Corpus overview


Overview

MeSH Disease

Vomiting (27)

Diarrhea (22)

Infections (17)

Cough (13)

Disease (11)


Human Phenotype

Vomiting (27)

Diarrhea (22)

Cough (13)

Fever (11)

Abdominal pain (7)


Transmission

Seroprevalence
    displaying 1 - 10 records in total 27
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    COVID-19 Vaccine Candidates by Identification of B and T Cell Multi-Epitopes Against SARS-COV-2

    Authors: Suresh Kumar; Sarmilah Mathavan; Wee Jia Jin; Nur Azznira Bt Azman; Devindren Subramanaiam; Nur Afiqah Binti Zainalabidin; Dhivashini Lingadaran; Zainah Binti Abdul Sattar; Danniya Lakshmi Manickam; Priscilla Sheba Anbananthan; Johan Ahmad Taqiyuddin; Yuvapriya Thevarajan

    id:10.20944/preprints202008.0092.v1 Date: 2020-08-04 Source: preprints.org

    Coronavirus disease MESHD (COVID-19) is a new discovered strain where WHO officially declares the disease MESHD as COVID-19 while the virus responsible for it called Severe Acute Respiratory Syndrome MESHD Coronavirus 2 or SARS-CoV-2. The incubation period TRANS of this disease MESHD is between 14 days. Ordinary clinical symptoms that reported around the world include fever MESHD fever HP, cough MESHD cough HP, fatigue MESHD fatigue HP, diarrhoea and vomiting MESHD vomiting HP as well as asymptomatic TRANS for certain people. Infection MESHD is spread mainly through broad droplets. In early March 2020, WHO again has announced that COVID-19 is a pandemic with currently no specific treatment. The potential use of SARS-COV-2 proteome as a vaccine candidate by analysing through B-cell and T-cell antigenicity by using a immunoinformatics approach as a vaccine development early stage. In this study, we used consensus sequence for SARS-COV-2 proteome that was retrieved from NCBI database. VaxiJen 2.0 was mainly used to identify the antigenic property of SARS-COV-2 proteins. IEDB then used to analyse the B-cell epitope, the presence of T cell immunogenic epitope in SARS-COV-2 proteins was obtained by using compromise method of MHC class I and II tools that accessible respectively using ProPred-1 server and MHC II Binding Prediction in IEDB database. The best epitopes of B and T-cell epitopes were predicted with high antigencity and the information is disseminated through web-based database resource (https://covid-19.omicstutorials.com/epitopes/). This study will be useful to find a new epitope-based candidate for SARS-COV-2. However, further study needs to be done for the next stages of vaccine development.

    Clinical characteristics of neonates with coronavirus disease MESHD 2019 (COVID-19): a systematic review

    Authors: Yuan Hu; Jing Xiong; Yuan Shi

    doi:10.21203/rs.3.rs-50795/v1 Date: 2020-07-29 Source: ResearchSquare

    This study aimed to summarize the existing literature on severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection in newborns to clarify the clinical features and outcomes of neonates with COVID-19. A systematic search was performed in PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Data, and VIP databases from January 1, 2019 to April 30, 2020. The references of relevant studies were also searched. A descriptive summary was organized by aspects of clinical presentations (symptoms, laboratory examinations, and imaging) and outcomes. We identified 14 studies reporting 18 newborns with COVID-19. The most common clinical manifestations were fever MESHD fever HP (62.5%), shortness of breath (50.0%), diarrhea MESHD diarrhea HP/ vomiting MESHD vomiting HP/feeding intolerance(43.8%), cough MESHD cough HP (37.5%), dyspnea MESHD dyspnea HP (25.0%), and nasal congestion/runny nose/ sneeze MESHD sneeze HP(25.0%). Atypical symptoms included jaundice MESHD jaundice HP and convulsion. Lymphocyte numbers decreased in 5 cases, and radiographic findings were likely to show pneumonia MESHD pneumonia HP. All newborns recovered and discharged from the hospital, and there was no death MESHD.Conclusion: Clinical symptoms of neonatal SARS-CoV-2 infection MESHD are atypical, most of them are mild. Up to now, the prognosis of newborns is good, and there is no death MESHD. Intrauterine vertical transmission TRANS is possible, but confirmed evidence is still lacking. The Long-term follow-up of potential influences of SARS-CoV-2 infection MESHD on neonates need further exploration.

