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SARS-CoV-2 proteins

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    Acute Brain Ischemia MESHD, Infarction and Hemorrhage MESHD in Subjects Dying with or Without Autopsy-Proven Acute Pneumonia MESHD

    Authors: Thomas G Beach; Lucia I Sue; Anthony J Intorcia; Michael J Glass; Jessica E Walker; Richard Arce; Courtney M Nelson; Geidy E Serrano

    doi:10.1101/2021.03.22.21254139 Date: 2021-03-26 Source: medRxiv

    Stroke is one of the most serious complications of Covid-19 MESHD disease but it is still unclear whether stroke MESHD is more common with Covid-19 MESHD pneumonia MESHD as compared to non- Covid-19 MESHD pneumonia MESHD. We investigated the concurrence rate of autopsy-confirmed acute brain ischemia MESHD, acute brain infarction MESHD and acute brain hemorrhage MESHD with autopsy-proven acute non-Covid pneumonia MESHD in consecutive autopsies in the Arizona Study of Aging and Neurodegenerative Disorders MESHD (AZSAND), a longitudinal clinicopathological study of normal aging and neurodegenerative diseases MESHD. Of 691 subjects with a mean age of 83.4 years, acute pneumonia MESHD was histopathologically diagnosed in 343 (49.6%); the concurrence rates for histopathologically-confirmed acute ischemia MESHD, acute infarction MESHD or subacute infarction MESHD was 14% and did not differ between pneumonia MESHD and non-pneumonia MESHD groups while the rates of acute brain hemorrhage MESHD were 1.4% and 2.0% of those with or without acute pneumonia MESHD, respectively. In comparison, in reviews of Covid-19 MESHD publications, reported clinically-determined rates of acute brain infarction MESHD range from 0.5% to 20% while rates of acute brain hemorrhage MESHD range from 0.13% to 2%. In reviews of Covid-19 MESHD autopsy studies, concurrence rates for both acute brain infarction MESHD and acute brain hemorrhage MESHD average about 10%. Covid-19 MESHD pneumonia MESHD and non- Covid-19 MESHD pneumonia MESHD may have similar risks tor concurrent acute brain infarction MESHD and acute brain hemorrhage MESHD when pneumonia MESHD is severe enough to cause death MESHD. Additionally, acute brain ischemia MESHD, infarction MESHD or hemorrhage MESHD may not be more common in subjects dying of acute pneumonia MESHD than in subjects dying without acute pneumonia MESHD.

    Endotracheal application of ultraviolet A light in critically ill severe acute respiratory syndrome coronavirus-2 MESHD patients: A first-in-human study

    Authors: Ali Rezaie; Gil Y Melmed; Gabriela Leite; Ruchi Mathur; Will Takakura; Isabel Pedraza; Michael Lewis; Rekha Murthy; George Chaux; Mark Pimentel

