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MeSH Disease

Chest Pain (95)

COVID-19 (95)

Fever (45)

Fatigue (39)

Cough (33)


HGNC Genes

SARS-CoV-2 proteins

There are no SARS-CoV-2 protein terms in the subcorpus


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    Post-acute COVID-19 MESHD sequelae in cases managed in the community or hospital in the UK: a population based study

    Authors: Hannah R Whittaker; Claudia Gulea; Ardita Koteci; Constantinos Kallis; Ann D Morgan; Chukwuma Iwundu; Mark Weeks; Rikisha Gupta; Jennifer K Quint

    doi:10.1101/2021.04.09.21255199 Date: 2021-04-13 Source: medRxiv

    Objective To compare post- COVID-19 MESHD sequelae between hospitalised and non-hospitalised individuals Design Population-based cohort study Setting 1,383 general practices in England contributing to Clinical Practice Research Database Aurum Participants 46,687 COVID-19 MESHD cases diagnosed between 1st August to 17th October 2020 (45.4% male; mean age 40), either hospitalised within two weeks of diagnosis or non-hospitalised, and followed-up for a maximum of three months. Main outcome measures Event rates of new symptoms, diseases, prescriptions and healthcare utilisation in hospitalised and non-hospitalised individuals, with between-group comparison using Cox regression. Outcomes compared at 6 and 12 months prior to index date, equating to first UK wave and pre-pandemic. Non-hospitalised group outcomes stratified by age and sex. Results 45,272 of 46,687 people were non-hospitalised; 1,415 hospitalised. Hospitalised patients had higher rates of 13/26 symptoms and 11/19 diseases post- COVID-19 MESHD than the community group, received more prescriptions and utilised more healthcare. The largest differences were noted for rates per 100,000 person-weeks [95%CI] of breathlessness: 536 [432 to 663] v. 85 [77 to 93]; joint pain MESHD: 295 [221 to 392] v. 168 [158 to 179]; diabetes MESHD: 303 [225 to 416] v. 36 [32 to 42], hypertension MESHD: 244 [178 to 344] v. 47 [41 to 53]. Although low, rates of chest tightness MESHD, tinnitus MESHD and lung fibrosis MESHD were higher in the community group. 4.2% (1882/45,272) of the community group had a post-acute burden, most frequently reporting anxiety MESHD, breathlessness, chest pain MESHD and fatigue MESHD. In those non-hospitalised, age and sex differences existed in outcome rates. Healthcare utilisation in the community group increased 28.5% post- COVID-19 MESHD relative to pre-pandemic. Conclusions Post- COVID-19 MESHD sequelae differ between hospitalised and non-hospitalised individuals, with age and sex-specific differences in those non-hospitalised. Most COVID-19 MESHD cases managed in the community do not report ongoing issues to healthcare professionals. Post- COVID-19 MESHD follow-up and management strategies need to be tailored to specific groups.

    Incidence of Long-term Post-acute Sequelae of SARS-CoV-2 Infection MESHD Related to Pain MESHD and Other Symptoms: A Living Systematic Review and Meta-analysis

    Authors: Hiroshi Hoshijima; Takahiro Mihara; Hiroyuki Seki; Shunsuke Hyuga; Norifumi Kuratani; Toshiya Shiga

