Corpus overview


Overview

MeSH Disease

Human Phenotype

Hypertension (364)

Fever (84)

Cough (70)

Obesity (63)

Pneumonia (62)


Transmission

Seroprevalence
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    Clinical symptoms, comorbidities and complications features in severe and non-severe patients with COVID-19: a systematic review and meta-analysis without cases duplication

    Authors: Zhufeng Wang; Hongsheng Deng; Changxing Ou; Jingyi Liang; Yingzhi Wang; Mei Jiang; Shiyue Li

    doi:10.21203/rs.3.rs-30787/v1 Date: 2020-05-21 Source: ResearchSquare

    Background: The pandemic of COVID-19 posed a challenge to global healthcare. The mortality rates of severe cases range from 8.1% to 31.8%, and it is particularly important to identify risk factors that aggravate the disease MESHD.Methods: We performed a systematic review of the literature with meta-analysis, using 7 databases to assess clinical characteristics, comorbidities and complications in severe and non-severe patients with COVID-19. All the observational studies were included. We performed a random or fixed effects model meta-analysis to calculate the pooled proportion and 95% CI. Measure of heterogeneity was estimated by Cochran’s Q statistic, I2 index and P value.Results: 4881 cases from 25 studies related to COVID-19 were included. The most prevalent comorbidity was hypertension MESHD hypertension HP (severe: 33.4%, 95% CI: 25.4% - 41.4%; non-severe 21.6%, 95% CI: 9.9% - 33.3%), followed by diabetes (severe: 14.4%, 95% CI: 11.5% - 17.3%; non-severe: 8.5%, 95% CI: 6.1% - 11.0%). The prevalence SERO of ARDS, AKI and shock MESHD shock HP were all higher in severe cases, with 41.1% (95% CI: 14.1% - 68.2%), 16.4% (95% CI: 3.4% - 29.5%) and 19.9% (95% CI: 5.5% - 34.4%), rather than 3.0% (95% CI: 0.6% - 5.5%), 2.2% (95% CI: 0.1% - 4.2%) and 4.1% (95% CI -4.8% - 13.1%) in non-severe patients, respectively. The death MESHD rate was higher in severe cases (30.3%, 95% CI: 13.8% - 46.8%) than non-severe cases (1.5%, 95% CI: 0.1% - 2.8%).Conclusions: Hypertension MESHD Hypertension HP, diabetes and cardiovascular diseases MESHD may be risk factors for COVID-19 patients to develop into severe cases.

    Identification of Risk Factors for in-Hospital Death MESHD of COVID - 19 Pneumonia MESHD Pneumonia HP

    Authors: Zhigang Wang; Zhiqiang Wang

    doi:10.21203/rs.3.rs-30755/v1 Date: 2020-05-21 Source: ResearchSquare

    Objective: To examine the clinical characteristics and identify independent risk factors for in-hospital mortality of 2019 novel coronavirus (COVID-19) pneumonia MESHD pneumonia HP.Methods: A total of 156 patients diagnosed with COVID-19 pneumonia MESHD pneumonia HP at the central Hospital of Wuhan from January 29, 2020, to March 20, 2020 were enrolled in this single-centered retrospective study. Their epidemiological parameters, clinical presentations, underlying diseases MESHD, laboratory test results and disease MESHD outcomes were collected and analyzed.Results: The median age TRANS of enrolled patients was 66. Underlying diseases MESHD were identified in 101 patients, with hypertension MESHD hypertension HP being the most common one, followed by cardiovascular disease MESHD and diabetes. The most common symptoms identified upon admission were fever MESHD fever HP, cough MESHD cough HP, dyspnea MESHD dyspnea HP and fatigue MESHD fatigue HP. Compared to survival cases, patients who dead during hospitalization had higher plasma SERO levels of D-dimer, creatinine, creatine kinase, lactate dehydrogenase, lactate and lower percentage of lymphocytes (LYM [%]), platelet count and albumin levels. Most enrolled patients received anti-biotics and anti-viral treatment. In addition, 60 patients received corticosteroid and 51 received intravenous immunoglobulin infusion. 44 patients received noninvasive ventilation, 19 received invasive ventilation. Respiratory failure HP was the most frequently observed complication (106 [67.9%]), followed by sepsis MESHD sepsis HP (103 [66.0%]), acute respiratory distress HP syndrome MESHD (ARDS) (67 [42.9%]) and septic shock MESHD shock HP (50 [32.1%]). Multivariable regression suggested that advanced age TRANS (OR [odds ratio]= 1.059, 95% CI [confidence interval]: 1.011-1.110, P= 0.016) and elevated lactate level upon admission (OR= 2.411, 95% CI: 1.177-4.941, P= 0.016) were independent risk factors for in-hospital mortality for COVID-19 infection MESHD. Meanwhile, increased LYM (%) at admission (OR= 0.798, 95% CI: 0.728-0.876, P< 0.001) indicated a better prognosis. Conclusions: In this study, we discovered that age TRANS, LYM (%) and lactate level upon admission were independent factors that could influence in-hospital mortality rate. 

