Corpus overview


MeSH Disease

Human Phenotype


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    From SARS-CoV-2 hematogenous spreading to endothelial dysfunction: clinical-histopathological study of cutaneous signs of COVID-19

    Authors: Angela Patrì; Maria Vargas; Pasquale Buonanno; Maria Carmela Annunziata; Daniela Russo; Stefania Staibano; Giuseppe Servillo; Gabriella Fabbrocini

    doi:10.21203/ Date: 2020-07-28 Source: ResearchSquare

    Background: To date, very few studies on clinical-histopathological correlations of cutaneous disorders associated with COVID-19 have been conducted. Case presentation: The Case 1 was a 90-year-old man, who tested positive for SARS-CoV-2 from a nasopharyngeal swab. Two days later,  he was hospitalized and after eleven days transferred to Intensive Care Unit. A chest CT showed bilateral ground-glass opacities. Just that day, an erythematous maculo-papular rash appeared on trunk, shoulders and neck, becoming purpuric after few days. Histological evaluations revealed a chronic superficial dermatitis with purpuric aspects. The superficial and papillary dermis appeared edematous, with a perivascular lympho-granulocytic infiltrate and erythrocytic extravasation. At intraepithelial level, spongiosis and a granulocyte infiltrate were detected. Arterioles, capillaries and post-capillary venules showed endothelial swelling and appeared ectasic. The patient was treated with hydroxychloroquine, azithromycin, lopinavir-ritonavir and tocilizumab. Regrettably, due to severe lung impairment, he died.The Case 2 was a 85-year-old man, admitted to Intensive Care Unit, where he was intubated. He had tested positive for SARS-CoV-2 from a nasopharyngeal swab two days before. A chest RX showed bilateral atypical pneumonia HP. After seven days, a cutaneous reddening involving trunk, upper limbs, neck and face developed, configuring a sub- erythroderma HP. Histological evaluations displayed edema HP in the papillary and superficial reticular dermis, and a perivascular lymphocytic infiltrate in the superficial dermis. The patient was treated with hydroxychloroquine, azithromycin, lopinavir-ritonavir and tocilizumab. Sub- erythroderma HP as well as respiratory symptoms gradually improved until healing. Conclusions: The endothelial swelling detected in the Case 1 could be a morphological expression of SARS-CoV-2-induced endothelial dysfunction. We hypothesize that cutaneous damage could be initiated by endothelial dysfunction, caused by SARS-CoV-2 infection of endothelial cells or induced by immune system activation. The disruption of endothelial integrity could enhance microvascular permeability, extravasation of inflammatory cells and cytokines, with cutaneous injury. The Case 2 developed a sub- erythroderma HP associated with COVID-19, and a non-specific chronic dermatitis was detected at histological level. We speculate that a purpuric rash could represent the cutaneous sign of a more severe coagulopathy, as highlighted histologically by vascular abnormalities, while a sub- erythroderma HP could be expression of viral hematogenous spreading, inducing a non-specific chronic dermatitis.

    Myocardial Injury MESHD in Post Mortem Biopsies of Patients with COVID-19

    Authors: Camila Hartmann; Anna Flavia dos Santos Miggiolaro; Jarbas da Silva Motta Junior; Lucas Baena Carstens; Caroline Busatta Vaz De Paula; Larissa Hermann de Souza Nunes; Gustavo Lenci Marques; Lidia Zytinsky Moura; Jose Rocha Faria Neto; Lucia de Noronha; Cristina Pellegrino Baena

