Corpus overview


MeSH Disease

Human Phenotype

Hypertension (369)

Fever (85)

Cough (71)

Obesity (64)

Pneumonia (62)


    displaying 181 - 190 records in total 369
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    Clinical characteristics of patients hospitalized with COVID-19 in Spain: results from the SEMI-COVID-19 Network.

    Authors: José Manuel Casas Rojo; Juan Miguel Antón Santos; Jesús Millán Núñez-Cortés; Carlos Lumbreras Bermejo; José Manuel Ramos Rincón; Emilia Roy-Vallejo; Arturo Artero Mora; Francisco Arnalich Fernández; José Miguel García Bruñén; Juan Antonio Vargas Núñez; Santiago J Freire Castro; Luis Manzano; Isabel Perales Fraile; Anxela Crestelo Vieitez; Francesc Puchades; Enrique Rodilla; Marta Nataya Solís Marquínez; David Bonet Tur; María del Pilar Fidalgo Moreno; Eva M Fonseca Aizpuru; Franscisco Javier Carrasco Sánchez; Elisa Rabadán Pejenaute; Manuel Rubio-Rivas; José David Torres Peńa; Ricardo Gómez Huelgas

    doi:10.1101/2020.05.24.20111971 Date: 2020-05-26 Source: medRxiv

    Background. Spain has been one of the countries most affected by the COVID-19 pandemic. Objective. To create a registry of patients with COVID-19 hospitalized in Spain in order to improve our knowledge of the clinical, diagnostic, therapeutic, and prognostic aspects of this disease MESHD. Methods. A multicentre retrospective cohort study, including consecutive patients hospitalized with confirmed COVID-19 throughout Spain. Epidemiological and clinical data, additional tests at admission and at seven days, treatments administered, and progress at 30 days of hospitalization were collected from electronic medical records. Results. Up to April 30th 2020, 6,424 patients from 109 hospitals were included. Their median age TRANS was 69.1 years (range: 18-102 years) and 56.9% were male TRANS. Prevalences SERO of hypertension MESHD hypertension HP, dyslipidemia, and diabetes mellitus MESHD diabetes mellitus HP were 50.2%, 39.7%, and 18.7%, respectively. The most frequent symptoms were fever MESHD fever HP (86.2%) and cough MESHD cough HP (76.5%). High values of ferritin (72.4%), lactate dehydrogenase (70.2%), and D-dimer (61.5%), as well as lymphopenia MESHD lymphopenia HP (52.6%), were frequent. The most used antiviral drugs were hydroxychloroquine (85.7%) and lopinavir/ritonavir (62.4%). 31.5% developed respiratory distress HP. Overall mortality rate was 21.1%, with a marked increase with age TRANS (50-59 years: 4.2%, 60-69 years: 9.1%, 70-79 years: 21.4%, 80-89 years: 42.5%, [≥] 90 years: 51.1%). Conclusions. The SEMI-COVID-19 Network provides data on the clinical characteristics of patients with COVID-19 hospitalized in Spain. Patients with COVID-19 hospitalized in Spain are mostly severe cases, as one in three patients developed respiratory distress HP and one in five patients died. These findings confirm a close relationship between advanced age TRANS and mortality.

    Association between comorbidities and the risk of death MESHD in patients with COVID-19: sex-specific differences

    Authors: Mingyang Wu; shuqiong Huang; Jun Liu; Yanling Shu; Yinbo Luo; Lulin Wang; Mingyan Li; Youjie Wang