    Chest CT changes in COVID-19 patients with hypertension MESHD hypertension HP comorbidities

    Authors: Wei Li; Wenjun Yu; Jianwei Liao; Yijie Fang; Lin Yao; Huaqian Cui; Xiang Zeng; Shaolin Li

    doi:10.21203/rs.3.rs-30394/v1 Date: 2020-05-19 Source: ResearchSquare

    AIMTo summarize the chest CT and clinical features of COVID-19 pneumonia MESHD pneumonia HP patients with hypertension MESHD hypertension HP comorbidities.METHODSThe initial chest CT imaging and clinical data of 15 confirmed COVID-19 patients with hypertension MESHD hypertension HP comorbidities treated in our hospital were analyzed retrospectively from January 1, 2019 to February 14, 2020. The chest CT images and clinical data were reviewed and their relationship of the disease MESHD was analyzed.RESULTSTotally 15 COVID-19 patients diagnosed with hypertension MESHD hypertension HP comorbidities were included. In terms of clinical characteristics, 14/15 (93.3%) of patients had characteristics of clustering onset, and the positive rates of the first RT-PCR test and the initial CT were 80% and 93% respectively. The most frequent CT abnormality observed was ground glass opacity (GGO) (13/15, 86.7%), including patchy/ punctate GGO and large/multiple GGO. Most of the lesions were multiple, and 60% of them involved 4-5 lobes. Most patients present with bilateral CT onset (12,80.0%), and most present with subpleural distribution (10,66.7%). The average CT score is 13.7, and 40% of the patients exceeded 20 points.CONCLUSIONThe common chest CT findings in COVID-19 patients with hypertension MESHD hypertension HP comorbidities are GGO, most of which at present with bilateral CT onset and subpleural distribution. CT is indispensable in the diagnosis and evaluation of this global health emergency MESHD.

    Association of Angiotensin-Converting Enzyme Inhibitors and Angiotensin Receptor Blockers with the Risk of Hospitalization and Death MESHD in Hypertensive Patients with Coronavirus Disease MESHD-19

    Authors: Rohan Khera; Callahan Clark; Yuan Lu; Yinglong Guo; Sheng Ren; Brandon Truax; Erica S Spatz; Karthik Murugiah; Zhenqiu Lin; Saad B Omer; Deneen Vojta; Harlan M Krumholz