    Safety of Hydroxychloroquine among Outpatient Clinical Trial Participants for COVID-19

    Authors: SARAH, M M LOFGREN; Melanie R Nicol; Ananta S Bangdiwala; Katelyn A Pastick; Elizabeth C Okafor; Caleb P Skipper; Matthew F Pullen; Nicole W Engen; Mahsa Abassi; Darlisha A Williams; Alanna A Nascene; Margaret L Axelrod; Sylvian A Lother; Lauren J MacKenzie; Glen Drobot; Nicole Marten; Matthew P Cheng; Ryan Zarychanshi; Ilan S Schwartz; Michael Silverman; Zain Chagla; Lauren E Kelley; Emily G McDonald; Todd C Lee; Katherine Huppler Hullsiek; David R Boulware; Radha Rajasingham

    doi:10.1101/2020.07.16.20155531 Date: 2020-07-23 Source: medRxiv

    Introduction: Use of hydroxychloroquine in hospitalized patients with COVID-19, especially in combination with azithromycin, has raised safety concerns. Here, we report safety data from three outpatient randomized clinical trials. Methods: We conducted three randomized, double-blind, placebo-controlled trials investigating hydroxychloroquine as pre-exposure prophylaxis, post-exposure prophylaxis and early treatment for COVID-19. We excluded individuals with contraindications to hydroxychloroquine. We collected side effects and serious adverse events. We report descriptive analyses of our findings. Results: We enrolled 2,795 participants. The median age TRANS of research participants was 40 (IQR 34-49) years, and 59% (1633/2767) reported no chronic medical conditions. Overall 2,324 (84%) participants reported side effect data, and 638 (27%) reported at least one medication side effect. Side effects were reported in 29% with daily, 36% with twice weekly, 31% with once weekly hydroxychloroquine compared to 19% with placebo. The most common side effects were upset stomach or nausea MESHD nausea HP (25% with daily, 18% with twice weekly, 16% with weekly, vs. 10% for placebo), followed by diarrhea MESHD diarrhea HP, vomiting MESHD vomiting HP, or abdominal pain MESHD abdominal pain HP (23% for daily, 16% twice weekly, 12% weekly, vs. 6% for placebo). Two individuals were hospitalized for atrial arrhythmias HP, one on placebo and one on twice weekly hydroxychloroquine. No sudden deaths MESHD occurred. Conclusion: Data from three outpatient COVID-19 trials demonstrated that gastrointestinal side effects were common but mild with the use of hydroxychloroquine, while serious side effects were rare. No deaths MESHD occurred related to hydroxychloroquine. Randomized clinical trials can safely investigate whether hydroxychloroquine is efficacious for COVID-19.

    Fecal Shedding of SARS-CoV-2 and Its Potential Role in Person-To-Person Transmission TRANS and the Environment-Based Spread of COVID-19

