Corpus overview


MeSH Disease

Human Phenotype

Fever (43)

Cough (37)

Pneumonia (35)

Hypertension (34)

Fatigue (17)


    displaying 1 - 10 records in total 155
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    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.

    Serial population based serosurvey of antibodies to SARS-CoV-2 SERO in a low and high transmission TRANS area of Karachi, Pakistan

    Authors: Muhammad Imran Nisar; Nadia Ansari; Mashal Amin; Farah Khalid; Aneeta Hotwani; Najeeb Rehman; Arjumand Rizvi; Arslan Memon; Zahoor Ahmed; Ashfaque Ahmed; Junaid Iqbal; Ali Faisal Saleem; Uzma Bashir Aamir; Daniel B Larremore; Bailey Fosdick; Fyezah Jehan

    doi:10.1101/2020.07.28.20163451 Date: 2020-07-29 Source: medRxiv

    Background Pakistan is among the first low- and middle-income countries affected by COVID-19 pandemic. Monitoring progress through serial sero-surveys SERO, particularly at household level, in densely populated urban communities can provide insights in areas where testing is non-uniform. Methods Two serial cross-sectional household surveys were performed in April (phase 1) and June (phase 2) 2020 each in a low- (District Malir) and high- transmission TRANS (District East) area of Karachi, Pakistan. Household were selected using simple random sampling (Malir) and systematic random sampling (East). Individual participation rate from consented households was 82.3% (1000/1215 eligible) in phase 1 and 76.5% (1004/1312 eligible) in phase 2. All household members or their legal guardians answered questions related to symptoms of Covid-19 and provided blood SERO for testing with commercial Elecsys Anti-SARS-CoV-2 immunoassay SERO targeting combined IgG and IgM. Seroprevalence SERO estimates were computed for each area and time point independently. Given correlation among household seropositivity values, a Bayesian regression model accounting for household membership, age TRANS and gender TRANS was used to estimate seroprevalence SERO. These estimates by age TRANS and gender TRANS were then post-stratified to adjust for the demographic makeup of the respective district. The household conditional risk of infection TRANS risk of infection TRANS infection MESHD was estimated for each district and its confidence interval were obtained using a non-parametric bootstrap of households. Findings Post-stratified seroprevalence SERO was estimated to be 0.2% (95% CI 0-0.7) in low-and 0.4% (95% CI 0 - 1.3) in high- transmission TRANS areas in phase 1 and 8.7% (95% CI 5.1-13.1) in low- and 15.1% (95% CI 9.4 -21.7) in high- transmission TRANS areas in phase 2, with no consistent patterns between prevalence SERO rates for males TRANS and females TRANS. Conditional risk of infection TRANS risk of infection TRANS infection MESHD estimates (possible only for phase 2) were 0.31 (95% CI 0.16-0.47) in low- and 0.41(95% CI 0.28-0.52) in high- transmission TRANS areas. Of the 166 participants who tested positive, only 9(5.4%) gave a history of any symptoms. Interpretation A large increase in seroprevalence SERO to SARS-CoV-2 infection MESHD is seen, even in areas where transmission TRANS is reported to be low. Mostly the population is still seronegative. A large majority of seropositives do not report any symptoms. The probability that an individual in a household is infected, given that another household member is infected is high in both the areas. These results emphasise the need to enhance surveillance activities of COVID-19 especially in low- transmission TRANS sites and provide insights to risks of household transmission TRANS in tightly knit neighbourhoods in urban LMIC settings.

    Seroprevalence SERO of anti-SARS-CoV-2 IgG antibodies SERO in Kenyan blood SERO donors

    Authors: Sophie Uyoga; Ifedayo M.O. Adetifa; Henry K. Karanja; James Nyagwange; James Tuju; Perpetual Wanjiku; Rashid Aman; Mercy Mwangangi; Patrick Amoth; Kadondi Kasera; Wangari Ng'ang'a; Charles Rombo; Christine K. Yegon; Khamisi Kithi; Elizabeth Odhiambo; Thomas Rotich; Irene Orgut; Sammy Kihara; Mark Otiende; Christian Bottomley; Zonia N. Mupe; Eunice W. Kagucia; Katherine Gallagher; Anthony Etyang; Shirine Voller; John Gitonga; Daisy Mugo; Charles N. Agoti; Edward Otieno; Leonard Ndwiga; Teresa Lambe; Daniel Wright; Edwine Barasa; Benjamin Tsofa; Philip Bejon; Lynette I. Ochola-Oyier; Ambrose Agweyu; J. Anthony G. Scott; George M Warimwe