    doi:10.1101/2021.03.05.21252997 Date: 2021-03-08 Source: medRxiv

    BackgroundPromising preclinical experiments show that, under specific and monitored conditions, ultraviolet-A (UVA) exposure reduces certain bacteria, fungi, and viruses including coronavirus-229E without harming mammalian columnar epithelial cells. We aimed to evaluate the safety and effects of UVA therapy administered by a novel device via endotracheal tube in critically ill subjects with SARS-CoV-2 infection MESHD. MethodsFive newly intubated mechanically ventilated adults with SARS-CoV-2 infection MESHD, with an endotracheal tube size 7.5mm or greater, were treated with UVA for 20 minutes daily for 5 days, and followed for 30 days. ResultsFive subjects were enrolled (mean age 56.6yrs, 3 male). At baseline, all subjects scored 9/10 on the WHO clinical severity scale (10= death MESHD) with predicted mortality ranging from 21 to 95%. Average log changes in endotracheal viral load from baseline to day 5 and day 6 were -2.41 (range -1.16 to -4.54; Friedman P=0.002) and -3.20 (range -1.20 to -6.77; Friedman P<0.001), respectively. There were no treatment-emergent adverse events. One subject died 17 days after enrollment due to intracranial hemorrhagic MESHD complications of anticoagulation while receiving extracorporeal membrane oxygenation. The remaining subjects clinically improved and scored 2, 4, 5, and 7 on the WHO scale at day 30. In these subjects, the slope of viral load reduction during UVA treatment correlated with the slope of improvement in clinical WHO severity score over time (Spearman rho=1, P<0.001). ConclusionIn this first-in-human study, endotracheal UVA therapy under specific and monitored settings, was safe with a significant reduction in respiratory SARS-CoV-2 MESHD viral burden over the treatment period. Trial RegistrationClinicalTrials.gov #NCT04572399. Key MessagesO_LIWhat is the key question? Can endotracheal narrow-band UVA therapy be a safe and effective treatment for severe SARS-CoV-2 infection MESHD? C_LIO_LIWhat is the bottom line? Under specific and monitored settings, endotracheal UVA light therapy may be an effective treatment for SARS-CoV-2 infection MESHD. Endotracheal UVA light therapy appears to be well tolerated in critically ill patients with SARS-CoV-2 infection MESHD. C_LIO_LIWhy read on? This is the fist-in-human trial of internal UVA therapy using a alternative novel approach to combat COVID-19 MESHD. C_LI

    Coronavirus Disease 2019 MESHD ( Covid-19 MESHD) Outbreak and Pituitary Apoplexy

    Authors: Rafael Martinez-Perez; Benjamin W Carroll; Daniel Duran; James S Neill; Gustavo D Luzardo; Marcus A Zachariah

    doi:10.21203/rs.3.rs-291430/v1 Date: 2021-03-02 Source: ResearchSquare

    Background. Pituitary apoplexy (PA) is a rare and potentially life-threatening condition characterized by pituitary hemorrhage MESHD, often in the setting of a preexisting pituitary adenoma MESHD. Risk factors and mechanisms associated to PA are poorly understood. Although involvement of the nervous system in SARS-CoV-2 infection MESHD causing intracranial hemorrhagic MESHD complications has been documented, the association between COVID-19 MESHD infection and PA has yet to be determined.Methods . From a prospectively collected database of patients with pituitary adenomas MESHD, we retrospectively reviewed the electronical medical records and scans of patients with pituitary apoplexy during the COVID-19 MESHD outbreak, since March 2020 to December 2020, that were treated at a tertiary care center.Results. Herein, we report three consecutive cases of patients with PA MESHD and concomitant COVID-19 MESHD infection. Most common symptom at presentation was headache MESHD and visual worsening. Included patients were successfully treated with surgical decompression and medical management of the hormonal deficits, experiencing moderate to significant improvement of their visual symptoms at last follow up. COVID-19 MESHD infection in the perioperative period was corroborated throughout polymerase chain reaction testing in all patients.Conclusions. COVID-19 MESHD positive patients may be at an increased risk of developing PA. Angiotensin-converting enzyme 2 receptors expressed in cerebrovascular endothelium may potentially play a role in the molecular mechanisms that induce changes of the vascular autoregulation and cerebral blood flow and predispose to pituitary hemorrhage MESHD in patients harboring a pituitary adenoma MESHD.