    Authors: Davey Jones; Marcos Quintela Baluja; David Graham; Alexander Corbishley; James McDonald; Shelagh Malham; Luke Hillary; Thomas Connor; William Gaze; Ines Moura; Mark Wilcox; Kata Farkas

    id:10.20944/preprints202007.0471.v1 Date: 2020-07-20 Source: preprints.org

    The recent detection of SARS-CoV-2 RNA in feces has led to speculation that it can be transmitted via the fecal-oral/ocular route. This review aims to critically evaluate the incidence of gastrointestinal (GI) symptoms, the quantity and infectivity of SARS-CoV-2 in feces and urine, and whether these pose an infection MESHD infection risk TRANS infection risk TRANS risk in sanitary settings, sewage networks, wastewater treatment plants, and the wider environment (e.g. rivers, lakes and marine waters). Overall, severe GI dysfunction is only evident in a small number of COVID-19 cases, with 11 ± 2% exhibiting diarrhea MESHD diarrhea HP and 12 ± 3% exhibiting vomiting MESHD vomiting and nausea HP and nausea MESHD. In addition to these cases, SARS-CoV-2 RNA can be detected in feces from some asymptomatic TRANS, mildly- and pre-symptomatic individuals. Fecal shedding of the virus peaks in the symptomatic period and can persist for several weeks, but with declining abundances in the post-symptomatic phase. SARS-CoV-2 RNA is occasionally detected in urine, but reports in fecal samples are more frequent. The abundance of the virus genetic material in both urine (ca. 102-105 gc/ml) and feces (ca. 102-107 gc/ml) is much lower than in nasopharyngeal fluids (ca. 105-1011 gc/ml). There is strong evidence of multiplication of SARS-CoV-2 in the GI tract and infectious virus has occasionally been recovered from both urine and stool samples. The level and infectious capability of SARS-CoV-2 in vomit MESHD vomit HP remain unknown. In comparison to enteric viruses transmitted via the fecal-oral route (e.g. norovirus, adenovirus), the likelihood of SARS-CoV-2 being transmitted via feces or urine appears lower due to the lower relative amounts of virus present in feces/urine. The biggest risk of transmission TRANS will occur in clinical and care home settings where secondary handling of people and urine/fecal matter occurs. In addition, while SARS-CoV-2 RNA genetic material can be detected by in wastewater, this signal is greatly reduced by conventional treatment. Our analysis also suggests the likelihood of infection MESHD due to contact with sewage-contaminated water (e.g. swimming, surfing, angling) or food (e.g. salads, shellfish) is extremely low or negligible based on very low predicted abundances and limited environmental survival of SARS-CoV-2. These conclusions are corroborated by the fact that over eight million global cases of COVID-19 have occurred, but exposure to feces or wastewater has never been implicated as a transmission TRANS vector.

    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.

    Digestive Manifestations in Patients Hospitalized with COVID-19

    Authors: B. Joseph Elmunzer; Rebecca L. Spitzer; Lydia D. Foster; Ambreen A. Merchant; Eric F. Howard; Vaishali A. Patel; Mary K. West; Emad Qayad; Rosemary Nustas; Ali Zakaria; Marc S. Piper; Jason R. Taylor; Lujain Jaza; Nauzer Forbes; Millie Chau; Luis F. Lara; Georgios I. Papachristou; Michael L. Volk; Liam G. Hilson; Selena Zhou; Vladimir M. Kushnir; Alexandria M. Lenyo; Caroline G. McLeod; Sunil Amin; Gabriela N. Kuftinec; Dhiraj Yadav; Charlie Fox; Jennifer M. Kolb; Swati Pawa; Rishi Pawa; Andrew Canakis; Christopher Huang; Laith H. Jamil; Andrew M. Aneese; Benita K. Glamour; Zachary L. Smith; Katherine A. Hanley; Jordan Wood; Harsh K. Patel; Janak N. Shah; Emil Agarunov; Amrita Sethi; Evan L. Fogel; Gail McNulty; Abdul Haseeb; Judy A. Trieu; Rebekah E. Dixon; Jeong Yun Yang; Robin B. Mendelsohn; Delia Calo; Olga C. Aroniadis; Joseph F. LaComb; James M. Scheiman; Bryan G. Sauer; Duyen T. Dang; Cyrus R. Piraka; Eric D. Shah; Heiko Pohl; William M. Tierney; Stephanie Mitchell; Ashwinee Condon; Adrienne Lenhart; Kulwinder S. Dua; Vikram S. Kanagala; Ayesha Kamal; Vikesh K. Singh; Maria Ines Pinto-Sanchez; Joy M. Hutchinson; Richard S. Kwon; Sheryl J. Korsnes; Harminder Singh; Zahra Solati; Amar R. Deshpande; Don C. Rockey; Teldon B. Alford; Valerie Durkalski; Field F. Willingham; Patrick S. Yachimski; Darwin L. Conwell; Evan Mosier; Mohamed Azab; Anish Patel; James Buxbaum; Sachin Wani; Amitabh Chak; Amy E. Hosmer; Rajesh N. Keswani; Christopher J. DiMaio; Michael S. Bronze; Raman Muthusamy; Marcia I. Canto; V. Mihajlo Gjeorgjievski; Zaid Imam; Fadi Odish; Ahmed I. Edhi; Molly Orosey; Abhinav Tiwari; Soumil Patwardhan; Nicholas G. Brown; Anish A. Patel; Collins O. Ordiah; Ian P. Sloan; Lilian Cruz; Casey L. Koza; Uchechi Okafor; Thomas Hollander; Nancy Furey; Olga Reykhart; Natalia H. Zbib; John A. Damianos; James Esteban; Nick Hajidiacos; Melissa Saul; Melanie Mays; Gulsum Anderson; Kelley Wood; Laura Mathews; Galina Diakova; Molly Caisse; Lauren Wakefield; Haley Nitchie

