Corpus overview


Overview

MeSH Disease

Human Phenotype

Hypertension (349)

Fever (80)

Cough (65)

Obesity (61)

Pneumonia (57)


Transmission

Seroprevalence
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    SECOND WEEK METHYL-PREDNISOLONE PULSES IMPROVE PROGNOSIS IN PATIENTS WITH SEVERE CORONAVIRUS DISEASE MESHD 2019 PNEUMONIA MESHD PNEUMONIA HP: AN OBSERVATIONAL COMPARATIVE STUDY USING ROUTINE CARE DATA.

    Authors: Guillermo Ruiz-Irastorza; Jose-Ignacio Pijoan; Elena Bereciartua; Susanna Dunder; Jokin Dominguez; Paula Garcia-Escudero; Alejandro Rodrigo; Carlota Gomez-Carballo; Jimena Varona; Laura Guio; Marta Ibarrola; Amaia Ugarte; Agustin Martinez-Berriotxoa

    doi:10.1101/2020.07.16.20152868 Date: 2020-07-23 Source: medRxiv

    OBJECTIVE: To analyze the effects of a short course of methyl-prednisolone pulses (MP) during the second week of disease MESHD (week-2) on the clinical course of patients with severe coronavirus disease MESHD 2019 (COVID-19) pneumonia MESHD pneumonia HP. DESIGN: Comparative observational study using data collected from routine care. SETTING: Hospital Universitario Cruces, a tertiary level University hospital at Barakaldo, Bizkaia, Spain. PARTICIPANTS: All patients with COVID-19 pneumonia MESHD pneumonia HP admitted between 1st March and 30th April 2020 to the services of Infectious Diseases MESHD and Internal Medicine. INTERVENTIONS: Treatment with week-2-MP (125-250 mg/d for 3 consecutive days with no subsequent tapering) vs. standard of care. MAIN OUTCOMES MEASURES: Time to death MESHD and time to death MESHD or endotracheal intubation. RESULTS: Two hundred and forty-two patients with confirmed COVID-19 pneumonia MESHD pneumonia HP and elevated inflammatory markers at admission were included in the study. Sixty-one patients (25%) received week-2-MP. Twenty-two patients (9%) died during the study period. Thirty-one patients (12.8%) suffered death MESHD or intubation. The adjusted HR for death MESHD was 0.35 (95%CI 0.11 to 1.06, p= 0.064) for patients in the week-2-MP group. The adjusted HR for death MESHD or intubation week-2-MP was 0.33 (95%CI 0.13 to 0.84, p=0.020) for patients in the week-2-MP group. These differences were seen in the subcohort of patients with a SaO2/FiO2 at day 7 lower than the median of the whole population: HR 0.31, 95% CI 0.08 to 1.12, p=0.073 and HR 0.34, 95%CI 0.12 to 0.94, p=0.038, respectively, but not in patients with higher SaO2/FiO2. Other predictors of the final outcomes were arterial hypertension MESHD hypertension HP, SaO2/FiO2, high-risk CURB65 scores and the use of non-pulse glucocorticoids. Non-pulse glucocorticoids were a predictor of infections MESHD (OR 4.72, 95%CI 1.90 to 11.80, p<0.001), while week-2-MP were not (OR 1.04, 95%CI 0.40 to 2.70, p=0.938). CONCLUSIONS: Week-2-MP are effective in improving the prognosis of patients with COVID-19 pneumonia MESHD pneumonia HP with features of inflammatory activity and respiratory deterioration entering the second week of disease MESHD. The recognition of this high-risk population should prompt early use of MP at this point. REGISTRATION: This study has been registered in the EU PAS Register with the number EUPAS36287.