    doi:10.1101/2020.07.27.20162693 Date: 2020-07-29 Source: medRxiv

    Background There are no data on SARS-CoV-2 seroprevalence SERO in Africa though the COVID-19 epidemic curve and reported mortality differ from patterns seen elsewhere. We estimated the anti- SARS-CoV-2 antibody SERO prevalence SERO among blood SERO donors in Kenya. Methods We measured anti-SARS-CoV-2 spike IgG prevalence SERO by ELISA SERO on residual blood SERO donor samples obtained between April 30 and June 16, 2020. Assay sensitivity SERO and specificity were 83% (95% CI 59, 96%) and 99.0% (95% CI 98.1, 99.5%), respectively. National seroprevalence SERO was estimated using Bayesian multilevel regression and post-stratification to account for non-random sampling with respect to age TRANS, sex and region, adjusted for assay performance SERO. Results Complete data were available for 3098 of 3174 donors, aged TRANS 15-64 years. By comparison with the Kenyan population, the sample over-represented males TRANS (82% versus 49%), adults TRANS aged TRANS 25-34 years (40% versus 27%) and residents of coastal Counties (49% versus 9%). Crude overall seroprevalence SERO was 5.6% (174/3098). Population-weighted, test-adjusted national seroprevalence SERO was 5.2% (95% CI 3.7, 7.1%). Seroprevalence SERO was highest in the 3 largest urban Counties; Mombasa (9.3% [95% CI 6.4, 13.2%)], Nairobi (8.5% [95% CI 4.9, 13.5%]) and Kisumu (6.5% [95% CI 3.3, 11.2%]). Conclusions We estimate that 1 in 20 adults TRANS in Kenya had SARS-CoV-2 antibodies SERO during the study period. By the median date of our survey, only 2093 COVID-19 cases and 71 deaths MESHD had been reported through the national screening system. This contrasts, by several orders of magnitude, with the numbers of cases and deaths MESHD reported in parts of Europe and America when seroprevalence SERO was similar.

    Efficacy and tolerability of bevacizumab in patients with severe Covid -19

    Authors: Jiaojiao Pang; Feng Xu; Gianmarco Aondio; Yu Li; Alberto Fumagalli; Ming Lu; Giuseppe Valmadre; Jie Wei; Yuan Bian; Margherita Canesi; Giovanni Damiani; Yuan Zhang; Dexin Yu; Jun Chen; Xiang Ji; Wenhai Sui; Bailu Wang; Shuo Wu; Attila Kovacs; Miriam Revera; Hao Wang; Ying Zhang; Yuguo Chen; Yihai Cao

    doi:10.1101/2020.07.26.20159756 Date: 2020-07-29 Source: medRxiv

    On the basis of Covid-19-induced pulmonary pathological and vascular changes, we hypothesized that the anti-VEGF drug bevacizumab might be beneficial for treating Covid-19 patients. We recruited 26 patients from 2-centers (China and Italy) with confirmed severe Covid-19, with respiratory rate [≥]30 times/min, oxygen saturation [≤]93% with ambient air, or partial arterial oxygen pressure to fraction of inspiration O2 ratio (PaO2/FiO2) >100mmHg and [≤]300 mmHg, and diffuse pneumonia MESHD pneumonia HP confirmed by chest radiological imaging. This trial was conducted from Feb 15 to April 5, 2020, and followed up for 28 days. Relative to comparable control patients with severe Covid-19 admitted in the same centers, bevacizumab showed clinical efficacy by improving oxygenation and shortening oxygen-support duration. Among 26 hospitalized patients with severe Covid-19 (median age TRANS, 62 years, 20 [77%] males TRANS), bevacizumab plus standard care markedly improved the PaO2/FiO2 ratios at days 1 and 7 (elevated values, day 1, 50.5 [4.0,119.0], p<0.001; day 7, 111.0 [85.0,165.0], p<0.001). By day 28, 24 (92%) patients showed improvement in oxygen-support status, 17 (65%) patients were discharged, and none showed worsen oxygen-support status nor died. Significant reduction of lesion areas and ratios were shown in chest CT or X-ray analysis within 7 days. Of 14 patients with fever MESHD fever HP, body temperature normalized within 72 hours in 13 (93%) patients. Lymphocyte counts in peripheral blood SERO were significantly increased and CRP levels were markedly decreased as shown in available data. Our findings suggested bevacizumab plus standard care was highly beneficial for treating patients with severe Covid-19. Clinical efficacy of bevacizumab warrants double blind, randomized, placebo-controlled trials.