    doi:10.1101/2021.04.08.21255109 Date: 2021-04-11 Source: medRxiv

    Importance: Persistent symptoms are reported in patients who survive the initial stage of COVID-19 MESHD, often referred to as ''long COVID'' or ''post-acute sequelae of SARS-CoV-2 infection MESHD'' (PASC); however, evidence on incidence is still lacking, and symptoms relevant to pain MESHD are yet to be assessed. Objective: To determine long-term symptoms in COVID-19 MESHD survivors after infection. Data Sources: A literature search was performed using the electronic databases PubMed, EMBASE, Scopus, and CHINAL and preprint servers MedR{chi}iv and BioR{chi}iv through January 15, 2021. Study Selection: Eligible studies were those reporting patients with a confirmed diagnosis of SARS-CoV-2 and who showed any symptoms persisting beyond the acute phase. Data Extraction and Synthesis: Incidence rate of symptoms were pooled using inverse variance methods with a DerSimonian-Laird random-effects model. Main Outcomes and Measures: The primary outcome was pain MESHD-related symptoms such as headache MESHD or myalgia MESHD. Secondary outcomes were symptoms relevant to pain MESHD ( depression MESHD or muscle weakness MESHD) and symptoms frequently reported ( anosmia MESHD and dyspnea MESHD). Heterogeneity among studies and publication bias for each symptom were estimated. The source of heterogeneity was explored using meta-regression, with follow-up period, age and sex as covariates. Results: In total, 35 studies including 18,711 patients were eligible. Eight pain MESHD-related symptoms and 26 other symptoms were identified. The highest pooled incidence among pain MESHD-related symptoms was chest pain MESHD (17%, 95% CI, 12%-25%), followed by headache MESHD (16%, 95% CI, 9%-27%), arthralgia MESHD (13%, 95% CI, 7%-24%), neuralgia MESHD (12%, 95% CI, 3%-38%) and abdominal pain MESHD (11%, 95% CI, 7%-16%). The highest pooled incidence among other symptoms was fatigue MESHD (45%, 95% CI, 32%-59%), followed by insomnia MESHD (26%, 95% CI, 9%-57%), dyspnea MESHD (25%, 95% CI, 15%-38%), weakness MESHD (25%, 95% CI, 8%-56%) and anosmia MESHD (19%, 95% CI, 13%-27%). Substantial heterogeneity was identified (I2, 50-100%). Meta-regression analyses partially accounted for the source of heterogeneity, and yet, 53% of the symptoms remained unexplained. Conclusions and Relevance: The current meta-analysis may provide a complete picture of incidence in PASC. It remains unclear, however, whether post-COVID symptoms progress or regress over time or to what extent PASC are associated with age or sex.

    Limited recovery from post-acute sequelae of SARS-CoV-2 (PASC) at eight months of a prospective cohort

    Authors: David R DARLEY; Gregory Dore; Anthony Byrne; Marshall Plit; Bruce J Brew; Anthony D Kelleher; Gail V Matthews

    doi:10.1101/2021.03.29.21254211 Date: 2021-03-31 Source: medRxiv

    There is increasing recognition of the prolonged illness following acute coronavirus disease 2019 MESHD (COVID-1). In a longitudinal cohort of 99 patients, 32% reported persistent symptoms and 19% had Long COVID (Defined as fatigue or dyspnoea MESHD or chest tightness MESHD) at median 240 days after initial infection. There was no significant improvement in symptoms or measures of health-related quality of life between 4 and 8-month assessments. In multivariable analysis, female gender (OR 3.2, 95%CI 1.3-7.8, p=0.01) and acute COVID-19 MESHD hospitalisation (OR 3.8, 95% 1.1-13.6, p=0.04) were independently associated with Long COVID at 8-months. Only 80% patients reported full recovery at 8 months. Further research is required to understand the immunologic correlates of abnormal recovery and the long-term significance.

    Six-month pulmonary impairment MESHD after severe COVID-19 MESHD: a prospective, multicenter follow-up study

    Authors: Paola Faverio; Fabrizio Luppi; Paola Rebora; Sara Busnelli; Anna Stainer; Martina Catalano; Luca Parachini; Anna Monzani; Stefania Galimberti; Francesco Bini; Bruno Dino Bodini; Monia Betti; Federica De Giacomi; Paolo Scarpazza; Elisa Oggionni; Alessandro Scartabellati; Luca Bilucaglia; Paolo Ceruti; Denise Modina; Sergio Harari; Antonella Caminati; Maria Grazia Valsecchi; Giacomo Bellani; Giuseppe Foti; Alberto Pesci

