During 2019, the number of patients suffering from cough, fever MESHD and reduction of WBC’s count increased. At the beginning, this mysterious illness was called “ fever MESHD with unknown origin”. At the present time, the cause of this pneumonia MESHD is known as the 2019 novel coronavirus (2019-nCoV) or the severe acute respiratory syndrome MESHD corona virus 2 (SARS-CoV-2). The SARS-CoV-2 is one member of great family of coronaviruses. Coronaviruses can cause different kind of illnesses including respiratory, enteric, hepatic, and neurological diseases MESHD in animals like cat and bat. Coronaviruses are enveloped positive-stranded RNA viruses. The SARS-CoV-2 has some particular structures for binding to host cells, reproducing itself in cells and damaging human cells. The SARS-CoV-2 can bind angiotensin-converting enzyme 2 HGNC ( ACE‐2 HGNC) receptors and cause various difficulties for human. The SARS-CoV-2 can cause either not-serious issues like fever MESHD and cough MESHD or serious concerns such as multi-organ failure MESHD. Source(s) of SARS-CoV-2 is under debate. Malayan pangolin and bat are the most suspicious candidate for being sources of the SARS-CoV-2. The SARS-CoV-2 can be transmitted by various ways such as transmitting from infected human to healthy human and can make severe pneumonia MESHD, which can lead to death. The SARS-CoV-2 can infect different kind of people with different ages, races, and social and economic levels. The SARS‐CoV‐2 infection MESHD can cause various sorts of clinical manifestations like cough and fever MESHD and intensity of signs and symptoms depends on sufferer conditions. Clinicians use all of available documents and tests like laboratory, histopathological and radiological findings for diagnosing new cases and curing patients with high accuracy. At the present time, there is no particular way for treating SARS-CoV-2 infection MESHD; neither antiviral drugs nor palliative agents. It seems that the best way for standing against the SARS-CoV-2 infection MESHD is preventing from it by social distancing and vaccination. This review tries to prepare an essential brief update about SARS-CoV-2 infection MESHD for clinicians.

Objective: To analyse susceptibility/risk of suffering COVID19 MESHD among adults with distinct underlying medical conditions. Methods: Cohort study (population-based) including 79,083 people >=50 years-old in Tarragona (Southern Catalonia, Spain). At study start (01/03/2020) baseline cohort characteristics (demographic, previous comorbidities, chronic medications and vaccinations history) were recorded. Primary outcome was laboratory-confirmed COVID19 MESHD incurred in cohort members throughout 01/03/2020-30/06/2020. Risk of suffering COVID19 MESHD was evaluated by Cox regression, estimating multivariable hazard ratios (HRs) adjusted for age/sex and previous comorbidities. Results: Across study period, 536 laboratory-confirmed COVID19 MESHD cases were observed (mean incidence: 39.5 cases per 100,000 persons-week). In multivariable-analysis, age/years (HR: 1.01; 95% CI: 1.00-1.02; p=0.050), nursing-home (HR: 20.19; 95% CI: 15.98-25.51; p<0.001), neurological disease MESHD (HR: 1.35; 95% CI: 1.03-1.77; p=0.029), taking diuretics (HR: 1.39; 95% CI: 1.10-1.75; p=0.006), antiplatelet (HR: 1.36; 95% CI: 1.05-1.76; p=0.021) and benzodiazepines (HR: 1.24; 95% CI: 1.00-1.53; p=0.047) significantly increased risk; while smoking (HR: 0.57; 95%CI: 0.41-0.80; p=0.001), angiotensin converting enzyme inhibitors (HR: 0.78; 95% CI: 0.61-1.00; p=0.048), angiotensin II receptor blockers (HR: 0.70; 95%CI: 0.51-0.96; p=0.027) and statins (HR: 0.75; 95% CI: 0.58-0.96; p=0.025) were associated with reduced risk. Among non-institutionalised persons, cancer MESHD, renal and cardiac disease MESHD appeared also related to increased risk, whereas influenza vaccination was associated with reduced risk. Conclusion: In a setting with relatively low incidence of COVID19 MESHD across the first wave of pandemic period, age, nursing-home residence and multiple comorbidities appear predisposing for COVID19 MESHD among middle-aged/older adults. Conversely, statins, angiotensin-receptor blockers/inhibitors and influenza vaccination were related with decreased risk. KEYWORDS: Coronavirus; SARS-COV-2; COVID19 MESHD; Incidence; Risk.