    doi:10.21203/ Date: 2020-07-17 Source: ResearchSquare

    Background: Myocardial injury MESHD is significantly and independently associated with mortality in COVID-19 patients. However, the pathogenesis of myocardial injury MESHD in COVID-19 is still not clear, and cardiac involvement by SARS-CoV-2 remains a major challenge worldwide.Aim: This histopathological and immunohistochemical study seeks to clarify the pathogenesis of myocardial injury MESHD in COVID-19.Methods: Postmortem minimally invasive autopsies were performed in two patients who died from COVID-19, and the myocardium samples were compared to a control patient. Immunohistochemistry (IHC) staining was performed using monoclonal antibodies SERO against the following targets: caspase-1, ICAM-1, TNF-α, IL-4, IL-6, CD163, TGF-β, MMP-9, type 1 and type 3 collagen.Results: The histopathological analysis showed severe pericellular interstitial edema HP edema MESHD surrounding each of the cardiomyocytes. The IHC analysis showed increased expression of caspase-1, ICAM-1, IL-4, IL-6, CD163, MMP-9 and type 3 collagen in the COVID-19 patients compared to the control. On the other hand, no difference from the control was observed in expression of TNF-α, TGF-β and type 1 collagen. Conclusion: Our findings point to a pathogenesis related with pyroptosis leading to endothelial disfunction. The subsequent inflammation MESHD with associated interstitial edema HP edema MESHD could explain the myocardial disfunction and arrythmias MESHD in COVID-19 patients. The presence of Th2 response, MMP-9 and type-3 collagen suggests progression to myocardial fibrosis HP myocardial fibrosis MESHD in the long term.

    Age TRANS-dependent progression of SARS-CoV-2 infection MESHD in Syrian hamsters

    Authors: Nikolaus Osterrieder; Luca D. Bertzbach; Kristina Dietert; Azza Abdelgawad; Daria Vladimirova; Dusan Kunec; Donata Hoffmann; Martin Beer; Achim D. Gruber; Jakob Trimpert

    doi:10.1101/2020.06.10.144188 Date: 2020-06-10 Source: bioRxiv

    In late 2019, an outbreak of a severe respiratory disease MESHD caused by an emerging coronavirus, SARS-CoV-2, resulted in high morbidity and mortality in infected humans1. Complete understanding of COVID-19, the multi-faceted disease caused by SARS-CoV-2, requires suitable small animal models, as does the development and evaluation of vaccines and antivirals2. Because age TRANS-dependent differences of COVID-19 were identified in humans3, we compared the course of SARS-CoV-2 infection MESHD in young and aged TRANS Syrian hamsters. We show that virus replication in the upper and lower respiratory tract was independent of the age TRANS of the animals. However, older hamsters exhibited more pronounced and consistent weight loss HP weight loss MESHD. In situ hybridization in the lungs identified viral RNA in bronchial epithelium, alveolar epithelial MESHD cells type I and II, and macrophages. Histopathology revealed clear age TRANS-dependent differences, with young hamsters launching earlier and stronger immune cell influx than aged TRANS hamsters. The latter developed conspicuous alveolar MESHD and perivascular edema HP edema MESHD, indicating vascular leakage. In contrast, we observed rapid lung recovery at day 14 after infection MESHD only in young hamsters. We propose that comparative assessment in young versus aged TRANS hamsters of SARS-CoV-2 vaccines and treatments may yield valuable information as this small-animal model appears to mirror age TRANS-dependent differences in human patients.

    Cytokine Release Syndrome-Associated Encephalopathy MESHD Encephalopathy HP in Patients with COVID-19

    Authors: Peggy Perrin; Nicolas Collongues; Seyyid Baloglu; Dimitri Bedo; Xavier Bassand; Thomas Lavaux; Gabriela Gautier; Nicolas Keller; Stephane Kremer; Samira Fafi-Kremer; Bruno Moulin; Ilies Benotmane; Sophie Caillard

    id:10.20944/preprints202006.0103.v1 Date: 2020-06-07 Source:

    Severe disease MESHD and uremia MESHD are risk factors for neurological complications of coronavirus disease MESHD-2019 (COVID-19). An in-depth analysis of a case series was conducted to describe the neurological manifestations of patients with COVID-19 and gain pathophysiological insights that may guide clinical decision-making – especially with respect to the cytokine release syndrome (CRS). Extensive clinical, laboratory, and imaging phenotyping was performed in five patients. Neurological presentation included confusion HP confusion MESHD, tremor HP tremor MESHD, cerebellar ataxia MESHD ataxia HP, behavioral alterations, aphasia HP aphasia MESHD, pyramidal syndrome, coma HP coma MESHD, cranial nerve palsy MESHD, dysautonomia MESHD, and central hypothyroidism HP hypothyroidism MESHD. Neurological disturbances MESHD were remarkably accompanied by laboratory evidence of CRS. SARS-CoV-2 was undetectable in the cerebrospinal fluid. Hyperalbuminorachy and increased levels of the astroglial protein S100B were suggestive of blood SERO-brain barrier (BBB) dysfunction. Brain MRI findings comprised evidence of acute leukoencephalitis MESHD (n = 3, of whom one with a hemorrhagic form), cytotoxic edema HP edema MESHD mimicking ischemic stroke HP ischemic stroke MESHD (n = 1), or normal results (n = 2). Treatment with corticosteroids and/or intravenous immunoglobulins was attempted – resulting in rapid recovery from neurological disturbances MESHD in two cases. Patients with COVID-19 can develop neurological manifestations that share clinical, laboratory, and imaging similarities with those of chimeric antigen receptor-T cell-related encephalopathy HP encephalopathy MESHD. The pathophysiological underpinnings appear to involve CRS, endothelial activation, BBB dysfunction, and immune-mediated mechanisms.

    Assembly of an integrated human lung cell atlas reveals that SARS-CoV-2 receptor is co-expressed with key elements of the kinin-kallikrein, renin-angiotensin and coagulation systems in alveolar MESHD cells

    Authors: Davi Sidarta-Oliveira; Carlos Poblete Jara; Adriano J Ferruzzi; Munir S Skaf; William H Velander; Eliana P Araujo; Licio A Velloso

    doi:10.1101/2020.06.02.20120634 Date: 2020-06-04 Source: medRxiv

    SARS-CoV-2, the pathogenic agent of COVID-19, employs angiotensin converting enzyme-2 (ACE2) as its cell entry receptor. Clinical data reveal that in severe COVID-19, SARS-CoV-2 infects MESHD the lung, leading to a frequently lethal triad of respiratory insufficiency HP respiratory insufficiency MESHD, acute cardiovascular failure MESHD, and coagulopathy MESHD. Physiologically, ACE2 plays a role in the regulation of three systems that could potentially be involved in the pathogenesis of severe COVID-19: the kinin-kallikrein system, resulting in acute lung inflammatory edema HP edema MESHD; the renin-angiotensin system, promoting cardiovascular instability; and the coagulation system, leading to thromboembolism HP thromboembolism MESHD. Here we analyzed ~130,000 human lung single-cell transcriptomes and show that key elements of the kinin-kallikrein, renin-angiotensin and coagulation systems are co-expressed with ACE2 in alveolar MESHD cells, which could explain how changes in ACE2 promoted by SARS-CoV-2 cell entry result in the development of the three most severe clinical components of COVID-19.

    Analysis of 4 imaging features in patients with COVID-19

    Authors: JUN JIN; De-hong Gao; Xin Mo; Si-ping Tan; Zhen-xia Kou; Yi-bo Chen; Jin-bo Cao; Wen-jing Chen; Ya-ming Zhang; Bing-qing Li; Kuan-long Huang; Bing-ren Xu; Xiao-li Tang; Yu-li Wang