    SARS-CoV-2 viral load dynamics, duration of viral shedding and infectiousness: a living systematic review and meta-analysis

    Authors: Muge Cevik; Matthew Tate; Oliver Lloyd; Alberto Enrico Maraolo; Jenna Schafers; Antonia Ho

    doi:10.1101/2020.07.25.20162107 Date: 2020-07-28 Source: medRxiv

    Background Viral load kinetics and the duration of viral shedding are important determinants for disease MESHD transmission TRANS. We aim i) to characterise viral load dynamics, duration of viral RNA, and viable virus shedding of SARS-CoV-2 in various body fluids and ii) to compare SARS-CoV-2 viral dynamics with SARS-CoV-1 and MERS-CoV. Methods: Medline, EMBASE, Europe PMC, preprint servers and grey literature were searched to retrieve all articles reporting viral dynamics and duration of SARS-CoV-2, SARS-CoV-1 and MERS-CoV shedding. We excluded case reports and case series with < 5 patients, or studies that did not report shedding duration from symptom onset TRANS. PROSPERO registration: CRD42020181914. Findings: Seventy-nine studies on SARS-CoV-2, 8 on SARS-CoV-1, and 11 on MERS-CoV were included. Mean SARS-CoV-2 RNA shedding duration in upper respiratory tract, lower respiratory tract, stool and serum SERO were 17.0, 14.6, 17.2 and 16.6 days, respectively. Maximum duration of SARS-CoV-2 RNA shedding reported in URT, LRT, stool and serum SERO was 83, 59, 35 and 60 days, respectively. Pooled mean duration of SARS-CoV-2 RNA shedding was positively associated with age TRANS (p=0.002), but not gender TRANS (p = 0.277). No study to date has detected live virus beyond day nine of illness despite persistently high viral loads. SARS-CoV-2 viral load in the upper respiratory tract appears to peak in the first week of illness, while SARS-CoV-1 and MERS-CoV peak later. Conclusion: Although SARS-CoV-2 RNA shedding in respiratory and stool can be prolonged, duration of viable virus is relatively short-lived. Thus, detection of viral RNA cannot be used to infer infectiousness. High SARS-CoV-2 titres are detectable in the first week of illness with an early peak observed at symptom onset TRANS to day 5 of illness. This review underscores the importance of early case finding and isolation, as well as public education on the spectrum of illness. However, given potential delays in the isolation of patients, effective containment of SARS-CoV-2 may be challenging even with an early detection and isolation strategy. Funding: No funding was received.

    Patients with COVID-19 Interstitial Pneumonia MESHD Pneumonia HP Exhibit Pancreatic Hyperenzymemia and Not Acute Pancreatitis HP Pancreatitis MESHD

    Authors: Raffaele Pezzilli; Stefano Centanni; Michele Mondoni; Rocco F. Rinaldo; Matteo Davì; Rossana Stefanelli; GianVico Melzi d’Eril; Alessandra Barassi

    doi:10.21203/ Date: 2020-07-28 Source: ResearchSquare

    Background and aims: Gastrointestinal manifestations of COVID-19 have been well established, but pancreatic involvement is under debate. The aim of the study is to evaluate the presence of acute pancreatitis HP pancreatitis MESHD in COVID-19 patients and to assess the frequency of pancreatic hyperenzymemia. Methods: From April 1st 2020 to April 30th 2020, 110 consecutive patients (69 males TRANS, 41 females TRANS; mean age TRANS 63.0 years, range 24-93 years) met these criteria and were enrolled in the study.. The clinical data and serum SERO activity of pancreatic amylase and lipase were assayed in all patients using commercially available kits. Results: None of the patients studied developed clinical signs or morphological alterations compatible with acute pancreatitis HP pancreatitis MESHD. However, it was found that 24.5% of the patients had amylase values above 53 IU/L and 16.4% had lipase values above 300 IU/. Only one patient (0.9%) had both amylase and lipase values in excess of three-fold the upper normal limit without clinical signs of pancreatitis MESHD pancreatitis HP. Conclusions: The presence of pancreatic hyperenzymemia in a patient with COVID-19 requires the management of these patients be guided by clinical evaluation and not merely by evaluation of the biochemical results.