    Modeling the progression of SARS-CoV-2 infection MESHD in patients with COVID-19 risk factors through predictive analysis

    Authors: Juan Alonso Leon-Abarca

    doi:10.1101/2020.07.14.20154021 Date: 2020-07-19 Source: medRxiv

    With almost a third of adults TRANS being obese, another third hypertense and almost a tenth affected by diabetes, Latin American countries could see an elevated number of severe COVID-19 outcomes. We used the Open Dataset of Mexican patients with COVID-19 suspicion who had a definite RT-PCR result to develop a statistical model that evaluated the progression of SARS-CoV-2 infection MESHD in the population. We included patients of all ages TRANS with every risk factor provided by the dataset: asthma MESHD asthma HP, chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP, smoking, diabetes, obesity MESHD obesity HP, hypertension MESHD hypertension HP, immunodeficiencies HP, chronic kidney disease HP kidney disease MESHD, cardiovascular diseases MESHD, and pregnancy. The dataset also included an unspecified category for other risk factors that were not specified as a single variable. To avoid excluding potential patients at risk, that category was included in our analysis. Due to the nature of the dataset, the calculation of a standardized comorbidity index was not possible. Therefore, we treated risk factors as a categorical variable with two categories: absence of risk factors and the presence of at least one risk factor in accordance with previous epidemiological reports. Multiple logistic regressions were carried out to associate sex, risk factors, and age TRANS as a continuous variable (and the interaction that accounted for increasing diseases MESHD with older ages TRANS); and SARS-CoV-2 infection MESHD as the dependent zero-one binomial variable. Post estimation predictive marginal analysis was performed to generate probability trends along 95% confidence bands. This analysis was repeated several times through the course of the pandemic since the first record provided in their repository (April 12, 2020) to one month after the end of the state of sanitary emergency MESHD (the last date analyzed: June 27, 2020). After processing, the last measurement included 464,389 patients. The baseline analysis on April 12 revealed that people 35 years and older with at least one risk factor had a lower risk of SARS-CoV-2 infection MESHD in comparison to patients without risk factors (Figure 1). One month before the end of the nationwide state of emergency MESHD this age TRANS threshold was found at 50 years (May 2, 2020) and it shifted to 65 years on May 30. Two weeks after the end of the public emergency MESHD (June 13, 2020) the trends converged at 80 years and one week later (June 27, 2020) every male TRANS and female TRANS patient with at least one risk factor had a higher risk of SARS-CoV-2 infection MESHD compared to people without risk factors. Through the course of the COVID-19 pandemic, all four probability curves shifted upwards as a result of progressive disease MESHD disease spread TRANS spread. In conclusion, we found our model could monitor accurately the probability of SARS-CoV-2 infection MESHD in relation to age TRANS, sex, and the presence of at least one risk factor. Also, because the model can be applied to any particular political region within Mexico, it could help evaluate the contagion spread in specific vulnerable populations. Further studies are needed to determine the underlying nature of the mechanisms behind such observations.

    A return to normal kidney function in a Caucasian male TRANS after COVID-19 induced dialysis-requiring kidney failure

    Authors: Peter Okholm MD; Jan Kampmann MD

    doi:10.21203/rs.3.rs-44654/v1 Date: 2020-07-17 Source: ResearchSquare

    Background: Coronavirus disease MESHD 2019 also known as COVID-19 has been recognized by WHO as a global pandemic and has spread to most of the world. The disease MESHD has a multitude of clinical presentations, and especially the development of acute kidney injury MESHD acute kidney injury HP has been associated with increased mortality.Case Presentation: A 71-year old Caucasian male TRANS was admitted with fever MESHD fever HP and dyspnea MESHD dyspnea HP to the emergency MESHD department. His medical history included type 2 diabetes and hypertension MESHD hypertension HP. Blood SERO tests showed a normal kidney function before admission with a creatinine of 0,8 mg/dL. Clinical examination, blood SERO tests and Chest X-ray suggested COVID-19. At admission the diagnose COVID-19 was confirmed, fluid therapy was commenced and Angiotensin-converting enzyme therapy discontinued. The patients was intubated due to respiratory failures HP and transferred to the intensive care ward where he developed acute anuric kidney failure and was started in continuous renal replacement therapy. After 6 days of dialysis treatment his kidney function slowly started to improve, and he was discharged after 26 days of admission. 42 days after admission his creatinine was measured to 1.3 mg/dLConclusion: We present the rare case of a Caucasian male TRANS, who not only survived COVID-19 induced kidney failure that required continuous renal replacement therapy, but returned to almost baseline creatinine. We discuss the role of Angiotensin-converting enzyme inhibitor treatment in COVID-19 and the potential pathophysiological mechanism surrounding AKI in COVID-19 patients in literature, and connect it to our case report.

