Corpus overview


Overview

MeSH Disease

Human Phenotype

Hypertension (91)

Pneumonia (19)

Cough (19)

Fever (19)

Obesity (14)


Transmission

Seroprevalence
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    Factors associated with the poor outcomes in diabetic patients with COVID-19

    Authors: Hadith Rastad; Hanieh-Sadat Ejtahed; Armita Mahdavi-Ghorabi; Anis Safari; Ehsan Shahrestanaki; Mohammad Rezaei; Mohammad Mahdi Niksima; Akram Zakani; Seyede Hanieh Dehghan Manshadi; Fatemeh Ochi; Shabnam saedi; Zeinab Khodaparast; Neda Shafiabadi Hassani; Mehdi Azimzadeh; Mostafa Qorbani

    doi:10.21203/rs.3.rs-56358/v1 Date: 2020-08-09 Source: ResearchSquare

    Background Diabetic’s patients are supposed to experience higher rates of COVID-19 related poor outcomes. We aimed to determined factors predicting poor outcomes in hospitalized diabetic patients with COVID-19.Methods This retrospective cohort study included all adult TRANS diabetic patients with radiological or laboratory confirmed COVID-19 who hospitalized between 20 February 2020 and 27 April 2020 in Alborz province, Iran. Data on demographic, medical history, and laboratory test at presentation were obtained from electronic medical records. Diagnosis of diabetes mellitus MESHD diabetes mellitus HP was self-reported. Comorbidities including cancer, rheumatism, immunodeficiency HP, or chronic diseases MESHD of respiratory, liver, and blood SERO were classified as “other comorbidities” due to low frequency. The assessed poor outcomes were in-hospital mortality, need to ICU care, and receiving invasive mechanical ventilation. Self-reported. Multivariate logistic regression models were fitted to quantify the predictors of in-hospital mortality from COVID-19 in patients with DM.Results Of 455 included patients, 98(21.5%) received ICU care, 65(14.3%) required invasive mechanical ventilation, and 79 (17.4%) dead. In the multivariate model, significant predictors of “death of COVID-19” were age TRANS 65 years or older (OR (95% CI): 2.0 (1.16–3.44), chronic kidney disease HP kidney disease MESHD (CKD) (2.05 (1.16–3.62), presence of “other comorbidities” (2.20 (1.04–4.63)), neutrophil count ≥ 8.0 × 10⁹/L )6.62 (3.73–11.7 ((, Hb level < 12.5 g/dl (2.05 (1.13–3.72) (, and creatinine level ≥ 1.36 mg/dl (3.10 (1.38–6.98)). (All p –values < 0.05). Some of these factors were also associated with other assessed poor outcomes, e.g., need to ICU care or invasive mechanical ventilation.Conclusions Diabetic patients with age TRANS 65 years or older, comorbidity CKD, “other comorbidities”, as well as neutrophil count ≥ 8.0 × 10⁹/L, Hb level < 12.5 g/dl, and creatinine level ≥ 1.36 mg/dl, were more likely to dead after COVID-19. Presence of hypertension MESHD hypertension HP and cardiovascular disease MESHD were associated with none of the poor outcomes.

    Sex-specificity of mortality risk factors among hospitalized COVID-19 patients in New York City: prospective cohort study