    doi:10.1101/2020.05.22.20109579 Date: 2020-05-25 Source: medRxiv

    Background: The coronavirus disease MESHD 2019 (Covid-19) spreads rapidly around the world. Objective: To evaluate the association between comorbidities and the risk of death MESHD in patients with COVID-19, and to further explore potential sex-specific differences. Methods: We analyzed the data from 18,465 laboratory- confirmed cases TRANS that completed an epidemiological investigation in Hubei Province as of February 27, 2020. Information on death MESHD was obtained from the Infectious Disease MESHD Information System. The Cox proportional hazards model was used to estimate the association between comorbidities and the risk of death MESHD in patients with COVID-19. Results: The median age TRANS for COVID-19 patients was 50.5 years. 8828(47.81%) patients were females TRANS. Severe cases accounted for 20.11% of the study population. As of March 7, 2020, a total of 919 cases deceased from COVID-19 for a fatality rate of 4.98%. Hypertension MESHD Hypertension HP (13.87%), diabetes (5.53%), and cardiovascular and cerebrovascular diseases MESHD CBVDs (4.45%) were the most prevalent comorbidities, and 27.37% of patients with COVID-19 reported having at least one comorbidity. After adjustment for age TRANS, gender TRANS, address, and clinical severity, patients with hypertension MESHD hypertension HP (HR 1.55, 95%CI 1.35-1.78), diabetes (HR 1.35, 95%CI 1.13-1.62), CBVDs (HR 1.70, 95%CI 1.43-2.02), chronic kidney diseases HP kidney diseases MESHD (HR 2.09, 95%CI 1.47-2.98), and at least two comorbidities (HR 1.84, 95%CI 1.55-2.18) had significant increased risks of death MESHD. And the association between diabetes and the risk of death MESHD from COVID-19 was prominent in women (HR 1.69, 95%CI 1.27-2.25) than in men (HR 1.16, 95%CI 0.91-1.46) (P for interaction = 0.036). Conclusion: Among laboratory- confirmed cases TRANS of COVID-19 in Hubei province, China, patients with hypertension MESHD hypertension HP, diabetes, CBVDs, chronic kidney diseases HP kidney diseases MESHD were significantly associated with increased risk of death MESHD. The association between diabetes and the risk of death MESHD tended to be stronger in women than in men. Clinicians should increase their awareness of the increased risk of death MESHD in COVID-19 patients with comorbidities.

    Antihypertensive medication uses and serum SERO ACE2 levels

    Authors: Valur Emilsson; Elias F Gudmundsson; Thor Aspelund; Brynjolfur G Jonsson; Alexander Gudjonsson; Lenore J Launer; Lori L Jennings; Valborg Gudmundsdottir; Vilmundur Gudnason

    doi:10.1101/2020.05.21.20108738 Date: 2020-05-25 Source: medRxiv

    Importance Recent reports have shown that hypertension MESHD hypertension HP is the most common comorbidity associated with mortality in the current coronavirus disease MESHD 2019 (COVID-19). This has been related to the use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) as animal studies indicate that these medications increase levels of ACE2, the cellular entry point for the coronavirus SARS-CoV-2. This has prompted clinicians to recommend discontinuing ACEIs and ARBs. Objective To examine the effect of ACEIs or ARBs treatment on serum SERO levels of ACE2 and other key enzymes in the renin-angiotensin system (RAS). Design, Setting, and Participants A single center population-based study of 5457 Icelanders from the Age TRANS, Gene/Environment Susceptibility Reykjavik Study ( AGES TRANS-RS) of the elderly TRANS (mean age TRANS 75+/-6 years) stratified by ACEIs (N = 699) or ARBs (N = 753) treatment. Main Outcomes and Measures The AGES TRANS-RS study population was stratified by ACEIs and ARBs medication use and compared for age TRANS, body mass index (BMI) (kg/m2), hypertension MESHD hypertension HP and type 2 diabetes (T2D) as well as serum SERO levels of renin, ACE and ACE2. Results While renin and ACE levels were significantly raised in serum SERO of individuals on ACEIs or ARBs treatments, the ACE2 levels remained unaffected. Conclusions and Relevance Treatment with ACEIs or ARBs does not raise ACE2 levels in serum SERO. Therefore, the present study does not support the proposed discontinuation of these medications among patients affected with COVID-19.

    COVID-19 Outcomes in 4712 consecutively confirmed SARS-CoV2 cases in the city of Madrid.

