Corpus overview


MeSH Disease

Nausea (30)

Vomiting (30)

Disease (18)

Fever (18)

Diarrhea (17)

Human Phenotype

Nausea and vomiting (30)

Fever (18)

Diarrhea (17)

Cough (15)

Headache (11)


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    Clinical and intestinal histopathological findings in SARS-CoV-2/COVID-19 patients with hematochezia HP

    Authors: Margaret Cho; Weiguo Liu; Sophie Balzora; Yvelisse Suarez; Deepthi Hoskoppal; Neil D Theise; Wenqing Cao; Suparna A Sarkar

    doi:10.1101/2020.07.29.20164558 Date: 2020-08-07 Source: medRxiv

    Gastrointestinal (GI) symptoms of SARS-CoV2/COVID-19 in the form of anorexia MESHD anorexia HP, nausea MESHD nausea, vomiting HP, vomiting MESHD, abdominal pain MESHD abdominal pain HP and diarrhea MESHD diarrhea HP are usually preceeded by respiratory manifestations and are associated with a poor prognosis. Hematochezia HP is an uncommon clinical presentation of COVID-19 disease MESHD and we hypothesize that older patients with significant comorbidites ( obesity MESHD obesity HP and cardiovascular) and prolonged hospitalization are suspectible to ischemic injury to the bowel. We reviewed the clinical course, key laboratory data including acute phase reactants, drug/medication history in two elderly TRANS male TRANS patients admitted for COVID-19 respiratory failure HP. Both patients had a complicated clinical course and suffered from hematochezia HP and acute blood SERO loss anemia MESHD anemia HP requiring blood SERO transfusion around day 40 of their hospitalization. Colonoscopic impressions were correlated with the histopathological findings in the colonic biopies and changes compatible with ischemia MESHD to nonspecific acute inflammation MESHD, edema MESHD edema HP and increased eosinophils in the lamina propria were noted.Both patients were on anticoagulants, multiple antibiotics and antifungal agents due to respiratory infections MESHD at the time of lower GI bleeding. Hematochezia HP resolved spontaneously with supportive care. Both patients eventually recovered and were discharged. Elderly TRANS patients with significant comorbid conditions are uniquely at risk for ischemic injury to the bowel. Hypoxic conditions due to COVID-19 pneumonia MESHD pneumonia HP and respiratory failure HP, compounded by preexisting cardiovascular complications, and/or cytokine storm orchestrated by the viral infection MESHD leading to alteration in coagulation profile and/or drug/medication injury can be difficult to distinguish in these critically ill patients. Presentation of hematochezia HP may further increase the mortality and morbidity of COVID-19 patients, and prompt consultation and management by gastroenterology is therefore warranted.

    Ontology-based annotation and analysis of COVID-19 phenotypes

    Authors: Yang Wang; Fengwei Zhang; Hong Yu; Xianwei Ye; Yongqun He

    id:2008.02241v1 Date: 2020-08-05 Source: arXiv

    The epidemic of COVID-19 has caused an unpredictable and devastated disaster to the public health in different territories around the world. Common phenotypes include fever MESHD fever HP, cough MESHD cough HP, shortness of breath, and chills MESHD chills HP. With more cases investigated, other clinical phenotypes are gradually recognized, for example, loss of smell, and loss of tastes. Compared with discharged or cured patients, severe or died patients often have one or more comorbidities, such as hypertension MESHD hypertension HP, diabetes, and cardiovascular disease MESHD. In this study, we systematically collected and analyzed COVID-19-related clinical phenotypes from 70 articles. The commonly occurring 17 phenotypes were classified into different groups based on the Human Phenotype Ontology (HPO). Based on the HP classification, we systematically analyze three nervous phenotypes (loss of smell, loss of taste, and headache MESHD headache HP) and four abdominal phenotypes ( nausea MESHD nausea, vomiting HP, vomiting MESHD, abdominal pain MESHD abdominal pain HP, and diarrhea MESHD diarrhea HP) identified in patients, and found that patients from Europe and USA turned to have higher nervous phenotypes and abdominal phenotypes than patients from Asia. A total of 23 comorbidities were found to commonly exist among COVID-19 patients. Patients with these comorbidities such as diabetes and kidney failure had worse outcomes compared with those without these comorbidities.