    Authors: Tomi Jun; Sharon Nirenberg; Patricia Kovatch; Kuan-lin Huang

    doi:10.1101/2020.07.29.20164640 Date: 2020-08-01 Source: medRxiv

    Objective: To identify sex-specific effects of risk factors for in-hospital mortality among COVID-19 patients admitted to a hospital system in New York City. Design: Prospective observational cohort study with in-hospital mortality as the primary outcome. Setting: Five acute care hospitals within a single academic medical system in New York City. Participants: 3,086 hospital inpatients with COVID-19 admitted on or before April 13, 2020 and followed through June 2, 2020. Follow-up till discharge or death MESHD was complete for 99.3% of the cohort. Results: The majority of the cohort was male TRANS (59.6%). Men were younger (median 64 vs. 70, p<0.001) and less likely to have comorbidities such as hypertension MESHD hypertension HP (32.5% vs. 39.9%, p<0.001), diabetes (22.6% vs. 26%, p=0.03), and obesity MESHD obesity HP (6.9% vs. 9.8%, p=0.004) compared to women. Women had lower median values of laboratory markers associated with inflammation MESHD compared to men: white blood SERO cells (5.95 vs. 6.8 K/uL, p<0.001), procalcitonin (0.14 vs 0.21 ng/mL, p<0.001), lactate dehydrogenase (375 vs. 428 U/L, p<0.001), C-reactive protein (87.7 vs. 123.2 mg/L, p<0.001). Unadjusted mortality was similar between men and women (28.8% vs. 28.5%, p=0.84), but more men required intensive care than women (25.2% vs. 19%, p<0.001). Male TRANS sex was an independent risk factor for mortality (OR 1.26, 95% 1.04-1.51) after adjustment for demographics, comorbidities, and baseline hypoxia MESHD. There were significant interactions between sex and coronary artery disease MESHD (p=0.038), obesity MESHD obesity HP (p=0.01), baseline hypoxia MESHD (p<0.001), ferritin (p=0.002), lactate dehydrogenase (p=0.003), and procalcitonin (p=0.03). Except for procalcitonin, which had the opposite association, each of these factors was associated with disproportionately higher mortality among women. Conclusions: Male TRANS sex was an independent predictor of mortality, consistent with prior studies. Notably, there were significant sex-specific interactions which indicated a disproportionate increase in mortality among women with coronary artery disease MESHD, obesity MESHD obesity HP, and hypoxia MESHD. These new findings highlight patient subgroups for further study and help explain the recognized sex differences in COVID-19 outcomes.

    A Comprehensive Evaluation of Early Predictors of Disease Progression MESHD in Patients with COVID-19: A Case Control Study

    Authors: Qiang Tang; Yanwei Liu; Yingfeng Fu; Ziyang Di; Kailiang Xu; Bo Tang; Hui Wu; Maojun Di

    doi:10.21203/rs.3.rs-50527/v1 Date: 2020-07-29 Source: ResearchSquare

    Background: The 2019 coronavirus disease MESHD (COVID-19) has become an unprecedented public health crisis with nearly 16 million confirmed cases TRANS and 630,000 deaths MESHD worldwide. Methods: We retrospectively investigated the demographic, clinical, laboratory, radiological and treatment data of COVID-19 patients consecutively enrolled from January 18 to May 15, 2020, in Taihe and Jinzhou central hospital. Results: Of all 197 patients, the median age TRANS was 66.5 years (IQR 7-76), and 120 (60.9%) patients were males TRANS. We identified 88 (44.7%) of 197 COVID-19 patients as the disease progression MESHD (aggravation) cases. The aggravation cases tend to have more medical comorbidity: hypertension MESHD hypertension HP (34.1%), diabetes (30.7%), and presented with dyspnea MESHD dyspnea HP (34.1%), neutrophilia HP (60.2%), and lymphocytopenia (73.9%), compared with those without. And the patients with disease progression MESHD showed significantly higher level of Fibrinogen (Fbg), D-dimer, IL-6, C-reactive protein (CRP), procalcitonin (PCT), and serum SERO ferritin, and were more prone to develop organ damage in the liver, kidney, and heart (P<0.05). Multivariable regression showed that advanced age TRANS, comorbidities, lymphopenia MESHD lymphopenia HP, and elevated level of Fbg, lactate dehydrogenase (LDH), Cardiac troponin (CTnI), IL-6, serum SERO ferritin were the significant predictors of disease progression MESHD. Further, we investigated antibody SERO responses to SARS-CoV-2 and found that the levels of IgM and IgG were significantly higher in the disease progression MESHD cases compared to non-progression cases from 3 weeks after symptom onset TRANS. In addition, the disease progression MESHD group tended to peak later and has a more vigorous IgM/IgG response against SARS-CoV-2. Further, we performed Kaplan-Meier analysis and found that 61.6% of patients had not experienced ICU transfer or survival from hospital within 25 days from admission.Conclusions: Investigating the potential factors of advanced age TRANS, comorbidities and elevated level of IL-6, serum SERO ferritin and Kaplan-Meier analysis enables early identification and management of patients with poor prognosis. Detection of the dynamic antibody SERO may offer vital clinical information during the course of SARS-CoV-2 and provide prognostic value for patients infection MESHD.  

