Corpus overview


MeSH Disease

Pneumonia (938)

Infections (439)

Disease (435)

Coronavirus Infections (273)

Death (203)

Human Phenotype

Pneumonia (1024)

Fever (166)

Cough (133)

Respiratory distress (78)

Hypertension (59)


    displaying 31 - 40 records in total 1064
    records per page

    Etiology and Antimicrobial Resistance of Secondary Bacterial Infections MESHD in Patients Hospitalized With COVID-19 in Wuhan, China: A Retrospective Analysis

    Authors: Jie Li; Junwei Wang; Yi Yang; Peishan Cai; Jingchao Cao; Xuefeng Cai; Yu Zhang

    doi:10.21203/ Date: 2020-07-23 Source: ResearchSquare

    Background: A considerable proportion of patients hospitalized with corona virus disease MESHD 2019 (COVID-19) have acquired secondary bacterial infections MESHD (SBIs). We report the etiology and antimicrobial resistance of bacteria to provide theoretical basis for appropriate infection MESHD therapy.Methods: In the retrospective study, we reviewed electronic medical records of all the patients hospitalized with COVID-19 in the Wuhan Union hospital from January 27 to March 17, 2020. According to the inclusion and exclusion criteria, patients who acquired SBIs were enrolled. Demographic, clinical course, etiology and antimicrobial resistance data of the SBIs were collected. Outcomes were also compared between patients who were classified as severe on admission and those who were classified as critical.Results: 6.8% (102/1495) of the patients with COVID-19 had acquired SBIs and almost half of them (50, 49.0%) died during hospitalization. Compared with the severe patients, the critical patients had a higher chance of SBIs. 159 strains of bacteria were isolated, 85.5% of which were Gram-negative bacteria. The top three bacteria of SBIs were A. baumannii (35.8%), K. pneumoniae MESHD pneumoniae HP (30.8%) and Staphylococcus (8.8%). The isolation rate of carbapenem-resistant A. baumannii and K. pneumoniae MESHD pneumoniae HP were 91.2% and 75.5%, respectively. Meticillin resistance was in 100% of Staphylococcus, and vancomycin resistance was not found. Conclusions: SBIs may occur in patients hospitalized with COVID-19 and lead to high mortality. The incidence of SBIs was associated with the grade on admission. Gram-negative bacteria, especially A. baumannii and K. pneumoniae MESHD pneumoniae HP, were the main bacteria and the resistance rates of the major isolated bacteria were generally high.

    Remote clinician-based home management of COVID-19 associated pneumonia MESHD pneumonia HP in a resource limited setting

    Authors: Nadir Kana; Shivesh Maharaj

    doi:10.21203/ Date: 2020-07-23 Source: ResearchSquare

    The coronavirus disease (COVID-19) pandemic has resulted in an increased number of patients that require respiratory support in terms of oxygen and ventilation. Due to the burden on the healthcare system there has been a shortage of hospitals beds in both the public and private sector. This has led to many patients being managed at home. Currently there is no consensus regarding best practice guidelines in terms of treatment of this subset of patients.We hereby present a case of a patient who was treated using appropriate respiratory support (a combination of low flow oxygen therapy via nasal prongs or face mask as high flow oxygen was not available), oral corticosteroids and anti-coagulants managed by remote clinician intervention. We also include our home management protocol.

