Corpus overview


Overview

MeSH Disease

Transmission

Seroprevalence
    displaying 21 - 30 records in total 507
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    Multi-organ impairment in low-risk individuals with long COVID

    Authors: Andrea Dennis; Malgorzata Wamil; Sandeep Kapur; Johann Alberts; Andrew Badley; Gustav Anton Decker; Stacey A Rizza; Rajarshi Banerjee; Amitava Banerjee; Mauro Giudici; Giovanni Naldi; Sabrina Gaito; Silvana Castaldi; Elia Biganzoli; Sachee Agrawal; Chandrakant Pawar; Mala Kaneria; Smita Mahale; Jayanthi Shastri; Vainav Patel; Paul Dark; Alexander Mathioudakis; Kathryn Gray; Graham Lord; Timothy Felton; Chris Brightling; Ling-Pei Ho; - NIHR Respiratory TRC; - CIRCO; Karen Piper Hanley; Angela Simpson; John R Grainger; Tracy Hussell; Elizabeth R Mann

    doi:10.1101/2020.10.14.20212555 Date: 2020-10-16 Source: medRxiv

    Background: Severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) infection MESHD has disproportionately affected older individuals and those with underlying medical conditions. Research has focused on short-term outcomes in hospital, and single organ involvement. Consequently, impact of long COVID (persistent symptoms three months post-infection) across multiple organs in low-risk individuals is yet to be assessed. Methods: An ongoing prospective, longitudinal, two-centre, observational study was performed in individuals symptomatic after recovery from acute SARS-CoV-2 infection MESHD. Symptoms and organ function (heart, lungs, kidneys, liver, pancreas, spleen) were assessed by standardised questionnaires (EQ-5D-5L, Dyspnoea-12 MESHD), blood SERO investigations and quantitative magnetic resonance imaging, defining single and multi-organ impairment by consensus definitions. Findings: Between April and September 2020, 201 individuals (mean age TRANS 44 (SD 11.0) years, 70% female TRANS, 87% white, 31% healthcare workers) completed assessments following SARS-CoV-2 infection MESHD (median 140, IQR 105-160 days after initial symptoms). The prevalence SERO of pre-existing conditions ( obesity HP obesity MESHD: 20%, hypertension HP hypertension MESHD: 6%; diabetes MESHD: 2%; heart disease MESHD: 4%) was low, and only 18% of individuals had been hospitalised with COVID-19 MESHD. Fatigue HP (98%), muscle aches MESHD (88%), breathlessness (87%), and headaches MESHD headaches HP (83%) were the most frequently reported symptoms. Ongoing cardiorespiratory (92%) and gastrointestinal (73%) symptoms were common, and 42% of individuals had ten or more symptoms. There was evidence of mild organ impairment in heart (32%), lungs (33%), kidneys (12%), liver (10%), pancreas MESHD (17%), and spleen (6%). Single (66%) and multi-organ (25%) impairment was observed, and was significantly associated with risk of prior COVID-19 MESHD hospitalisation (p<0.05). Interpretation: In a young, low-risk population with ongoing symptoms, almost 70% of individuals have impairment in one or more organs four months after initial symptoms of SARS-CoV-2 infection MESHD. There are implications not only for burden of long COVID but also public health approaches which have assumed low risk in young people with no comorbidities.

    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 TRANS diagnosed as febrile seizure MESHD febrile seizure HP caused by infection (1799/60.7% vs 980/59%, P = 0.141), dyskinesia MESHD dyskinesia HP (31/1.0% vs 28/1.7%, P = 0.075) and benign intracranial hypertension MESHD hypertension HP (41/1.4% vs 21/1.3%, P = 0.791) did not change. While children TRANS diagnosed as epilepsy MESHD (304/10.3% vs 348/21%, P < 0.001), migraine MESHD migraine HP (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 peripheral neuropathy HP (38/1.3% vs 43/2.6%, P = 0.001) increased in 2020. Children TRANS diagnosed as intracranial infection MESHD (535/18% vs113/6.8%, P < 0.001) and myopathy MESHD myopathy HP (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.