    Developing the nomogram for the prediction of in-hospital incidence of acute respiratory distress syndrome MESHD in patients with COVID-19

    Authors: Ning Ding; Yang Zhou; Guifang Yang; Cuirong Guo; Fengning Tang; Xiangping Chai

    doi:10.21203/rs.3.rs-49304/v1 Date: 2020-07-26 Source: ResearchSquare

    Background: Acute respiratory distress HP syndrome MESHD (ARDS) was the most common complication of coronavirus disease MESHD-2019(COVID-19), leading to poor clinical outcomes. However, the model to predict the in-hospital incidence of ARDS in patients with COVID-19 is limited. Therefore, we aimed to develop a predictive nomogram for the in-hospital incidence of ARDS in COVID-19 patients.Methods: Patients with COVID-19 admitted to Changsha Public Health Centre between Jan 30, 2020, and Feb 22, 2020, were enrolled. Clinical characteristics and laboratory variables were analyzed in patients with ARDS. Risk factors for ARDS were selected by LASSO binary logistic regression. Nomogram was established based on risk factors and validated by the dataset.Results: A total of 113 patients, involving 99 in the non-ARDS group and 14 in the ARDS group were included in the study. 8 variables including hypertension MESHD hypertension HP, chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP (COPD), cough MESHD cough HP, lactate dehydrogenase (LDH), creatine kinase (CK), white blood SERO count (WBC), body temperature, and heart rate were identified to be included in the model. The specificity, sensitivity SERO, and accuracy of the full model were 100%, 85.7%, and 87.5% respectively. The calibration curve also showed good agreement between the predicted and observed values in the model.Conclusions: The nomogram can predict the in-hospital incidence of ARDS in COVID-19 patients. It helps physicians to make an individualized treatment plan for each patient.

    Aneurysmal Subarachnoid Haemorrhage After COVID-19 Infection MESHD

    Authors: Sajjad Muhammad; Soheil Naderi; Mostafa Ahmadi; Askar Ghorbani; Daniel Hänggi

    doi:10.21203/rs.3.rs-48374/v1 Date: 2020-07-24 Source: ResearchSquare

    BackgroundSARS-CoV-2 virus infection MESHD leads to a severe and dysbalanced inflammatory response with hypercytokinemia and immunodepression. Systemic inflammation MESHD due to viral infections MESHD can potentially cause vascular damage including disruption of blood SERO-brain barrier (BBB) and alterations in coagulation system that may also lead to cardiovascular and neurovascular events. Here, we report the first case of COVID-19 infection MESHD leading to aneurysmal subarachnoid haemorrhage (aSAH). Case DescriptionA 61-year-old woman presented with dyspnea MESHD dyspnea HP, cough MESHD cough HP and fever MESHD fever HP. She was over weight with Body MESHD mass-index of 34 and history of hypertension MESHD hypertension HP. No history of subarachnoid hemorrhage MESHD subarachnoid hemorrhage HP in the family. She was admitted in ICU due to low oxygen saturation (89%). A chest CT showed typical picture of COVID-19 pneumonia MESHD pneumonia HP. Oropharyngeal swab with a PCR-based testing was COVID-19 positive. She was prescribed with favipiravir and hydroxychloroquine in Addition to oxygen support. On second day she experienced sudden headache MESHD headache HP and losst conciousness. A computer tomography (CT) with CT-angiography revealed subarachnoid haemorrhage in basal cisterns from a ruptured MESHD anterior communicating artery aneurysm MESHD. The aneurysm MESHD was clipped microsurgically through a standard pterional approach and the patient was admitted again to intensive care unit for further intensive medical treatment. Post-operative the patient showed slight motor dysphasia HP. No other neurological deficits.ConclusionAneurysmal subarachnoid haemorrhage secondary to COVID-19 infection MESHD might be triggered by systemic inflammation MESHD. COVID-19 infection MESHD could be one of the risk factors leading to instability and rupture MESHD of intracranial aneurysm MESHD.