    Pandemic of Coronavirus (COVID-19) in Saudi Arabia

    Authors: Maryam Ahmed Awaji

    id:10.20944/preprints202007.0549.v1 Date: 2020-07-23 Source:

    Introduction Most cases of COVID-19 coronavirus infection MESHD occurred in the Chinese city of Wuhan at the end of December 2019 in the form of acute pneumonia MESHD pneumonia HP. COVID-19 virus infects people of all ages TRANS. The most affected elderly TRANS people with underlying medical conditions. This may cause various symptoms such as fever MESHD fever HP, difficulty breathing, lung infection MESHD, coughing MESHD coughing HP and sneezing MESHD sneezing HP. Aim The aim of the present study to highlight the COVID-19 pandemic in Saudi Arabia. Method A search was conducted using the relevant keywords to retrieve the studies conducted in Saudi Arabia regarding COVID-19. The search was by Google Scholar, Pub MED, and Twitter. Conclusion The COVID-19 pandemic carries multiple-risk, and public health groups, such as the United States' Centres for Disease MESHD Control and Prevention (CDC) and the World Health Organisation (WHO), are monitoring the pandemic and posting updates on their website. These groups have also made recommendations on disease MESHD prevention and treatment, and according to the Saudi Centres for Disease MESHD Control, they have also included the necessary public health measures for mandatory reporting by calling a certain number and through the e-health monitoring network.

    Invasive pulmonary aspergillosis MESHD Invasive pulmonary aspergillosis HP in critically ill patients with severe COVID-19 pneumonia MESHD pneumonia HP: results from the prospective AspCOVID-19 study

    Authors: Tobias Lahmer

    doi:10.1101/2020.07.21.20158972 Date: 2020-07-22 Source: medRxiv

    Background: Superinfections MESHD, including invasive pulmonary aspergillosis MESHD invasive pulmonary aspergillosis HP (IPA), are well-known complications of critically ill patients with severe viral pneumonia MESHD pneumonia HP. Aim of this study was to evaluate the incidence, risk factors and outcome of IPA in critically ill patients with severe COVID-19 pneumonia MESHD pneumonia HP. Methods: We prospectively screened 32 critically ill patients with severe COVID-19 pneumonia MESHD pneumonia HP for a time period of 28 days using a standardized study protocol for oberservation of developement of COVID-19 associated invasive pulmonary aspergillosis MESHD invasive pulmonary aspergillosis HP (CAPA). We collected laboratory, microbiological, virological and clinical parameters at defined timepoints in combination with galactomannan-antigen-detection from bronchial aspirates. We used logistic regression analyses to assess if COVID-19 was independently associated with IPA and compared it with matched controls. Findings: CAPA was diagnosed at a median of 4 days after ICU admission in 11/32 (34%) of critically ill patients with severe COVID-19 pneumonia MESHD pneumonia HP as compared to 8% in the control cohort. In the COVID-19 cohort, mean age TRANS, APACHE II score and ICU mortality were higher in patients with CAPA than in patients without CAPA (36% versus 9.5%; p<0.001). ICU stay (21 versus 17 days; p=0.340) and days of mechanical ventilation (20 versus 15 days; p=0.570) were not different between both groups. In regression analysis COVID-19 and APACHE II score were independently associated with IPA. Interpretation: CAPA is highly prevalent and associated with a high mortality rate. COVID-19 is independently associated with invasive pulmonary aspergillosis MESHD invasive pulmonary aspergillosis HP. A standardized screening and diagnostic approach as presented in our study can help to identify affected patients at an early stage.

    Serum SERO cholinesterase on admission as a predictor of COVID-19 pneumonia MESHD pneumonia HP severity and mortality

    Authors: Kento Nakajima; Takeru Abe; Ryo Saji; Fumihiro Ogawa; Hayato Taniguchi; Keishi Yamaguchi; Kazuya Sakai; Tomoki Nakagawa; Reo Matsumura; Yasuhumi Oi; Mototsugu Nishii; Ichiro Takeuchi