OBJECTIVE: Neurological complications can worsen outcomes in COVID-19 MESHD. We defined the prevalence of a wide range of neurological conditions MESHD among patients hospitalized with COVID-19 MESHD in geographically diverse multinational populations. METHODS: Using electronic health record (EHR) data from 348 participating hospitals across 6 countries and 3 continents between January and September 2020, we performed a cross-sectional study of hospitalized adult and pediatric patients with a positive SARS-CoV-2 reverse transcription polymerase chain reaction test, both with and without severe COVID-19 MESHD. We assessed the frequency of each disease category and 3-character International Classification of Disease MESHD ( ICD MESHD) code of neurological diseases MESHD by countries, sites, time before and after admission for COVID-19 MESHD, and COVID-19 MESHD severity. RESULTS: Among the 35,177 hospitalized patients with SARS-CoV-2 infection MESHD, there was increased prevalence of disorders of consciousness (5.8%, 95% confidence interval [CI]: 3.7%-7.8%, pFDR

Olfactory and gustatory dysfunctions MESHD ( OGD MESHD) are a frequent symptom of Coronavirus disease 2019 MESHD ( COVID-19 MESHD). It has been proposed that the neuroinvasive potential of the novel SARS-CoV-2 could be due to olfactory bulb invasion, conversely studies suggest it could be a good prognostic factor. The aim of the current study was to investigate the prognosis value of OGD in COVID-19 MESHD.These symptoms were recorded on admission from a cohort study of 5868 patients with confirmed or highly suspected COVID-19 MESHD infection included in the multicenter international HOPE Registry (NCT04334291).There was statistical relation in multivariate analysis for OGD in gender, more frequent in female 12.41% vs 8.67% in male, related to age, more frequent under 65 years, presence of hypertension MESHD, dyslipidemia MESHD, diabetes MESHD, smoke, renal insufficiency MESHD, lung, heart, cancer MESHD and neurological disease MESHD. We did not find statistical differences in pregnant (p=0.505), patient suffering cognitive (p=0.484), liver (p=0.1) or immune disease (p=0.32). There was inverse relation (protective) between OGD MESHD and prone positioning (0.005) and death MESHD (<0.0001), but no with ICU (0.165) or mechanical ventilation (0.292). On univariable logistic regression OGD was found to be inversely related to death in COVID-19 MESHD patients. The Odds Ratio was 0.26 (0.15-0.44) (p<0.001) and Z was -5.05.The presence of anosmia MESHD is fundamental in the diagnosis of SARS.CoV-2 infection MESHD, but also could be important when classifying patients and in therapeutic decisions. Even more knowing that it is an early symptom of the disease. Knowing that other situations as being Afro-American or Latino-American, Hypertension MESHD, renal insufficiency MESHD, or increase of C-reactive protein HGNC ( CRP HGNC) imply a worse prognosis we can make a clinical score to estimate the vital prognosis of the patient.The exact pathogenesis of SARS-CoV-2 that causes olfactory and gustative disorders remains unknown but seems related to the prognosis. This point is fundamental, insomuch as could be a plausible way to find a treatment. 

