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MeSH Disease

COVID-19 (436)

Fever (96)

Pneumonia (87)

Death (66)

Hypertension (65)


HGNC Genes

SARS-CoV-2 proteins

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ORF1ab (1)

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    Clinical Features and Death Risk Factors in COVID-19 MESHD Patients with Cancer MESHD: A Retrospective Study

    Authors: Yi Zhou; Qiao Yang; Jun Ye; Xiaocheng Wu; Xianhua Hou; Yimei Feng; Bangyu Luo; Jixi Li; Guangrong Yang; Lingchen Li; Xiu Yang; Bin Wang; Songtao Zhao; Li Li; Qi Li; Zi Xu; Hao Wu; Jianguo Sun

    doi:10.21203/rs.3.rs-149362/v1 Date: 2021-01-17 Source: ResearchSquare

    Purpose: Coronavirus disease 2019 MESHD ( COVID-19 MESHD) has spread around the world. This retrospective study aims to analyze the clinical features of COVID-19 MESHD patients with cancer MESHD and identify death outcome related risk factors.Methods: From February 10th to April 15th, 2020, 103 COVID-19 MESHD patients with cancer MESHD were enrolled. Difference analyses were performed between severe and non-severe patients. A propensity score matching analysis, including 103 COVID-19 MESHD patients with cancer MESHD and 206 matched non-cancer COVID-19 MESHD patients were performed. Next, we identified death related risk factors and developed a nomogram for predicting the probability.Results: In 103 COVID-19 MESHD patients with cancer MESHD, the main cancer MESHD categories were breast cancer MESHD, lung cancer MESHD and bladder cancer MESHD. Compared to non-severe patients, severe patients had a higher median age, and a higher proportion of smokers, diabetes MESHD, heart disease MESHD and dyspnea MESHD. In addition, most of the laboratory results between two groups were significant different. PSM analysis found that the proportion of dyspnea MESHD was much higher in COVID-19 MESHD patients with cancer MESHD. The severity incidence in two groups were similar, while a much higher mortality was found in COVID-19 MESHD patients with cancer MESHD compared to that in COVID-19 MESHD patients without cancer MESHD (11.7% vs. 4.4%, P = 0.028). Furthermore, we found that neutrophil-to-lymphocyte ratio (NLR) and C-reactive protein HGNC ( CRP HGNC) were related to death outcome. And a nomogram based on the factors was developed.Conclusion: In COVID-19 MESHD patients with cancer MESHD, the clinical features and laboratory results between severe group and non-severe group were significant different. NLR and CRP HGNC were the risk factors that could predict death outcome.

    Meta-analysis of randomized trials of ivermectin to treat SARS-CoV-2 infection MESHD

    Authors: Andrew Hill; Ahmed Abdulamir; Sabeena Ahmed; Asma Asghar; Olufemi Emmanuel Babalola; Rabia Basri; Carlos Chaccour; Aijaz Zeeshan Khan Chachar; Abu Tauib Mohammed Chowdhury; Ahmed Elgazzar; Leah Ellis; Jonathan Falconer; Anna Garratt; Basma Hany; Hashim A Hashim; Wasim Ul Haque; Arshad Hayat; Shuixiang He; Ramin Jamshidian; Wasif Ali Khan; Ravi Kirti; Alejandro Krolewiecki; Carlos Lanusse; Jacob Levi; Reaz Mahmud; Sermand Ahmed Mangat; Kaitlyn McCann; Anant Mohan; Mortezza Shakshi Niaee; Nurullah Okumus; Victoria Pilkington; Chinmay Saha Podder; Ambar Qavi; Houssam Raad; Mohammaed Sadegh Rezai; Surapaneni Sasank; Veerapaneni Spoorthi; Tejas Suri; Junzheng Wang; Hannah Wentzel