    doi:10.1101/2020.05.17.20104943 Date: 2020-05-19 Source: medRxiv

    Background: Whether angiotensin-converting enzyme (ACE) Inhibitors and angiotensin receptor blockers (ARBs) mitigate or exacerbate SARS-CoV-2 infection MESHD remains uncertain. In a national study, we evaluated the association of ACE inhibitors and ARB with coronavirus disease MESHD-19 (COVID-19) hospitalization and mortality among individuals with hypertension MESHD hypertension HP. Methods: Among Medicare Advantage and commercially insured individuals, we identified 2,263 people with hypertension MESHD hypertension HP, receiving [≥]1 antihypertensive agents, and who had a positive outpatient SARS-CoV-2 test (outpatient cohort). In a propensity score-matched analysis, we determined the association of ACE inhibitors and ARBs with the risk of hospitalization for COVID-19. In a second study of 7,933 individuals with hypertension MESHD hypertension HP who were hospitalized with COVID-19 (inpatient cohort), we tested the association of these medications with in-hospital mortality. We stratified all our assessments by insurance groups. Results: Among individuals in the outpatient and inpatient cohorts, 31.9% and 29.8%, respectively, used ACE inhibitors and 32.3% and 28.1% used ARBs. In the outpatient study, over a median 30.0 (19.0 - 40.0) days after testing positive, 12.7% were hospitalized for COVID-19. In propensity score-matched analyses, neither ACE inhibitors (HR, 0.77 [0.53, 1.13], P = 0.18), nor ARBs (HR, 0.88 [0.61, 1.26], P = 0.48), were significantly associated with risk of hospitalization. In analyses stratified by insurance group, ACE inhibitors, but not ARBs, were associated with a significant lower risk of hospitalization in the Medicare group (HR, 0.61 [0.41, 0.93], P = 0.02), but not the commercially insured group (HR: 2.14 [0.82, 5.60], P = 0.12; P-interaction 0.09). In the inpatient study, 14.2% died, 59.5% survived to discharge, and 26.3% had an ongoing hospitalization. In propensity score-matched analyses, neither use of ACE inhibitor (0.97 [0.81, 1.16]; P = 0.74) nor ARB (1.15 [0.95, 1.38]; P = 0.15) was associated with risk of in-hospital mortality, in total or in the stratified analyses. Conclusions: The use of ACE inhibitors and ARBs was not associated with the risk of hospitalization or mortality among those infected with SARS-CoV-2. However, there was a nearly 40% lower risk of hospitalization with the use of ACE inhibitors in the Medicare population. This finding merits a clinical trial to evaluate the potential role of ACE inhibitors in reducing the risk of hospitalization among older individuals, who are at an elevated risk of adverse outcomes with the infection MESHD.

    Clinical presentations, laboratory and radiological findings, and treatments for 11,028 COVID-19 patients: a systematic review and meta-analysis

    Authors: Carlos K.H. Wong; Janet Y. Wong; Eric H.M. Tang; Chi Ho Au; Abraham K. Wai

    doi:10.21203/rs.3.rs-30388/v1 Date: 2020-05-19 Source: ResearchSquare

    Objective: To conduct a systematic review and meta-analysis on the comorbidities, symptoms, clinical characteristics and treatment of COVID-19 patients.Method: Epidemiological studies published in 2020 (from January-March) on the clinical presentation, laboratory findings and treatments of COVID-19 patients were identified from PubMed/MEDLINE and Embase databases. Studies published in English by 27th March, 2020 with original data were included. A random-effects model was used to aggregate estimates across eligible studies and produce meta-analytic estimates. Primary outcomes included comorbidities of COVID-19 patients, their symptoms presented on hospital admission, laboratory results and radiological outcomes, and pharmacological and in-patient treatments.Results: 77 studies were included in this meta-analysis, accounting for a total of 11,028 COVID- 19 patients in multiple countries. The most common comorbidities were hypertension MESHD hypertension HP (18.1%, 95%CI: 15.4-20.8%). The most frequently identified symptoms were fever MESHD fever HP (72.4%, 95%CI: 67.2-77.7%) and cough MESHD cough HP (55.5%, 95%CI: 50.7-60.3%). For pharmacological treatment, 63.9% (95%CI: 52.5-75.3%), 62.4% (95%CI: 47.9-76.8%) and 29.7% (95%CI: 21.8-37.6%) of patients were given antibiotics, antiviral, and corticosteroid, respectively. Notably, 62.6% (95%CI: 39.9- 85.4%) and 20.2% (95%CI: 14.6-25.9%) of in-patients received oxygen therapy and non- invasive mechanical ventilation, respectively.Conclusions: This meta-analysis informed healthcare providers about the timely status of characteristics and treatments of COVID-19 patients across different countries.PROSPERO Registration Number: CRD42020176589

    Identification of risk factors for the severity of coronavirus disease MESHD 2019: a retrospective study of 163 hospitalized patients