    Authors: Sarah Heili-Frades; Pablo Minguez; Ignacio Mahillo-Fernandez; Tomas Prieto-Rumeau; Antonio Herrero Gonzalez; Lorena de la Fuente; Maria Jesus Rodriguez Nieto; German Peces-Barba Romero; Mario Peces-Barba; Maria del Pilar Carballosa de Miguel; Itziar Fernandez Ormaechea; Alba Naya Prieto; Farah Ezzine de Blas; Luis Jimenez Hiscock; Cesar Perez Calvo; Arnoldo Santos; Luis Enrique Munoz Alameda; Fredeswinda Romero Bueno; Miguel Gorgolas Hernandez-Mora; Alfonso Cabello Ubeda; Beatriz Alvarez Alvarez; Elizabet Petkova; Nerea Carrasco; Dolores Martin Rios; Nicolas Gonzalez Mangado; Olga Sanchez Pernaute

    doi:10.1101/2020.05.22.20109850 Date: 2020-05-25 Source: medRxiv

    There is limited information describing features and outcomes of patients requiring hospitalization for COVID19 disease MESHD and still no treatments have clearly demonstrated efficacy. Demographics and clinical variables on admission, as well as laboratory markers and therapeutic interventions were extracted from electronic Clinical Records (eCR) in 4712 SARS-CoV2 infected patients attending 4 public Hospitals in Madrid. Patients were stratified according to age TRANS and stage of severity. Using multivariate logistic regression analysis, cut-off points that best discriminated mortality were obtained for each of the studied variables. Principal components analysis and a neural network (NN) algorithm were applied. A high mortality incidence associated to age TRANS >70, comorbidities ( hypertension MESHD hypertension HP, neurological disorders and diabetes), altered vitals such as fever MESHD fever HP, heart rhythm disturbances or elevated systolic blood pressure HP blood SERO pressure, and alterations in several laboratory tests. Remarkably, analysis of therapeutic options either taken individually or in combination drew a universal relationship between the use of Cyclosporine A and better outcomes as also a benefit of tocilizumab and/or corticosteroids in critically ill patients. We present a large Spanish population-based study addressing factors influencing survival in current SARS CoV2 pandemic, with particular emphasis on the effectivity of treatments. In addition, we have generated an NN capable of identifying severity predictors of SARS CoV2. A rapid extraction and management of data protocol from eCR and artificial intelligence in-house implementations allowed us to perform almost real time monitoring of the outbreak evolution.

    Sociodemographic predictors of outcomes in COVID-19: examining the impact of ethnic disparities in Northern Nevada

    Authors: Daniel Antwi-Amoabeng; Bryce David Beutler; Munadel Awad; Zahara Kanji; Sumaiya Mahboob; Jasmine Ghuman; Sri Harsha Boppana; Mohammad Salman Sheikh; Mark B. Ulanja; Nageshwara Gullapalli

    doi:10.1101/2020.05.24.20112094 Date: 2020-05-25 Source: medRxiv

    Background: On March 11, 2020, the World Health Organization declared coronavirus disease MESHD-19 (COVID-19) a pandemic. Nearly five million individuals have since been diagnosed with this increasingly common and potentially lethal viral infection MESHD. Emerging evidence suggests a disproportionate burden of illness and death MESHD among minority communities. We aimed to evaluate the effect of ethnicity on outcomes among patients diagnosed with COVID-19 in Northern Nevada. Design: Single-center, retrospective observational study Materials and methods: The electronic health records of 172 patients diagnosed with COVID-19 were obtained from a 946-bed tertiary referral center serving Northern Nevada. Demographic and clinical characteristics were compared by ethnic group (Hispanic versus non-Hispanic). Logistic regression was used to determine predictors of mortality. Results: Among 172 patients who were diagnosed with COVID-19 between March 12th and May 8th, 2020, 87 (50.6%) identified as Hispanic and 81 (47.1%) as non-Hispanic. The mean age TRANS was 46.0 among Hispanics and 55.8 among non-Hispanics. Comorbidities linked to increased COVID-19-related mortality - hypertension MESHD hypertension HP, obesity MESHD obesity HP, and chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP - were more common among the non-Hispanic population. Hispanic individuals were significantly more likely to be uninsured and to live in low-income communities as compared to their non-Hispanic counterparts (27.6% versus 8.2% and 52.9% versus 30.6%, respectively). Hispanic patients were also less likely than non-Hispanics to have a primary care provider (42.5% versus 61.2%). However, mortality was significantly higher among the non-Hispanic population (15.3% versus 5.8%). Conclusion: The COVID-19 pandemic has disproportionately affected Hispanic individuals in Northern Nevada, who account for only 25.7% of the population but over half of the confirmed cases TRANS. Hispanic individuals were younger and had fewer comorbidities than their non-Hispanic counterparts; consequently, despite considerable socioeconomic disadvantage, mortality was lower among the Hispanic population. The underlying causes of ethnic disparities in COVID-19 incidence remain to be established, but further investigation may lead to more effective community- and systems-based interventions.