    Impact of COVID-19 MESHD Restrictions on People with Hypertension MESHD Hypertension HP

    Authors: Carissa Bonner; Erin Cvejic; Julie Ayre; Jennifer Isautier; Christopher Semsarian; Brooke Nickel; Carys Batcup; Kristen Pickles; Rachael Dodd; Samuel Cornell; Tessa Copp; Kirsten J McCaffery; Olav Rooyackers; Lars I. Eriksson; Anders Sonnerborg; Soo Aleman; Kristoffer Stralin; Sara Gredmark-Russ; Jonas Klingstrom; Jenny Mjosberg; - the Karolinska KI/K COVID-19 Study Group; Mervyn Andiapen; Marianna Fontana; Angelique Smit; Amanda Semper; Ben O'Brien; Benjamin Chain; Tim Brooks; Charlotte Manisty; Thomas Treibel; James Moon; - COVIDsortium Investigators; Mahdad C. Noursadeghi; - COVIDsortium Immune correlates network; Daniel M Altmann; Mala K. Mani; Aine McKnight; Rosemary J. Boyton; DANIEL PRIETO-ALHAMBRA

    doi:10.1101/2020.10.12.20211722 Date: 2020-10-14 Source: medRxiv

    Objectives: It is unclear how people with hypertension HP hypertension MESHD are responding to the COVID-19 MESHD pandemic given their increased risk, and whether targeted public health strategies are needed. Design: This retrospective case-control study compared people with hypertension MESHD hypertension HP to matched healthy controls during COVID-19 MESHD lockdown, to determine whether they have higher risk perceptions, anxiety HP anxiety MESHD and prevention intentions. Methods: Baseline data from a national survey were collected in April 2020 during COVID-19 MESHD lockdown. Of 4362 baseline participants, 466 people reported hypertension HP hypertension MESHD with no other chronic conditions, and were randomly matched to healthy controls with similar age TRANS, gender TRANS, education and health literacy. A subset (n=1369) was followed-up at 2 months after restrictions eased, including 147 participants with hypertension MESHD hypertension HP only. Risk perceptions, prevention intentions and anxiety HP anxiety MESHD were measured. Results: At baseline, perceived seriousness was high for both hypertension HP hypertension MESHD and control groups. The hypertension HP hypertension MESHD group had higher anxiety HP anxiety MESHD than controls; and were more willing to have the influenza vaccine. At follow-up, these differences were no longer present in the longitudinal sub-sample. Perceived seriousness and anxiety HP anxiety MESHD had decreased, but vaccine intentions for both influenza and COVID-19 MESHD remained high (>80%). Conclusions: Anxiety MESHD Anxiety HP was above normal levels during the COVID-19 MESHD lockdown. This was higher in the hypertension HP hypertension MESHD group, who also had higher vaccination intentions. Locations with prolonged restrictions may require targeted mental health screening for vulnerable groups. Despite a decrease in perceived risk and anxiety HP anxiety MESHD after 2 months of lockdown restrictions, vaccination intentions for both influenza and COVID-19 MESHD remained high, which is encouraging for future prevention of COVID-19 MESHD.

    Predictors of mortality in hospitalized COVID-19 MESHD patients in Athens, Greece

    Authors: Dimitrios Giannoglou; Evangelia Meimeti; Xenia Provatopoulou; Kostantinos Stathopoulos; Kriton-Ioannis Roukas; Petros Galanis

    doi:10.1101/2020.10.12.20211193 Date: 2020-10-14 Source: medRxiv

    Background: The epidemic of COVID-19 MESHD has rapidly spread worldwide, with millions of confirmed cases TRANS and related deaths. Numerous efforts are being made to clarify how the infection progresses and potential factors associated with disease severity and mortality. We investigated the mortality in Greek hospitalized COVID-19 MESHD patients and also the predictors of this mortality. Methods: Study population included 512 COVID-19 MESHD patients admitted to the hospitals of the Attica region of Greece. Patients demographic characteristics, comorbidities, allergies MESHD allergies HP, previous vaccination for seasonal influenza virus, admission to ICU, intubation, and death MESHD were recorded. Potential predictors of in-hospital mortality were identified by regression analysis. Results: The mean age TRANS of hospitalized patients was 60.4 years, and was higher in patients who deceased. The most common comorbidities were respiratory diseases MESHD, hypertension HP hypertension MESHD, gastrointestinal disorders MESHD, dyslipidemia MESHD, mental health diseases, asthma MESHD asthma HP, diabetes mellitus MESHD diabetes mellitus HP and cardiovascular diseases MESHD. The need for ICU care and intubation was significantly higher among patients who died. The mortality rate was 15.8% (81 out of 512). Age TRANS [≥]65 years, cancer MESHD, chronic kidney disease MESHD chronic kidney disease HP, endocrine diseases MESHD, central nervous system disorders MESHD, anemia MESHD anemia HP, and intubation were independently associated with increased in-hospital mortality, while allergies MESHD allergies HP and previous influenza vaccination were associated with decreased in-hospital mortality. Conclusion: Our finding of a beneficial effect of allergies MESHD allergies HP and influenza vaccination against COVID-19 MESHD infection merits further investigation, as it may shed light in the mechanisms underlying disease progression and severity. Most importantly, it may assist in the implementation of efficient protective measures and public healthcare policies.