ObjectivesTo determine if there is an association between survival rates in intensive care units (ICU) and occupancy of the unit on the day of admission. DesignNational retrospective observational cohort study spanning the first wave of the Englands COVID-19 pandemic MESHD. Setting114 hospital trusts (groups of hospitals functioning as single operational units). Participants4,032 adults admitted to an ICU in England between 2nd April and 1st June, 2020, with presumed or confirmed COVID-19 MESHD, for whom data was submitted to the national surveillance programme and met study inclusion criteria. InterventionsN/A Main Outcomes and MeasuresA Bayesian hierarchical approach was used to model the association between hospital trust level (mechanical ventilation compatible) bed occupancy, and in-hospital all-cause mortality. Results were adjusted for unit characteristics (pre-pandemic size), individual patient-level demographic characteristics (age, sex, ethnicity, time-to-ICU admission), and recorded chronic comorbidities ( obesity MESHD, diabetes MESHD, respiratory disease MESHD, liver disease MESHD, heart disease MESHD, hypertension MESHD, immunosuppression, neurological disease MESHD, renal disease MESHD). Results79,793 patient-days were observed, with a mortality rate of 19.4 per 1,000 patient days. Adjusting for patient-level factors, mortality was higher for admissions during periods of high occupancy (>85% occupancy versus the baseline of 45 to 85%) [OR 1.19 (95% posterior credible interval (PCI): 1.00 to 1.44)]. In contrast, mortality was decreased for admissions during periods of low occupancy (<45% relative to the baseline) [OR 0.75 (95% PCI: 0.62 to 0.89)]. Conclusion and RelevanceIncreasing occupancy of beds compatible with mechanical ventilation, a proxy for operational strain, is associated with a higher mortality risk for individuals admitted to ICU. Public health interventions (such as expeditious vaccination programmes and non-pharmaceutical interventions) to control both incidence and prevalence of COVID-19 MESHD, and therefore keep ICU occupancy low in the context of the pandemic, are necessary to mitigate the impact of this type of resource saturation. Trial RegistrationN/A O_TEXTBOXSummary Box What is already known on this topicPre-pandemic, higher occupancy of intensive care units was shown to be associated with increased mortality risk. However, there is limited data on the extent to which occupancy levels impacted patient outcomes during the first wave of COVID-19 MESHD, especially in light of the mobilisation of significant additional resources. A recent study from Belgium reported a 42% higher mortality during periods of ICU surge capacity deployment, although in the analysis surge capacity was evaluated only as a binary variable. Although, this contradicts earlier results from smaller studies in Australia and Wales, where no association between ICU occupancy and mortality was identified. What this study addsThe results of this study suggest that survival rates for patients with COVID-19 MESHD in intensive care settings appears to deteriorate as the occupancy of (surge capacity) beds compatible with mechanical ventilation (a proxy for operational pressure), increases. Moreover, this risk doesnt occur above a specific threshold, but rather appears linear; whereby going from 0% occupancy to 100% occupancy increases risk of mortality by 92% (after adjusting for relevant individual-level factors). Furthermore, risk of mortality based on occupancy on the date of recorded outcome is even higher; OR 4.74 (95% posterior credible interval: 3.54 - 6.34). As such, this national-level cohort study of England provides compelling evidence for a relationship between occupancy and critical care mortality, and highlights the needs for decisive action to control the incidence and prevalence of COVID-19 MESHD. C_TEXTBOX

Introduction: Although patients' clinical conditions were previously shown to be associated with coronavirus disease 2019 MESHD ( COVID-19 MESHD) severity and outcomes, their impact on hospital costs is not known. The economic evaluation of COVID-19 MESHD admissions allows the assessment of hospital costs associated with the treatment of these patients, including the main cost components and costs driven by demographic and clinical conditions. The aim of this study was to determine the COVID-19 MESHD hospitalization-related costs and their association with clinical conditions. Methods: Prospective observational cohort study of the hospitalization costs of patients with COVID-19 MESHD admitted between March 30 and June 30, 2020, who were followed until discharge, death MESHD, or external transfer, using micro-costing methodology. The study was carried out in the Central Institute of the Hospital das Clinicas, affiliated with the Faculty of