    Hospitalizations for emergency-sensitive conditions in Germany during the Covid-19 pandemic MESHD - Insights from the German-wide Helios hospital network

    Authors: ANDREAS BOLLMANN; Sven Hohenstein; Vincent Pellissier; Sebastian Koenig; Laura Ueberham; Gerhard Hindricks; Andreas Meier-Hellmann; Ralf Kuhlen

    doi:10.1101/2021.02.08.21250309 Date: 2021-02-11 Source: medRxiv

    Background: While there are numerous reports that describe emergency care during the early Covid-19 pandemic MESHD, there is scarcity of data for later stages. This study analyzes hospitalization rates for 37 emergency-sensitive conditions in the largest German-wide hospital network during different pandemic phases. Methods: Using claims data of 80 hospitals, consecutive cases between January 1 and November 17, 2020 were analyzed and compared to a corresponding period in 2019. Incidence-rate ratios ( IRR HGNC) comparing the both periods were calculated using Poisson regression to model the number of hospitalizations per day. Results: There was a hospitalization deficit between March 12 and June 13, 2020 (coinciding with the 1st pandemic wave) with 32,807 hospitalizations as opposed to 39,379 in 2019 ( IRR HGNC 0.83, 95% CI 0.82-0.85, P<0.01). During the following period (June 14 to November 17, 2020, including the start of 2nd wave), hospitalizations were reduced from 63,799 in 2019 to 59,910 in 2020, but this reduction was not that pronounced ( IRR HGNC 0.94, 95% CI 0.93-0.95, P<0.01). There was an increase in hospitalizations for acute myocardial infarction MESHD, aortic aneurism MESHD/dissection and pulmonary embolism MESHD after the 1st wave during which hospitalizations had been reduced for those conditions. In contrast, hospitalizations for sepsis MESHD, pneumonia MESHD, obstructive pulmonary disease MESHD, and intracranial injuries MESHD were reduced during the entire pandemic. Conclusions: There was an overall reduction of hospitalizations for emergency-sensitive conditions in Germany during the Covid-19 pandemic MESHD with heterogeneous effects on different disease categories. The increase of hospitalizations for acute myocardial infarction MESHD, aortic aneurism MESHD/dissection and pulmonary embolism MESHD is an alarming signal that requires attention and further studies.

    Six-month Neurological and Psychiatric Outcomes in 236,379 Survivors of COVID-19 MESHD

    Authors: Maxime Taquet; John R Geddes; Masud Husain; Sierra Luciano; Paul J Harrison

    doi:10.1101/2021.01.16.21249950 Date: 2021-01-24 Source: medRxiv

    BackgroundNeurological and psychiatric MESHD sequelae of COVID-19 MESHD have been reported, but there are limited data on incidence rates and relative risks. MethodsUsing retrospective cohort studies and time-to-event analysis, we estimated the incidence of ICD-10 diagnoses in the 6 months after a confirmed diagnosis of COVID-19 MESHD: intracranial haemorrhage MESHD; ischaemic stroke MESHD; Parkinsonism MESHD; Guillain-Barre syndrome MESHD; nerve/nerve root/plexus disorders; myoneural/muscle disease MESHD; encephalitis MESHD; dementia MESHD; mood, anxiety MESHD, and psychotic disorders MESHD; substance misuse; and insomnia MESHD. Data were obtained from the TriNetX electronic health records network (over 81 million patients). We compared incidences with those in propensity score-matched cohorts of patients with influenza or other respiratory infections MESHD using a Cox model. We investigated the effect on incidence estimates of COVID-19 MESHD severity, as proxied by hospitalization and encephalopathy MESHD (including delirium MESHD and related disorders). Findings236,379 patients survived a confirmed diagnosis of COVID-19 MESHD. Among them, the estimated incidence of neurological or psychiatric MESHD sequelae at 6 months was 33.6%, with 12.8% receiving their first such diagnosis. Most diagnostic categories were commoner after COVID-19 MESHD than after influenza or other respiratory infections MESHD (hazard ratios from 1.21 to 5.28), including stroke MESHD, intracranial haemorrhage MESHD, dementia MESHD, and psychotic disorders MESHD. Findings were equivocal for Parkinsonism and Guillain-Barre syndrome MESHD. Amongst COVID-19 MESHD cases, incidences and hazard ratios for most disorders were higher in patients who had been hospitalized, and markedly so in those who had experienced encephalopathy MESHD. Results were robust to sensitivity analyses, including comparisons against an additional four index health events. InterpretationThe study provides evidence for substantial neurological and psychiatric MESHD morbidity following COVID-19 MESHD infection. Risks were greatest in, but not limited to, those who had severe COVID-19 MESHD. The information can help in service planning and identification of research priorities. FundingNational Institute for Health Research (NIHR) Oxford Health Biomedical Research Centre.