    doi:10.21203/ Date: 2020-07-22 Source: ResearchSquare

    Background Although some predictors of COVID-19 pneumonia MESHD pneumonia HP severity and mortality have been identified, much of the pathophysiology of this emerging infectious disease MESHD remains unclear. We hypothesized that a patient’s cholinesterase level on admission could predict COVID-19 pneumonia MESHD pneumonia HP severity and mortality.Methods We retrospectively collected data of 26 COVID-19 pneumonia MESHD pneumonia HP patients from February–May 2020. Outcomes were aggravation of symptoms and in-hospital mortality. We compared receiver operating curves of cholinesterase, C-reactive protein, lymphocytes, albumin, D-dimer, and PaO2/FiO2 ratio and examined prediction accuracy. Regarding the interaction between cholinesterase and other variables, each independent variable was divided into two groups using cutoff values, and interaction terms were created.Results Cholinesterase levels on admission were significantly lower in the severe group than in the mild-to-moderate group (326 vs. 218 IU/L, p = 0.006; area under the curve: 0.81; 95% confidence interval 0.61–0.94). When comparing the area under the curve, cholinesterase was comparable to C-reactive protein, albumin, lymphocytes, and PaO2/FiO2 ratio other than D-dimer in the prediction accuracy of severe cases and mortality. Cholinesterase levels on admission were significantly lower in the death MESHD group than in the survival group (274 vs. 187.5 IU/L, p = 0.028; area under the curve: 0.79; 95% interval 0.58–0.93). Regarding the interaction between cholinesterase and established predictors, the prediction accuracy of both severity and death MESHD was higher when cholinesterase was combined with each predictor than when cholinesterase was used alone.Conclusions Cholinesterase may reflect the disease MESHD state of COVID-19 pneumonia MESHD pneumonia HP, suggesting that a patient’s cholinesterase level on admission may be useful as a predictor of severity and prognosis.

    Older adults TRANS hospitalized with Covid-19: Clinical characteristics and early outcomes from a single center in Istanbul, Turkey 

    Authors: Alpay Medetalibeyoğlu; Naci Senkal; Murat Kose; Yunus Catma; Emine Bilge Caparali; Mustafa Erelel; Mustafa Oral Oncul; Gulistan Bahat; Tufan Tukek

    doi:10.21203/ Date: 2020-07-22 Source: ResearchSquare

    Objective: Older adults TRANS have been continuously reported to be at higher risk for adverse outcomes of Covid-19. We aimed to describe clinical characteristics and early outcomes of the older Covid-19 patients hospitalized in our center comparatively with the younger patients, and also to analyze the triage factors that were related to the in-hospital mortality of older adults TRANS.Design: Retrospective; observational studySetting: Istanbul Faculty of Medicine hospital, TurkeyParticipants: 362 hospitalized patients with laboratory-confirmed Covid-19 from March 11 to May 11, 2020.Measurements: The demographic information; associated comorbidities; presenting clinical, laboratory, radiological characteristics on admission and outcomes from the electronic medical records were analyzed comparatively between the younger (<65 years) and older (≥65 years) adults TRANS. Factors associated with in-hospital mortality of the older adults TRANS were analyzed by multivariate regression analyses.Results: The median age TRANS was 56 years (interquartile range [IQR], 46-67), and 224 (61.9%) were male TRANS. There were 104 (28.7%) patients ≥65 years of age TRANS. More than half of the patients (58%) had one or more chronic comorbidity. The three most common presenting symptoms in the older patients were fatigue MESHD fatigue HP/ myalgia MESHD myalgia HP (89.4%), dry cough MESHD cough HP (72.1%), and fever MESHD fever HP (63.5%). Cough MESHD Cough HP and fever MESHD fever HP were significantly less prevalent in older adults TRANS compared to younger patients (p=0.001 and 0.008, respectively). Clinically severe pneumonia MESHD pneumonia HP was present in 31.5% of the study population being more common in older adults TRANS (49% vs. 24.4%) (p<0.001). The laboratory parameters that were significantly different between the older and younger adults TRANS were as follows: the older patients had significantly higher CRP, D-dimer, TnT, pro-BNP, procalcitonin levels, higher prevalence SERO of lymphopenia MESHD lymphopenia HP, neutrophilia HP, increased creatinine, and lower hemoglobin, ALT, albumin level (p<0.05). In the radiological evaluation, more than half of the patients (54.6%) had moderate-severe pneumonia MESHD pneumonia HP, which was more prevalent in older patients (66% vs. 50%) (p=0.006). The adverse outcomes were significantly more prevalent in older adults TRANS compared to the younger patients (ICU admission, 28.8% vs. 8.9%; mortality, 23.1% vs. 4.3%, p<0.001).  Among the triage evaluation parameters, the only factor associated with higher mortality was the presence of clinically severe pneumonia MESHD pneumonia HP on admission (Odds Ratio=12.3, 95% confidence interval=2.7-55.5, p=0.001).Conclusion: Older patients presented with more prevalent chronic comorbidities, less prevalent symptomatology but more severe respiratory signs and laboratory abnormalities than the younger patients. Among the triage assessment factors, the clinical evaluation of pulmonary involvement came in front to help clinicians to stratify the patients for mortality risk.