    Clinical features and disease MESHD severity in an Iranian population of COVID-19 patients

    Authors: Shima Nabavi; Zahra Javidarabshahi; Abolghasem Allahyari; Mohammad Ramezani; Mohsen Seddigh-Shamsi; Sahar Ravanshad; Mina AkbariRad; Farnoosh Ebrahimzadeh; Shohre Khatami; Maryam Emadzadeh; Neda Saeedian; Ahmadreza Zarifian; Maryam Miri; Fariba Rezaeetalab; Sepide Hejazi; Reza Basiri; Mahnaz Mozdourian

    doi:10.21203/ Date: 2020-07-31 Source: ResearchSquare

    Objectives: Coronavirus disease MESHD 2019 (COVID-19) can present with a variety of symptoms. Severity of the disease MESHD may be associated with several factors. Here, we review clinical features of COVID-19 patients with different severities.Methods: This cross-sectional study was performed in Imam Reza hospital, Mashhad, Iran, during February-April 2020. COVID-19 patients with typical computed tomography (CT) patterns and/or positive reverse-transcriptase polymerase chain reaction (RT-PCR) were included. The patients were classified into three groups of moderate, severe, and critical based on disease MESHD severity. Demographic, clinical, laboratory, and radiologic findings were collected and compared. P<0.05 was considered statistically significant.Results: Overall, 200 patients with mean age TRANS of 69.75±6.39 years, of whom 82 (41%) were female TRANS were studied. Disease MESHD was severe/critical in the majority of patients (167, 83.5%). Disease MESHD severity was significantly associated with age TRANS, malignant comorbidities, dyspnea MESHD dyspnea HP, nausea MESHD nausea/vomiting HP/ vomiting MESHD, confusion MESHD confusion HP, respiratory rate, pulse rate, O2 saturation, extent of CT involvement, serum SERO C-reactive protein (CRP), pH, pO2, and aspartate transaminase (P<0.05). Moreover, complications including shock MESHD shock HP, coagulopathy, acidosis MESHD acidosis HP, sepsis MESHD sepsis HP, acute respiratory distress HP syndrome MESHD (ARDS), intensive care unit (ICU) admission, and intubation were significantly higher in patients with higher severities. O2 saturation, nausea MESHD nausea/vomiting HP/ vomiting MESHD, and extent of lung CT involvement were independent predictors of severe/critical COVID-19 (OR=0.342, 45.93, and 25.48, respectively; P<0.05).Conclusions: Our results indicate O2 saturation, nausea MESHD nausea/vomiting HP/ vomiting MESHD, and extent of lung CT involvement as independent predictors of severe COVID-19 conditions. Serum SERO CRP levels and pO2 were also considerably higher patients with higher severity and can be used along with other factors as possible predictors of severe disease MESHD in COVID-19 patients.

    CCOFEE-GI Study: Colombian COVID19 First Experience in Gastroentrology. Characterization of digestive manifestations in patients diagnosed with COVID-19 at a highly complex institution in Bogota D.C., Colombia


    doi:10.1101/2020.07.24.20161604 Date: 2020-07-24 Source: medRxiv

    The current pandemic caused by SARS-CoV-2 has posed an important threat to the human health, healthcare systems, economy, and structure of societies. In Colombia, the first case was diagnosed on March 6, 2020 , with exponential progressive growth, and there were >200,000 confirmed cases TRANS as of July 20, 2020, in this cross-sectional, analytical, and observational study, we focused on the demographic, epidemiologic, and clinical characteristics of patients with confirmed SARS-CoV-2 infection MESHD at a highly complex institution in Latinamerica, with special emphasis on gastrointestinal symptoms. Methods: Demographic and clinical data were collected, results related to the outcomes such as hospitalization time, admission to ICU, need for orotracheal intubation, and death MESHD were also included. Statistical analyses were conducted using Stata software V.15. Results: We included 72 patients RT-PCR positive for SARS-CoV-2 (34 women and 38 men) with age TRANS 47.5 17.7 years; 17 (23.6%) presented at least one of the gastrointestinal symptoms ( nausea MESHD nausea/vomiting HP/ vomiting MESHD, abdominal pain MESHD abdominal pain HP, and/or diarrhea MESHD diarrhea HP). 13 (76.47%) presented with diarrhea MESHD diarrhea HP, 29.41% with nausea MESHD nausea/vomiting HP/ vomiting MESHD, and five (29.41%) with abdominal pain MESHD abdominal pain HP. Diarrhea MESHD Diarrhea HP in 18.06% of all those infected with SARS-CoV-2 at the time of consultation, which was the most common digestive symptom. No significant differences were observed in requirement for endotracheal intubation, hospitalization, ICU admission, and fatal outcome between the NGIS and GIS groups (p:0.671, 0.483, 1,000, and 1,000). Conclusion: In our study, patients with gastrointestinal symptoms had no significant differences in disease MESHD severity, admission to ICU or death MESHD compared to those who did not have such symptoms.