    doi:10.21203/rs.3.rs-148845/v1 Date: 2021-01-16 Source: ResearchSquare

    Ivermectin is an antiparasitic drug being investigated for repurposing to SARS-CoV-2. In-vitro, ivermectin showed limited antiviral activity and a COVID-19 MESHD animal model demonstrated pathological benefits but no effect on viral RNA. This meta-analysis investigated ivermectin in 18 randomized clinical trials (2282 patients) identified through systematic searches of PUBMED, EMBASE, MedRxiv and trial registries. Ivermectin was associated with reduced inflammatory markers ( C-Reactive Protein HGNC, d-dimer and ferritin) and faster viral clearance by PCR. Viral clearance was treatment dose- and duration-dependent. In six randomized trials of moderate or severe infection, there was a 75% reduction in mortality (Relative Risk=0.25 [95%CI 0.12-0.52]; p=0.0002); 14/650 (2.1%) deaths on ivermectin; 57/597 (9.5%) deaths in controls) with favorable clinical recovery and reduced hospitalization. Many studies included were not peer reviewed and meta-analyses are prone to confounding issues. Ivermectin should be validated in larger, appropriately controlled randomized trials before the results are sufficient for review by regulatory authorities.

    Antibiotic Prescribing Patterns at COVID-19 MESHD Dedicated Wards in Bangladesh: A Single Center Point-Prevalence Survey

    Authors: Md. Maruf Ahmed Molla; Mahmuda Yeasmin; Md. Khairul Islam; Md. Mohiuddin Sharif; Mohammad Robed Amin; Tasnim Nafisa; Asish Kumar Ghosh; Monira Parveen; Md. Masum Hossain Arif; Junaid Abdullah Jamiul Alam; Syed Jafar Raza Rizvi; KM Saif-Ur-Rahman; Arifa Akram; AKM Shamsuzzaman; Amoolya Vusirikala; Sakib Rokadiya; Meaghan Kall; Maria Zambon; Mary Ramsay; Tim Brooks; - SIREN Sudy Group; Colin S Brown; Meera A Chand; Susan Hopkins; Sigrid Gouma; Madison E. Weirick; Christopher M. McAllister; Erin Bange; Peter Gabriel; Marylyn Ritchie; Daniel J. Rader; Robert H. Vonderheide; Lynn M Schuchter; Anurag Verma; Ivan Maillard; Ronac Mamtani; Scott E. Hensley; Robert Gross; E. Paul Wileyto; Alexander C. Huang; Kara N. Maxwell; Angela DeMichele; Devendra Singh Parihar; Anas Saifi; Jasleen Kaur; Virendra Kumar; Avinash Mishra; Iranna Gogeri; Geetha Vani Rayasam; Praveen Singh; Rahul Chakraborty; Gaura Chaturvedi; Pinreddy Karunakar; Rohit Yadav; Sunanda Singhmar; Dayanidhi Singh; Sharmistha Sarkar; Purbasha Bhattacharya; Sundaram Acharya; Vandana Singh; Shweta Verma; Drishti Soni; Surabhi Seth; Firdaus Fatima; Shakshi Vashisht; Sarita Thakran; Akash Pratap Singh; Akanksha Sharma; Babita Sharma; Manikandan Subramanian; Yogendra Padwad; Vipin Hallan; Vikram Patial; Damanpreet Singh; Narendra Vijay Tirpude; Partha Chakrabarti; Sujay Krishna Maity; Dipyaman Ganguly; Jit Sarkar; Sistla Ramakrishna; Balthu Narender Kumar; Kiran A Kumar; Sumit G. Gandhi; Piyush Singh Jamwal; Rekha Chouhan; Vijay Lakshmi Jamwal; Nitika Kapoor; Debashish Ghosh; Ghanshyam Thakkar; Umakanta Subudhi; Pradip Sen; Saumya Raychaudhri; Amit Tuli; Pawan Gupta; Rashmi Kumar; Deepak Sharma; Rajesh P. Ringe; Amarnarayan D; Mahesh Kulkarni; Dhanasekaran Shanmugam; Mahesh Dharne; Syed G Dastager; Rakesh Joshi; Amita P. Patil; Sachin N Mahajan; Abu Junaid Khan; Vasudev Wagh; Rakeshkumar Yadav; Ajinkya Khilari; Mayuri Bhadange; Arvindkumar H. Chaurasiya; Shabda E Kulsange; Krishna khairnar; Shilpa Paranjape; Jatin Kalita; G.Narahari Sastry; Tridip Phukan; Prasenjit Manna; Wahengbam Romi; Pankaj Bharali; Dibyajyoti Ozah; Ravi Kumar Sahu; Elapaval VSSK Babu; Rajeev K Sukumaran; Aishwarya R Nair; Anoop Puthiyamadam; Prajeesh Kooloth Valappil; Adarsh Velayudhanpillai; Kalpana Chodankar; Samir Damare; Yennapu Madhavi; Ved Varun Agrawal; Sumit Dahiya; Anurag Agrawal; Debasis Dash; Shantanu Sengupta