    Impact of COVID-19 MESHD on the Central Nervous System: Are Spontaneous Intracranial Haemorrhage and Aseptic Meningitis Extrapulmonary MESHD Manifestations of COVID-19 MESHD?

    Authors: MOHAMED AWAD MOHAMED HASSAN

    doi:10.21203/rs.3.rs-139945/v1 Date: 2021-01-03 Source: ResearchSquare

    Background:The coronavirus pandemic that started in December 2019 is mainly related to respiratory symptoms. Clinical presentations have been reported, but so far, no definitive therapy has been established. Intracranial haemorrhage MESHD has been observed in patients with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection MESHD, but the clinical, imaging, and pathophysiological features of intracranial bleeding MESHD during coronavirus disease 2019 MESHD ( COVID-19 MESHD) infection remain poorly characterized. The occurrence of spontaneous intracranial haemorrhage MESHD complicated with aseptic meningitis MESHD secondary to COVID-19 MESHD is extremely rare.Case presentation:A 19-month-old fever MESHD, and shortness of breath MESHD was admitted to our intensive care unit on an emergency basis. Two weeks later, the patient developed a generalized convulsion MESHD with deterioration of consciousness MESHD. A computed tomography scan of the brain revealed a bifrontal intracerebral  haemorrhage MESHD compressing the anterior horns of both lateral ventricles of the brain with a massive intraventricular haemorrhage MESHD causing hydrocephalus MESHD. Emergency ventriculostomy MESHD was performed, and a nasal swab for SARSCoV-2 was positive. Cerebrospinal fluid analysis and culture were negative for microorganisms, and analysis revealed features of aseptic meningitis MESHD.Conclusions:The possible occurrence of spontaneous intracranial haemorrhage MESHD and aseptic meningitis MESHD should be kept in mind by physicians, especially when treating critically ill young children with COVID-19 MESHD. Early recognition Conclusions: The possible occurrence of spontaneous intracranial haemorrhage MESHD and aseptic meningitis MESHD should be kept in mind by physicians, especially when treating critically ill young children with COVID- 19. Early recognition of central nervous system involvement may be key to providing a better prognosis.

    Impact of SARS-CoV-2 on reperfusion therapies for acute ischemic stroke in Lombardy, Italy. The STROKOVID network

    Authors: Alessandro Pezzini; Mario Grassi; Giorgio Silvestrelli; Martina Locatelli; Nicola Rifino; Simone Beretta; Massimo Gamba; Elisa Raimondi; Giuditta Giussani; Federico Carimati; Davide Sangalli; Manuel Corato; Simonetta Gerevini; Stefano Masciocchi; Matteo Cortinovis; Sara La Gioia; Francesca Barbieri; Valentina Mazzoleni; Debora Pezzini; Sonia Bonacina; Andrea Pilotto; Alberto Benussi; Mauro Magoni; Enrico Premi; Alessandro Cesare Prelle; Elio Clemente Agostoni; Fernando Palluzzi; Valeria De Giuli; Anna Magherini; Daria Valeria Roccatagliata; Luisa Vinciguerra; Valentina Puglisi; Laura Fusi; Rubjona Xhani; Federico Pozzi; Susanna Diamanti; Francesco Santangelo; Giampiero Grampa; Maurizio Versino; Andrea Salmaggi; Simona Marcheselli; Anna Cavallini; Alessia Giossi; Bruno Censori; Carlo Ferrarese; Alfonso Ciccone; Maria Sessa; Alessandro Padovani