    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:

    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.

    Comparison of Clinical Features on Admission Between Coronavirus Disease MESHD 2019 and Influenza A among Children TRANS: A Retrospective Study in China

    Authors: Feng Liang; Xianfeng Wang; Hui Li; Jun Chen; Lei Liu; Jianbo Shao; Yi Xu; Liya He; Huiying Liang; Kuanrong Li; Sitang Gong; Huimin Xia

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

    Background: Coronavirus disease MESHD 2019 (COVID-19) share similar symptoms with influenza A (IA), but it is more worthwhile to understand the disparities of the two infections MESHD regarding their clinical characteristics on admission. Methods: A total of 71 age TRANS-matched pediatric IA and COVID-19 patient pairs were formed and their clinical data on admission were compared. Results: Fever MESHD Fever HP, cough MESHD cough HP, nasal congestion and nausea MESHD nausea/vomiting HP/ vomiting MESHD were the most common symptoms on admission for both infections MESHD but occurred less often in COVID-19. The IA patients were more likely to have lower-than-normal levels of lymphocyte count and percentage and to have higher-than-normal levels of activated partial thromboplastin time, prothrombin time, serum SERO C-reactive protein, and serum SERO procalcitonin, while the COVID-19 patients had higher odds of having lower-than-normal levels of neutrophil count and percentage.Conclusions: This study suggests that influenza A is more symptomatic than COVID-19 for children TRANS and might be an overall more severe infection HP infection MESHD at the time of admission. 

    RT-PCR testing to detect a COVID-19 outbreak in Austria: rapid, accurate and early diagnosis in primary care (The REAP study)

    Authors: Werner Leber; Oliver Lammel; Monika Redlberger-Fritz; Maria Elisabeth Mustafa-Korninger; Karin Stiasny; Reingard Christina Glehr; Eva-Maria Hochstrasser; Christian Hoellinger; Andrea Siebenhofer; Chris Griffiths; Jasmina Panovska-Griffiths

    doi:10.1101/2020.07.13.20152439 Date: 2020-07-15 Source: medRxiv

    Background Delay in COVID-19 detection has led to a major pandemic. We report rapid early detection of SARS-CoV-2 by reverse transcriptase-polymerase chain reaction (RT-PCR), comparing it to the serostatus of convalescent infection MESHD, at an Austrian National Sentinel Surveillance Practice in an isolated ski-resort serving a population of 22,829 people. Methods Retrospective dataset of all 73 patients presenting with mild to moderate flu-like symptoms to a sentinel practice in the ski-resort of Schladming-Dachstein, Austria, between 24 February and 03 April, 2020. We split the outbreak in two halves, by dividing the period from the first to the last case by two, to characterise the following three cohorts of patients with confirmed infection TRANS infection MESHD: people with reactive RT-PCR presenting during the first half (early acute infection MESHD) vs. those presenting in the second half (late acute), and people with non-reactive RT-PCR (late convalescent). For each cohort we report the number of cases detected, the accuracy of RT-PCR and the duration of symptoms. We also report multivariate regression of 15 clinical symptoms as covariates, comparing all people with convalescent infection MESHD to those with acute infection MESHD. Findings All 73 patients had SARS-CoV-2 RT-PCR testing. 22 patients were diagnosed with COVID-19, comprising: 8 patients presenting early acute, and 7 presenting late acute and 7 late convalescent respectively; 44 patients tested SARS-COV-2 negative, and 7 were excluded. RT-PCR sensitivity SERO was high (100%) among acute presenters, but dropped to 50% in the second half of the outbreak; specificity was 100%. The mean duration of symptoms was 2 days (range 1-4) among early acute presenters, and 4.4 days (1-7) among late acute and 8 days (2-12) among late convalescent presenters respectively. Convalescent infection MESHD was only associated with loss of taste (ORs=6.02;p=0.047). Acute infection MESHD was associated with loss of taste (OR=571.72;p=0.029), nausea MESHD nausea and vomiting HP and vomiting MESHD (OR=370.11;p=0.018), breathlessness (OR=134.46;p=0.049), and myalgia MESHD myalgia HP (OR=121.82;p=0.032); but not loss of smell, fever MESHD fever HP or cough MESHD cough HP. Interpretation RT-PCR rapidly and reliably detects early COVID-19 among people presenting with viral illness and multiple symptoms in primary care, particularly during the early phase of an outbreak. RT-PCR testing in primary care should be prioritised for effective COVID-19 prevention and control.