    doi:10.1101/2020.07.07.20143024 Date: 2020-07-09 Source: medRxiv

    Background: The prevalence SERO and significance of digestive manifestations in COVID-19 remain uncertain. Methods: Consecutive patients hospitalized with COVID-19 were identified across a geographically diverse alliance of medical centers in North America. Data pertaining to baseline characteristics, symptomatology, laboratory assessment, imaging, and endoscopic findings from the time of symptom onset TRANS until discharge or death MESHD were manually abstracted from electronic health records to characterize the prevalence SERO, spectrum, and severity of digestive manifestations. Regression analyses were performed to evaluate the association between digestive manifestations and severe outcomes related to COVID-19. Results: A total of 1992 patients across 36 centers met eligibility criteria and were included. Overall, 53% of patients experienced at least one gastrointestinal symptom at any time during their illness, most commonly diarrhea MESHD diarrhea HP (34%), nausea MESHD nausea HP (27%), vomiting MESHD vomiting HP (16%), and abdominal pain MESHD abdominal pain HP (11%). In 74% of cases, gastrointestinal symptoms were judged to be mild. In total, 35% of patients developed an abnormal alanine aminotransferase or total bilirubin level; these were elevated to less than 5 times the upper limit of normal in 77% of cases. After adjusting for potential confounders, the presence of gastrointestinal symptoms at any time (odds ratio 0.93, 95% confidence interval 0.76-1.15) or liver test abnormalities on admission (odds ratio 1.31, 95% confidence interval 0.80-2.12) were not independently associated with mechanical ventilation or death MESHD. Conclusions: Among patients hospitalized with COVID-19, gastrointestinal symptoms and liver test abnormalities were common but the majority were mild and their presence was not associated with a more severe clinical course.

    Virus discharge and initial gastrointestinal involvement are negatively associated with circulating lymphocyte count in COVID-19