    Management of mild COVID-19: Policy implications of initial experience in India

    Authors: Rohit Kumar; bisakh bhattacharya; Ved Prakash Meena; Anivita Aggarwal; Manasi Tripathi; Manish Soneja; Ankit Mittal; Komal Singh; Nishkarsh Gupta; Rakesh Kumar Garg; Brajesh Ratre; Balbir Kumar; Shweta Bhopale; Pavan Tiwari; Ankit Verma; Sushma Bhatnagar; Anant Mohan; Naveet Wig; Randeep Guleria

    doi:10.1101/2020.05.20.20107664 Date: 2020-05-25 Source: medRxiv

    Objectives- Ongoing pandemic due to COVID-19 has spread across countries, surprisingly with variable clinical characteristics and outcomes. This study was aimed at describing clinical characteristics and outcomes of admitted patients with mild COVID-19 illness in the initial phase of pandemic in India. Design - Retrospective (observational ) study. Setting - COVID facilities under AIIMS, New Delhi, where, isolation facilities were designed to manage patients with mild illness and dedicated COVID ICUs was created to cater patients with moderate to severe illness. Participants - Patients aged TRANS 18 years or more, with confirmed illness were eligible for enrolment. Patients who were either asymptomatic TRANS or mildly ill at presentation were included. Patients with moderate to severe illness at admission, or incomplete clinical symptomatology records were excluded. Methods - Data regarding demographic profile, comorbidities, clinical features, hospital course, treatment, details of results of RT-PCR for SARS-CoV-2 done at baseline and at day 14, chest radiographs (wherever available) as well as laboratory parameters was obtained retrospectively from the hospital records. Main outcome measures - Final outcome was noted in terms of course of the disease MESHD, patients discharged, still admitted (at time of conclusion of study) or death MESHD. Results -Out of 231 cases included, majority were males TRANS(78.3%) with a mean age TRANS of 39.8 years. Comorbidities were present in 21.2% of patients, diabetes mellitus MESHD diabetes mellitus HP and hypertension MESHD hypertension HP being most common. The most common symptoms were dry cough MESHD cough HP(81, 35%), fever MESHD fever HP(64, 27.7%), sore throat(36, 15.6%), and dyspnoea(24, 10.4%); asymptomatic infection MESHD asymptomatic TRANS was noted in 108(46.8%) patients. Presence of comorbidities was an independent predictor of symptomatic disease MESHD (OR-2.66; 95% CI 1.8 to 6.53, p= 0.03). None of the patients progressed to moderate to severe COVID-19. There were no deaths MESHD in this cohort. Conclusions - Patients with mild disease MESHD at presentation had a stable disease MESHD course and therefore such cases can be managed outside hospital setting. A large proportion of patients remained asymptomatic TRANS throughout the course of infection MESHD and those with comorbidities are more likely to be symptomatic. Trial registration - Not applicable

    Risk factors affecting COVID-19 case fatality rate: A quantitative analysis of top 50 affected countries

    Authors: Hui Poh Goh; Wafiah Ilyani Mahari; Norhadyrah Izazie Ahad; Liling Chaw; Nurolaini Kifli; Bey Hing Goh; Siang Fei Yeoh; Long Chiau Ming