    A return to normal kidney function in a Caucasian male TRANS after COVID-19 induced dialysis-requiring kidney failure

    Authors: Peter Okholm MD; Jan Kampmann MD

    doi:10.21203/rs.3.rs-44654/v1 Date: 2020-07-17 Source: ResearchSquare

    Background: Coronavirus disease MESHD 2019 also known as COVID-19 has been recognized by WHO as a global pandemic and has spread to most of the world. The disease MESHD has a multitude of clinical presentations, and especially the development of acute kidney injury MESHD acute kidney injury HP has been associated with increased mortality.Case Presentation: A 71-year old Caucasian male TRANS was admitted with fever MESHD fever HP and dyspnea MESHD dyspnea HP to the emergency MESHD department. His medical history included type 2 diabetes and hypertension MESHD hypertension HP. Blood SERO tests showed a normal kidney function before admission with a creatinine of 0,8 mg/dL. Clinical examination, blood SERO tests and Chest X-ray suggested COVID-19. At admission the diagnose COVID-19 was confirmed, fluid therapy was commenced and Angiotensin-converting enzyme therapy discontinued. The patients was intubated due to respiratory failures HP and transferred to the intensive care ward where he developed acute anuric kidney failure and was started in continuous renal replacement therapy. After 6 days of dialysis treatment his kidney function slowly started to improve, and he was discharged after 26 days of admission. 42 days after admission his creatinine was measured to 1.3 mg/dLConclusion: We present the rare case of a Caucasian male TRANS, who not only survived COVID-19 induced kidney failure that required continuous renal replacement therapy, but returned to almost baseline creatinine. We discuss the role of Angiotensin-converting enzyme inhibitor treatment in COVID-19 and the potential pathophysiological mechanism surrounding AKI in COVID-19 patients in literature, and connect it to our case report.

    Changes in lipid metabolism in patients with severe COVID-19

    Authors: Yi Li; Yan Zhang; Minhui Dai; Minxue Shen; Jianchu Zhang; Yanhui Cui; Ben Liu; Fengyu Lin; Lingli Chen; Duoduo Han; Yifei Fan; Yanjun Zeng; Wen Li; Sha Li; Xiang Chen; Pinhua Pan