    Acute acalculous cholecystitis MESHD cholecystitis HP on a COVID-19 patient: a case report

    Authors: Edoardo Mattone; Maria Sofia; Elena Schembari; Valentina Palumbo; Rosario Bonaccorso; Valentina Randazzo; Gaetano La Greca; Carmelo Iacobello; Domenico Russello; Saverio Latteri

    doi:10.21203/ Date: 2020-07-13 Source: ResearchSquare

    Background coronavirus disease MESHD-19 (COVID-19) has spread to several countries around the world and has become an unprecedented pandemic. We report an extremely rare case of acute acalculous cholecystitis MESHD cholecystitis HP on a COVID-19 patient. In our knowledge, this is the first report of laparoscopic cholecystectomy performed on a COVID-19 patient.Case presentation: a COVID-19 patient was diagnosed with acute acalculous cholecystitis MESHD cholecystitis HP and a multidisciplinary team decided to perform a percutaneous transhepatic biliary drainage (PTBD) as the first treatment. SARS-CoV-2 RNA was not found in the bile fluid. Because of deterioration of the patient’s clinical conditions, laparoscopic cholecystectomy had to be performed and since the gallbladder was gangrenous, the severe inflammation MESHD made surgery difficult to perform.Conclusions acalculous cholecystitis MESHD cholecystitis HP was related with mechanical ventilation and prolonged total parenteral nutrition, in this case the gangrenous histopathology pattern and the gallbladder wall ischemia MESHD was probably caused by vascular insufficiency secondary to severe acute respiratory distress HP syndrome MESHD of COVID-19 pneumonia MESHD pneumonia HP. The percutaneous transhepatic gallbladder drainage (PTBD) was performed according to Tokyo Guidelines because of high surgical risk. Laparoscopic cholecystectomy was next performed due to no clinical improvement. The absence of viral RNA in the bile highlights that SARS-CoV-2 is not eliminated with the bile while it probably infects small intestinal enterocytes which is responsible of gastrointestinal symptoms such as anorexia MESHD anorexia HP, nausea MESHD nausea, vomiting HP, vomiting MESHD, and diarrhea MESHD diarrhea HP. Although the lack of evidence and guidelines about the management of patient with acute cholecystitis MESHD cholecystitis HP during COVID-19 pandemic, laparoscopic cholecystectomy, at most preceded by PTGBD on high surgical risk patients, remains the gold standard for the treatment of acute cholecystitis MESHD cholecystitis HP on COVID-19 patients.

    Community prevalence SERO of SARS-CoV-2 virus in England during May 2020: REACT study

    Authors: Steven Riley; Kylie E. C. Ainslie; Oliver Eales; Benjamin Jeffrey; Caroline E. Walters; Christina J Atchison; Peter J. Diggle; Deborah Ashby; Christl A. Donnelly; Graham Cooke; Wendy Barclay; Helen Ward; Graham Taylor; Ara Darzi; Paul Elliott