    doi:10.1101/2020.05.20.20108449 Date: 2020-05-25 Source: medRxiv

    Background: Latest clinical data on treatment on coronavirus disease MESHD 2019 (COVID-19) indicated that older patients and those with underlying history of smoking, hypertension MESHD hypertension HP or diabetes mellitus MESHD diabetes mellitus HP might have poorer prognosis of recovery from COVID-19. We aimed to examine the relationship of various prevailing population-based risk factors in comparison with mortality rate and case fatality rate (CFR) of COVID-19. Methods: Demography and epidemiology data which have been identified as verified or postulated risk factors for mortality of adult TRANS inpatients with COVID-19 were used. The number of confirmed cases TRANS and the number of deaths MESHD until April 16, 2020 for all affected countries were extracted from Johns Hopkins University COVID-19 websites. Datasets for indicators that are fitting with the factors of COVID-19 mortality were extracted from the World Bank database. Out of about 185 affected countries, only top 50 countries were selected to be analyzed in this study. The following seven variables were included in the analysis, based on data availability and completeness: 1) proportion of people aged TRANS 65 above, 2) proportion of male TRANS in the population, 3) diabetes prevalence SERO, 4) smoking prevalence SERO, 5) current health expenditure, 6) number of hospital beds and 7) number of nurses and midwives. Quantitative analysis was carried out to determine the correlation between CFR and the aforementioned risk factors. Results: United States shows about 0.20% of confirmed cases TRANS in its country and it has about 4.85% of CFR. Luxembourg shows the highest percentage of confirmed cases TRANS of 0.55% but a low 2.05% of CFR, showing that a high percentage of confirmed cases TRANS does not necessarily lead to high CFR. There is a significant correlation between CFR, people aged TRANS 65 and above (p = 0.35) and diabetes prevalence SERO (p = 0.01). However, in our study, there is no significant correlation between CFR of COVID-19, male TRANS gender TRANS (p = 0.26) and smoking prevalence SERO (p = 0.60). Conclusion: Older people above 65 years old and diabetic patients are significant risk factors for COVID-19. Nevertheless, gender TRANS differences and smoking prevalence SERO failed to prove a significant relationship with COVID-19 mortality rate and CFR. Keywords: Coronavirus, COVID-19, risk, epidemiology, fatality, age TRANS, diabetes

    Comparison of renin-angiotensin-aldosterone system inhibitors with other antihypertensives in association with coronavirus disease MESHD-19 clinical outcomes: systematic review and meta-analysis

    Authors: Yihienew Mequanint Bezabih; Alemayehu Bezabih; Endalkachew Alamneh; Gregory M. Peterson; Woldesellassie M. Bezabhe

    doi:10.1101/2020.05.21.20108993 Date: 2020-05-25 Source: medRxiv

    Introduction: The effects of renin-angiotensin-aldosterone system (RAAS) inhibitors on the clinical outcomes of coronavirus disease MESHD-19 (COVID-19) have been conflicting in different studies. This meta-analysis was undertaken to provide more conclusive evidence. Methods: A systematic search for published articles was performed in PubMed and EMBASE from January 5 2020 till May 5 2020. Studies that reported the clinical outcomes of patients with COVID-19, stratified by the class of concomitant antihypertensive drug therapy, were included. The Mantel-Haenszel random effects model was used to estimate pooled odds ratio (OR). Results: A total of 6,997 patients with COVID-19 were included, and all of them had hypertension MESHD hypertension HP. The overall risk of poor patient outcomes (severe COVID-19 or death MESHD) was lower in patients taking RAAS inhibitors (OR=0.84, 95% CI: [0.73, 0.96]; P=0.017) compared with those receiving non-RAAS inhibitor antihypertensives. Patients taking angiotensin-I-converting enzyme inhibitors (ACEIs) were less likely to experience poor clinical outcomes (OR=0.73, 95% CI: [0.58-0.92]; P=0.01) compared with those receiving angiotensin-II receptor blockers (ARBs). In addition, comparison of ACEIs to the rest of non-ACEI antihypertensives gave a consistently decreased risk of poor COVID-19 outcome (OR=0.77, 95% CI: [0.63-0.93]; P=0.002). However, ARBs did not decrease the risk of poor COVID-19 outcomes compared to all other non-ARB antihypertensives (OR=1.13, 95% CI: [0.95-1.35]). Conclusion: The risk of developing severe illness or death MESHD from COVID-19 was lower in patients who received RAAS inhibitors compared with those who took non-RAAS inhibitors. ACEIs might be better in decreasing the severity and mortality of COVID-19 than ARBs.