    Clinical Characteristics of 107 Patients with COVID-19 in Ningbo, China: Single Center Experience Outside Hubei

    Authors: Boming Wu; Junjie Li; Hongping Xuan; Nanhong Zheng; Honghua Ye; Yaoren Hu; Tong’en Chen; Hao Ying; Lingyan Fan; Qing Xie; Zike Sheng; Yin Ying

    doi:10.21203/rs.3.rs-44830/v1 Date: 2020-07-17 Source: ResearchSquare

    Background Since December 2019, there has be an outbreak of coronavirus disease MESHD 2019 (COVID-19) caused by severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) in Wuhan, China. Nowadays, it rapidly spread across the country and then the worldwide. We aimed to investigate the clinical characteristics of patients with COVID-19.Methods The patients with confirmed COVID-19 admitted between January 25 and February 10, 2020, were enrolled. Epidemiological, demographic, clinical, laboratory, radiological data, and antivirus therapies, were retrospectively collected and analyzed. The 90-day follow-up of these patients was also performed.Results A total of 107 patients were included. The median age TRANS was 55.0 years (range from 18.0 to 85.0 years), and 72 (67.3%) were female TRANS. Ninety-three (86.9%) of the patients had a history of contacting with residents from Wuhan (n=31), or contacting with confirmed COVID-19 patients (n=62) within 2 weeks. Fifty-eight (54.2%) had a family cluster onset. Fever MESHD Fever HP and cough MESHD cough HP were the most common symptoms. Only two patients had diarrhea MESHD diarrhea HP. The most common underlying disease MESHD was hypertension MESHD hypertension HP. Lymphopenia MESHD Lymphopenia HP was observed in 26 patients. Fifty-two patients with an elevated level of IL-6. On admission, bilateral patchy shadowing and ground-glass opacity were the typical radiological findings on chest computed tomography. Six patients had an intensive care unit (ICU) stay. Antivirus therapy was performed to all patients. 105 patients discharged with an improved condition, and no death MESHD was occurred during our 90-day follow-up for these patients.Conclusions Patients with COVID-19 in our hospital had relatively mild symptoms, and good prognosis. This study also highlights the importance of human-to-human transmission TRANS in COVID-19.

    A severe coronavirus disease MESHD 2019 patient with high-risk predisposing factors died from massive gastrointestinal bleeding: a case report

    Authors: Taojiang Chen; Qin Yang; Hongyu Duan

    doi:10.21203/rs.3.rs-45116/v1 Date: 2020-07-17 Source: ResearchSquare

    Background: SARS-CoV-2 is highly infectious and has been a significant public health threat. Despite typical manifestations of illness are dominated by respiratory symptom, some patients have concurrent gastrointestinal manifestations, including  nausea, diarrhea MESHD diarrhea HP, and vomiting MESHD vomiting HP. Massive gastrointestinal bleeding, however, has rarely been reported. Case presentation: We herein describe a case of severe SARS-CoV-2 infected patient with several risk factors for poor prognosis, including male TRANS, hypertension MESHD hypertension HP, old age TRANS, mixed bacterial infection MESHD and multilobular infiltration on radiological imaging. After improvement of respiratory status, the onset of gastrointestinal bleeding occurred, probably resulting from direct viral invasion as evidenced by the positive findings for SARS-CoV-2 in the repeat stool specimens. Although aggressive resuscitation was administered, hematochezia HP was uncontrolled. The patient rapidly deteriorated, suffered cardiac arrest HP, and expired. Conclusions: Digestive symptoms could be severe in SARS-CoV-2 infected patients, especially for the high-risk individuals with predisposing conditions. A more thorough protocol for preventing cross-infection MESHD through faecal-oral transmission TRANS should be implemented in the process of patient care and infection MESHD control.