    Adjunctive Corticosteroids for COVID-19: A Retrospective Cohort Study

    Authors: Say Tat Ooi; Purnima Parthasarathy; Yi Lin; Valliammai Nallakaruppan; Shereen Ng; Teck Choon Tan; Serena Low; Terence Tang

    doi:10.1101/2020.07.18.20157008 Date: 2020-07-21 Source: medRxiv

    Background: Coronavirus disease MESHD 2019 (COVID-19) is associated with severe pneumonia MESHD pneumonia HP, respiratory failure HP and death MESHD. We aim to evaluate the efficacy of adjunctive corticosteroids in the management of COVID-19. Methods: This is a retrospective cohort study of hospitalized adults TRANS ([≥]18 years) who were diagnosed with COVID-19 and were given treatment. Treatment included hydroxycholoroquine and lopinavir-ritonavir. Corticosteroids were included as adjunctive therapy in mid-April, 2020. We compared composite outcomes of clinical progression and invasive mechanical ventilation (MV) or death MESHD between group that received treatment only (Group A) versus group that received adjunctive corticosteroids (Group B). Entropy balancing was used to generate stabilized weight for covariates between treatment groups. Unweighted Kaplan-Meir curves, weighted and adjusted Cox regression analysis were used to estimate effect of adjunctive corticosteroids on composite outcomes. Subgroup analysis was performed on those with pneumonia MESHD pneumonia HP. Results: Of 1046 patients with COVID-19, 57 received treatment alone (Group A) and 35 received adjunctive corticosteroids in addition to treatment (Group B). Median day of illness at treatment initiation was 5 day. There were 44 patients with pneumonia MESHD pneumonia HP; 68.9% of them were not requiring supplemental oxygen at treatment initiation. Overall, 17 (18.5%) of 92 patients had clinical progression including 13 (22.8%) of 57 patients in Group A versus 4 (11.4%) of 35 patients in Group B (p=0.172). Unweighted Kaplan-Meier estimates showed no significant difference in the proportion of patients who had clinical progression or invasive MV or death MESHD between the 2 treatment groups. However in those with pneumonia MESHD pneumonia HP, there were lower proportions of patients in Group B with clinical progression (11.1% , 95% CI 0.0 - 22.2 versus 58.8%, 95% CI 27.3 - 76.7, log rank p<0.001 ); and invasive MV or death MESHD (11.3%, 95% CI 0.0 - 22.5 versus 41.2%, 95% CI 12.4. - 60.5, log rank p=0.016). In weighted and adjusted cox regression analysis, patients in Group B were less likely to have clinical progression, (adjusted HR [aHR] 0.08, 95% CI 0.01-0.99, p=0.049) but there was no statistical significant difference in risk of requiring invasive MV or death MESHD (aHR 0.22, 95%CI 0.02 - 2.54, p=0.22). In subgroup with pneumonia MESHD pneumonia HP, patients in Group B were significantly at lower risk of clinical progression (aHR 0.15, 95% CI 0.06 - 0.39, p<0.001) and requiring invasive MV compared to Group A (aHR 0.30, 0.10-0.87, p=0.029). Conclusions: Use of adjunctive corticosteroids is associated with lower risk of clinical progression and invasive MV or death MESHD, especially in those with pneumonia MESHD pneumonia HP. Concurrent use of antivirals and corticosteroids should be considered in the management of COVID-19 related pneumonia MESHD pneumonia HP.