Medicine of the University of Sao Paulo, Brazil, which is the largest hospital complex in Latin America and was designated to exclusively admit COVID-19 MESHD patients during the pandemic response. Results: The average cost of the 3,254 admissions (51.7% of which involved intensive care unit (ICU) stays) was US$12,637.42. Overhead cost was the main cost component, followed by daily fixed costs and drugs. Sex, age and underlying hypertension MESHD (US$14,746.77), diabetes MESHD (US$15,002.12), obesity MESHD (US$18,941.55), cancer MESHD (US$10,315.06), chronic renal failure MESHD (US$15,377.84), and rheumatic MESHD (US$17,764.61), hematologic (US$15,908.25) and neurologic diseases MESHD (US$15,257.95) were significantly associated with higher costs. Age >69 years, RT-PCR-confirmed COVID-19 MESHD, comorbidities, the use of mechanical ventilation, dialysis, or surgery, and poor outcomes remained significantly associated with higher costs after model adjustment. Conclusion: Knowledge of COVID-19 MESHD-associated hospital costs and their impact across different populations can aid in the development of a generalizable and comprehensive approach to hospital preparedness, decision-making and planning for future risk management. Determining the disease-associated costs is the first step in evaluating the cost-effectiveness of treatments and vaccination programs.

Background: We present data on risk factors for severe outcomes among patients with coronavirus disease 2019 MESHD ( COVID-19 MESHD) in the southeast United States (U.S.). Objective: To determine risk factors associated with hospitalization, intensive care unit (ICU) admission, and mortality among patients with confirmed COVID-19 MESHD. Design: A retrospective cohort study. Setting: Fulton County in Atlanta Metropolitan Area, Georgia, U.S. Patients: Community-based individuals of all ages that tested positive for SARS-CoV-2. Measurements: Demographic characteristics, comorbid conditions, hospitalization, ICU admission, death (all-cause mortality), and severe COVID-19 MESHD disease, defined as a composite measure of hospitalization and death MESHD. Results: Between March 2 HGNC and May 31, 2020, we included 4322 individuals with various COVID-19 MESHD outcomes. In a multivariable logistic regression random-effects model, patients in age groups [≥]45 years compared to those <25 years were associated with severe COVID-19 MESHD. Males compared to females (adjusted odds ratio [aOR] 1.4, 95% confidence interval [CI]: 1.1-1.6), non-Hispanic blacks MESHD (aOR 1.9, 95%CI: 1.5-2.4) and Hispanics (aOR 1.7, 95%CI: 1.2-2.5) compared to non-Hispanic whites were associated with increased odds of severe COVID-19 MESHD. Those with chronic renal disease MESHD (aOR 3.6, 95%CI: 2.2-5.8), neurologic disease MESHD (aOR 2.8, 95%CI: 1.8-4.3), diabetes MESHD (aOR 2.0, 95%CI: 1.5-2.7), chronic lung disease MESHD (aOR 1.7, 95%CI: 1.2-2.3), and ''other chronic diseases'' (aOR 1.8, 95%CI: 1.3-2.6) compared to those without these conditions were associated with increased odds of having severe COVID-19 MESHD. Conclusions: Multiple risk factors for hospitalization, ICU admission, and death MESHD were observed in this cohort from an urban setting in the southeast U.S. Improved screening and early, intensive treatment for persons with identified risk factors is urgently needed to reduce COVID-19 MESHD related morbidity and mortality.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection MESHD can cause neurological disease MESHD in humans, but little is known about the pathogenesis of SARS-CoV-2 infection MESHD in the central nervous system. Herein, using K18- hACE2 HGNC mice, we demonstrate that SARS-CoV-2 neuroinvasion MESHD and encephalitis MESHD is associated with mortality in these mice. Intranasal infection of K18- hACE2 HGNC mice with 105 plaque-forming units of SARS-CoV-2 resulted in 100% mortality by day 6 after infection. The highest virus titers in the lungs were observed at day 3 and declined at days 5 and 6 after infection. In contrast, very high levels of infectious virus were uniformly detected in the brains of all the animals at days 5 and 6. Onset of severe disease MESHD in infected MESHD mice correlated with peak viral levels in the brain. SARS-CoV-2-infected MESHD mice exhibited encephalitis hallmarks MESHD characterized by production of cytokines and chemokines, leukocyte infiltration, hemorrhage MESHD and neuronal cell death MESHD. SARS-CoV-2 was also found to productively infect cells within the nasal turbinate, eye and olfactory bulb, suggesting SARS-CoV-2 entry into the brain by this route after intranasal infection. Our data indicate that direct infection of CNS cells together with the induced inflammatory response in the brain resulted in the severe disease observed in SARS-CoV-2-infected MESHD K18- hACE2 HGNC mice.