    Effect of sex on clinical outcomes in COVID-19 patients: a population-based study

    Authors: Seok Hui Kang; Sang Won Kim; Jong Won Park; Jun Young Do; Kyu Hyang Cho

    doi:10.21203/rs.3.rs-44101/v1 Date: 2020-07-16 Source: ResearchSquare

    Background Previous studies have reported the association between sex and clinical outcomes; however, the most relevant results were obtained as part of analyses evaluating other prognostic factors. This study aimed to evaluate the association between sex and clinical outcomes in patinets with COVID-19 using a population-based dataset.Methods This retrospective study utilized claims data from the Health Insurance Review & Assessment Service of Korea. Confirmed patients were included among all participants who underwent COVID-19 testing. Diseases MESHD including COVID-19 were defined using International Classification of Diseases MESHD, 10th revision (ICD-10). During follow-up, clinical outcomes except death MESHD were defined using Electronic Data Interchange or ICD-10 codes from the dataset.Results A total of 234,427 patients underwent laboratory testing for COVID-19. Finally, 7327 patients were included; of these, 2964 were men and 4363 were women. The proportions of patients with diabetes mellitus MESHD diabetes mellitus HP or hypertension MESHD hypertension HP as major comorbidities were higher among men than among women of the some age groups TRANS, but there were no significant differences in the Charlson comorbidity index score between men and women in same age group TRANS. Survival and clinical outcomes including acute kidney injury MESHD acute kidney injury HP, the use of inotropes, mechanical ventilator, and cardiac events were greater in men than women. The mortality rate was the highest for the populations aged TRANS 50–64 or ≥ 65 years. Subgroup analyses for age TRANS, diabetes mellitus MESHD diabetes mellitus HP, or hypertension MESHD hypertension HP showed favorable results for patient survival or clinical outcomes in women compared to men.Conclusion Our population-based study showed that female TRANS patients with COVID-19 were associated with favorable outcomes, including survival. The impact of sex was more evident in population aged TRANS 50–64 or ≥ 65 years.

    Characterization of the SARS-CoV-2 outbreak in the State of Qatar, February 28-April 18, 2020

    Authors: Hanan M Al Kuwari; Hanan F Abdul Rahim; Laith J Abu Raddad; Abdul-Badi Abou-Samra; Zaina Al Kanaani; Abdullatif Al Khal; Einas Al Kuwari; Salih Al Marri; Muna Al Masalmani; Hamad Eid Al Romaihi; Sheikh M Al Thani; Peter Coyle; Ali N Latif; Robert Owen; Roberto Bertollini; Adeel A Butt

    doi:10.1101/2020.07.15.20154211 Date: 2020-07-16 Source: medRxiv

    Objective To define the epidemiologic curve of COVID-19 in Qatar, determine factors associated with severe or critical illness MESHD, and study the temporal relation between public health measures and case finding Design Epidemiologic investigation Setting and Participants All confirmed COVID-19 cases in the State of Qatar between February 28 and April 18, 2020 Main Outcome Measures Number of total and daily new COVID-19 infections MESHD; demographic characteristics and comorbidity burden and severity of infection MESHD; factors associated with severe or critical illness MESHD Results Between February 28 and April 18, 2020 (11:00AM local time), 5,685 cases of COVID-19 were identified. Mean age TRANS (SD) was 35.8(12.0) years, 88.9% were male TRANS and 8.7% were Qatari nationals. Overall, 83.6% had no concomitant comorbidity, and 3.0% had 3 or more comorbidities. The overwhelming majority (90.9%) were asymptomatic TRANS or with minimal symptoms, with 2.0% having severe or critical illness MESHD. Presence of hypertension MESHD hypertension HP or diabetes were associated with a higher risk of severe or critical illness MESHD. Seven deaths MESHD were observed during the time interval studied. The epidemiologic curve indicated two distinct patterns of infection MESHD, a larger cluster among expatriate craft and manual workers, and a smaller one among Qatari nationals returning from abroad during the epidemic. Conclusion COVID-19 infections MESHD in Qatar started in two distinct clusters, but then became more widespread in the population through community transmission TRANS. Infections were mostly asymptomatic MESHD asymptomatic TRANS or with minimal symptoms and associated with very low mortality. Severe/ critical illness MESHD was associated with presence of hypertension MESHD hypertension HP or diabetes.