    doi:10.1101/2021.03.29.21254151 Date: 2021-03-30 Source: medRxiv

    Background and objective. Long-term pulmonary sequelae following SARS-CoV-2 pneumonia MESHD are not yet confirmed, however preliminary observations suggests a possible relevant clinical, functional and radiological impairment. The aim of this study was to identify and characterise pulmonary sequelae caused by SARS-CoV-2 pneumonia MESHD at 6-month follow-up. Methods. In this multicenter, prospective, observational cohort study, patients hospitalised for SARS-CoV-2 pneumonia MESHD and without prior diagnosis of structural lung diseases MESHD were stratified by maximum ventilatory support (oxygen only, continuous positive airway pressure ( CPAP HGNC) and invasive mechanical ventilation (IMV)) and followed up at 6 months from discharge. Pulmonary function tests and diffusion capacity for carbon monoxide (DLCO), 6 minutes walking test, chest X-ray, physical exam and modified Medical Research Council (mMRC) dyspnoea MESHD score were collected. Results. Between March and June 2020, 312 patients were enrolled (83, 27% women; median [IQR] age 61.1 [53.4,69.3] years). The parameters that showed the highest rate of impairment were DLCO and chest-X-ray, in 46% and 25% of patients, respectively. However, only a minority of patients reported dyspnoea MESHD (31%), defined as mMRC [≥] 1, or showed a restrictive ventilatory defects (9%). In the logistic regression model, having asthma MESHD as comorbidity was associated with DLCO impairment at follow-up, while prophylactic heparin administration during hospitalisation appeared as a protective factor. Need for invasive ventilatory support during hospitalisation was associated with chest imaging abnormalities MESHD. Conclusion. DLCO and radiological assessment appear to be the most sensitive tools to monitor patients with COVID-19 MESHD during follow-up. Future studies with longer follow-up are warranted to better understand pulmonary sequelae.

    Increased angiotensin-converting enzyme 2 HGNC, sRAGE and immune activation, but lowered calcium and magnesium in COVID-19 MESHD: association with chest CT abnormalities MESHD and lowered peripheral oxygen saturation.

    Authors: Hussein Al-Hakeim; Hawraa Al-Jassas; Gerwyn Morris; Michael Maes

    doi:10.1101/2021.03.26.21254383 Date: 2021-03-26 Source: medRxiv

    Background. The characterization of new biomarkers of COVID-19 MESHD is extremely important. Few studies measured the soluble receptor for advanced glycation end product (sRAGE), angiotensin-converting enzyme 2 HGNC ( ACE2 HGNC), calcium and magnesium in COVID-19 MESHD. Aims: To measure sRAGE, ACE2 HGNC, interleukin (IL)-6 HGNC, IL-10 HGNC, CRP HGNC, calcium, magnesium, and albumin in COVID-19 MESHD patients in association with peripheral oxygen saturation (SpO2) and chest CT scan abnormalities (CCTA) including ground glass opacities. Methods. This study measured sRAGE, ACE2 HGNC, IL-6 HGNC, IL-10 HGNC, CRP HGNC using ELISA techniques, and calcium, magnesium, and albumin using a spectrophotometric method in 60 COVID-19 MESHD patients and 30 healthy controls. Results. COVID-19 MESHD is characterized by significantly increased IL-6 HGNC, CRP HGNC, IL-10 HGNC, sRAGE, ACE2 HGNC, and lowered levels of SpO2, albumin, magnesium and calcium. Neural networks showed that a combination of calcium, IL-6 HGNC, CRP HGNC, and sRAGE yielded an accuracy of 100% in detecting COVID-19 MESHD patients with calcium being the most important predictor followed by IL-6 HGNC, and CRP HGNC. COVID-19 MESHD patients with CCTAs showed lower SpO2 and albumin levels than those without CCTAs. SpO2 was significantly and inversely correlated with IL-6 HGNC, IL-10 HGNC, CRP HGNC, sRAGE, and ACE2 HGNC, and positively with albumin, magnesium and calcium. Patients with positive IgG results showed a significant elevation in the serum level of IL-6 HGNC, sRAGE, and ACE2 HGNC compared to the negatively IgG patient subgroup. Conclusion. The results show that immune-inflammatory and RAGE HGNC pathway biomarkers may be used as external validating criterion for the diagnosis COVID-19 MESHD. Those pathways coupled with lowered SpO2, calcium and magnesium are drug targets that may help to reduce the consequences of COVID-19 MESHD.