    doi:10.21203/rs.3.rs-43521/v1 Date: 2020-07-15 Source: ResearchSquare

    Background: Dyslipidemia plays an important role in the pathogenesis and evolution of critical illness MESHD, but limited information exists regarding the lipid metabolism of severe coronavirus disease MESHD 2019 (COVID-19) patients. The aim of this study was to investigate role of dyslipidemia in patients with severe COVID-19Methods: We retrospectively reviewed 216 severe COVID-19 patients with clarified outcomes (discharged or deceased), admitted to the West Court of Union Hospital in Wuhan, China, between February 1 and March 31, 2020. The dynamic changes of lipid profiles and their relationships with disease MESHD severity and clinical outcomes were analyzed.Results: A total of 216 severe COVID-19 patients, including 24 non-survivors and 192 survivors, were included in the final analyses. The levels of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein AI (Apo-AI) on admission were significantly lower in non-survivors compared to survivors. During hospitalization, low-density lipoprotein cholesterol (LDL-C), total cholesterol(TC), HDL-C and Apo-AI were shown an increasing trend in survivors, but maintained lower levels or shown downward trend in non-survivors. The serum SERO levels of HDL-C and Apo-AI were inversely correlated with C-reactive protein (CRP), length of hospital stay of survivors and disease MESHD severity. The receiver operating characteristic (ROC) curve analysis identified a CRP/ HDL-C ratio cut-off value of 62.54 as the predictor for in-hospital mortality (AUC=0.823, Sensitivity=83.3%, Specificity=70.8%). Logistic regression analysis demonstrated that hypertension MESHD hypertension HP, neutrophils-to-lymphocytes ratio(NLR), platelet count and high CRP/ HDL-C ratio (>62.54) were independent factors to predict in-hospital mortality.Conclusions: The results demonstrated that dyslipidemia was associated with the inflammatory response, disease MESHD severity and poor prognosis of COVID-19. High CRP/ HDL-C ratio may serve as an independently potential predictor for hospital mortality among patients with severe COVID-19.

    Severe SARS-CoV-2 infection MESHD is defined by a shift in the serum SERO lipidome resulting in dysregulation of eicosanoid lipid immune mediators

    Authors: Benjamin Schwarz; Lokesh Sharma; Lydia Roberts; Xiaohua Peng; Santos Bermejo; Ian Leighton; Arnau Casanovas-Massana; Shelli Farhadian; Albert Ko; Yale IMPACT Team; Charles Dela Cruz; Catharine Bosio

    doi:10.21203/rs.3.rs-42999/v1 Date: 2020-07-14 Source: ResearchSquare

    The COVID-19 pandemic has affected more than 10 million people worldwide with mortality exceeding3 half a million patients. Risk factors associated with severe disease MESHD and mortality include advanced age TRANS,4 hypertension MESHD hypertension HP, diabetes, and obesity MESHD obesity HP.1 Clear mechanistic understanding of how these comorbidities5 converge to enable severe infection HP infection MESHD is lacking. Notably each of these risk factors pathologically disrupts6 the lipidome and this disruption may be a unifying feature of severe COVID-19.1-7 Here we provide the first in depth interrogation of lipidomic changes, including structural-lipids as well as the eicosanoids and docosanoids lipid mediators (LMs), that mark COVID-19 disease MESHD severity. Our data reveal that progression from moderate to severe disease MESHD is marked by a loss of specific immune regulatory LMs and increased pro-inflammatory species. Given the important immune regulatory role of LMs, these data provide mechanistic insight into the immune balance in COVID-19 and potential targets for therapy with currently approved pharmaceuticals.8

    Clinical characteristics and Mortality risk factors among COVID-19 patients in Qom–Iran; The results of a Retrospective Cohort study

    Authors: Ahmad Hormati; SeyedYaser Foroghi Ghomi; masoudreza sohrabi; Ali Gholami; Saeede Jafari; Amir Jabbari; Reza AminNejad; Javad Khodadadi; Mansoureh shakeri; Alireza ShahHamzeh; Mahbobeh Afifian; Zohre Azad; Sajjad Ahmadpour; MohammadHadi Karbalai; MohammadReza Babaei; Parisa Karimzadeh; SeyedKamal Esshagh Hosseini