    doi:10.21203/ Date: 2020-05-29 Source: ResearchSquare

    Background : The aim of this was to analyze 4 chest CT imaging features of patients with coronavirus disease MESHD 2019 (COVID-19) in Shenzhen, China so as to improve the diagnosis of COVID-19.   Methods: Chest CT of 34 patients with COVID-19 confirmed by the nucleic acid test (NAT) were retrospectively analyzed. Analyses were performed to investigate the pathological basis of four imaging features(“feather sign”,“dandelion sign”,“pomegranate sign”, and “rime sign”) and to summarize the follow-up results.   Results: There were 22 patients (65.2 %) with typical “feather sign”and 18 (52.9%) with “dandelion sign”, while few patients had “pomegranate sign” and “rime sign”. The “feather sign” and “dandelion sign” were composed of stripe or round ground-glass opacity(GGO), thickened blood SERO vessels, and small-thickened interlobular septa. The “pomegranate sign” was characterized as follows: the increased range of GGO, the significant thickening of the interlobular septum, complicated with a small amount of punctate alveolar hemorrhage. The “rime sign” was characterized by numerous alveolar edemas HP. Microscopically, the wall thickening, small vascular proliferation, luminal stenosis, and occlusion, accompanied by interstitial infiltration of inflammatory cells, as well as numerous pulmonary interstitial fibrosis and partial hyaline degeneration were observed. Repeated chest CT revealed the mediastinal lymphadenectasis in one patient. Re-examination of the NAT showed another positive anal swab in two patients.   Conclusion: “Feather sign” and “dandelion sign” were typical chest CT features in patients with COVID-19; “pomegranate sign” was an atypical feature, and “rime sign” was a severe feature. In clinical work, accurate identification of various chest CT signs can help to improve the diagnostic accuracy of COVID-19 and reduce the misdiagnosis or missed diagnosis rate.

    Clinical and Radiological Evaluations of COVID-19 Patients with Anosmia HP Anosmia MESHD: Preliminary Report.

    Authors: Jerome R Lechien; Justin Michel; Thomas Radulesco; Carlos M Chiesa-Estomba; Luigi A Vaira; Giacomo De Riu; Leigh J Sowerby; Claire Hopkins; Sven Saussez

    doi:10.1101/2020.05.20.20106633 Date: 2020-05-26 Source: medRxiv

    Objective: To investigate clinical and radiological features of olfactory clefts MESHD of patients with mild coronavirus disease MESHD 2019 (COVID-19). Methods: Sixteen COVID-19 patients were recruited. The epidemiological and clinical data were extracted. Nasal complaints were assessed through the sino-nasal outcome test 22 (SNOT-22). Patients underwent psychophysical olfactory testing, olfactory cleft examination and CT-scan. Results: Sixteen anosmic patients were included. The mean Sniffin Sticks score was 4.6+/-1.7. The majority of patients had no endoscopical abnormality, with a mean olfactory cleft endoscopy score of 0.6+/-0.9. The olfactory clefts were opacified in 3 patients on the CT-scan. The mean radiological olfactory cleft score was 0.7+/-0.8. There were no significant correlations between clinical, radiological and psychophysical olfactory testing. Conclusion: The olfactory cleft of anosmic COVID-19 patients is free regarding endoscopic examination and imaging. The anosmia HP anosmia MESHD etiology would be not related to edema HP edema MESHD of the olfactory cleft.

    Multisystem inflammatory syndrome MESHD with features of Atypical Kawasaki disease MESHD during COVID-19 pandemic: Report of a case from India

    Authors: Abdul Rauf; Ajay Vijayan; Shaji Thomas John; Raghuram A Krishnan; Abdul Latheef

    doi:10.21203/ Date: 2020-05-15 Source: ResearchSquare

    There is a global concern of increasing number of children TRANS presenting with inflammatory syndrome MESHD with clinical features simulating Kawasaki disease, during ongoing COVID-19 pandemic. We report a very similar case of 5-year-old boy from a COVID-19 hotspot area in Kerala state of India who presented in late April 2020 with acute febrile illness MESHD with abdominal pain HP abdominal pain MESHD and loose stools followed by shock HP. On examination, child TRANS had bulbar conjunctivitis HP conjunctivitis MESHD and extremity edema HP edema MESHD. Initial investigations showed high inflammatory parameters, elevated serum creatinine HP serum SERO creatinine and liver enzymes. Echocardiography showed moderate LV dysfunction MESHD and normal coronaries. Cardiac enzymes were also elevated, suggesting myocarditis HP myocarditis MESHD. He was treated with inotropic support, respiratory support with High Flow Nasal Cannula, IV Immunoglobulins, aspirin, steroids and diuretics. RT PCR for SARS-CoV-2 was negative twice. His clinical condition improved rapidly, was afebrile from day 2, inflammatory parameters decreased, left ventricular function improved and was discharged after 6 days of hospital stay.