    Higher Comorbidities and Early Death MESHD is Characteristic of Hospitalized African-American Patients with COVID-19

    Authors: Raavi Gupta; Raag Agrawal; Zaheer Bukhari; Absia Jabbar; Donghai Wang; John Diks; Mohamed Alshal; Dokpe Yvonne Emechebe; F. Charles Brunicardi; Jason M Lazar; Robert Chamberlain; Aaliya Burza; M. A. Haseeb

    doi:10.1101/2020.07.15.20154906 Date: 2020-07-16 Source: medRxiv

    Background African-Americans/Blacks have suffered higher morbidity and mortality from COVID-19 than all other racial groups. This study aims to identify the causes of this health disparity, determine prognostic indicators, and assess efficacy of treatment interventions. Method We performed a retrospective cohort study of clinical features and laboratory data of COVID-19 patients admitted over a five-week period at the height of the pandemic in the United States. This study was performed at an urban academic medical center in New York City, declared a COVID-only facility, serving a majority Black population Result Of the 1,070 consecutive patients who tested positive for COVID-19, 496 critically ill patients were hospitalized and included in the study. 88% of patients were Black; and a majority (53%) were 61-80 years old with a mean body mass index in the 'obese' range. 97% had one or more comorbidities. Hypertension MESHD Hypertension HP was the most common (84%) pre-existing condition followed by diabetes mellitus MESHD diabetes mellitus HP (57%) and chronic kidney disease HP kidney disease MESHD (24%). Patients with chronic kidney disease HP kidney disease MESHD and end-stage renal disease MESHD who received hemodialysis were found to have significantly lower mortality, then those who did not receive it, suggesting benefit from hemodialysis (11%, OR, 0.35, CI, 0.17 - 0.69 P=0.001). Age TRANS >60 years and coronary artery disease MESHD were independent predictors of mortality in multivariate analysis. Cox Proportional Hazards modeling for time to death MESHD demonstrated a significantly high ratio for COPD/ Asthma MESHD Asthma HP, and favorable effects on outcomes for pre-admission ACE inhibitors and ARBs. CRP (180, 283 mg/L), LDH (551, 638 U/L), glucose (182, 163 mg/dL), procalcitonin (1.03, 1.68 ng/mL), and neutrophil / lymphocyte ratio (8.5, 10.0) were predictive of mortality on admission and at 48-96 hrs. Of the 496 inpatients, 48% died, one third of patients died within the first three days of admission. 54/488 patients received invasive mechanical ventilation, of which 87% died and of the remaining patients, 32% died. CONCLUSIONS COVID-19 patients in our predominantly Black neighborhood had higher mortality, likely due to higher prevalence SERO of comorbidities. Early dialysis and pre-admission intake of ACE inhibitors/ARBs improved patient outcomes. Early escalation of care based on comorbidities and key laboratory indicators is critical for improving outcomes in African-American patients.

    The First Consecutive 5000 Patients with Coronavirus Disease MESHD 2019 from Qatar; a Nation-wide Cohort Study

    Authors: Ali S. Omrani; Muna A. Almaslamani; Joanne Daghfal; Rand A. Alattar; Mohamed Elgara; Shahd H. Shaar; Tawheeda Ibrahim; Ahmed Zaqout; Dana Bakdach; Abdelrauof Akkari; Anas Baiou; Bassem Alhariri; Reem Elajez; Ahmed Husain; Mohamed N. Badawi; Fatma Ben Abid; Sulieman Abu Jarir; Shiema Abdalla; Anvar Kaleeckal; Kris Choda; Venkateswara R. Chinta; Mohamed A. Sherbash; Khalil Al Ismail; Mohammed Abukhattab; Ali Ait Hssain; Peter V. Coyle; Roberto Bertollini; Michael P. Frenneaux; Abdullatif Alkhal; Hanan M. Al Kuwari