    Characterising long COVID more than 6 months after acute infection MESHD in adults; prospective longitudinal cohort study, England

    Authors: Zahin Amin-Chowdhury; Ross J Harris; Felicity Aiano; Maria Zavala; Marta Bertran; Ray Borrow; Ezra Linley; Shazaad Ahmad; Ben Parker; Alex Horsley; Bassam Hallis; Jessica Flood; Kevin E Brown; Gayatri Amirthalingam; Mary E Ramsay; Nick Andrews; Shamez N Ladhani

    doi:10.1101/2021.03.18.21253633 Date: 2021-03-24 Source: medRxiv

    Background Most individuals with COVID-19 MESHD will recover without sequelae, but some will develop long-term multi-system impairments. The definition, duration, prevalence and symptoms associated with long COVID, however, have not been established. Methods Public Health England (PHE) initiated longitudinal surveillance of clinical and non-clinical healthcare workers for monthly assessment and blood sampling for SARS-CoV-2 antibodies in March 2020. Eight months after enrolment, participants completed an online questionnaire including 72 symptoms in the preceding month. Symptomatic mild-to-moderate cases with confirmed COVID-19 MESHD were compared with asymptomatic, seronegative controls. Multivariable logistic regression was used to identify independent symptoms associated with long COVID. Findings All 2,147 participants were contacted and 1,671 (77.8%) completed the questionnaire, including 140 (8.4%) cases and 1,160 controls. At a median of 7.5 (IQR 7.1-7.8) months after infection, 20 cases (14.3%) had ongoing (4/140, 2.9%) or episodic (16/140, 11.4%) symptoms. We identified three clusters of symptoms associated with long COVID, those affecting the sensory (ageusia, anosmia MESHD, loss of appetite and blurred vision MESHD), neurological (forgetfulness, short-term memory loss MESHD and confusion MESHD/brain fog HGNC) and cardiorespiratory ( chest tightness/pain MESHD, unusual fatigue MESHD, breathlessness after minimal exertion/at rest, palpitations) systems. The sensory cluster had the highest association with being a case (aOR 5.25, 95% CI 3.45-8.01). Dermatological, gynaecological, gastrointestinal MESHD or mental health symptoms were not significantly different between cases and controls. Interpretation Most persistent symptoms reported following mild COVID-19 MESHD were equally common in cases and controls. While all three clusters identified had a strong association with cases, the sensory cluster had the highest specificity and strength of association, and therefore, most likely to be characteristic of long COVID.

    COVID-19 MESHD Survivors' Reports of the Timing, Duration, and Health Impacts of Post-Acute Sequelae of SARS-CoV-2 (PASC) Infection

    Authors: Natalie Lambert; - Survivor Corps; Sarah A El-Azab; Nathan S Ramrakhiani; Anthony Barisano; Lu Yu; Kaitlyn Taylor; Alvaro Esperanca; Charles A Downs; Heather L Abrahim; Melissa D Pinto; Rana Chakraborty; Jessica L Borelli

