 62, 46.6 to 47.3, 54 to 63 and 16.0 to 16.7 for USA, Brazil, Mexico, UK, India and Russia, respectively. Our estimates for the prevalences SERO of infections MESHD are in reasonable agreement with some preliminary reports from serological studies carried out in USA and Brazil. The method represents an effective framework to estimate the line-shape of the infection MESHD curves and the uncertainties of the relevant parameters based on the actual data.

### Exposure to Mycobacteria influences disease progression MESHD in COVID-19 patients

Authors: Ajay Gupta; Sumit Sural; Ayush Gupta; Shashank Rousa; B.C.Koner; Anju Bhalotra; Rohit Chawla

doi:10.21203/rs.3.rs-56141/v1 Date: 2020-08-08 Source: ResearchSquare

Background: COVID-19−related deaths MESHD are significantly higher in countries with higher quality of life. A strong negative correlation is reported between the BCG index and COVID- 19 mortality. The present study explored if a high Th1immunity due to frequent exposure to strong Th1 antigens like Mycobacteria or Salmonella could be the cause for lesser COVID-19−related deaths MESHD in Indian population. Methods: This prospective comparative study was conducted with 3 groups of twenty patients each of mildly symptomatic (A), severely ill (S) Covid patients and healthy volunteers with a Covid Negative report (H).Results: All severely ill patients showed increased leucocyte counts, lymphopenia MESHD lymphopenia HP and raised D-dimer. A gross reversible unresponsiveness of T cells was seen among all patients in S group with absolutely no response even to the mitogen stimulus. Quantiferon TB test value and distribution of test positivity was significantly lower in group S. Three out of 6 survived patients in S group had positive Quantiferon TB test while 2 patients turned positive on repeat test and the sixth patient showed high TH titre on widal test.Conclusion: Altered Th1 immunity associated with frequent community exposure of tuberculosis MESHD and typhoid antigen in Indian population might be responsible for its relatively lesser prevalence SERO and mortality following Covid-19.

### Estimating the Changing Infection MESHD Rate of COVID-19 Using Bayesian Models of Mobility

Authors: Luyang Liu; Sharad Vikram; Junpeng Lao; Xue Ben; Alexander D'Amour; Shawn O'Banion; Mark Sandler; Rif A. Saurous; Matthew D. Hoffman

doi:10.1101/2020.08.06.20169664 Date: 2020-08-07 Source: medRxiv

In order to prepare for and control the continued spread of the COVID-19 pandemic while minimizing its economic impact, the world needs to be able to estimate and predict COVID-19's spread. Unfortunately, we cannot directly observe the prevalence SERO or growth rate of COVID-19; these must be inferred using some kind of model. We propose a hierarchical Bayesian extension to the classic susceptible-exposed-infected-removed (SEIR) compartmental model that adds compartments to account for isolation and death MESHD and allows the infection MESHD rate to vary as a function of both mobility data collected from mobile phones and a latent time-varying factor that accounts for changes in behavior not captured by mobility data. Since confirmed-case TRANS data is unreliable, we infer the model's parameters conditioned on deaths MESHD data. We replace the exponential-waiting-time assumption of classic compartmental models with Erlang distributions, which allows for a more realistic model of the long lag between exposure and death MESHD. The mobility data gives us a leading indicator that can quickly detect changes in the pandemic's local growth rate and forecast changes in death MESHD rates weeks ahead of time. This is an analysis of observational data, so any causal interpretations of the model's inferences should be treated as suggestive at best; nonetheless, the model's inferred relationship between different kinds of trips and the infection MESHD rate do suggest some possible hypotheses about what kinds of activities might contribute most to COVID-19's spread.

### An improved methodology for estimating the prevalence SERO of SARS-CoV-2

Authors: Virag Patel; Catherine McCarthy; Rachel A Taylor; Ruth Moir; Louise A Kelly; Emma L Snary