    doi:10.1101/2021.01.15.21249868 Date: 2021-01-15 Source: medRxiv

    There is a clear deficiency MESHD in antimicrobial usage data and ongoing stewardship programs both in government and private health care facilities in Bangladesh. As evidences are mounting regarding irrational and often unnecessary use of antibiotics during COVID-19 pandemic MESHD, a point prevalence survey (PPS) was conducted across COVID-19 MESHD dedicated wards in Dhaka Medical College and Hospital (DMCH). Antibiotic usage data were collected from 193 patients at different COVID-19 MESHD dedicated wards at DMCH between 21 May, 2020 and 10 June, 2020. Comparisons in antibiotic usage were made between different groups using Pearson chi-square and Fisher exact test. Factors associated with multiple antibiotic prescription were evaluated using binary logistic regression model. On survey date all (100%) patients were receiving at least one antibiotic with 133 patients (68.91%) receiving multiple antibiotics. Overall, patients presenting with severe disease received more antibiotics on average. Third generation cephalosporin ceftriaxone (53.8%), meropenem (40.9%), moxifloxacin (29.5%) and doxycycline (25.4%) were the four most prescribed antibiotics among survey patients. Among comorbidities diabetes mellitus MESHD ( DM MESHD) was independently associated with increased antibiotic prescribing. Abnormal C-reactive protein HGNC ( CRP HGNC) and serum d-dimer were linked with higher odds of antibiotic prescribing among survey patients. Overall, prevalence of antibiotic prescribing in COVID-19 MESHD patients at DMCH was very high. This could be attributed to a lack of clear treatment protocol against COVID-19 MESHD till date as well as lack of modern laboratory facilities to support judicial antibiotic prescribing in Bangladesh. A well-functioning antibiotic stewardship program in Bangladesh is required to prevent an impending health crisis.

    Innate lymphoid cells and disease tolerance in SARS-CoV-2 infection MESHD

    Authors: Noah J. Silverstein; Yetao Wang; Zachary Manickas-Hill; Claudia C. Carbone; Ann Dauphin; Jonathan Z. Li; Bruce D. Walker; Xu G. Yu; Jeremy Luban; Liza Lee; Ashleigh Tuite; David N Fisman; John S Brownstein; Lauren Lapointe-Shaw; Patrick Chinnery; Nathalie Kingston; Sofia Papadia; Kathleen Stirrups; Neil Walker; Ravindra K Gupta; Mark Toshner; Michael Weekes; James A Nathan; Sarah Walmsley; Willem Hendrik Ouwehand; Mary Kasanicki; Berthold Gottgens; John C Marioni; Smith GC Smith; Jordan S Pober; John R Bradley