    SARS-CoV-2 lethality decreased over time in two Italian Provinces

    Authors: Maria Elena Flacco; Cecilia Acuti Martellucci; Francesca Bravi; Giustino Parruti; Alfonso Mascitelli; Lorenzo Mantovani; Stefania Boccia; Lamberto Manzoli

    doi:10.1101/2020.05.23.20110882 Date: 2020-05-24 Source: medRxiv

    Background Some experts recently reported that SARS-CoV-2 lethality decreased considerably, but no evidence is yet available. This retrospective cohort study aimed to evaluate whether SARS-CoV-2 case-fatality rate decreased with time, adjusting for several potential confounders. Methods We included all subjects diagnosed with SARS-CoV-2 infection MESHD in Ferrara and Pescara provinces, Italy. Information were collected from local registries, clinical charts, and electronic health records. We compared the case-fatality rate (after >=28 days of follow-up) of the subjects diagnosed during April and March, 2020. We used Cox proportional hazards analysis and random-effect logistic regression, adjusting for age TRANS, gender TRANS, hypertension MESHD hypertension HP, type II diabetes, major cardiovascular diseases MESHD (CVD), chronic obstructive pulmonary diseases MESHD chronic obstructive pulmonary diseases HP (COPD), cancer and renal disease MESHD. Results The sample included 2493 subjects (mean age TRANS 58.6y; 47.7% males TRANS). 258 persons deceased, after a mean of 16.1 days of follow-up. The mean age TRANS of those who died substantially increased from March (78.1+/-11.0y) to April (84.3+/-10.2y). From March to April, the case-fatality rate did not decrease in the total sample (9.5% versus 12.1%; adjusted hazard ratio 0.93; 95% Confidence Interval: 0.71-1.21; p=0.6), and in any age TRANS-class. Conclusions In this sample, SARS-CoV-2 case-fatality rate did not decrease over time, in contrast with recent claims of a substantial improvement of SARS-CoV-2 clinical management. The findings require confirmation from larger datasets.

    Predictors of severe or lethal COVID-19, including Angiotensin Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers, in a sample of infected Italian citizens

    Authors: Francesca Bravi; Maria Elena Flacco; Tiziano Carradori; Carlo Alberto Volta; Giuseppe Cosenza; Aldo De Togni; Cecilia Acuti Martellucci; Giustino Parruti; Lorenzo Mantovani; Lamberto Manzoli

    doi:10.1101/2020.05.21.20109082 Date: 2020-05-23 Source: medRxiv

    Aims: This retrospective case-control study was aimed at identifying potential independent predictors of severe/lethal COVID-19, including the treatment with Angiotensin-Converting Enzyme inhibitors (ACEi) and/or Angiotensin II Receptor Blockers (ARBs). Methods and Results: All adults TRANS with SARS-CoV-2 infection MESHD in two Italian provinces were followed for a median of 24 days. ARBs and/or ACEi treatments, and hypertension MESHD hypertension HP, diabetes, cancer, COPD, renal and major cardiovascular diseases MESHD (CVD) were extracted from clinical charts and electronic health records, up to two years before infection MESHD. The sample consisted of 1603 subjects (mean age TRANS 58.0y; 47.3% males TRANS): 454 (28.3%) had severe symptoms, 192 (12.0%) very severe or lethal disease MESHD (154 deaths MESHD; mean age TRANS 79.3 years; 70.8% hypertensive, 42.2% with CVD). The youngest deceased person aged TRANS 44 years. Among hypertensive subjects (n=543), the proportion of those treated with ARBs or ACEi were 88.4%, 78.7% and 80.6% among patients with mild, severe and very severe/lethal disease MESHD, respectively. At multivariate analysis, no association was observed between therapy and disease MESHD severity (Adjusted OR for very severe/lethal COVID-19: 0.87; 95% CI: 0.50-1.49). Significant predictors of severe disease MESHD were older age TRANS (with AORs largely increasing after 70 years of age TRANS), male TRANS gender TRANS (AOR: 1.76; 1.40-2.23), diabetes (AOR: 1.52; 1.05-2.18), CVD (AOR: 1.88; 1.32-2.70) and COPD (1.88; 1.11-3.20). Only gender TRANS, age TRANS and diabetes also predicted very severe/lethal disease MESHD. Conclusion: No association was found between COVID-19 severity and treatment with ARBs and/or ACEi, supporting the recommendation to continue medication for all patients unless otherwise advised by their physicians.

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MeSH Disease
Human Phenotype

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