    doi:10.21203/rs.3.rs-105649/v1 Date: 2020-11-10 Source: ResearchSquare

    Whether and how SARS-CoV-2 outbreak affected in-hospital acute stroke MESHD care system is still matter of debate. In the setting of the STROKOVID network, a collaborative project between the 10 centers designed as hubs for the treatment of acute stroke MESHD during SARS-CoV-2 outbreak in Lombardy, Italy, we retrospectively compared clinical features and process measures of patients with confirmed infection ( COVID-19 MESHD) and non-infected MESHD patients (non- COVID-19 MESHD) who underwent reperfusion therapies for acute ischemic stroke MESHD. Between March 8 HGNC and April 30, 2020, 296 consecutive patients (median age, 74 [interquartile range (IQR), 62–80.75] years; males, 154 [52.0%]; 34 [11.5%] COVID-19 MESHD) qualified for the analysis. Time from symptoms onset to treatment was longer in the COVID-19 MESHD group (230 [IQR, 200.5–270] minutes vs 190 [IQR, 150–245] minutes; p=0.007), especially in the first half of the study period. Patients with COVID-19 MESHD who underwent endovascular thrombectomy had more frequently absent collaterals or collaterals filling ≤50% of the occluded territory (50.0% vs 16.6%; OR, 5.05; 95% CI, 1.82–13.80) and a lower rate of good/complete recanalization of the primary arterial occlusive lesion MESHD (55.6% vs 81.0%; OR, 0.29; 95% CI, 0.10–0.80). Post-procedural intracranial hemorrhages MESHD were more frequent (35.3% vs 19.5%; OR, 2.24; 95% CI, 1.04-4.83) and outcome was worse among COVID-19 MESHD patients (in-hospital death, 38.2% vs 8.8%; OR, 6.43; 95% CI, 2.85-14.50). Our findings showed longer delays in the intra-hospital management of acute ischemic stroke MESHD in COVID-19 MESHD patients, especially in the early phase of the outbreak, that likely impacted patients outcome and should be the target of future interventions. 

    Change of disease distribution in pediatric neurology inpatients during the COVID-19 MESHD outbreak in southwest China

    Authors: Xueping Wang; Wenguang Hu; Jialei Chen; Ling Liu

    doi:10.21203/rs.3.rs-93515/v1 Date: 2020-10-16 Source: ResearchSquare

    This study aimed to investigate the change of disease distribution in pediatric neurology inpatients during the COVID-19 MESHD outbreak in southwest China. We retrospectively extracted the demographic data and diagnosis of discharged patients registered at pediatric neurology department of Chengdu Women’s and Children’s Central Hospital from January 1 to July 31, 2019 and January 1 to July 31, 2020. Total number of inpatients decreased during COVID-19 MESHD outbreak. Children diagnosed as febrile seizure MESHD caused by infection (1799/60.7% vs 980/59%, P = 0.141), dyskinesia MESHD (31/1.0% vs 28/1.7%, P = 0.075) and benign intracranial hypertension MESHD (41/1.4% vs 21/1.3%, P = 0.791) did not change. While children diagnosed as epilepsy MESHD (304/10.3% vs 348/21%, P < 0.001), migraine MESHD (25/0.8% vs 31/1.9%, P = 0.003), mental disease MESHD (24/0.8% vs 43/2.6%, P < 0.001) and peripheral neuropathy MESHD (38/1.3% vs 43/2.6%, P = 0.001) increased in 2020. Children diagnosed as intracranial infection MESHD (535/18% vs113/6.8%, P < 0.001) and myopathy MESHD (106/3.6% in vs 22/2.0%, P = 0.003) reduced in 2020. Conclusions: We found a significant increase in the proportion of mood-related diseases, while disease caused by infection decreased. We should pay attention to children’s mental state during the public health epidemic and the management of chronic disease MESHD.