    doi:10.1101/2021.01.14.21249839 Date: 2021-01-15 Source: medRxiv

    BACKGROUNDRisk of severe coronavirus disease 2019 MESHD ( COVID-19 MESHD) increases with age, is greater in males, and is associated with decreased numbers of blood lymphoid cells. Though the reasons for these robust associations are unclear, effects of age and sex on innate and adaptive lymphoid subsets, including on homeostatic innate lymphoid cells (ILCs) implicated in disease tolerance, may underlie the effects of age and sex on COVID-19 MESHD morbidity and mortality. METHODSFlow cytometry was used to quantitate subsets of blood lymphoid cells from people infected MESHD with severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV-2), comparing those hospitalized with severe COVID-19 MESHD (n=40) and those treated as outpatients for less severe disease (n=51). 86 healthy individuals served as controls. The relationship between abundance of specific blood lymphoid cell types, age, sex, hospitalization, duration of hospitalization, and elevation of blood markers for systemic inflammation MESHD, was determined using multiple regression. RESULTSAfter accounting for effects of age and sex, hospitalization for COVID-19 MESHD was associated with 1.78-fold fewer ILCs (95%CI: 2.34-1.36; p = 4.55 x 10-5) and 2.31-fold fewer CD16+ natural killer (NK) cells (95%CI: 3.1-1.71; p = 1.04 x 10-7), when compared to uninfected controls. Among people infected with SARS-CoV-2, the odds ratio for hospitalization, adjusted for age, sex, and duration of symptoms, was 0.413 (95%CI: 0.197-0.724; p = 0.00691) for every 2-fold increase in ILCs. In addition, higher ILC abundance was associated with less time spent in the hospital and lower levels of blood markers associated with COVID-19 MESHD severity: each two-fold increase in ILC abundance was associated with a 9.38 day decrease in duration of hospital stay (95% CI: 15.76-3.01; p= 0.0054), and decrease in blood C-reactive protein HGNC ( CRP HGNC) by 46.29 mg/L (95% CI: 71.34-21.24; p = 6.25 x 10-4), erythrocyte sedimentation rate (ESR) by 11.04 mm/h (95% CI: 21.94-0.13; p = 0.047), and the fibrin degradation product D-dimer by 1098.52 ng/mL (95% CI: 1932.84-264.19; p = 0.011). CONCLUSIONSBoth ILCs and NK cells were depleted in the blood of people hospitalized for severe COVID-19 MESHD, but, among lymphoid cell subsets, only ILC abundance was independently associated with the need for hospitalization, duration of hospital stay, and severity of inflammation MESHD. These results indicate that, by promoting disease tolerance, homeostatic ILCs protect against morbidity and mortality in SARS-CoV-2 infection MESHD, and suggest that reduction in the number of ILCs with age and in males accounts for the increased risk of severe COVID-19 MESHD in these demographic groups.

    Detection of SARS-Cov-2 RNA in serum is associated with increased mortality risk in hospitalized COVID-19 MESHD patients.

    Authors: Diego A. Rodriguez Serrano; Emilia Roy-Vallejo; Nelly D. Zurita Cruz; Alexandra Martin Ramirez; Sebastian C. Rodriguez-Garcia; Nuria Arevalillo-Fernandez; Jose Maria Galvan-Roman; Leticia Fontan Garcia-Rodrigo; Lorena Vega Piris; Marta Chicot Llano; David Arribas Mendez; Begona Gonzalez de Marcos; Julia Hernando Santos; Ana Sanchez Azofra; Elena Avalos Perez-Urria; Pablo Rodriguez-Cortes; Laura Esparcia; Ana Marcos-Jimenez; Santiago Sanchez-Alonso; Irene Llorente; Joan B. Soriano; Carmen Suarez Fernandez; Rosario Garcia-Vicuna; Julio Ancochea; Jesus Sanz; Cecilia Munoz-Calleja; Rafael de la Camara; Alfonso Canabal Berlanga; Isidoro Gonzalez-Alvaro; Laura Cardenoso; John R Bradley