    doi:10.1101/2021.03.22.21254026 Date: 2021-03-22 Source: medRxiv

    IMPORTANCEPost-Acute Sequelae of SARS-CoV-2 Infection MESHD (PASC) is a major public health concern. Studies suggest that 1 in 3 infected with SARS-CoV-2 may develop PASC, including those without initial symptoms or with mild COVID-19 MESHD disease.1, 2 OBJECTIVETo evaluate the timing, duration, and health impacts of PASC reported by a large group of primarily non-hospitalized COVID-19 MESHD survivors. DESIGN, SETTING, AND PARTICIPANTSA survey of 5,163 COVID-19 MESHD survivors reporting symptoms for more than 21 days following SARS-CoV-2 infection MESHD. Participants were recruited from Survivor Corps and other online COVID-19 MESHD survivor support groups. MAIN OUTCOMES AND MEASURESParticipants reported demographic information, as well as the timing, duration, health impacts, and other attributes of PASC. The temporal distribution of symptoms, including average time of onset and duration of symptoms were determined, as well as the perceived distress and impact on ability to work. RESULTSOn average, participants reported 21.4 symptoms and the number of symptoms ranged from 1 to 93. The most common symptoms were fatigue MESHD (79.0%), headache MESHD (55.3%), shortness of breath MESHD (55.3%), difficulty concentrating (53.6%), cough MESHD (49.0%), changed sense of taste (44.9%), diarrhea MESHD (43.9%), and muscle or body aches (43.5%). The timing of symptom onset varied and was best described as happening in waves. The longest lasting symptoms on average for all participants (in days) were "frequently changing" symptoms (112.0), inability to exercise (106.5), fatigue MESHD (101.7), difficulty concentrating (101.1), memory problems (100.8), sadness (99.2), hormone imbalance (99.1), and shortness of breath MESHD (96.9). The symptoms that affected ability to work included the relapsing/remitting nature of illness (described by survivors as "changing symptoms"), inability to concentrate, fatigue MESHD, and memory problems MESHD, among others. Symptoms causing the greatest level of distress (on scale of 1 "none" to 5 "a great deal") were extreme pressure at the base of the head (4.4), syncope MESHD (4.3), sharp or sudden chest pain MESHD (4.2), brain pressure (4.2), headache MESHD (4.2), persistent chest pain MESHD or pressure (4.1), and bone pain MESHD in extremities (4.1). CONCLUSIONS AND RELEVANCEPASC is an emerging public health priority characterized by a wide range of changing symptoms, which hinder survivors ability to work. PASC has not been fully characterized and the trajectory of symptoms and long-term outcomes are unknown. There is no treatment for PASC, and survivors report distress in addition to a host of ongoing symptoms. Capturing patient reports of symptoms through open-ended inquiry is a critical first step in accurately and comprehensively characterizing PASC to ensure that medical treatments and management strategies best meet the needs of individual patients and help mitigate health impacts of this new disease.

    Long COVID, A Comprehensive Systematic Scoping Review

    Authors: Hossein Akbarialiabad; Mohammad Hossein Taghrir; Ashkan Abdollahi; Nasrollah Ghahramani; Manasi Kumar; Shahram paydar; Babak Razani; John Mwangi; Ali A. Asadi-pooya; Leila Malekmakan; Bahar Bastani

    id:10.20944/preprints202103.0490.v1 Date: 2021-03-18 Source: Preprints.org

    Introduction: Despite more than one year passed since the first cases of SARS-CoV-2 were reported, there is still no consensus on the definition and clinical management of post-acute- COVID-19 MESHD. The condition has heterogeneously been named as Chronic COVID syndrome MESHD, Post COVID-19 MESHD Syndrome, post-acute sequela of SARS-CoV-2 (PASC), and the more familiar long COVID. Method: In order to capture all relevant published studies, we undertook a multi-step search with no language restriction. The following four-step search strategy was utilized: First, a preliminary (limited) search was conducted on January 20, 2021, in Google Scholar and PubMed to identify the appropriate keywords. Then, on January 30, 2021, we adopted a search strategy of electronic databases from Cochrane Library, PsycINFO, PubMed, Embase, Scopus, and Web of sciences, using those keywords. Then, after duplicate removal, we screened all titles, abstracts, and full texts. This resulted in 66 eligible studies. Subsequently, after a forward and backward search of their references and citations an additional 54 publications were found, resulting in a total of 120 publications that formed the basis of the present analysis. The titles, abstracts, and full-texts of non-English articles were translated using Google Translate for further evaluation. We conducted our scoping review based on the PRISMA-ScR Checklist.Results: We found only one randomized clinical trial in our search. Of the 67 original studies, 22 were cohort and 28 were cross-sectional studies totaling 74.6% of the original studies. Of the total of 120 publications, 59 (49.1%) focused on signs and symptoms, 28 (23.3%) were focused on management, and 13 (10.8%) focused on pathophysiology. Ten (9%) publications focused on imaging studies. Ninety-one percent of the original investigations came from high and upper-middle-income countries, highlighting the scarcity of reports originating from low-income and lower-middle-income countries.Conclusion: The predominant symptoms among those with the so-called “Long COVID” were: fatigue MESHD, breathlessness, arthralgia MESHD, sleep difficulties, and chest pain MESHD. Recent reports also point to the risk of long-term sequela with cutaneous, respiratory, cardiovascular, musculoskeletal MESHD, mental health, neurologic, and renal involvement in those who survive the acute phase of the illness. The ambiguity and controversies in its definition have impaired proper recognition and management of those requiring additional support following the resolution of the acute phase of this infection. This has resulted in long-standing distress for the patients and their families. Our findings highlight the need for a multidisciplinary approach, support, and rehabilitation for these patients in terms of long-term mental and physical health.