    Levels of the TNF related cytokine, LIGHT increase in hospitalized COVID-19 patients with Cytokine Release Syndrome MESHD and ARDS

    Authors: David S Perlin; Inbal Zafir-Lavie; Lori Roadcap; Shane Raines; Carl F Ware; Garry A Neil

    doi:10.1101/2020.07.27.20152892 Date: 2020-07-28 Source: medRxiv

    Many COVID-19 patients demonstrate lethal respiratory complications caused by cytokine release syndrome MESHD (CRS). Multiple cytokines have been implicated in CRS, but TNFSF14 (LIGHT) has not been previously measured in this setting. In this study, we observed significantly elevated serum SERO LIGHT levels in hospitalized COVID-19 patients as compared to healthy age TRANS and gender TRANS matched control patients. The assay detected bioavailable LIGHT unbound to the inhibitor Decoy receptor-3 (DcR3). Bioavailable LIGHT levels were elevated in patients both on and off ventilatory support, with a trend toward higher levels in patients requiring mechanical ventilation. In hospitalized patients over the age TRANS of 60, who exhibited a mortality rate of 82%, LIGHT levels were significantly higher (p=0.0209) in those who died compared to survivors. As previously reported, interleukin 6 (IL-6) levels were also elevated in these patients with significantly (p=0.0076) higher levels observed in patients who died vs. survivors, paralleling the LIGHT levels. Although attempts to block IL-6 binding to its receptor have shown limited effect in COVID-19 CRS, neutralization of LIGHT may prove to be more effective owing to its more central role in regulating antiviral immune responses.

    Evidence of gender TRANS bias in the diagnosis and management of COVID-19 patients: A Big Data analysis of Electronic Health Records

    Authors: Julio Ancochea; Jose L. Izquierdo; - Savana COVID-19 Research Group; Joan B Soriano

    doi:10.1101/2020.07.20.20157735 Date: 2020-07-26 Source: medRxiv

    Background: It remains unknown whether the frequency and severity of COVID-19 affect women differently than men. Here, we aim to describe the characteristics of COVID-19 patients at disease MESHD onset, with special focus on the diagnosis and management of female TRANS patients with COVID-19. Methods: We explored the unstructured free text in the electronic health records (EHRs) within the SESCAM Healthcare Network (Castilla La-Mancha, Spain). The study sample comprised the entire population with available EHRs (1,446,452 patients) from January 1st to May 1st, 2020. We extracted patients' clinical information upon diagnosis, progression, and outcome for all COVID-19 cases. Results: A total of 4,780 patients with a test-confirmed diagnosis of COVID-19 were identified. Of these, 2,443 (51%) were female TRANS, who were on average 1.5 years younger than males TRANS (61.7{+/-}19.4 vs. 63.3{+/-}18.3, p=0.0025). There were more female TRANS COVID-19 cases in the 15-59 yr.-old interval, with the greatest sex ratio (SR; 95% CI) observed in the 30-39 yr.-old interval (1.69; 1.35-2.11). Upon diagnosis, headache MESHD headache HP, anosmia HP, and ageusia MESHD were significantly more frequent in females TRANS than males TRANS. Imaging by chest X-ray or blood SERO tests were performed less frequently in females TRANS (65.5% vs. 78.3% and 49.5% vs. 63.7%, respectively), all p<0.001. Regarding hospital resource use, females TRANS showed less frequency of hospitalization (44.3% vs. 62.0%) and ICU admission (2.8% vs. 6.3%) than males TRANS, all p<0.001. Conclusion: Our results indicate important sex-dependent differences in the diagnosis, clinical manifestation, and treatment of patients with COVID-19. These results warrant further research to identify and close the gender TRANS gap in the ongoing pandemic.