    COVID-19 MESHD Disease Severity and Determinants among Ethiopian Patients: A study of the Millennium COVID-19 MESHD Care Center

    Authors: Tigist W. Leulseged; Kindalem G. Abebe; Ishmael S. Hassen; Endalkachew H. Maru; Wuletaw C Zewde; Nigat W Chamesew; Kalkidan T. Yegile; Abdi B. Bayisa; Dagne F. Siyoum; Mesay G. Edo; Edmealem G. Mesfin; Meskerem N. Derejie; Hilina K. Shiferaw; Jake Dunning; Cameron J Fairfield; Carrol Gamble; Christopher A Green; Sophie Halpin; Hayley Hardwick; Karl Holden; Peter Horby; Clare Jackson; Kenneth McLean; Laura Merson; Jonathan S Nguyen-Van-Tam; Lisa Norman; Piero L Olliaro; Mark G Pritchard; Clark D Russell; James Scott-Brown; Catherine A Shaw; Aziz Sheikh; Tom Solomon; Cathie LM Sudlow; Olivia V Swann; Lance Turtle; Peter JM Openshaw; J Kenneth Baillie; Malcolm Gracie Semple; Mahdad Noursadeghi

    doi:10.1101/2020.10.09.20209999 Date: 2020-10-13 Source: medRxiv

    Background: Understanding determinants of developing severe COVID-19 MESHD disease is important as studies show that severe disease is associated with worse outcomes. Objective: The study aimed to assess the determinants of COVID-19 MESHD disease severity among COVID-19 MESHD patients admitted to Millennium COVID-19 MESHD Care Center in Ethiopia. Methods: A cross-sectional study was conducted from June to August 2020 among randomly selected 686 patients. Chi-square test was used to detect the presence of a statistically significant difference in the characteristics of the patients based on disease severity (Mild Vs Moderate Vs Severe), where p-value of <0.05 was considered as having a statistically significant difference. A Multivariable multinomial logistic regression model was used to assess the presence of a significant association between the independent variables and COVID-19 MESHD disease severity where Adjusted Odds ratio (AOR), 95% CIs for AOR and P-values were used for testing significance and interpretation of results. Results: Having moderate as compared with mild disease was significantly associated with having hypertension MESHD hypertension HP (AOR= 2.302, 95% CI= 1.266, 4.184, p-value=0.006), diabetes mellitus MESHD diabetes mellitus HP (AOR=2.607, 95% CI= 1.307, 5.198, p-value=0.007 for diabetes mellitus MESHD diabetes mellitus HP), fever MESHD fever HP (AOR= 6.115, 95% CI= 2.941, 12.716, p-value=0.0001) and headache MESHD headache HP (AOR= 2.695, 95% CI= 1.392, 5.215, p-value=0.003). Similarly, having severe disease as compared with mild disease was associated with age group TRANS (AOR= 4.428, 95% CI= 2.497, 7.853, p-value=0.0001 for 40-59 years and AOR=18.070, 95% CI=9.292, 35.140, p-value=0.0001 for [≥] 60 years), sex (AOR=1.842, 95% CI=1.121, 3.027, p-value=0.016), hypertension MESHD hypertension HP (AOR= 1.966, 95% CI= 1.076, 3.593, p-value=0.028), diabetes mellitus MESHD diabetes mellitus HP (AOR= 3.926, 95% CI= 1.964, 7.847, p-value=0.0001), fever MESHD fever HP (AOR= 13.218, 95% CI= 6.109, 28.601, p-value=0.0001) and headache HP headache MESHD (AOR= 4.816, 95% CI= 2.324, 9.979, p-value=0.0001). In addition, determinants of severe disease as compared with moderate disease were found to be age group TRANS (AOR= 4.871, 95% CI= 2.854, 8.315, p-value=0.0001 for 40-59 years and AOR= 18.906, 95% CI= 9.838, 36.334, p-value=0.0001 for [≥] 60 years), fever HP fever MESHD (AOR= 2.161, 95% CI= 1.286, 3.634, p-value=0.004) and headache HP headache MESHD (AOR= 1.787, 95% CI= 1.028, 3.107, p-value=0.039). Conclusions: Being old, male TRANS sex, hypertension MESHD hypertension HP, diabetes mellitus HP diabetes mellitus MESHD, and having symptoms of fever HP fever MESHD and headache MESHD headache HP were found to be determinants of developing a more severe COVID-19 MESHD disease category. We recommend a better preventive practice to be set in place so that these groups of patients can be protected from acquiring the disease. And for those who are already infected MESHD, a more careful follow-up and management should be given so that complication and death can be prevented. Furthermore, considering the above non respiratory symptoms as disease severity indicator could be important.