    Leg-heel chest MESHD compression as an alternative for medical professionals in times of COVID-19 MESHD

    Authors: Matthias Ott; Alexander Krohn; Laurence H. Bilfield; Florian Dengler; Christina Jaki; Fabian Echterdiek; Tobias Schilling; Johannes Heymer

    doi:10.1101/2021.03.09.21253220 Date: 2021-03-12 Source: medRxiv

    ObjectiveTo evaluate leg-heel chest compression without previous training as an alternative for medical professionals and its effects on distance to potential aerosol spread during chest compression. Methods20 medical professionals performed standard manual chest compression followed by leg-heel chest compression after a brief instruction on a manikin. We compared percentage of correct chest compression position, percentage of full chest recoil, percentage of correct compression depth, average compression depth, percentage of correct compression rate and average compression rate between both methods. In a second approach, potential aerosol spread during chest compression was visualized. ResultsThere was no significant difference between manual and leg-heel compression. The distance to potential aerosol spread could have been increased by leg-heel method. ConclusionUnder special circumstances like COVID-19 MESHD-pandemic, leg-heel chest compression may be an effective alternative without previous training compared to manual chest compression while markedly increasing the distance to the patient.

    COVID-19 MESHD-Related Symptoms Among Cancer MESHD Patients and Healthcare Workers— First Results From the PAPESCO-19 Prospective Cohort Study

    Authors: Ke Zhou; Audrey Blanc-Lapierre; Valérie Seegers; Michèle Boisdron-Celle; Frédéric Bigot; Marianne Bourdon; Hakim Mahammedi; Aurélien Lambert; Mario Campone; Martine Bellanger; Jean-Luc Raoul

    id:10.20944/preprints202103.0292.v1 Date: 2021-03-10 Source: Preprints.org

    Background: Cancer MESHD patients may fail to distinguish COVID-19 MESHD symptoms such as anosmia MESHD, dysgeusia/ageusia MESHD, anorexia MESHD, headache MESHD, and fatigue MESHD, which are frequent after cancer MESHD treatments. We aimed to identify symptoms associated with COVID-19 MESHD and to assess the strength of their association in cancer MESHD and cancer MESHD-free populations. Methods: The prospective multicenter cohort study PAPESCO-19 included 878 cancer MESHD patients and 940 healthcare workers (HCWs) systematically tested for SARS-CoV-2-specific antibodies. Participants reported the results of routine screening RT-PCR and thirteen COVID-19 MESHD symptoms. Backward logistic regression identified the symptom combinations significantly associated with COVID-19 MESHD. Results: COVID+ proportions were similar in patients (8%) and HCWs (9.5%, p=0.26), whereas symptomatic proportions were lower in patients (32%) than HCWs (52%, p<0.001). Anosmia MESHD, anorexia MESHD, fever MESHD, headache MESHD, and rhinorrhea MESHD together accurately discriminated (c-statistic=0.7027) COVID-19 MESHD cases in patients. Anosmia, dysgeusia/ageusia MESHD, muscle pain MESHD, intense fatigue MESHD, headache MESHD, and chest pain MESHD better discriminated (c-statistic=0.8830) COVID-19 MESHD cases in HCWs. Anosmia had the strongest association in patients (OR=7.48, 95% CI: 2.96–18.89) and HCWs (OR=5.71, 95% CI: 2.21–14.75). Conclusions: COVID-19 MESHD symptoms and their diagnostic performance differ in cancer MESHD patients and HCWs. Anosmia is associated with COVID-19 MESHD for patients, while dysgeusia MESHD/ageusia are not. Cancer MESHD patients deserve tailored preventive measures due to their particular COVID-19 MESHD symptom pattern.

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HGNC Genes
SARS-CoV-2 Proteins


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