doi:10.1101/2020.08.04.20168187 Date: 2020-08-06 Source: medRxiv

Since the identification of Coronavirus disease MESHD 2019 (COVID-19) caused by severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) in China in December 2019, there have been more than 17 million cases of the disease MESHD in 216 countries worldwide. Comparisons of prevalence SERO estimates between different communities can inform policy decisions regarding safe travel TRANS between countries, help to assess when to implement (or remove) disease MESHD control measures and identify the risk of over-burdening healthcare providers. Estimating the true prevalence SERO can, however, be challenging because officially reported figures are likely to be significant underestimates of the true burden of COVID-19 within a community. Previous methods for estimating the prevalence SERO fail to incorporate differences between populations (such as younger populations having higher rates of asymptomatic TRANS cases) and so comparisons between, for example, countries, can be misleading. Here, we present an improved methodology for estimating COVID-19 prevalence SERO. We take the reported number of cases and deaths MESHD (together with population size) as raw prevalence SERO for the population. We then apply an age TRANS-adjustment to this which allows the age TRANS-distribution of that population to influence the case-fatality rate and the proportion of asymptomatic TRANS cases. Finally, we calculate the likely underreporting factor for the population and use this to adjust our prevalence SERO estimate further. We use our method to estimate the prevalence SERO for 166 countries (or the states of the United States of America, hereafter referred to as US state) where sufficient data were available. Our estimates show that as of the 30th July 2020, the top three countries with the highest estimated prevalence SERO are Brazil (1.26%, 95% CI: 0.96 - 1.37), Kyrgyzstan (1.10%, 95% CI: 0.82 - 1.19) and Suriname (0.58%, 95% CI: 0.44 - 0.63). Brazil is predicted to have the largest proportion of all the current global cases (30.41%, 95%CI: 27.52 - 30.84), followed by the USA (14.52%, 95%CI: 14.26 - 16.34) and India (11.23%, 95%CI: 11.11 - 11.24). Amongst the US states, the highest prevalence SERO is predicted to be in Louisiana (1.07%, 95% CI: 1.02 - 1.12), Florida (0.90%, 95% CI: 0.86 - 0.94) and Mississippi (0.77%, 95% CI: 0.74 - 0.81) whereas amongst European countries, the highest prevalence SERO is predicted to be in Montenegro (0.47%, 95% CI: 0.42 - 0.50), Kosovo (0.35%, 95% CI: 0.29 - 0.37) and Moldova (0.28%, 95% CI: 0.23 - 0.30). Our results suggest that Kyrgyzstan (0.04 tests per predicted case), Brazil (0.04 tests per predicted case) and Suriname (0.29 tests per predicted case) have the highest underreporting out of the countries in the top 25 prevalence SERO. In comparison, Israel (34.19 tests per predicted case), Bahrain (19.82 per predicted case) and Palestine (9.81 tests per predicted case) have the least underreporting. The results of this study may be used to understand the risk between different geographical areas and highlight regions where the prevalence SERO of COVID-19 is increasing most rapidly. The method described is quick and easy to implement. Prevalence SERO estimates should be updated on a regular basis to allow for rapid fluctuations in disease MESHD patterns.

### Reconciling epidemiological models with misclassified case-counts for SARS-CoV-2 with seroprevalence SERO surveys: A case study in Delhi, India

Authors: Rupam Bhattacharyya; Ritwik Bhaduri; Ritoban Kundu; Maxwell Salvatore; Bhramar Mukherjee

doi:10.1101/2020.07.31.20166249 Date: 2020-08-04 Source: medRxiv

Underreporting of COVID-19 cases and deaths MESHD is a hindrance to correctly modeling and monitoring the pandemic. This is primarily due to limited testing, lack of reporting infrastructure and a large number of asymptomatic infections MESHD asymptomatic TRANS. In addition, diagnostic tests (RT-PCR tests for detecting current infection MESHD) and serological antibody tests SERO for IgG (to assess past infections MESHD) are imperfect. In particular, the diagnostic tests have a high false negative rate. Epidemiologic models with a latent compartment for unascertained infections MESHD like the Susceptible-Exposed-Infected-Removed (SEIR) models can provide predictions for unreported cases and deaths MESHD under certain assumptions. Typically, the number of unascertained cases is unobserved and thus we cannot validate these estimates for a real study except for simulation studies. Population-based seroprevalence SERO studies can provide a rough estimate of the total number of infections MESHD and help us check epidemiologic model projections. In this paper, we develop a method to account for high false negative rates in RT-PCR in an extension to the classic SEIR model. We apply this method to Delhi, the national capital region of India, with a population of 19.8 million and a COVID-19 hotspot of the country, obtaining estimates of underreporting factor for cases at 34-53 times and that for deaths MESHD at 8-13 times. Based on a recently released serological survey for Delhi with an estimated 22.86% seroprevalence SERO, we compute adjusted estimates of the true number of infections MESHD reported by the survey (after accounting for misclassification of the antibody test SERO results) which is largely consistent with the model outputs, yielding an underreporting factor for cases from 30-42. Together with the model and the serosurvey, this implies approximately 96-98% cases in Delhi remained unreported and whereas only 109,140 cases were reported on July 10, the true number of infections MESHD varied somewhere between 4.4-4.6 million across different estimates. While repeated serological monitoring is resource intensive, model-based adjustments, run with the most up to date data, can provide a viable option to keep track of the unreported cases and deaths MESHD and gauge the true extent of transmission TRANS of this insidious virus.