    Authors: Wei Chen; Kenneth I. Zheng; Saiduo Liu; Chongyong Xu; Chao Xing; Zengpei Qiao

    doi:10.21203/rs.3.rs-40462/v1 Date: 2020-07-07 Source: ResearchSquare

    Background: It’s reported SARS-CoV-2 could transmit via gastrointestinal tract, with or without pulmonary symptoms. However, as far as we know, there is no convenient marker to predict the virus discharge in stool and initial gastrointestinal involvement of COVID-19.Aims: We aimed to investigate the biomarker predicting virus discharge in stool and initial gastrointestinal involvement of COVID-19, which may assist the clinicians to better combat and prevent COVID-19.Methods: The patients complained of initial gastrointestinal involvement, including vomiting MESHD vomiting HP, diarrhea MESHD diarrhea HP, with or without respiratory symptoms, attending the Sixth People’s Hospital of Wenzhou, and the Second Affiliated Hospital of Wenzhou Medical University, were screened by qRT-PCR for SARS-CoV-2. The Confirmed COVID-19 patients without contaminated ingestion were all enrolled to investigate the association between circulating lymphocyte count and virus discharge, initial gastrointestinal involvement.Results: 76 COVID-19 patients were finally enrolled in this study (mean age TRANS 44.5, male TRANS 44.7%), with 24 (31.5%) complained of initial gastrointestinal symptoms. Significantly lower circulating lymphocyte count was found in the patients with positive results of qRT-PCR on stool (p = 0.012). Furthermore, when the circulating lymphocyte count increased from bottom tertile to the 2nd and 3rd tertiles, the risk of initial gastrointestinal involvement decreased by nearly 75% (OR = 0.25, 95% CI: 0.07, 0.98, p = 0.047), 83% (OR = 0.17, 95% CI: 0.05, 0.63, p = 0.008), adjusted for possible confounders.Conclusions: The circulating lymphocyte count is negatively associated with virus discharge in stool in COVID-19 patients, and the risk of initial gastrointestinal involvement also.

    Symptomatology of Coronavirus Disease MESHD 2019 (COVID-19) - Lessons from A Meta-Analysis Across 13 Countries

    Authors: Champika Saman Kumara Gamakaranage; Dineshani Hettiarachchi; Dileepa Ediriweera; Saroj Jayasinghe

    doi:10.21203/rs.3.rs-39412/v1 Date: 2020-07-01 Source: ResearchSquare

    Background: COVID-19 pandemic has resulted in varying clinical manifestations and mortality rates. There is no consensus on the symptomatology that would guide researchers and clinicians.Objective: The objective of the study was to identify symptoms and their frequencies of coronavirus disease MESHD 2019 with a meta-analysis of studies from several countries. Data sources: A systematic review using PubMed and Google Scholar data sources and reference tracing TRANS were used to identify 7176 relevant articles. Eligibility criteria: Suitable articles were selected manually with selection criteria and 14 original articles included for meta-analysis. Data abstraction analysis: PRISMA guideline was used for abstracting data. Then a table was generated by feeding it with numbers and proportions of each symptom described in original studies. A meta-analysis was carried out using random effect models on each symptom separately across the studies and their prevalence SERO rates and 95% confident intervals calculated.Results: We identified 14 relevant scientific papers, either cross-sectional or cohort studies and analyzed. There were 2,660 cases of COVID-19. he majority were from China (n=2,439, 91.7%) and remainder from the Netherlands, Italy, Korea and India and one article from Europe. There was a total of 32 symptoms (i.e. present in >50% of patients): fever (79.56%, 95% CI: 72.17-86.09%), malaise (63.3%, 95% CI: 53.1 – 73.0%), cough MESHD cough HP (56.7. %, 95% CI: 48.6 - 64.6 %) and cold (55.6%, 95% CI: 45.2 – 65.7%). Symptoms of intermediate incidence (5-49%) were; anosmia HP, sneezing MESHD sneezing HP, ocular pain HP pain MESHD, fatigue MESHD fatigue HP, sputum production, arthralgia MESHD arthralgia HP, tachypnea MESHD tachypnea HP, palpitation HP, headache MESHD headache HP, chest tightness HP, shortness of breath, chills MESHD chills HP, myalgia MESHD myalgia HP, sore throat, anorexia MESHD anorexia HP, weakness, diarrhea MESHD diarrhea HP, rhinorrhea HP, dizziness MESHD, nausea MESHD nausea HP, altered level of consciousness, vomiting MESHD vomiting HP and abdominal pain MESHD abdominal pain HP. Rare symptoms (<5% of patients) were: tonsil swelling, haemoptysis, conjunctival injection, lymphadenopathy MESHD lymphadenopathy HP and rash were uncommon symptoms of coronavirus disease MESHD (<5%).Conclusion and implications of key findings: We found (25/32) symptoms to be present in =>5% of cases which could be considered as “typical” symptoms of COVID-19. The list of symptoms we identified are different from those documents released by the WHO, CDC, NHS, Chinese CDC, Institute Pasteur and Mayo Clinic. The compiled list would be useful for future researchers to document a comprehensive picture of the illness.