    Ventilator-Associated Pneumonia MESHD Pneumonia HP in Patients with SARS-CoV-2–Associated Acute Respiratory Failure HP Requiring Mechanical Ventilation: A Retrospective Cohort Study

    Authors: Charles-Edouard Luyt; Tarek Sahnoun; Melchior Gautier; Pauline Vidal; Sonia Burrel; Marc Pineton de Chambrun; Juliette Chommeloux; Cyrielle Desnos; Jeremy Arzoine; Ania Nieszkowska; Nicolas Bréchot; Matthieu Schmidt; Guillaume Hekimian; David Boutolleau; Jérôme Robert; Alain Combes; Jean Chastre

    doi:10.21203/ Date: 2020-07-21 Source: ResearchSquare

    Background. Data on incidence, clinical presentation and outcomes of ventilator-associated pneumonia MESHD pneumonia HP (VAP) in patients with severe coronavirus disease MESHD 2019 (COVID-19) pneumonia MESHD pneumonia HP requiring mechanical ventilation (MV) are limited.Methods. Case series of patients with COVID-19 pneumonia MESHD pneumonia HP admitted to a single ICU in France. All consecutive patients requiring MV with RT-PCR–confirmed SARS-CoV-2 infection MESHD between March 12th and April 24th, 2020 were included. Frequency, clinical characteristics, responsible pathogens and outcomes of VAP were assessed, and compared to an historical cohort of patients with severe influenza-associated pneumonia MESHD pneumonia HP requiring MV admitted to the same ICU during the preceding three winter seasons.Results: Among 54 consecutive patients with Covid-19–associated acute respiratory failure HP requiring MV included (median (IQR) age TRANS 48 (42-58) years; 74% male TRANS; 93% requiring venovenous-extracorporeal membrane oxygenation), 46 (85%) developed VAP (median (IQR) MV duration before the first episode, 11 (8-16) days). VAP-causative pathogens were predominantly Enterobacteriaceae (72%), particularly inducible AmpC-cephalosporinase producers (41%), followed by Pseudomonas aeruginosa (35%). VAP recurred in 46 (85%) patients and 17 (31%) died. Most recurrences MESHD were relapses (ie, infection MESHD with the same pathogen), with a high percentage occurring on adequate antimicrobial treatment. Despite a high P. aeruginosa-VAP rate in patients with influenza-associated ARDS, the pulmonary infection MESHD recurrence MESHD rate was significantly lower than in Covid-19 patients. Overall mortality was similar for the two groups.Conclusions: Patients with severe Covid-19–associated acute respiratory failure HP requiring MV had a very high late-onset VAP rate. Inducible AmpC-cephalosporinase–producing Enterobacteriaceae and Pseudomonas aeruginosa frequently caused VAP, with multiple recurrences MESHD and difficulties eradicating the pathogen from the lung. 

    Single cell RNA sequencing of blood SERO antigen-presenting cells in severe Covid-19 reveals multi-process defects in antiviral immunity

