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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Impact of Congestive Heart Failure HP Heart Failure MESHD and Role of Cardiac Biomarkers in COVID-19 patients: A Systematic Review and Meta-Analysis

    Authors: Tarun Dalia; Shubham Lahan; Sagar Ranka; Prakash Acharya; Archana Gautam; Ioannis Mastoris; Andrew Sauer; Zubair Shah

    doi:10.1101/2020.07.06.20147421 Date: 2020-07-07 Source: medRxiv

    Background: Coronavirus disease MESHD 2019 (COVID-19) has been reported to cause worse outcomes in patients with underlying cardiovascular disease MESHD, especially in patients with acute cardiac injury, which is determined by elevated levels of high- sensitivity SERO troponin. There is a paucity of data on the impact of congestive heart failure HP heart failure MESHD (CHF) on outcomes in COVID-19 patients. Methods: We conducted a literature search of PubMed/Medline, EMBASE, and Google Scholar databases from 11/1/2019 till 06/07/2020, and identified all relevant studies reporting cardiovascular comorbidities, cardiac biomarkers, disease MESHD severity, and survival. Pooled data from the selected studies were used for metanalysis to identify the impact of risk factors and cardiac biomarker elevation on disease MESHD severity and/or mortality. Results: We collected pooled data on 5,967 COVID-19 patients from 20 individual studies. We found that both non-survivors and those with severe disease MESHD had an increased risk of acute cardiac injury and cardiac arrhythmias MESHD arrhythmias HP, our pooled relative risk (RR) was - 8.52 (95% CI 3.63-19.98) (p<0.001); and 3.61 (95% CI 2.03-6.43) (p=0.001), respectively. Mean difference in the levels of Troponin-I, CK-MB, and NT-proBNP was higher in deceased and severely infected patients. The RR of in-hospital mortality was 2.35 (95% CI 1.18-4.70) (p=0.022) and 1.52 (95% CI 1.12-2.05) (p=0.008) among patients who had pre-existing CHF and hypertension MESHD hypertension HP, respectively. Conclusion: Cardiac involvement in COVID-19 infection MESHD appears to significantly adversely impact patient prognosis and survival. Pre-existence of CHF and high cardiac biomarkers like NT-pro BNP and CK-MB levels in COVID-19 patients correlates with worse outcomes. Keywords: Acute cardiac injury; cardiac arrhythmia MESHD arrhythmia HP; mortality risk; cardiac biomarkers, COVID-19.

    Association of Smoking Status with Outcomes in Hospitalized COVID-19 Patients

    Authors: Muhammad Adrish; Sridhar Chilimuri; Nikhitha Mantri; Haozhe Sun; Maleeha Zahid; Sudharsan Gongati; Ked Fortuzi; Abhishrut Pramod Jog; Pravish Purmessur; Ravish Singhal

    doi:10.21203/rs.3.rs-39752/v1 Date: 2020-07-01 Source: ResearchSquare

    Introduction: Smoking causes inflammation MESHD of the lung epithelium by releasing cytokines and impairing muco-ciliary clearance. Some studies have linked smoking with severity of illness of COVID-19 whereas others have found no such association.Methods: This was a retrospective analysis of all adults TRANS hospitalized with COVID-19 from March 09 to May 18, 2020. Results: 1173 patients met the study criteria. 837 patients never smoked and 336 patients were either current smokers or past smoker and were grouped together in smokers group. Patients in smokers group were more likely to be male TRANS and had higher incidence of underlying COPD (19% vs. 6%, p<0.001), human immunodeficiency HP virus infection MESHD (11% vs. 5%,p<0.001), cancer (11% vs. 6%, p=0.005), congestive heart failure HP heart failure MESHD (15% vs. 8%, p<0.001), coronary artery disease MESHD (15% vs. 9%, p=0.027), chronic kidney disease HP kidney disease MESHD (11% vs. 8%, p=0.037), and end-stage renal disease MESHD (10% vs. 6%, p=0.009) compared to non-smokers. Smokers were more likely to develop critical illness MESHD requiring mechanical ventilation (47% vs. 37% p=0.005). Univariate Cox model for survival analysis by smoking status showed that smokers only current smokers had higher risk of death MESHD compared to never-smokers (HR 1.61, 95% confidence interval 1.22–2.12, p<0.001). In the multivariate approach Cox model for the survival, female TRANS sex, age TRANS, LDH and systemic steroid use were associated with overall survival.Conclusion: In our large single center retrospective database of patients hospitalized with COVID-19, smoking was associated with development of critical illness MESHD and higher likelihood of death MESHD

    Point of care lung ultrasound is useful when screening for CoVid-19 in Emergency MESHD Department patients.