    Authors: Ye Tu; Ping Yang; Jingjing Wang; Xuebi Tian; Kai Wang; Chaolong Wang; Ailin Luo; Feng Gao

    doi:10.21203/rs.3.rs-29825/v1 Date: 2020-05-19 Source: ResearchSquare

    Background: To compare clinical features between moderate and severe cases with COVID-19, and screen factors associated with disease MESHD severity.Methods: Demographic and clinical data were compared between moderate and severe cases. Logistic regression was performed for prognostic factors.Results: 163 patients (median age TRANS 65.0 (56.8-71.0) years, 78 (47.9%) females TRANS) were enrolled, including 87 (53.4%) severe and 76 (46.6%) moderate cases. 79 (90.8%) severe and 59 (77.6%) moderate cases had comorbidities, with hypertension MESHD hypertension HP and diabetes commonly presented. The most common symptoms were fever MESHD fever HP. Severe cases had higher lactate dehydrogenase (LDH), inflammatory cytokines and lymphopenia MESHD lymphopenia HP, eosinopenia on admission, and lower eosinophil and higher neutrophil counts from admission to day 13 and 19. Multivariable regression showed that neutrophilia HP, eosinopenia, high LDH and D-dimer were associated with severe COVID-19. In receiver operating characteristic curve analysis, LDH, eosinophil and neutrophil + eosinophil + LDH + D-dimer combination, with area under curve of 0.86, 0.76 and 0.93, predicted severe illness with high sensitivity SERO (82.8%, 83.3%, 88.0%) and specificity (68.4%, 84.2%, 81.3%).Conclusions: Eosinopenia, higher LDH and neutrophil + eosinophil + LDH + D-dimer combination on admission were powerful indicators of severe COVID-19. Dynamic changes of neutrophils and eosinophils may be used to evaluate disease progression MESHD.

    Analysis of Initial Clinical and CT Features of COVID-19 Pneumonia MESHD Pneumonia HP in Different Clinical Types

    Authors: Wei Li; Wenjun Yu; Jianwei Liao; Lin Yao; Yijie Fang; Cunxue Pan; Qing Xie; Huaqian Cui; Xiang Zeng; Shaolin Li

    doi:10.21203/rs.3.rs-30395/v1 Date: 2020-05-19 Source: ResearchSquare

    Background Different clinical classifications of COVID-19 pneumonia MESHD pneumonia HP patients have different clinical and CT features, which is very important for the treatment after admission. As the epidemic situation in China continues to improve, it is particularly important to re-clarify the correlation between them.Methods 97 confirmed patients with COVID-19 pneumonia MESHD pneumonia HP were enrolled from January 17, 2019 to February 21, 2020, including 75 mild/ordinary cases and 22 severe/critical cases. The clinical data and initial chest CT images of the patients were reviewed and compared. The risk factors associated with disease MESHD severity were analyzed.Results Compared with the mild/ordinary patients, the severe/critical patients had older ages TRANS, higher incidence of comorbidities, first CT positive, CT always negative and fever MESHD fever HP. Mild/ordinary patients had lower body temperature than mild/ordinary patients. The incidences of large/multiple GGO in severe/critical patients were significantly higher than those of the mild/ordinary patients, furthermore, severe/critical patients showed higher incidences of 4-5 lobe infections MESHD than the ordinary patients. The CT scores of severe/critical patients were significantly higher than those of the ordinary patients (P < 0.001). The clinical factors of age TRANS, sex, comorbidities, hypertension MESHD hypertension HP, diabetes mellitus MESHD diabetes mellitus HP, heart disease MESHD, pharyngeal discomfort, abdominal pain MESHD abdominal pain HP/ diarrhea MESHD diarrhea HP, temperature and CT score were risk factors for severe/critical COVID-19 pneumonia MESHD pneumonia HP.Conclusion The initial clinical and CT characteristics have certain significance for the clinical classification of COVID-19 respiratory infection MESHD. Especially in terms of CT score, it can predict the trend of clinical classification of patients to a certain extent. 

    Behavioural change towards reduced intensity physical activity is disproportionately prevalent among adults TRANS with serious health issues or self-perception of high risk during the UK COVID-19 lockdown.