    doi:10.1101/2021.01.14.21249372 Date: 2021-01-15 Source: medRxiv

    Background COVID-19 MESHD has overloaded national health services worldwide. Thus, early identification of patients at risk of poor outcomes is critical. Our objective was to analyse SARS-CoV-2 RNA detection in serum as a severity biomarker in COVID-19 MESHD. Methods and FindingsRetrospective observational study including 193 patients admitted for COVID-19 MESHD. Detection of SARS-CoV-2 RNA in serum (CoVemia) was performed with samples collected at 48-72 hours of admission by two techniques from Roche and Thermo Fischer Scientific (TFS). Main outcome variables were mortality and need for ICU admission during hospitalization for COVID-19 MESHD. CoVemia was detected in 50-60% of patients depending on technique. The correlation of Ct in serum between both techniques was good (intraclass correlation coefficient: 0.612; p < 0.001). Patients with CoVemia were older (p = 0.006), had poorer baseline oxygenation (PaO2/FiO2; p < 0.001), more severe lymphopenia MESHD (p < 0.001) and higher LDH (p < 0.001), IL-6 HGNC (p = 0.021), C-reactive protein HGNC ( CRP HGNC; p = 0.022) and procalcitonin (p = 0.002) serum levels. We defined "relevant CoVemia" when detection Ct was < 34 with Roche and < 31 for TFS. These thresholds had 95% sensitivity and 35 % specificity. Relevant CoVemia predicted death during hospitalization (OR 9.2 [3.8 - 22.6] for Roche, OR 10.3 [3.6 - 29.3] for TFS; p < 0.001). Cox regression models, adjusted by age, sex and Charlson index, identified increased LDH serum levels and relevant CoVemia (HR = 9.87 [4.13-23.57] for TFS viremia MESHD and HR = 7.09 [3.3-14.82] for Roche viremia MESHD) as the best markers to predict mortality. ConclusionsCoVemia assessment at admission is the most useful biomarker for predicting mortality in COVID-19 MESHD patients. CoVemia is highly reproducible with two different techniques (TFS and Roche), has a good consistency with other severity biomarkers for COVID-19 MESHD and better predictive accuracy. AUTHOR SUMMARY COVID-19 MESHD shows a very heterogeneous clinical picture. In addition, it has overloaded national health services worldwide. Therefore, early identification of patients with poor prognosis is critical to improve the use of limited health resources. In this work, we evaluated whether baseline SARS-CoV2 RNA detection in blood (CoVemia) is associated with worse outcomes. We studied almost 200 patients admitted to our hospital and about 50-60% of them showed positive CoVemia. Patients with positive CoVemia were older and had more severe disease; CoVemia was also more frequent in patients requiring admission to the ICU. Moreover, we defined "relevant CoVemia", as the amount of viral load that better predicted mortality obtaining 95% sensitivity and 35% specificity. In addition, relevant CoVemia was a better predictor than other biomarkers such as LDH, lymphocyte count, interleukin-6 HGNC, and indexes used in ICU such as qSOFA and CURB65. In summary, detection of CoVemia is the best biomarker to predict death MESHD in COVID-19 MESHD patients. Furthermore, it is easy to be implemented and is reproducible with two techniques (Roche and Thermo Fisher Scientific) that are currently used for diagnosis in nasopharyngeal swabs samples.

    Challenges in the application of a mortality prediction model for COVID-19 MESHD patients on an Indian cohort