    Meta-analysis and adjusted estimation of COVID-19 MESHD case fatality risk in India and its association with the underlying comorbidities

    Authors: Balbir Bagicha Singh; Michael P Ward; Mark Lowerison; Ryan T Lewinson; Isabelle A Vallerand; Rob Deardon; Jatinder PS Gill; Baljit Singh; Herman W Barkema; M. Anwar Hossain

    doi:10.1101/2020.10.08.20209163 Date: 2020-10-13 Source: medRxiv

    There is a lack of COVID-19 MESHD adjusted case fatality risk (aCFR) estimates and information on states with high aCFR. State-specific aCFRs were estimated, using 13 day lag for fatality. To estimate country level aCFR, state estimates were meta-analysed. Multiple correspondence analyses (MCA), followed by univariable logistic regression, were conducted to understand the association between aCFR and geodemographic, health and social indicators. Based on health indicators, states likely to report a higher aCFR were identified. Using random- and fixed-effects models, the aCFRs in India were 1.42 (95% CI 1.19 - 1.70) and 2.97 (95% CI 2.94 - 3.00), respectively. The aCFR was grouped with the incidence of diabetes MESHD, hypertension HP hypertension MESHD, cardiovascular diseases MESHD and acute respiratory infections MESHD in the first and second dimensions of MCA. The current study demonstrated the value of using meta-analysis to estimate aCFR. To decrease COVID-19 MESHD associated fatalities, states estimated to have a high aCFR must take steps to reduce co-morbidities.

    Covid-19 MESHD and HIV: not always an unfavorable combination

    Authors: Pedro Vieira Bertozzi; Amanda de Oliveira Vicente; Amanda Siqueira Pereira; João Pedro Espinha de Sant'Ana; Rafaela Braga Cabrera Mano; Luciana Souza Jorge; Rodrigo Afonso da Silva Sardenberg

    doi:10.21203/rs.3.rs-91431/v1 Date: 2020-10-12 Source: ResearchSquare

    Background: A 73-years-old-man patient who had a history of Human Immunodefiency Virus (HIV) infection MESHD for over 20 years was diagnosed with SARS-CoV-2 infection MESHD.Case presentation: The patient was admitted to the Intensive Care Unit (ICU), where he remained for 25 days, due to a severe condition. Intubation, hemodialysis and tracheostomy were necessary to maintain homeostasis. In addition to regular treatment with etravirine, dolutegravir, darunavir and ritonavir for highly active antiretroviral therapy, the patient received To-cilizumab, which showed a great recovery in the patient's condition.Conclusion : The patient had several risk factors, such as: male TRANS gender TRANS, age TRANS> 70 years and hypertension MESHD hypertension HP. The use of To-cilizumab was of great importance in the patient's recovery, since the drug increased his immune response, which is deficient, due to HIV infection MESHD.

    DEVELOPING AND VALIDATING COVID-19 MESHD ADVERSE OUTCOME RISK PREDICTION MODELS FROM A BI-NATIONAL EUROPEAN COHORT OF 5594 PATIENTS.