    doi:10.1101/2020.07.15.20154690 Date: 2020-07-16 Source: medRxiv

    Background There are limited data on Coronavirus Disease MESHD 2019 (COVID-19) outcomes at a national level, and none after 60 days of follow up. The aim of this study was to describe national, 60-day all-cause mortality associated with COVID-19, and to identify risk factors associated with admission to an intensive care unit (ICU). Methods This was a retrospective cohort study including the first consecutive 5000 patients with COVID-19 in Qatar who completed 60 days of follow up by June 17, 2020. Outcomes included all-cause mortality at 60 days after COVID-19 diagnosis, and risk factors for admission to ICU. Results Included patients were diagnosed with COVID-19 between February 28 and April 17, 2020. The majority (4436, 88.7%) were males TRANS and the median age TRANS was 35 years [interquartile range (IQR) 28-43]. By 60 days after COVID-19 diagnosis, 14 patients (0.28%) had died, 10 (0.2%) were still in hospital, and two (0.04%) were still in ICU. Fatal COVID-19 cases had a median age TRANS of 59.5 years (IQR 55.8-68), and were mostly males TRANS (13, 92.9%). All included pregnant women (26, 0.5%), children TRANS (131, 2.6%), and healthcare workers (135, 2.7%) were alive and not hospitalized at the end of follow up. A total of 1424 patients (28.5%) required hospitalization, out of which 108 (7.6%) were admitted to ICU. Most frequent co-morbidities in hospitalized adults TRANS were diabetes (23.2%), and hypertension MESHD hypertension HP (20.7%). Multivariable logistic regression showed that older age TRANS [adjusted odds ratio (aOR) 1.041, 95% confidence interval (CI) 1.022-1.061 per year increase; P <0.001], male TRANS sex (aOR 4.375, 95% CI 1.964-9.744; P <0.001), diabetes (aOR 1.698, 95% CI 1.050-2.746; P 0.031), chronic kidney disease HP kidney disease MESHD (aOR 3.590, 95% CI 1.596-8.079, P 0.002), and higher BMI (aOR 1.067, 95% CI 1.027-1.108 per unit increase; P 0.001), were all independently associated with increased risk of ICU admission. Conclusions In a relatively younger national cohort with a low co-morbidity burden, COVID-19 was associated with low all-cause mortality. Independent risk factors for ICU admission included older age TRANS, male TRANS sex, higher BMI, and co-existing diabetes or chronic kidney disease HP kidney disease MESHD.

    Changes in lipid metabolism in patients with severe COVID-19

    Authors: Yi Li; Yan Zhang; Minhui Dai; Minxue Shen; Jianchu Zhang; Yanhui Cui; Ben Liu; Fengyu Lin; Lingli Chen; Duoduo Han; Yifei Fan; Yanjun Zeng; Wen Li; Sha Li; Xiang Chen; Pinhua Pan

    doi:10.21203/rs.3.rs-43521/v1 Date: 2020-07-15 Source: ResearchSquare

    Background: Dyslipidemia plays an important role in the pathogenesis and evolution of critical illness MESHD, but limited information exists regarding the lipid metabolism of severe coronavirus disease MESHD 2019 (COVID-19) patients. The aim of this study was to investigate role of dyslipidemia in patients with severe COVID-19Methods: We retrospectively reviewed 216 severe COVID-19 patients with clarified outcomes (discharged or deceased), admitted to the West Court of Union Hospital in Wuhan, China, between February 1 and March 31, 2020. The dynamic changes of lipid profiles and their relationships with disease MESHD severity and clinical outcomes were analyzed.Results: A total of 216 severe COVID-19 patients, including 24 non-survivors and 192 survivors, were included in the final analyses. The levels of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein AI (Apo-AI) on admission were significantly lower in non-survivors compared to survivors. During hospitalization, low-density lipoprotein cholesterol (LDL-C), total cholesterol(TC), HDL-C and Apo-AI were shown an increasing trend in survivors, but maintained lower levels or shown downward trend in non-survivors. The serum SERO levels of HDL-C and Apo-AI were inversely correlated with C-reactive protein (CRP), length of hospital stay of survivors and disease MESHD severity. The receiver operating characteristic (ROC) curve analysis identified a CRP/ HDL-C ratio cut-off value of 62.54 as the predictor for in-hospital mortality (AUC=0.823, Sensitivity=83.3%, Specificity=70.8%). Logistic regression analysis demonstrated that hypertension MESHD hypertension HP, neutrophils-to-lymphocytes ratio(NLR), platelet count and high CRP/ HDL-C ratio (>62.54) were independent factors to predict in-hospital mortality.Conclusions: The results demonstrated that dyslipidemia was associated with the inflammatory response, disease MESHD severity and poor prognosis of COVID-19. High CRP/ HDL-C ratio may serve as an independently potential predictor for hospital mortality among patients with severe COVID-19.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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