    Authors: Yukti Makhija; Samarth Bhatia; Shalendra Singh; Sneha Kumar Jayaswal; Prabhat Singh Malik; Pallavi Gupta; Shreyas N. Samaga; Shreya Johri; Sri Krishna Venigalla; Rabi Narayan Hota; Surinder Singh Bhatia; Ishaan Gupta

    id:2101.07215v1 Date: 2021-01-15 Source: arXiv

    Many countries are now experiencing the third wave of the COVID-19 pandemic MESHD straining the healthcare resources with an acute shortage of hospital beds and ventilators for the critically ill patients. This situation is especially worse in India with the second largest load of COVID-19 MESHD cases and a relatively resource-scarce medical infrastructure. Therefore, it becomes essential to triage the patients based on the severity of their disease and devote resources towards critically ill patients. Yan et al. 1 have published a very pertinent research that uses Machine learning (ML) methods to predict the outcome of COVID-19 MESHD patients based on their clinical parameters at the day of admission. They used the XGBoost algorithm, a type of ensemble model, to build the mortality prediction model. The final classifier is built through the sequential addition of multiple weak classifiers. The clinically operable decision rule was obtained from a 'single-tree XGBoost' and used lactic dehydrogenase (LDH), lymphocyte and high-sensitivity C-reactive protein HGNC (hs-CRP) values. This decision tree achieved a 100% survival prediction and 81% mortality prediction. However, these models have several technical challenges and do not provide an out of the box solution that can be deployed for other populations as has been reported in the "Matters Arising" section of Yan et al. Here, we show the limitations of this model by deploying it on one of the largest datasets of COVID-19 MESHD patients containing detailed clinical parameters collected from India.

    Preliminary Efficacy of Tocilizumab Treatment in The Patients With COVID-19 MESHD.

    Authors: Yu Chen; Xijing Zhang

    doi:10.21203/rs.3.rs-147574/v1 Date: 2021-01-14 Source: ResearchSquare

    Background: Interleukin-6 HGNC ( IL-6 HGNC) was considered to be with the severity and mortality in COVID-19 MESHD patients, which implies a potential therapeutic target for treatment. We aimed to evaluate the safety and initial efficacy of Tocilizumab treatment for COVID-19 MESHD patients.Methods: In the retrospective study, sixty-one patients with COVID-19 MESHD with the mean age of 69 were enrolled from Feb 27 to Mar 14, 2020 in Wuhan Huoshenshan Hospital. Twenty-nine of them received one dose (400 mg) of add-on Tocilizumab treatment as the treated group and remaining 32 cases served as control group. The clinical manifestations and laboratory examinations were compared between the two groups.Results: The average duration of symptoms to admission was 28.2 days. Compared with the cases in control group, the treated cases exhibited a significant increase of serum IL-6 HGNC on the seventh day since Tocilizumab injection, however, there were no differences in whole blood white cell count, circulating lymphocyte count, serum C-reactive protein HGNC, and respiratory parameters or other clinical manifestations between the treated and control groups. There were no adverse events associated with Tocilizumab treatment in the treated COVID-19 MESHD patients.Conclusions: In the elder moderate and severe patients with COVID-19 MESHD, one dose of Tocilizumab treatment was safe but no clinical benefit was observed on the seventh day in this study.Trial registration: Chinese Clinical Trail Registry, ChiCTR2000033705. Registered June 10, 2020 - Retrospectively registered, http://www.chictr.org.cn/showprojen.aspx?proj=54989.

    Cerebrospinal fluid in COVID-19 MESHD neurological complications: no cytokine storm or neuroinflammation.

    Authors: Maria A. Garcia; Paula V. Barreras; Allie Lewis; Gabriel Pinilla; Lori J. Sokoll; Thomas Kickler; Heba Mostafa; Mario Caturegli; Abhay Moghekar; Kathryn C. Fitzgerald; - Hopkins Neuro-COVID-19 Group; Carlos A Pardo; Sriram Subramaniam; Alyson Ann Ann Kelvin; Mohamed G. Al Kuwari; Hamad Eid Al Romaihi; Mohamed H. Al-Thani; Roberto Bertollini; Abdullatif Al Khal; Laith J Abu-Raddad; Menno D. de Jong; Marije K Bomers