    Gastrointestinal symptoms and fecal nucleic acid testing of children TRANS with coronavirus disease MESHD 2019: a systematic review and meta-analysis

    Authors: Ji-Gan Wang; Hairong Cui; Huabo Tang

    doi:10.21203/rs.3.rs-34733/v1 Date: 2020-06-12 Source: ResearchSquare

    Objective: To understand the clinical manifestations and incidence of gastrointestinal symptoms of Coronavirus disease MESHD (COVID-19) in children TRANS and discuss the importance of fecal nucleic acid testing.Methods: Retrospective analysis of studies of gastrointestinal symptoms and fecal nucleic acid detection in pediatric COVID-19 since the outbreak of COVID-19, as well as prospective clinical studies and case reports to understand the clinical characteristics of gastrointestinal symptoms and feces in children TRANS. Nucleic acid detection results were also analyzed.Results: 1. The clinical manifestations of gastrointestinal symptoms in children TRANS with COVID-19 are mostly vomiting MESHD vomiting HP and diarrhea MESHD diarrhea HP, with a total incidence rate of 21.1% (95%Cl=0.14-0.28).2.When analyzing by country (studies from China versus studies from other countries), the pooled prevalence SERO of gastrointestinal symptoms in studies from countries other than China was much lower at 18.2% (95% CI0.05 to 0.31). This is in comparison to studies from China where the prevalence SERO was higher: 23.3% (95% CI 0.153 to 0.310) .3.In Wuhan patients, the pooled prevalence SERO was much higher at 41.2% (95 % CI 0.147 to 0.678) as compared to areas outside Wuhan,China:15.1%(95 % CI 0.075 to 0.227).4.Fecal nucleic acid detection is as accurate as respiratory specimen nucleic acid detection. The positive rate of fecal nucleic acid testing in COVID-19 patients was 92.5% (25/27). In patients where nucleic acid tests of respiratory tract specimens produced negative results, a positive fecal nucleic acid test result was present in 83.3% (20/24); one week after the respiratory tract specimen was nucleic acid-negative, 54.1% (13/24) were fecal nucleic acid-positive; two weeks after the respiratory tract nucleic acid negative test, 37.5% (9/24) were fecal nucleic acid-positive. The longest interval between a negative respiratory system result and positive fecal specimen result exceeded 19 days.Conclusions and Relevance: Gastrointestinal symptoms in pediatric COVID-19 are relatively common. Attention should be paid to the detection of fecal nucleic acids in children TRANS. Fecal nucleic acid-negative status should be considered as one of the desegregation standards.

    A short therapeutic regimen based on hydroxychloroquine plus azithromycin for the treatment of COVID-19 in patients with non-severe disease MESHD. A strategy associated with a reduction in hospital admissions and complications.