    Placental pathology in COVID-19

    Authors: Elisheva D Shanes; Leena B Mithal; Sebastian Otero; Hooman A Azad; Emily S Miller; Jeffery A Goldstein

    doi:10.1101/2020.05.08.20093229 Date: 2020-05-12 Source: medRxiv

    Objectives: To describe histopathologic findings in the placentas of women with COVID-19 during pregnancy. Methods: Pregnant women with COVID-19 delivering between March 18, 2020 and May 5, 2020 were identified. Placentas were examined and compared to historical controls and women with placental evaluation for a history of melanoma HP melanoma MESHD. Results: 16 placentas from patients with SARS-CoV-2 were examined (15 with live birth in the 3rd trimester 1 delivered in the 2nd trimester after intrauterine fetal demise). Compared to controls, third trimester placentas were significantly more likely to show at least one feature of maternal vascular malperfusion (MVM), including abnormal or injured maternal vessels, as well as delayed villous maturation, chorangiosis, and intervillous thrombi MESHD. Rates of acute and chronic inflammation MESHD were not increased. The placenta from the patient with intrauterine fetal demise showed villous edema MESHD edema HP and a retroplacental hematoma MESHD. Conclusions: Relative to controls, COVID-19 placentas show increased prevalence SERO of features of maternal vascular malperfusion (MVM), a pattern of placental injury reflecting abnormalities in oxygenation within the intervillous space associated with adverse perinatal outcomes. Only 1 COVID-19 patient was hypertensive MESHD despite the association of MVM with hypertensive disorders MESHD and preeclampsia HP. These changes may reflect a systemic inflammatory or hypercoagulable state influencing placental physiology.

    Hydroxychloroquine; Why It Might Be Successful and Why It Might Not Be Successful in the Treatment of Covid-19 Pneumonia HP? Could It Be A Prophylactic Drug?

    Authors: Omer Deniz

    id:10.20944/preprints202004.0348.v3 Date: 2020-05-12 Source:

    According to current literature and preliminary data, hydroxychloroquine (HCQ) seems potentially effective in the treatment of patients with Covid-19 pneumonia HP pneumonia MESHD. The concentrations of HCQ in lungs might be well above that of plasma SERO. Most likely, this property of HCQ provides effective drug concentrations in lungs. HCQ has a gradual onset of action in the treatment of rheumatic diseases MESHD. This could be valid for the treatment of Covid-19 pneumonia HP pneumonia MESHD. It was suggested that regular HCQ administration in animals for a certain time might result in gradual accumulation of HCQ in tissues. Reduced perfusion, somewhat distorted architecture of lung tissue, edema HP edema MESHD and, suggested gradual accumulation of HCQ in lung tissue might cause reduced HCQ concentrations in pneumonic areas of the lungs in Covid-19 pneumonia HP pneumonia MESHD. Patients with Covid-19 pneumonia HP pneumonia MESHD and extensive lung involvement might have less HCQ concentrations in their lungs than patients having limited lung involvement. Furthermore, patients with Covid-19 pneumonia HP pneumonia MESHD and extensive lung involvement might have more viral load than patients having limited lung involvement. That’s why treatment of patients with advanced Covid-19 pneumonia HP pneumonia MESHD using HCQ might result in treatment failure, however HCQ might be effective in the treatment of patients with mild and moderate Covid-19 pneumonia HP pneumonia MESHD. Using HCQ in Covid-19 pneumonia HP pneumonia MESHD prophylaxis seems logical since providing enough accumulation of HCQ in the healthy lungs, before the arrival of the SARS-CoV-2 virus, might prevent Covid-19 pneumonia HP pneumonia MESHD. However, the purpose of this paper is not to recommend using or not using HCQ for the treatment or for the prophylaxis of Covid-19 pneumonia HP pneumonia MESHD. The purpose of this paper is only to try to bring a new perspective on the role of HCQ in the treatment or in the prophylaxis of Covid-19 pneumonia HP pneumonia MESHD. This paper proposes only hypotheses, which need further researches to be confirmed.

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MeSH Disease
Human Phenotype

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