    Authors: Andrea Hankins; Heejung Bang; Paul Walsh

    doi:10.1101/2020.06.09.20123836 Date: 2020-06-12 Source: medRxiv

    Background CoVid-19 can be a life-threatening lung disease MESHD or a trivial upper respiratory infection MESHD depending on whether the alveoli are involved. Emergency MESHD department (ED) screening in symptomatic patients with normal vital signs is frequently limited to oro-nasopharyngeal swabs. We tested the null hypothesis that patients being screened for CoVid-19 in the ED with normal vital signs and without hypoxia MESHD would have a point-of-care lung ultrasound (LUS) consistent with CoVid-19 less than 2% of the time. Methods Subjects Subjects were identified from ED ultrasound logs. Inclusion criteria Age TRANS 14 years or older with symptoms prompting ED screening for CoVid-19. Exclusion criteria Known congestive heart failure HP heart failure MESHD or other chronic lung condition likely to cause excessive B lines on LUS. Intervention Structured blinded ultrasound review and chart review Analysis We used an exact hypothesis tests for binomial random variables. We also measured LUS diagnostic performance SERO using computed tomography as the gold standard. Results We reviewed 77 charts; 62 met inclusion criteria. Vital signs were normal in 31 patients; 10 (32%) of these patients had LUS consistent with CoVid-19. We rejected the null hypothesis (p-value for bitest <0.001). The treating physicians' interpretation of their own point of care lung ultrasounds had a sensitivity SERO of 100% (95% CI 75%, 100%) and specificity of 80% (95% CI 68%, 89%). Conclusion LUS has a meaningful detection rate for CoVid-19 in symptomatic emergency MESHD department patients with normal vital signs. We recommend at least LUS be used in addition to PCR testing when screening symptomatic ED patients for CoVid-19.

    The association of cardiovascular disease MESHD and other pre-existing comorbidities with COVID-19 mortality: A systematic review and meta-analysis

    Authors: Paddy Ssentongo; Anna E. Ssentongo; Emily S. Heilbrunn; Djibril M Ba; Vernon M. Chinchilli

    doi:10.1101/2020.05.10.20097253 Date: 2020-05-14 Source: medRxiv

    Background Exploring the association of coronavirus-2019 disease MESHD (COVID-19) mortality with chronic pre-existing conditions may promote the importance of targeting these populations during this pandemic to optimize survival. The objective of this systematic review and meta-analysis is to explore the association of pre-existing conditions with COVID-19 mortality. Methods We searched MEDLINE, OVID databases, SCOPUS, and medrxiv.org for the period December 1, 2019, to May 1, 2020. The outcome of interest was the risk of COVID-19 mortality in patients with and without pre-existing conditions. Comorbidities explored were cardiovascular diseases MESHD ( coronary artery disease MESHD, hypertension MESHD hypertension HP, cardiac arrhythmias MESHD arrhythmias HP, and congestive heart failure HP heart failure MESHD), chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP, type 2 diabetes, cancer, chronic kidney disease HP kidney disease MESHD, chronic liver disease MESHD, and stroke MESHD stroke HP. Two independent reviewers extracted data and assessed the risk of bias. All analyses were performed using random-effects models and heterogeneity was quantified. Results Ten chronic conditions from 19 studies were included in the meta-analysis (n = 61,455 patients with COVID-19; mean age TRANS, 61 years; 57% male TRANS). Overall the between-study study heterogeneity was medium and studies had low publication bias and high quality. Coronary heart disease MESHD, hypertension MESHD hypertension HP, congestive heart failure HP heart failure MESHD, and cancer significantly increased the risk of mortality from COVID-19. The risk of mortality from COVID-19 in patients with coronary heart disease MESHD was 2.4 times as high as those without coronary heart disease MESHD (RR= 2.40, 95%CI=1.71-3.37, n=5) and twice as high in patients with hypertension MESHD hypertension HP as high as that compared to those without hypertension MESHD hypertension HP (RR=1.89, 95%CI= 1.58-2.27, n=9). Patients with cancer also were at twice the risk of mortality from COVID-19 compared to those without cancer (RR=1.93 95%CI 1.15-3.24, n=4), and those with congestive heart failure HP heart failure MESHD were at 2.5 times the risk of mortality compared to those without congestive heart failure HP heart failure MESHD (RR=2.66, 95%CI 1.58-4.48, n=3). Conclusions COVID-19 patients with all any cardiovascular disease MESHD, coronary heart disease MESHD, hypertension MESHD hypertension HP, congestive heart failure HP heart failure MESHD, and cancer have an increased risk of mortality. Tailored infection MESHD prevention and treatment strategies targeting this high-risk population are warranted to optimize survival.

