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SARS-CoV-2 proteins

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    Patterns of Multimorbidity and Risk of Severe SARS-CoV-2 Infection MESHD: an observational study in the U.K.

    Authors: Yogini V Chudasama; Francesco Zaccardi; Clare L Gillies; Cameron Razieh; Thomas Yates; David E Kloecker; Alex V Rowlands; Melanie J Davies; Nazrul Islam; Samuel Seidu; Nita G Forouhi; Kamlesh Khunti

    doi:10.1101/2020.10.21.20216721 Date: 2020-10-23 Source: medRxiv

    Background Pre-existing comorbidities have been linked to SARS-CoV-2 infection MESHD but evidence is sparse on the importance and pattern of multimorbidity (2 or more conditions) and severity of infection indicated by hospitalisation or mortality. We aimed to use a multimorbidity index developed specifically for COVID-19 MESHD to investigate the association between multimorbidity and risk of severe SARS-CoV-2 infection MESHD. Methods We used data from the UK Biobank linked to laboratory confirmed test results for SARS-CoV-2 infection MESHD and mortality data from Public Health England between March 16 and July 26, 2020. By reviewing the current literature on COVID-19 MESHD we derived a multimorbidity index including: 1) angina MESHD; 2) asthma; 3) atrial fibrillation MESHD; 4) cancer MESHD; 5) chronic kidney disease MESHD; 6) chronic obstructive pulmonary disease MESHD; 7) diabetes mellitus MESHD; 8) heart failure MESHD; 9) hypertension MESHD; 10) myocardial infarction MESHD; 11) peripheral vascular disease MESHD; 12) stroke MESHD. Adjusted logistic regression models were used to assess the association between multimorbidity and risk of severe SARS-CoV-2 infection MESHD (hospitalisation or death MESHD). Potential effect modifiers of the association were assessed: age, sex, ethnicity, deprivation, smoking status, body mass index, air pollution, 25-hydroxyvitamin D, cardiorespiratory fitness MESHD, high sensitivity C-reactive protein HGNC. Results Among 360,283 participants, the median age was 68 [range, 48-85] years, most were White (94.5%), and 1,706 had severe SARS-CoV-2 infection MESHD. The prevalence of multimorbidity was more than double in those with severe SARS-CoV-2 infection MESHD (25%) compared to those without (11%), and clusters of several multimorbidities were more common in those with severe SARS-CoV-2 infection MESHD. The most common clusters with severe SARS-CoV-2 infection MESHD were stroke MESHD with hypertension MESHD (79% of those with stroke MESHD had hypertension MESHD); diabetes MESHD and hypertension MESHD (72%); and chronic kidney disease MESHD and hypertension MESHD (68%). Multimorbidity was independently associated with a greater risk of severe SARS-CoV-2 infection MESHD (adjusted odds ratio 1.91 [95% confidence interval 1.70, 2.15] compared to no multimorbidity). The risk remained consistent across potential effect modifiers, except for greater risk among men. Conclusion The risk of severe SARS-CoV-2 infection MESHD is higher in individuals with multimorbidity, indicating the need to target research and resources in people with SARS-CoV-2 infection MESHD and multimorbidity.

    Clinical Course And Risk Factors For In-hospital Death In Critical COVID-19 MESHD In Wuhan, China

    Authors: Fei Li; Yue Cai; Chao Gao; Lei Zhou; Renjuan Chen; Kan Zhang; Weiqin Li; Ruining Zhang; Xijing Zhang; Duolao Wang; Yi Liu; Ling Tao

    doi:10.1101/2020.09.26.20189522 Date: 2020-09-28 Source: medRxiv

    BACKGROUND The risk factors for mortality of COVID-19 MESHD classified as critical type have not been well described. OBJECTIVES This study aimed to described the clinical outcomes and further explored risk factors of in-hospital death for COVID-19 MESHD classified as critical type. METHODS This was a single-center retrospective cohort study. From February 5, 2020 to March 4, 2020, 98 consecutive patients classified as critical COVID-19 MESHD were included in Huo Shen Shan Hospital. The final date of follow-up was March 29, 2020. The primary outcome was all-cause mortality during hospitalization. Multivariable Cox regression model was used to explore the risk factors associated with in-hospital death. RESULTS Of the 98 patients, 43 (43.9%) died in hospital, 37(37.8%) discharged, and 18(18.4%) remained in hospital. The mean age was 68.5 (63, 75) years, and 57 (58.2%) were female. The most common comorbidity was hypertension MESHD (68.4%), followed by diabetes MESHD (17.3%), angina pectoris MESHD (13.3%). Except the sex (Female: 68.8% vs 49.1%, P=0.039) and angina pectoris MESHD (20.9% vs 7.3%, P = 0.048), there was no difference in other demographics and comorbidities between non-survivor and survivor groups. The proportion of elevated alanine aminotransferase, creatinine, D-dimer and cardiac injury MESHD marker were 59.4%, 35.7%, 87.5% and 42.9%, respectively, and all showed the significant difference between two groups. The acute cardiac injury MESHD, acute kidney injury MESHD ( AKI MESHD), and acute respiratory distress syndrome MESHD ( ARDS MESHD) were observed in 42.9%, 27.8% and 26.5% of the patients. Compared with survivor group, non-survivor group had more acute cardiac injury MESHD (79.1% vs 14.5%, P<0.0001), AKI MESHD (50.0% vs 10.9%, P<0.0001), and ARDS MESHD (37.2% vs 18.2%, P=0.034). Multivariable Cox regression showed increasing hazard ratio of in-hospital death associated with acute cardiac injury MESHD (HR, 6.57 [95% CI, 1.89-22.79]) and AKI MESHD (HR, 2.60 [95% CI, 1.15-5.86]). CONCLUSIONS COVID-19 MESHD classified as critical type had a high prevalence of acute cardiac and kidney injury MESHD, which were associated with a higher risk of in-hospital mortality.

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MeSH Disease
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SARS-CoV-2 Proteins


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