    Ocular findings and retinal involvement in COVID-19 pneumonia MESHD pneumonia HP patients: A cross-sectional study in an Italian referral centre

    Authors: Maria Pia Pirraglia; Giancarlo Ceccarelli; Alberto Cerini; Giacomo Visioli; Gabriella d'Ettorre; Claudio Maria Mastroianni; Francesco Pugliese; Alessandro Lambiase; Magda Gharbiya

    doi:10.21203/ Date: 2020-07-23 Source: ResearchSquare

    Background: changes in immune and coagulation systems and possible viral spread through blood SERO-brain barrier have been described in SARS-CoV-2 infection MESHD. In this study, we evaluate the possible retinal involvement and ocular findings in severe COVID-19 pneumonia MESHD pneumonia HP patients.  Methods: a cross sectional study was conducted on 46 patients affected by severe COVID-19 who were hospitalized in one Intensive Care Unit (ICU) and in two Infectious Diseases MESHD wards, including a bedside eye screening, corneal sensitivity SERO assessment and retinography. Results: a total of 43 SARS-CoV-2 positive pneumonia MESHD pneumonia HP patients affected with COVID-19 pneumonia MESHD pneumonia HP were included, 25 males TRANS and 18 females TRANS, with a median age TRANS of 70 [IQR 59-78]. Except for one patient with unilateral posterior chorioretinitis MESHD chorioretinitis HP of opportunistic origin, of whom aqueous tap was negative for SARS-CoV-2, no further retinal manifestation related to COVID-19 infection MESHD was found in our cohort. We found 3 patients (7%) with bilateral conjunctivitis MESHD conjunctivitis HP in whom PCR analysis on conjunctival swab provided negative results for SARS-CoV-2. No alterations of corneal sensitivity SERO were found.Conclusion: we demonstrated the absence of retinal involvement in SARS-CoV-2 pneumonia MESHD pneumonia HP patients. Ophthalmologic evaluation in COVID-19, particularly in patients hospitalized in an ICU setting, may be useful to reveal systemic co- infections by opportunistic MESHD infections by opportunistic HP pathogens. 

    High Community SARS-CoV-2 Antibody SERO Seroprevalence SERO in a Ski Resort Community, Blaine County, Idaho, US. Preliminary Results

    Authors: Colleen McLaughlin; Margaret K. Doll; Kathryn T Morrison; William L McLaughlin III; Terry OConnor; Anton M Sholukh; Emily L Bossard; Khamsone Phasouk; Emily S Ford; Kurt Diem; Alexis M Hlock; Keith R Jerome; Lawrence Corey

    doi:10.1101/2020.07.19.20157198 Date: 2020-07-21 Source: medRxiv

    Community-level seroprevalence SERO surveys are needed to determine the proportion of the population with previous SARS-CoV-2 infection MESHD, a necessary component of COVID-19 disease MESHD surveillance. In May, 2020, we conducted a cross-sectional seroprevalence SERO study of IgG antibodies SERO for nucleocapsid of SARS-CoV-2 among the residents of Blaine County, Idaho, a ski resort community with high COVID-19 attack rates TRANS in late March and Early April (2.9% for ages TRANS 18 and older). Participants were selected from volunteers who registered via a secure web link, using prestratification weighting to the population distribution by age TRANS and gender TRANS within each ZIP Code. Participants completed a survey reporting their demographics and symptoms; 88% of volunteers who were invited to participate completed data collection survey and had 10 ml of blood SERO drawn. Serology was completed via the Abbott Architect SARS-CoV-2 IgG immunoassay SERO. Primary analyses estimated seroprevalence SERO and 95% credible intervals (CI) using a hierarchical Bayesian framework to account for diagnostic uncertainty. Stratified models were run by age TRANS, sex, ZIP Code, ethnicity, employment status, and a priori participant-reported COVID-19 status. Sensitivity SERO analyses to estimate seroprevalence SERO included base models with post-stratification for ethnicity, age TRANS, and sex, with or without adjustment for multi-participant households. IgG antibodies SERO to the virus that causes COVID-19 were found among 22.7% (95% CI: 20.1%, 25.5%) of residents of Blaine County. Higher levels of antibodies SERO were found among residents of the City of Ketchum 34.8% (95% CI 29.3%, 40.5%), compared to Hailey 16.8% (95%CI 13.7%, 20.3%) and Sun Valley 19.4% (95% 11.8%, 28.4%). People who self-identified as not believing they had COVID-19 had the lowest prevalence SERO 4.8% (95% CI 2.3%, 8.2%). The range of seroprevalence SERO after correction for potential selection bias was 21.9% to 24.2%. This study suggests more than 80% of SARS-CoV-2 infections MESHD were not reported. Although Blaine County had high levels of SARS-CoV-2 infection MESHD, the community is not yet near the herd immunity threshold.

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MeSH Disease
Human Phenotype

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