    doi:10.1101/2021.01.10.20249014 Date: 2021-01-12 Source: medRxiv

    BACKGROUND. Neurological complications MESHD occur in COVID-19 MESHD. We aimed to examine cerebrospinal fluid (CSF) of COVID-19 MESHD subjects with neurological complications MESHD and determine presence of neuroinflammatory changes implicated in pathogenesis. METHODS. Cross-sectional study of CSF neuroinflammatory profiles from 18 COVID-19 MESHD subjects with neurological complications categorized by diagnosis ( stroke MESHD, encephalopathy MESHD, headache MESHD) and illness severity (critical, severe, moderate, mild). COVID-19 MESHD CSF was compared with CSF from healthy, infectious and neuroinflammatory disorders MESHD and stroke MESHD controls (n=82). Cytokines ( IL-6 HGNC, TNF-alpha HGNC, IFN-gamma HGNC, IL-10 HGNC, IL-12p70, IL-17A HGNC), inflammation MESHD and coagulation markers (high-sensitivity- C Reactive Protein HGNC [hsCRP], ferritin, fibrinogen HGNC, D-dimer, Factor VIII) and neurofilament light chain ( NF-L HGNC), were quantified. SARS-CoV2 RNA and SARS-CoV2 IgG and IgA antibodies in CSF were tested with RT-PCR and ELISA. RESULTS. CSF from COVID-19 MESHD subjects showed a paucity of neuroinflammatory changes, absence of pleocytosis MESHD or specific increases in pro-inflammatory markers or cytokines ( IL-6 HGNC, ferritin, or D-dimer). Anti-SARS-CoV2 antibodies in CSF of COVID-19 MESHD subjects (77%) were observed despite no evidence of SARS-CoV2 viral RNA. A similar increase of pro-inflammatory cytokines ( IL-6 HGNC, TNF-alpha HGNC;, IL-12p70) and IL-10 HGNC in CSF of COVID-19 MESHD and non- COVID-19 MESHD stroke MESHD subjects was observed compared to controls. CSF-NF-L was elevated in subjects with stroke MESHD and critical COVID-19 MESHD. CSF-hsCRP was present almost exclusively in COVID-19 MESHD cases. CONCLUSION. The paucity of neuroinflammatory changes in CSF of COVID-19 MESHD subjects and lack of SARS-CoV2 RNA do not support the presumed neurovirulence of SARS-CoV2 or neuroinflammation MESHD in pathogenesis of neurological complications in COVID-19 MESHD. Elevated CSF-NF-L indicates neuroaxonal injury MESHD in COVID-19 MESHD cases. The role of CSF SARS-CoV2 IgG antibodies is still undetermined.

    Immunological and Inflammatory Indicators of COVID-19 MESHD Patients With Returned-positive Nucleic Acid Tests During Hospitalization: a Retrospective Cohort Study

    Authors: Yin Wang; Xiaobei Chen; Yi Zhang; Hongyan Chen; Quan Zhou; Dong Li; Zhili Niu; Huidan Yu; Xiaojun Wang; Haijun Zhang; Tingting Liu; Bicheng Zhang; Hui Yu; Xiaochuan Wang; Yuan Jiang; Yalan Dou; Xiaotian Chen; Xiaoyang Zhou; Weili Yan