    Authors: Espen Jimenez Solem; Tonny Studsgaard Petersen; Christina Lioma; Christian Igel; Wouter Boomsma; Oswin Krause; Casper Hansen; Christian Hansen; Stephan Lorentzen; Raghavendra Selvan; Janne Petersen; Martin Erik Nyeland; Mikkel Zoellner Ankarfeldt; Gert Mehl Virenfeldt; Mathilde Winther-Jensen; Allan Linneberg; Mostafa Mediphour Ghazi; Nicki Detlefsen; Andreas Lauritzen; Abraham George Smith; Marleen de Bruijne; Bulat Ibragimov; Jens Petersen; Martin Lillholm; Marie Helleberg; Benjamin Skov Kaas-Hansen; Jon Middleton; Stine Hasling Mogensen; Hans Christian Thorsen-Meyer; Anders Perner; Mikkel Bonde; Alexander Bonde; Akshay Pai; Mads Nielsen; Martin Sillesen

    doi:10.1101/2020.10.06.20207209 Date: 2020-10-11 Source: medRxiv

    Background: Patients with severe COVID-19 MESHD have overwhelmed healthcare systems worldwide. We hypothesized that Machine Learning (ML) models could be used to predict risks at different stages of management (at diagnosis, hospital admission and ICU admission) and thereby provide insights into drivers and prognostic markers of disease progression and death MESHD. Methods: From a cohort of approx. 2.6 million citizens in the two regions of Denmark, SARS-CoV-2 PCR tests were performed on subjects suspected for COVID-19 MESHD disease; 3944 cases had at least one positive test and were subjected to further analysis. A cohort of SARS-CoV-2 positive cases from the United Kingdom Biobank was used for external validation. Findings: The ML models predicted the risk of death (Receiver Operation Characteristics Area Under the Curve, ROC-AUC) of 0.904 at diagnosis, 0.818, at hospital admission and 0.723 at Intensive Care Unit (ICU) admission. Similar metrics were achieved for predicted risks of hospital and ICU admission and use of mechanical ventilation. We identified some common risk factors, including age TRANS, body mass index (BMI) and hypertension MESHD hypertension HP as driving factors, although the top risk features shifted towards markers of shock MESHD shock HP and organ dysfunction MESHD in ICU patients. The external validation indicated fair predictive performance SERO for mortality prediction, but suboptimal performance SERO for predicting ICU admission. Interpretation: ML may be used to identify drivers of progression to more severe disease and for prognostication patients in patients with COVID-19 MESHD. Prognostic features included age TRANS, BMI and hypertension MESHD hypertension HP, although markers of shock HP shock MESHD and organ dysfunction became more important in more severe cases. We provide access to an online risk calculator based on these findings.

    A Comparative COVID 19 Characterizations and Clinical Course Analysis between ICU and Non ICU Settings

    Authors: Amit Patel; Parloop Bhatt; Surabhi Madan; Nitesh Shah; Vipul Thakkar; Bhagyesh Shah; Rashmi Chovatia; Hardik Shah; Minesh Patel; Pradip Dabhi; Aditi Nanavati; Milan Chag; Keyur Parikh; Elizabeth M Anderson; Eileen C Goodwin; Scott Hensley; Karen M Puopolo; Nicki Detlefsen; Andreas Lauritzen; Abraham George Smith; Marleen de Bruijne; Bulat Ibragimov; Jens Petersen; Martin Lillholm; Marie Helleberg; Benjamin Skov Kaas-Hansen; Jon Middleton; Stine Hasling Mogensen; Hans Christian Thorsen-Meyer; Anders Perner; Mikkel Bonde; Alexander Bonde; Akshay Pai; Mads Nielsen; Martin Sillesen