    Authors: Nina Trivedy Rogers; Naomi Waterlow; Hannah E Brindle; Luisa Enria; Rosalind M Eggo; Shelley Lees; Chrissy h Roberts

    doi:10.1101/2020.05.12.20098921 Date: 2020-05-18 Source: medRxiv

    Importance: There are growing concerns that the UK COVID-19 lockdown has reduced opportunities to maintain health through physical activity, placing individuals at higher risk of chronic disease MESHD and leaving them more vulnerable to severe sequelae of COVID-19. Objective: To examine whether the UK's lockdown measures have had disproportionate impacts on intensity of physical activity in groups who are, or who perceive themselves to be, at heightened risk from COVID-19. Designs, Setting, Participants: UK-wide survey of adults TRANS aged TRANS over 20, data collected between 2020-04-06 and 2020-04-22. Exposures: Self-reported doctor-diagnosed obesity MESHD obesity HP, hypertension MESHD hypertension HP, type I/II diabetes, lung disease MESHD, cancer, stroke MESHD stroke HP, heart disease MESHD. Self-reported disabilities and depression. Sex, gender TRANS, educational qualifications, household income, caring for school- age TRANS children TRANS. Narrative data on coping strategies. Main Outcomes and Measures: Change in physical activity intensity after implementation of UK COVID-19 lockdown (self-reported). Results: Most (60%) participants achieved the same level of intensity of physical activity during the lockdown as before the epidemic. Doing less intensive physical activity during the lockdown was associated with obesity MESHD obesity HP (OR 1.21, 95% CI 1.02-1.41), hypertension MESHD hypertension HP (OR 1.52, 1.33-1.71), lung disease MESHD (OR 1.31,1.13-1.49), depression (OR 2.02, 1.82-2.22) and disability (OR 2.34, 1.99-2.69). Participants who reduced their physical activity intensity also had higher odds of being female TRANS, living alone or having no garden, and more commonly expressed sentiments about personal or household risks in narratives on coping. Conclusions and relevance: Groups who reduced physical activity intensity included disproportionate numbers of people with either heightened objective clinical risks or greater tendency to express subjective perceptions of risk. Policy on exercise for health during lockdowns should include strategies to facilitate health promoting levels of physical activity in vulnerable groups, including those with both objective and subjective risks.

    On two cases of atypical respiratory distress HP in eastern Democratic Republic of the Congo months before the COVID-19 pandemic was declared. Could SARS-Cov-2 have been already spreading? Case report

    Authors: Guy-Quesney MATESO; Marius BAGUMA; Pacifique MWENE-BATU; Ghislain MAHESHE BALEMBA; Fabrice NZABARA; Samuel MAKALI; Aline BEDHA; Bonheur FURAHA; Jimmy MINANI; Christian TSHONGO MUHINDO; Espoir BWENGE MALEMBAKA; Mannix Imani MASIMANGO; Tony Akilimali SHINDANO; Justin Cirhuza CIKOMOLA; Kanigula MUBAGWA

    doi:10.21203/rs.3.rs-29541/v1 Date: 2020-05-18 Source: ResearchSquare

    Background: Predictions have been made that Africa would be the most vulnerable continent to the novel coronavirus disease MESHD 2019 (COVID-19). Interestingly, the spread of the disease TRANS disease MESHD in Africa seems to be slower than in many parts of the World. Among possible hypotheses, some parts of Africa may have undergone a “silent” COVID-19 epidemic and acquired a herd immunity before the official declaration of the disease MESHD in December 2019.Case presentation: We report two cases (one 55-year-old man and one 25-year-old woman) of acute respiratory distress HP secondary to atypical pneumonia MESHD pneumonia HP in Bukavu, in eastern Democratic Republic of the Congo (DRC) which occurred between September and December 2019, before the official beginning of the COVID-19 pandemic. One patient had returned from China and the other had close contacts TRANS with travellers from China in the 2 weeks prior to the onset of symptoms TRANS. In either case, the aetiology could not be accurately determined. However, the two cases presented a clinical picture (progressive dyspnoea, preceded by dry cough MESHD cough HP and fever MESHD fever HP) and laboratory changes (procalcitonin within the normal range, slight inflammation MESHD, and lymphopenia MESHD lymphopenia HP) compatible with a viral infection MESHD. The chest X-Rays series of the first patient showed lesions (reticulations, ground glass, and nodules ≤ 6 mm) similar to those found in COVID-19. In addition, unlike the 25-year-old female TRANS patient who had no comorbidity, the 55-year-old male TRANS patient who had hypertension MESHD hypertension HP as comorbidity, developed a more severe acute respiratory distress HP which progressed to death MESHD.Conclusion: These cases bring to the attention a number of facts which make us suspect that the COVID-19 epidemic may have already been present in the region months before the official beginning of the pandemic. 