    doi:10.21203/rs.3.rs-142839/v1 Date: 2021-01-07 Source: ResearchSquare

    Background: COVID-19 MESHD cases with suspected returned-positive SRAS-CoV-2 tests following consecutive negative tests have been reported, but evidence-based explanations for this phenomenon is still lacking. We aimed to describe the clinical and laboratory characteristics of returned-positive COVID-19 MESHD patients during treatment in comparison with other patients.Methods: From January 20 to April 10, 2020, all COVID-19 MESHD inpatient with at least three RT-PCR SARS-CoV-2 tests in Renmin Hospital in Wuhan, China were enrolled. Patients with 2 consecutively negative RT-PCR results followed by a positive result were classified as returned-positive patients, and their characteristics and repeatedly measured laboratory results were compared with the rest of the patients. Linear mixed effects models were performed.Results: A total of 789 COVID-19 MESHD patients were included and 22.8% patients returned positive in RT-PCR SARS-CoV-2 test. No significant differences were found for general characteristics between the returned-positive and the control groups. The trends of inflammatory and immune factors including the third component of complement (C3), C-reactive protein HGNC, procalcitonin (PCT), IL-4 HGNC, IL-6 HGNC, the counts of lymphocyte, CD3+, CD8+, white blood cell and immunoglobulin levels during hospitalization were significantly different between the two groups. During the returned-positive period, C3, PCT, serum IgM, anti-SARS-CoV-2 IgM and anti-SARS-CoV-2 IgG were significantly higher in the returned-positive patients at certain time points.Conclusions: Returned-positive COVID-19 MESHD patients appeared to be more sever at admission, and had periodically higher levels in C3, PCT, serum IgM and two specific antibodies during hospitalization. This suggests that positive return of SARS-COV-2 could not be completely explained by false-negative testing and longer observation of these patients is warranted. 

    Respiratory and non-respiratory manifestations in children admitted with COVID 19 in Rio de Janeiro city, Brazil

    Authors: ANDRE RICARDO ARAUJO ARAUJO DA SILVA; CARLOS GABRIEL BRANDAO FOINSECA; JACKSON LINO PAULA SANTANA DE MIRANDA; BEATRIZ VALLADARES TRAVASSOS; CAROLINA RODRIGUES BAIAO; KALINA DOMINIK SILVA; LINO BRENO AZEVEDO ESTEVAM DOS SANTOS; MARIANNA MELO RODRIGUES DE BRITTO; PABLO AUGUSTO LUCAS DE SOUZA CERQUEIRA; SILVIA NAZARE BRAGA PEREIRA; REBECA BITTENCOURT JAQUEIRA RIOS; CRISTINA SOUZA VIEIRA; IZABEL ALVES LEAL; NATALIA COCHRANE MARTINS; LIEGE MARIA ABREU DE CARVALHO; ANDREA BARCHIK PEREIRA; CRISTIANE HENRIQUES TEIXEIRA

    doi:10.1101/2020.12.29.20248994 Date: 2021-01-04 Source: medRxiv

    IntroductionCOVID 19 is still a challenge in pediatrics due to variety of symptoms and different presentations AimTo describe clinical, laboratorial and treatment of confirmed COVID-19 MESHD pediatric admitted in hospitals. MethodsA retrospective study was conducted in children (0-18 years), admitted between March and November 15, 2020, with confirmed COVID-19 MESHD by reverse transcription polymerase chain reaction or serological tests. Clinical data about symptoms, laboratorial exams and treatments were analysed. Patients were evaluated according predominant (PRS) or non-predominant respiratory symptoms (non-PRS) ResultsSixty-four patients were evaluated, being the median age 5.6 years. Forty-seven (73.4%) children were admitted with PRS MESHD and 17 (26.4%) with non-PRS. The main symptoms in the PRS group were fever MESHD in 74.5% of children and cough in 66%; and fever MESHD in 76.5% and edema MESHD/cavitary effusion in 29.4% in the non-PRS group. The median of C-reactive protein HGNC (in mg/dl) was 2.5 in the PRS group and 6.1 in the non-PRS group. Antibiotics were used in 85.1% of the PRS group and 94.1% of non-group. Comorbidity was present in 30/47 (63.8%) of PRS group and 8/17 (47.1%) of non-PRS group (p=0.22). Length of stay until 7 days in patients with comorbidity was present in 27/64 (42.1%) and more than 7 days in 11/64 (17.1%) (p= 0.2) ConclusionNon-PRS represented more than one quarter of admitted patients. Fever MESHD was the main symptom detected, elevated CRP HGNC was frequent and antibiotics were commonly prescribed. Comorbidity was found in both groups and his presence was not associated with a longer length of stay.

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