### Altitude as a protective factor from COVID-19

Authors: Timothy M Thomson; Fresia Casas; Harold Andre Guerrero; Rómulo Figueroa-Mujica; Francisco C Villafuerte; Claudia Machicado

doi:10.1101/2020.08.03.20167262 Date: 2020-08-04 Source: medRxiv

The COVID-19 pandemic had a delayed onset in South America compared to Asia (outside of China), Europe or North America. In spite of the presumed time advantage for the implementation of preventive measures to help contain its spread, the pandemic in that region followed growth rates that paralleled, and currently exceed, those observed several weeks before in Europe. Indeed, in early August, 2020, many countries in South and Central America presented among the highest rates in the world of COVID-19 confirmed cases TRANS and deaths MESHD per million inhabitants. Here, we have taken an ecological approach to describe the current state of the pandemic in Peru and its dynamics. Our analysis supports a protective effect of altitude from COVID-19 incidence and mortality. Further, we provide circumstantial evidence that internal migration through a specific land route is a significant factor progressively overriding the protection from COVID-19 afforded by high altitude. Finally, we show that protection by altitude is independent of poverty indexes and is inversely correlated with the prevalence SERO in the population of risk factors associated with severe COVID-19, including hypertension MESHD hypertension HP and hypercholesterolemia MESHD hypercholesterolemia HP. We discuss long-term multisystemic adaptations to hypobaric hypoxia MESHD as possible mechanisms that may explain the observed protective effect of high altitude from death MESHD from COVID-19.

### Paradoxical Case Fatality Rate dichotomy of Covid-19 among rich and poor nations points to the hygiene hypothesis.

Authors: Bithika Chatterjee; Rajeeva Laxman Karandikar; Shekhar C. Mande

doi:10.1101/2020.07.31.20165696 Date: 2020-08-04 Source: medRxiv

In the first six months of its deadly spread across the world, the Covid-19 incidence has exhibited interesting dichotomy between the rich and the poor countries. Surprisingly, the incidence and the Case Fatality Rate has been much higher in the richer countries compared with the poorer countries. However, the reasons behind this dichotomy have not been explained based on data or evidence, although some of the factors for the susceptibility of populations to SARS-CoV-2 infections MESHD have been proposed. We have taken into consideration all publicly available data and mined for the possible explanations in order to understand the reasons for this phenomenon. The data included many parameters including demography of nations, prevalence SERO of communicable and non- communicable diseases MESHD, sanitation parameters etc. Results of our analyses suggest that demography, improved sanitation and hygiene, and higher incidence of autoimmune disorders as the most plausible factors to explain higher death MESHD rates in the richer countries Thus, the much debated hygiene hypothesis appears to lend credence to the Case Fatality Rate dichotomy between the rich and the poor countries.

### SARS-CoV-2 antigens expressed in plants detect antibody SERO responses in COVID-19 patients

Authors: Mohau S Makatsa; Marius B Tincho; Jerome M Wendoh; Sherazaan D Ismail; Rofhiwa Nesamari; Francisco Pera; Scott de Beer; Anura David; Sarika Jugwanth; Maemu P Gededzha; Nakampe Mampeule; Ian Sanne; Wendy Stevens; Lesley Scott; Jonathan Blackburn; Elizabeth S Mayne; Roanne S Keeton; Wendy A Burgers

doi:10.1101/2020.08.04.20167940 Date: 2020-08-04 Source: medRxiv

Background: The SARS-CoV-2 pandemic has swept the world and poses a significant global threat to lives and livelihoods, with over 16 million confirmed cases TRANS and at least 650 000 deaths MESHD from COVID-19 in the first 7 months of the pandemic. Developing tools to measure seroprevalence SERO and understand protective immunity to SARS-CoV-2 is a priority. We aimed to develop a serological assay SERO using plant-derived recombinant viral proteins, which represent important tools in less-resourced settings. Methods: We established an indirect enzyme-linked immunosorbent assay SERO ( ELISA SERO) using the S1 and receptor-binding domain (RBD) portions of the spike protein from SARS-CoV-2, expressed in Nicotiana benthamiana. We measured antibody SERO responses in sera from South African patients (n=77) who had tested positive by PCR for SARS-CoV-2. Samples were taken a median of six weeks after the diagnosis, and the majority of participants had mild and moderate COVID-19 disease MESHD. In addition, we tested the reactivity of pre-pandemic plasma SERO (n=58) and compared the performance SERO of our in-house ELISA SERO with a commercial assay. We also determined whether our assay could detect SARS-CoV-2-specific IgG and IgA in saliva. Results: We demonstrate that SARS-CoV-2-specific immunoglobulins are readily detectable using recombinant plant-derived viral proteins, in patients who tested positive for SARS-CoV-2 by PCR. Reactivity to S1 and RBD was detected in 51 (66%) and 48 (62%) of participants, respectively. Notably, we detected 100% of samples identified as having S1-specific antibodies SERO by a validated, high sensitivity SERO commercial ELISA SERO, and OD values were strongly and significantly correlated between the two assays. For the pre-pandemic plasma SERO, 1/58 (1.7%) of samples were positive, indicating a high specificity for SARS-CoV-2 in our ELISA SERO. SARS-CoV-2-specific IgG correlated significantly with IgA and IgM responses. Endpoint titers of S1- and RBD-specific immunoglobulins ranged from 1:50 to 1:3200. S1-specific IgG and IgA were found in saliva samples from convalescent volunteers. Conclusions: We demonstrate that recombinant SARS-CoV-2 proteins produced in plants enable robust detection of SARS-CoV-2 humoral responses. This assay can be used for seroepidemiological studies and to measure the strength and durability of antibody SERO responses to SARS-CoV-2 in infected patients in our setting.

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