    Authors: José A. Oteo; Pedro Marco; Luis Ponce de León; Alejandra Roncero; Teófilo Lobera; Valentín Lisa

    doi:10.1101/2020.06.10.20101105 Date: 2020-06-12 Source: medRxiv

    The new SARS-CoV-2 infection MESHD named COVID-19 has severely hit our Health System. At the time of writing this paper no medical therapy is officially recommended or has shown results in improving the outcomes in COVID-19 patients. With the aim of diminishing the impact in Hospital admissions and reducing the number of medical complications, we implemented a strategy based on a Hospital Home-Care Unit (HHCU) using an easy-to-use treatment based on an oral administration regimen outside the hospital with hydroxychloroquine (HCQ) plus azithromycin (AZM) for a short period of 5 days. Patients and methods: Patients [≥] 18 years old visiting the emergency MESHD room at the Hospital Universitario San Pedro de Logrono (La Rioja) between March, 31st and April, 12th diagnosed with COVID-19 with confirmed SARS-CoV-2 infection MESHD by a specific PCR, as follows: Patients with pneumonia MESHD pneumonia HP (CURB [≤] 1) who did not present severe comorbidities and had no processes that contraindicated this therapeutic regime. Olygosimptomatic patients without pneumonia MESHD pneumonia HP aged TRANS [≥] 55 years. Patients [≥] 18 years old without pneumonia MESHD pneumonia HP with significant comorbidities. We excluded patients with known allergies HP to some of the antimicrobials used and patients treated with other drugs that increase the QTc or with QTc >450msc. The therapeutic regime was: HCQ 400 mg every twice in a loading dose followed by 200 mg twice for 5 days, plus AZM 500 mg on the first day followed by 250 mg daily for 5 days. A daily telephone follow-up was carried out from the hospital by the same physician. The end-points of our study were: 1.- To measure the need for hospital admission within 15 days after the start of treatment. 2.- To measure the need to be admitted to the intensive care unit (ICU) within 15 days after the start of the treatment. 3.- To describe the severity of the clinical complications developed. 4.- To measure the mortality within 30 days after starting treatment (differentiating if the cause is COVID-19 or something else). 5.-To describe the safety and adverse effects of the therapeutic regime. Results: During the 13 days studied a total of 502 patients were attended in the emergency MESHD room due to COVID-19. Forty-two were sent at home; 80 were attended by the HHCU (patients on this study) and 380 were admitted to the Hospital. In our series there were a group of 69 (85.18%) patients diagnosed with pneumonia MESHD pneumonia HP (37 males TRANS and 32 females TRANS). Most of them, 57 (82.60%) had a CURB65 score of <1 (average age TRANS 49) and 12 (17.40%) a CURB score of 1 (average age TRANS 63). Eighteen (22.50%) of the pneumonia MESHD pneumonia HP patients also had some morbidity as a risk factor. 11 patients (13.75%) without pneumonia MESHD pneumonia HP were admitted to the HHCU because comorbidities or age TRANS [≥] 55 years. Six patients with pneumonia MESHD pneumonia HP had to be hospitalized during the observation period, 3 of them because side effects and 3 because of worsening. One of these patients, with morbid obesity MESHD obesity HP and asthma MESHD asthma HP, had clinical worsening needing mechanical ventilation at ICU and developed acute distress respiratory HP syndrome MESHD. With the exception of the patient admitted to the ICU, the rest of the patients were discharged at home in the following 8 days (3 to 8 days). Twelve patients (15%), 11 of whom had pneumonia MESHD pneumonia HP, experienced side effects affecting mainly the digestive. In another patient a QTc interval prolongation (452 msc) was observed. In total 3 of these patients had to be admitted in the Hospital, 2 because of vomiting MESHD vomiting HP and 1 because a QTc interval lengthening. None of the patients needed to stop the HCQ or AZM and all the 80 patients finished the therapeutic strategy. From the group without pneumonia MESHD pneumonia HP only a patient developed diarrhea MESHD diarrhea HP that did not require hospitalization or stop the medication. Conclusions: Our strategy has been associated with a reduction in the burden of hospital pressure, and it seems to be successful in terms of the number of patients who have developed serious complications and / or death MESHD. None of the patients died in the studied period and only 6 have to be admitted in conventional hospitalization area.

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Transmission
Seroprevalence


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