    doi:10.1101/2020.10.07.20208389 Date: 2020-10-11 Source: medRxiv

    Objective: With COVID-19 MESHD pandemic severely affecting India and Ahmedabad city being one accounting for half COVID cases, objective was to determine disease course and severity of in patients at a COVID care hospital. Design: A Clinical trial registry of India registered observational study (CTRI/2020/05/025247). Setting: Certified COVID hospital located in Ahmedabad, Gujarat, India. Participants: 549 COVID positive patients hospitalized between 15 th May to 10 th August, 2020 and treated in ICU and non ICU settings. Main Outcome Measure: Comparative analysis of demographic, clinical characteristics, investigations, treatment, complications and outcome of COVID patients in ICU and non ICU settings. Results: Of the 549 hospitalized COVID positive patients, 159 were admitted in ICU during disease course while 390 had ward admissions. Overall median age TRANS was 52 (1-86) years. The ICU group was older (>65years), with associated comorbidities like hypertension HP hypertension MESHD and diabetes MESHD (p<0.001); higher proportion of males TRANS (79.25%); with dyspnea HP dyspnea MESHD as a major clinical characteristic and consolidation in lungs as a major radiological finding as compared to ward patients. C - reactive protein, D-Dimer and Ferritin were higher in ICU patients. Overall 50% females TRANS depicted elevated Ferritin levels. Steriods(92.45%)and tocilizumab (69.18%) were more frequently used for ICU patients . Remdesivir was prescribed to both ICU and non ICU patients. Favirapir was also a line of treatment for 25% of ICU patients. Convalescent plasma SERO therapy was given to 7 ICU patients. Complications like acute kidney injury HP acute kidney injury MESHD (13.84%), shock HP (10.69 %), sepsis HP sepsis MESHD and encephalopathy MESHD encephalopathy HP were observed in ICU patients. Overall mortality rate was 5.47 % with higher mortality among males TRANS in comparison to females TRANS (p<0.0001). Conclusion: About 29% of overall patients required ICU admission that was commonly elderly TRANS males TRANS. Chances of ICU admission were higher with baselines comorbidities (1.5 times) and dyspnea HP dyspnea MESHD (3.4 times) respectively. A multi-specialty COVID care team and updated treatment protocols improves outcomes.

    SARS-CoV-2 genomic characterization and clinical manifestation of the COVID-19 MESHD outbreak in Uruguay

    Authors: Victoria Elizondo; Gordon W Harkins; Batsirai Mabvakure; Sabine Smidt; Paul Zappile; Christian Marier; Matthew T Maurano; Victoria Perez; Natalia Mazza; Carolina Beloso; Silvana Ifran; Mariana Fernandez; Andrea Santini; Veronica Perez; Veronica Estevez; Matilde Nin; Gonzalo Manrique; Leticia Perez; Fabiana Ross; Susana Boschi; Maria Noel Zubillaga; Raquel Balleste; Simon Dellicour; Adriana Heguy; Ralf Duerr; Benjamin Skov Kaas-Hansen; Jon Middleton; Stine Hasling Mogensen; Hans Christian Thorsen-Meyer; Anders Perner; Mikkel Bonde; Alexander Bonde; Akshay Pai; Mads Nielsen; Martin Sillesen

    doi:10.1101/2020.10.08.20208546 Date: 2020-10-11 Source: medRxiv

    COVID-19 MESHD is a respiratory illness MESHD caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and declared by the World Health Organization as a global public health emergency. Among the severe outbreaks across South America, Uruguay has become known for curtailing SARS-CoV-2 exceptionally well. To understand the SARS-CoV-2 introductions, local transmissions TRANS, and associations with genomic and clinical parameters in Uruguay, we sequenced the viral genomes of 44 outpatients and inpatients in a private healthcare system in its capital, Montevideo, from March to May 2020. We performed a phylogeographic analysis using sequences from our cohort and other studies that indicate a minimum of 23 independent introductions into Uruguay, resulting in five major transmission TRANS clusters. Our data suggest that most introductions resulting in chains of transmission TRANS originate from other South American countries, with the earliest seeding of the virus in late February 2020, weeks before the borders were closed to all non-citizens and a partial lockdown implemented. Genetic analyses suggest a dominance of S and G clades (G, GH, GR) that make up >90% of the viral strains in our study. In our cohort, lethal outcome of SARS-CoV-2 infection MESHD significantly correlated with arterial hypertension MESHD hypertension HP, kidney failure MESHD, and ICU admission (FDR < 0.01), but not with any mutation in a structural or non-structural protein, such as the spike D614G mutation. Our study contributes genetic, phylodynamic, and clinical correlation data about the exceptionally well-curbed SARS-CoV-2 outbreak in Uruguay, which furthers the understanding of disease patterns and regional aspects of the pandemic in Latin America.

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