    Tracking Results and Utilization of Artificial Intelligence (tru-AI) in Radiology: Early-Stage COVID-19 MESHD COVID-19 MESHD Pandemic Observations

    Authors: Axel Wismüller; Larry Stockmaster

    id:2010.07437v1 Date: 2020-10-14 Source: arXiv

    Objective: To introduce a method for tracking results and utilization of Artificial Intelligence (tru-AI) in radiology. By tracking both large-scale utilization and AI results data, the tru-AI approach is designed to calculate surrogates for measuring important disease-related observational quantities over time, such as the prevalence of intracranial hemorrhage MESHD during the COVID-19 pandemic MESHD COVID-19 pandemic MESHD outbreak. Methods: To quantitatively investigate the clinical applicability of the tru-AI approach, we analyzed service requests for automatically identifying intracranial hemorrhage MESHD ( ICH MESHD) on head CT using a commercial AI solution. This software is typically used for AI-based prioritization of radiologists' reading lists for reducing turnaround times in patients with emergent clinical findings, such as ICH MESHD or pulmonary embolism MESHD.We analyzed data of N=9,421 emergency-setting non-contrast head CT studies at a major US healthcare system acquired from November 1, 2019 through June 2, 2020, and compared two observation periods, namely (i) a pre-pandemic epoch from November 1, 2019 through February 29, 2020, and (ii) a period during the COVID-19 pandemic MESHD outbreak, April 1-30, 2020. Results: Although daily CT scan counts were significantly lower during (40.1 +/- 7.9) than before (44.4 +/- 7.6) the COVID-19 MESHD outbreak, we found that ICH MESHD was more likely to be observed by AI during than before the COVID-19 MESHD outbreak (p<0.05), with approximately one daily ICH MESHD+ case more than statistically expected. Conclusion: Our results suggest that, by tracking both large-scale utilization and AI results data in radiology, the tru-AI approach can contribute clinical value as a versatile exploratory tool, aiming at a better understanding of pandemic-related effects on healthcare.

    SARS-CoV-2 and Stroke Characteristics: A Report from the Multinational COVID-19 MESHD Stroke Study Group

    Authors: Shima Shahjouei; Georgios Tsivgoulis; Ghasem Farahmand; Eric Koza; Ashkhan Mowla; Alireza Vafaei Sadr; Arash Kia; Alaleh Vaghefi Far; Stefania Mondello; Achille Cernigliaro; Annemarei Ranta; Martin Punter; Faezeh Khodadadi; Mrina Sabra; Mahtab Ramezani; Soheil Naderi; Oluwaseyi Olulana; Durgesh Chaudhary; Aicha Lyoubi; Bruce Campbell; Juan F Arenillas; Daniel Bock; Joan Montaner; Saeideh Aghayari Sheikh Neshin; Diana Aguiar de Sousa; Mattew Tenser; Ana Aires; Mercedes De Lera Alfonso; Orkhan Alizada; Elsa Azevedo; Nitin Goyal; Zabihollah Babaeepour; Gelareh Banihashemi; Leo H Bonati; Carlo Cereda; Jason J Chang; Miljenko Crnjakovic; GianMarco De Marchis; Massimo del Sette; Seyed Amir Ebrahimadeh; Mehdi Farhoudi; Ilaria Gandoglia; Bruno Goncalves; Christoph Griessenauer; Mehmet Murat Hanci; Aristeidis H. Katsanos; Christos Krogias; Ronen Leker; Lev Lotman; Jeffrey Mai; Shailesh Male; konark Malhotra; Branko Malojcic; Tresa Mesquita; Asadollah Mirghasemi; Hany Mohamed Aref; Zeinab Mohseni Afshar; Junsun Moon; Mika Niemela; Behnam Rezai Jahromi; Lawrence Nolan; Abhi Pandhi; Jong-Ho Park; Joao Pedro Marto; Francisco Purroy; Sakineh Ranji-Burachaloo; Nuno Reis Carreira; Manuel Requena; Marta Rubiera; Seyed Aidin Sajedi; Joao SargentoFreitas; Vijay Sharma; Thorsten Steiner; Kristi Tempro; Guillaume Turc; Yassaman Ahmadzadeh; Mostafa Almasi-Dooghaee; Farhad Assarzadegan; Arefeh Babazadeh; Humain Baharvahdat; Fabricio Cardoso; Apoorva Dev; Mohammad Ghorbani; Ava Hamidi; Zeynab Sadat Hasheminejad; Sahar Hojjat-Anasri Komachali; Fariborz Khorvash; Firas Kobeissy; Hamidreza Mirkarimi; Elahe Mohammadi-Vosough; Debdipto Misra; Alierza Noorian; Peyman Nowrouzi-Sohrabi; Sepideh Paybast; Leila Poorsaadat; mehrdad Roozbeh; Behnam Sabayan; Saeideh Salehizadeh; Alia Saberi; Mercedeh Sepehrnia; Fahimeh Vahabizad; Thomas Yasuda; Ahmadreza Hojati Marvasti; Mojdeh Ghabaee; Nasrin Rahimian; Mohammad Hosein Harirchian; Afshin Borhani-Haghighi; Rohan Arora; Saeed Ansari; Venkatesh Avula; Jian Li; Vida Abedi; Ramin Zand