Many countries have seen a two-wave pattern in reported cases of coronavirus disease-19 MESHD during the 2020 pandemic, with a first wave during spring followed by the current second wave in late summer and autumn. Empirical data show that the characteristics of the effects of the virus do vary between the two periods. Differences in age range and severity of the disease have been reported, although the comparative characteristics of the two waves still remain largely unknown. Those characteristics are compared in this study using data from two equal periods of 3 and a half months. The first period, between 15th March and 30th June, corresponding to the entire first wave, and the second, between 1st July and 15th October, corresponding to part of the second wave, still present at the time of writing this article. Two hundred and four patients were hospitalized during the first period, and 264 during the second period. Patients in the second wave were younger and the duration of hospitalization and case fatality rate were lower than those in the first wave. In the second wave, there were more children, and pregnant and post-partum women. The most frequent signs and symptoms in both waves were fever MESHD, dyspnea MESHD, pneumonia MESHD, and cough, and the most relevant comorbidities were cardiovascular diseases MESHD, type 2 diabetes mellitus MESHD, and chronic neurological diseases MESHD. Patients from the second wave more frequently presented renal and gastrointestinal symptoms MESHD, were more often treated with non-invasive mechanical ventilation and corticoids, and less often with invasive mechanical ventilation, conventional oxygen therapy and anticoagulants. Several differences in mortality risk factors were also observed. These results might help to understand the characteristics of the second wave and the behaviour and danger of SARS-CoV-2 in the Mediterranean area and in Western Europe. Further studies are needed to confirm our findings.

Background: Regular outpatient rehabilitation is prescribed for many patients with chronic neurological disorders MESHD, such as Parkinson's disease MESHD or Multiple Sclerosis MESHD, to constantly support patients and their proxies in disease management. Due to the COVID-19 pandemic MESHD, federal institutions and governments worldwide have directed local or nationwide lockdowns. During these times, the provision of regular outpatient rehabilitation service is drastically limited, making it actually impossible for community-dwelling patients with neurological disorders MESHD to receive prescribed rehabilitation interventions.Case presentation: A 67-year-old man with two chronic neurological diseases MESHD, Parkinson's disease MESHD and Multiple Sclerosis MESHD, underwent a 4-week inpatient rehabilitation in our hospital. The patient gained significant functional improvements that he maintained over the following months, supported by the continuation of physiotherapy in the domestic environment. Due to a COVID-19 pandemic MESHD related interruption of the regular ambulatory rehabilitation for several weeks, the patient’s functional abilities decreased significantly. Thus, the patient was again referred to our hospital for intensive inpatient rehabilitation to regain his physical functioning and mobility capacity. At hospital discharge, the patient improved most of his physical functioning to a pre-pandemic level.Conclusions: The interruption of a rehabilitation service due to a pandemic-related lockdown can significantly impact the functional abilities of patients with chronic neurological diseases MESHD. This case report supports the claim for continuous access to rehabilitation services for all people with rehabilitation needs.