    doi:10.1101/2020.07.10.20150524 Date: 2020-07-11 Source: medRxiv

    Background England has experienced one of the highest rates of confirmed COVID-19 mortality in the world. SARS-CoV-2 virus has circulated in hospitals, care homes and the community since January 2020. Our current epidemiological knowledge is largely informed by clinical cases with far less understanding of community transmission TRANS. Methods The REal-time Assessment of Community Transmission TRANS (REACT) study is a nationally representative prevalence SERO survey of SARS-CoV-2 virus swab-positivity in the community in England. We recruited participants regardless of symptom status. Results We found 159 positives from 120,610 swabs giving an average prevalence SERO of 0.13% (95% CI: 0.11%,0.15%) from 1st May to 1st June 2020. We showed decreasing prevalence SERO with a halving time of 8.6 (6.2, 13.6) days, implying an overall reproduction number TRANS R of 0.57 (0.45, 0.72). Adults TRANS aged TRANS 18 to 24 yrs had the highest swab-positivity rates, while those >64 yrs had the lowest. Of the 126 participants who tested positive with known symptom status in the week prior to their swab, 39 reported symptoms while 87 did not, giving an estimate that 69% (61%,76%) of people were symptom-free for the 7 days prior testing positive in our community sample. Symptoms strongly associated with swab-positivity were: nausea MESHD nausea and/or vomiting HP and/or vomiting MESHD, diarrhoea, blocked nose, loss of smell, loss of taste, headache MESHD headache HP, chills MESHD chills HP and severe fatigue MESHD fatigue HP. Recent contact with a known COVID-19 case was associated with odds of 24 (16, 38) for swab-positivity. Compared with non-key workers, odds of swab-positivity were 7.7 (2.4, 25) among care home (long-term care facilities) workers and 5.2 (2.9, 9.3) among health care workers. However, some of the excess risk associated with key worker status was explained by recent contact with COVID-19 cases. We found no strong evidence for geographical variability in positive swab results. Conclusion Our results provide a reliable baseline against which the impact of subsequent relaxation of lockdown can be assessed to inform future public health efforts to control transmission TRANS.

    A Randomized Trial of Ivermectin-Doxycycline and Hydroxychloroquine-Azithromycin therapy on COVID19 patients.

    Authors: Abu Taiub Mohammed Mohiuddin Chowdhury; Mohammad Shahbaz; Md Rezaul Karim; Johirul Islam; Dan Guo; Shuixiang He

    doi:10.21203/ Date: 2020-06-29 Source: ResearchSquare

    Background The worldwide COVID-19 pandemic was caused by a newly discovered Coronavirus. The treatment methods for COVID-19 are emerging and rapidly evolving. Existing drugs, including Ivermectin and Hydroxychloroquine, offer the hope of effective treatment in early disease MESHD. In this study, we investigated and compared outcomes of Ivermectin-Doxycycline vs. Hydroxychloroquine-Azithromycin combination therapy COVID19 patients with mild to moderate disease MESHD.Methods Patients with mild to moderate COVID-19 disease MESHD, tested positive by RT PCR for SARS-CoV-2 infection MESHD at Chakoria Upazilla Health Complex, Cox's Bazar, Bangladesh, were included in this study. Patients were divided randomly into two groups: Ivermectin 200µgm/kg single dose + Doxycycline 100 mg BID for 10days in group A, and Hydroxychloroquine 400 mg 1st day, then200mg BID for 9days + Azithromycin 500 mg daily for 5 days in group B. PCR for SARS-CoV-2 was repeated in all symptomatic patients on the second day onward without symptoms, or, for those who were asymptomatic TRANS (throughout the process), on the 5th day after taking medication and repeated every two days onward if the result is positive. Time to negative PCR and time to full symptomatic recovery was measured for each group.Results All subjects in the Ivermectin-Doxycycline group (group A) reached a negative PCR for SARS-CoV-2, at a mean of 8.93days, and all reached symptomatic recovery, at a mean of 5.93days, with 55.10% symptom-free by the 5th day. In the Hydroxychloroquine-Azithromcyin group (group B), 96.36% reached a negative PCR at a mean of 6.99days and were symptoms-free at 9.33days. Group A patients had symptoms that could have been caused by the medication in 31.67% of patients, including lethargy MESHD lethargy HP in 14(23.3%), nausea MESHD nausea HP in 11(18.3%), and occasional vertigo MESHD vertigo HP in 7(11.66%) of patients. In Group B, 46.43% had symptoms that could have been caused by the medication, including 13(23.21%) mild blurring of vision HP and headache MESHD headache HP; 22(39.2%) increased lethargy MESHD lethargy HP and dizziness MESHD, 10(17.85%) occasional palpitation HP, and 9(16.07%) nausea MESHD nausea and vomiting HP and vomiting MESHD.Conclusion The Ivermectin-Doxycycline combination showed a trend toward superiority to the Hydroxychloroquine-Azithromycin combination therapy in the case of patients with mild to moderate COVID19 disease MESHD, though the difference in time to becoming symptom-free and the difference in time to negative PCR was not statistically significant.

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MeSH Disease
Human Phenotype

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