    Authors: Melissa Saichi; Maha Zohra Ladjemi; Sarantis Korniotis; Christophe Rousseau; Zakaria Ait-Hamou; Lucile Massenet; Elise Amblard; Floriane Noel; Yannick Marie; Delphine Bouteiller; Jasna Medvedovic; Frederic Pene; Vassili Soumelis

    doi:10.1101/2020.07.20.212837 Date: 2020-07-21 Source: bioRxiv

    COVID-19 can lead to life-threatening acute respiratory failure HP, characterized by simultaneous increase in inflammatory mediators and viral load. The underlying cellular and molecular mechanisms remain unclear. We performed single-cell RNA-sequencing to establish an exhaustive high-resolution map of blood SERO antigen-presenting cells (APC) in 7 COVID-19 patients with moderate or severe pneumonia MESHD pneumonia HP, at day-1 and day-4 post-admission, and two healthy donors. We generated a unique dataset of 31,513 high quality APC, including monocytes and rare dendritic cell (DC) subsets. We uncovered multiprocess and previously unrecognized defects in anti-viral immune defense in specific APC compartments from severe patients: i) increase of pro-apoptotic genes exclusively in pDC, which are key effectors of antiviral immunity, ii) sharp decrease of innate sensing receptors, TLR7 and DHX9, in pDC and cDC1, respectively, iii) down-regulation of antiviral effector molecules, including Interferon stimulated genes (ISG) in all monocyte subsets, and iv) decrease of MHC class II-related genes, and MHC class II transactivator (CIITA) activity in cDC2, suggesting a viral inhibition of antigen presentation. These novel mechanisms may explain patient aggravation and suggest strategies to restore defective immune defense.

    Chest X-Ray Findings and Temporal Lung Changes in Patients with COVID-19 Pneumonia MESHD Pneumonia HP

    Authors: Liqa A Rousan; Eyhab Elobeid; Musaab Karrar; Yousef Khader

    doi:10.21203/ Date: 2020-07-20 Source: ResearchSquare

    Background: Chest CT scan and chest x-rays show characteristic radiographic findings in patients with COVID-19 pneumonia MESHD pneumonia HP. Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia MESHD pneumonia HP. The study aims at describing the chest x-ray findings and temporal radiographic changes in COVID-19 patients.Methods: From March 15 to April 20, 2020 patients with positive reverse transcription polymerase chain reaction (RT-PCR) for COVID-19 were retrospectively studied. Patients’ demographics, clinical characteristics, and chest x-ray findings were reported. Radiographic findings were correlated with the course of the illness and patients’ symptoms.Results: A total of 88 patients (50 (56.8%) females TRANS and 38 (43.2%) males TRANS) were admitted to the hospital with confirmed COVID-19 pneumonia MESHD pneumonia HP. Their age TRANS ranged from 3-80 years (35.2 ±18.2 years). 48/88 (45%) were symptomatic, only 13/88 (45.5%) showed abnormal chest x-ray findings. A total of 190 chest x-rays were obtained for the 88 patients with a total of 59/190 (31%) abnormal chest x-rays. The most common finding on chest x-rays was peripheral ground glass opacities (GGO) affecting the lower lobes. In the course of illness, the GGO progressed into consolidations peaking around 6-11 days (GGO 70%, consolidations 30%). The consolidations regressed into GGO towards the later phase of the illness at 12-17 days (GGO 80%, consolidations 10%). There was increase in the frequency of normal chest x-rays from 9% at days 6- 11 up to 33% after 18 days indicating a healing phase. The majority (12/13, 92.3%) of patients with abnormal chest x-rays were symptomatic (P=0.005).Conclusion: The chest x-ray findings were similar to those reported on chest CT scan in patients with COVID-19, Chest x-ray can be used in diagnosis and follow up in patients with COVID-19 pneumonia MESHD pneumonia HP.

The ZB MED preprint Viewer preVIEW includes all COVID-19 related preprints from medRxiv and bioRxiv, from ChemRxiv, from ResearchSquare, from arXiv and from and is updated on a daily basis (7am CET/CEST).



MeSH Disease
Human Phenotype

Export subcorpus as Endnote

This service is developed in the project nfdi4health task force covid-19 which is a part of nfdi4health.

nfdi4health is one of the funded consortia of the National Research Data Infrastructure programme of the DFG.