    ACE2 interaction networks in COVID-19: a physiological framework for prediction of outcome in patients with cardiovascular risk factors

    Authors: Zofia Wicik; Ceren Eyileten; Daniel Jakubik; Rodrigo Pavao; Jolanta M Siller-Matula; Marek Postula

    doi:10.1101/2020.05.13.094714 Date: 2020-05-14 Source: bioRxiv

    BackgroundSevere acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection MESHD ( coronavirus disease MESHD 2019; COVID-19) is associated with adverse outcome in patients with cardiovascular disease MESHD (CVD). AimTo characterize the interaction between SARS-CoV-2 and Angiotensin Converting Enzyme 2 (ACE2) functional networks with focus on CVD. MethodsUsing bioinformatic tools, network medicine approaches and publicly available datasets, we investigated ACE2 tissue expression and described ACE2 interaction network which could be affected by SARS-CoV-2 infection MESHD. We identified top ACE2 interactors, including miRNAs which are shared regulators between the ACE2, virus- infection MESHD related proteins and heart interaction networks, using lung and nervous system networks as a reference. We also identified main SARS-CoV-2 risk groups and performed drug predictions for them. ResultsWe found the same range of ACE2 expression confidence in respiratory and cardiovascular systems (averaging 4.48 and 4.64, respectively). Analysing the complete ACE2 interaction network, we identified 11 genes (ACE2, DPP4, ANPEP, CCL2, TFRC, MEP1A, ADAM17, FABP2, NPC1, CLEC4M, TMPRSS2) associated with virus- infection MESHD related processes. Previously described genes associated with cardiovascular risk factors DPP4, CCL2 and ANPEP were extensively connected with top regulators of ACE2 network, including ACE, INS and KNG1. Enrichment analysis revealed several disease MESHD phenotypes associated with interaction networks of ACE2, heart tissue, and virus- infection MESHD related protein, with the strongest associations with the following diseases MESHD (in decreasing rank order): obesity MESHD obesity HP, hypertensive disease MESHD, non-insulin dependent diabetes mellitus MESHD diabetes mellitus HP, congestive heart failure HP heart failure MESHD, and coronary artery disease MESHD. We described for the first time microRNAs-miR (miR-302c-5p, miR-1305, miR-587, miR-26b-5p, and mir-27a-3p), which were common regulators of the three networks: ACE2, heart tissue and virus- infection MESHD related proteins. ConclusionOur study provides novel information regarding the complexity of signaling pathways affected by SARS-CoV-2 and proposes predictive tools as miR towards personalized diagnosis and therapy in COVID-19. Additionally, our study provides a list of miRNAs with biomarker potential in prediction of adverse outcome in patients with COVID-19 and CVD. O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=106 SRC="FIGDIR/small/094714v2_ufig1.gif" ALT="Figure 1"> View larger version (29K): org.highwire.dtl.DTLVardef@11e52b0org.highwire.dtl.DTLVardef@1c6d9ceorg.highwire.dtl.DTLVardef@57be3org.highwire.dtl.DTLVardef@8889c_HPS_FORMAT_FIGEXP M_FIG C_FIG

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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