    doi:10.1101/2020.08.05.20169169 Date: 2020-08-07 Source: medRxiv

    Background: Stroke MESHD is reported as a consequence of SARS-CoV-2 infection MESHD. However, there is a lack of regarding comprehensive stroke MESHD phenotype and characteristics Methods: We conducted a multinational observational study on features of consecutive acute ischemic stroke MESHD ( AIS MESHD), intracranial hemorrhage MESHD ( ICH MESHD), and cerebral venous or sinus thrombosis MESHD ( CVST MESHD) among SARS-CoV-2 infected MESHD patients. We further investigated the association of demographics, clinical data, geographical regions, and countrie's health expenditure among AIS MESHD patients with the risk of large vessel occlusion (LVO), stroke MESHD severity as measured by National Institute of Health stroke MESHD scale (NIHSS), and stroke MESHD subtype as measured by the TOAST criteria. Additionally, we applied unsupervised machine learning algorithms to uncover possible similarities among stroke MESHD patients. Results: Among the 136 tertiary centers of 32 countries who participated in this study, 71 centers from 17 countries had at least one eligible stroke MESHD patient. Out of 432 patients included, 323(74.8%) had AIS MESHD, 91(21.1%) ICH MESHD, and 18(4.2%) CVST MESHD. Among 23 patients with subarachnoid hemorrhage MESHD, 16(69.5%) had no evidence of aneurysm MESHD. A total of 183(42.4%) patients were women, 104(24.1%) patients were younger than 55 years, and 105(24.4%) patients had no identifiable vascular risk factors. Among 380 patients who had known interval onset of the SARS-CoV-2 and stroke MESHD, 144(37.8%) presented to the hospital with chief complaints of stroke MESHD-related symptoms, with asymptomatic or undiagnosed SARS-CoV-2 infection MESHD. Among AIS MESHD patients 44.5% had LVO; 10% had small artery occlusion MESHD according to the TOAST criteria. We observed a lower median NIHSS (8[3-17], versus 11[5-17]; p=0.02) and higher rate of mechanical thrombectomy (12.4% versus 2%; p<0.001) in countries with middle to high-health expenditure when compared to countries with lower health expenditure. The unsupervised machine learning identified 4 subgroups, with a relatively large group with no or limited comorbidities. Conclusions: We observed a relatively high number of young, and asymptomatic SARS-CoV-2 infections MESHD among stroke MESHD patients. Traditional vascular risk factors were absent among a relatively large cohort of patients. Among hospitalized patients, the stroke MESHD severity was lower and rate of mechanical thrombectomy was higher among countries with middle to high-health expenditure.

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