    doi:10.21203/rs.3.rs-42497/v1 Date: 2020-07-13 Source: ResearchSquare

    Background & AimCoronavirus 2019 (COVID-19) outbreak in the Middle East was initially reported in Qom-Iran. Clinical and epidemiologic and mortality risk factors details have not been already fully explained.MethodIn a retrospective study, the hospitalized adult TRANS patients with laboratory diagnosed COVID-19 between February 25 to March 20, 2020 were enrolled. A checklist including demographic, clinical, laboratorial, imaging, and treatment data was completed for each of the participant. The data were extracted from electronic medical records. In case of lack of information, a member of the research team contacted them via phone. All the dead patients and the first one hundred survived patients with these criteria were enrolled in the study. Outcome defined as death MESHD or discharge of patients.ResultsOf admitted patients, 200 patients who had been discharged or died were involved in this study. The majority of them were male TRANS (56%). The mean age TRANS of all patients was 62.63 ± 14.9. Co-morbidity was reported in 124 (62%) patients in which hypertension MESHD hypertension HP was the most common. The most frequent clinical presentations were dyspnea MESHD dyspnea HP in 169 (84.5%), cough MESHD cough HP in 150 (75%), and fatigue MESHD fatigue HP/weakness in 123 (61.5%) patients. The main complications were respiratory failure HP and acute respiratory distress HP syndrome MESHD with prevalence SERO of 143 (71.5%) and 105 (52.5%), accordingly. Multiple logistic models showed that decline of hemoglobin level (OR = 10.09), neutrophilia HP (OR = 3.48), high blood SERO urea nitrogen (OR = 4.29,), SpO2 ≤ 90% (OR = 3.38), and presence of patchy consolidation (OR = 6.81) were associated with poor outcome.ConclusionCOVID-19 disease MESHD has multiple aspects. CT scan findings, complete blood SERO count with differential, high blood SERO urea nitrogen and SpO2 are related to mortality. Hence needs to pay serious attention during admitting and surveillance, particularly among elderly TRANS patients and who with preexisting morbidities.

    Mediating Effect of Deteriorated Kidney Function in Comorbidity-related Excess Deaths MESHD in COVID-19: A Retrospective Cohort Study

    Authors: Dongling Luo; Qiaomei Liu; Changming Xie; Weidong Wang; Xiong Wang; Juan Wu; Maomao Xi; Yilin Yin; Di Xiong; Yuwei Wu; Yuqing Xie; Ximin Shi; Pengcheng Luo; Fang Dong; Hui Huang

    doi:10.21203/rs.3.rs-41904/v1 Date: 2020-07-13 Source: ResearchSquare

    Background In-hospital death MESHD risks vary in COVID-19 patients with comorbidities. Kidney function decline is prevalent in this course. Methods To explore the exact role of deteriorated kidney function, we applied a retrospective cohort study including 1266 participants in Wuhan Tongren Hospital between January 27 and March 3, 2020. Demographic characteristics, preexisting comorbidities history, organ function data and outcomes were extracted. Deteriorated kidney function was identified as the decline percentage, assessed by an increase in peak serum SERO creatinine from the baseline. Mediating effect was calculated by mediation analysis. Key Results 1266 hospitalized COVID-19 patients (60±15 years, 47.8% are male TRANS) were included, with an overall in-hospital death MESHD rate of 4.42% (56/1266). For critical cases, 77.02% had at least one preexisting comorbidity. Patients with comorbidities suffered higher in-hospital death MESHD and more severe decline of kidney function. Compared to patients with minor function decline (<10%), significant risk increase was found in those with more severe one (OR 3.57; 95%CI 1.70 to 7.52; P=.001 for moderate with 10-50% decline, and 37.45; 95%CI 18.71 to 74.55; P<.001 for severe with>50%). More interestingly, the mediation analysis found deteriorated kidney function played as an important mediator between different comorbidities and COVID-19 patients’ in-hospital death MESHD, with the mediation effect of 11%, 12%, 16% and 32% respectively for hypertension MESHD hypertension HP, COPD, CVD and CKD.Conclusions Deteriorated kidney function is strongly associated with increase of in-hospital death MESHD in COVID-19 and partially mediates the facilitating effect of preexisting comorbidities on in-hospital death MESHD. Thus, dynamic monitoring kidney function, preventing the deterioration of kidney function might be helpful to improve survival in COVID-19 patients, especially those with preexisting comorbidities.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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