    Early experience with COVD-19 patients at tertiary care teaching hospital in southwestern United states

    Authors: Rahul Shekhar; Shubhra Upadhyay; Abubaker Sheikh; Jeanette Atencio; Devika Kapuria

    doi:10.1101/2020.05.15.20094284 Date: 2020-05-18 Source: medRxiv

    Abstract Importance: There is limited information about presenting characteristics, treatment and outcomes of patients requiring hospitalization for coronavirus disease MESHD 2019 (COVID-19) serving underserved population in southwestern United states. Objective: To describe the clinical characteristics and outcomes of patients with COVID-19, hospitalized in a tertiary care teaching hospital in southwestern United states serving Underserved population. Methods: Case series of first 50 adults TRANS admitted at the University of New Mexico (UNM) Health Science center, the only tertiary care teaching hospital in the state of New Mexico between Jan 19th to April 24th 2020 via retrospective and prospective chart review. Main outcomes and measures: Clinical outcomes during hospitalization, such as invasive mechanical ventilation, kidney replacement therapy and death MESHD. Demographics, baseline comorbidities, presenting vital signs, and test results were also collected. Results: A total of 50 patients were included (median age TRANS, 55.5; 20-85-year-old, 54% were female TRANS). Obesity MESHD Obesity HP was the most common comorbidity in 20/39 (51%), followed by diabetes in 18/50 (36%) and hypertension MESHD hypertension HP 17/50(34%). Mean onset of symptoms TRANS duration before admission 7.39 days (range 1-21days). Most common symptoms on presentation included subjective fevers MESHD fevers HP 40/42 (95.2%), cough MESHD cough HP 43/46 (93%) 43/46 and shortness of breath 40/46(87%). At triage only 24% were febrile and 46% patient did not have a single febrile episode throughout hospitalization, 56% had respiratory rate > 20 and 66% had a heart rate > 90. 80% patients required oxygen and 20%required intubation on presentation. On differential analysis 46% had elevated neutrophil counts, and 48% had low lymphocytes counts. Median D dimer, Ferritin, CRP, LDH were all elevated at presentation. 10% of patients had a negative initial chest x ray. 19.3% patients have coinfection MESHD with another respiratory viral pathogen. 34 (68%) patient required ICU level of care at some point during hospitalization. More than 70% of patients were treated with antibiotics mainly directed towards community acquired pneumonia MESHD pneumonia HP but 97.5% patient has negative blood SERO culture and 93.3% has negative sputum cultures. Of admitted patients, 34% (17/50) were directly admitted to ICU and. Of these ICU patients 82.4% (28/34) required invasive mechanical ventilation. Patients spent a median of 2 days on the floor prior to ICU transfer, median length of stay in the ICU was 7 days. On comparing characteristics of patients, patients with diabetes, and higher lactate dehydrogenase on admission were more likely to require ICU level of care. No patient deaths MESHD were reported on the floor. Of 34 patients in the ICU 13 died while 6 are still receiving care in the hospital, with an overall mortality of 30.2% (13/43). Out of 13 patients who died, 2 were on HD, 11/13(84%) patients had acute kidney injury MESHD acute kidney injury HP and required CRRT or HD. The median length of stay is 7 days (Range 1-31days), for floor patients 4 days and ICU patients 13 days. Out of 43 patients who completed their clinical course 24/43(58.1%) were discharged home, 5/43(11.6%) went to rehabilitation facilities and 30.2% died. 16/30(53.3%) required oxygen on discharge. Conclusion: This case series provides characteristics and early experience in treating patient admitted to tertiary care teaching hospital in state of NEW Mexico.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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