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Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    High in-hospital mortality due to COVID-19 in a community hospital in Spain: a prospective observational study

    Authors: Joan Carles Trullàs; Eva Ruiz; Clara Weisweiler; Gemma Badosa; Alba Serra; Hugo Briceño; Sílvia Soler; Josep Bisbe

    doi:10.21203/rs.3.rs-39421/v1 Date: 2020-07-01 Source: ResearchSquare

    Background To describe the clinical characteristics and outcome of patients with COVID-19 in a community hospital in SpainMethods Prospective, single-centre case series of the first 100 consecutive hospitalized patients with COVID-19 at a community hospital in Spain, from March 16 to April 20, 2020. Demographics, comorbidities, clinical presentation, radiologic and laboratory findings, treatment and clinical outcome were collected.Results Of the 100 patients included in the study, the median age TRANS (IQR; range) was 75 years (20; 28–96) and 52% were men. The most common comorbidities were hypertension MESHD hypertension HP (63%), diabetes (22%) and cardiovascular diseases MESHD (28%). The most common symptoms were fever MESHD fever HP (80%), cough MESHD cough HP (69%), fatigue MESHD fatigue HP (59%) and dyspnea MESHD dyspnea HP (52%) and 64% had respiratory insufficiency MESHD respiratory insufficiency HP. Bilateral interstitial infiltrates (65/100, 65%) and bilateral vertical “B-kerley” lines (38/46, 82.6%) were the most common imaging manifestations in chest radiographs and lung ultrasound, respectively. All patients received supplementary oxygen, 69 (69%) received medical treatment (the most common regimen being hydroxychloroquine plus azithromycin in 66 patients) and 12% were treated with glucocorticoids. During hospitalization, 26 patients (26%) died, 10 (10%) were transferred to ICU and 64 (64%) were discharged at home. Mortality or ICU admission was more frequent in advanced age TRANS and with comorbidities.Conclusions This case series provides clinical characteristics and outcome of consecutively hospitalized patients with COVID-19 admitted to a community hospital in Spain. The majority were old patients, with comorbidities and in-hospital mortality was high (26%).

    Increased Expression of Chondroitin Sulfotransferases following AngII may Contribute to Pathophysiology Underlying Covid-19 Respiratory Failure HP: Impact may be Exacerbated by Decline in Arylsulfatase B Activity

    Authors: Sumit Bhattacharyya; Kumar Kotlo; Joanne Kramer Tobacman

    doi:10.1101/2020.06.25.171975 Date: 2020-06-25 Source: bioRxiv

    The spike protein of SARS-CoV-2 binds to respiratory epithelium through the ACE2 receptor, an endogenous receptor for Angiotensin II (AngII). The mechanisms by which this viral infection MESHD leads to hypoxia MESHD and respiratory failure HP have not yet been elucidated. Interactions between the sulfated glycosaminoglycans heparin and heparan sulfate and the SARS-CoV-2 spike glycoprotein have been identified as participating in viral adherence and infectivity. In this brief report, we present data indicating that stimulation of vascular smooth muscle cells by AngII leads to increased expression of two chondroitin sulfotransferases (CHST11 and CHST15), which are required for the synthesis of the sulfated glycosaminoglycans chondroitin 4-sulfate (C4S) and chondroitin 4,6-disulfate (CSE). We suggest that increased expression of these chondroitin sulfotransferases and the ensuing production of chondroitin sulfates may contribute to viral adherence to bronchioalveolar cells and to the progression of respiratory disease MESHD in Covid-19. The enzyme Arylsulfatase B (ARSB; N-acetylgalactosamine-4-sulfatase), which removes 4-sulfate groups from the non-reducing end of chondroitin 4-sulfate residues, is required for degradation of C4S and CSE. In hypoxic conditions or following treatment with chloroquine, ARSB activity is reduced. Decline in ARSB can contribute to ongoing accumulation and airway obstruction MESHD by C4S and CSE. Decline in ARSB leads to increased expression of Interleukin(IL)-6 in human bronchial epithelial cells, and IL-6 is associated with cytokine storm in Covid-19. These findings indicate how chondroitin sulfates, chondroitin sulfotransferases, and chondroitin sulfatases may participate in the progression of hypoxic respiratory insufficiency MESHD respiratory insufficiency HP in Covid-19 disease MESHD and suggest new therapeutic targets.

    COVID-19 Pandemic in Bergamo outbreak: a call to war. Implementation of a “COVID-Hospital” model in ASST Bergamo-Est Trust as a disaster-response strategy.

    Authors: Edoardo Iaculli; Michele Marini; Isabella Pezzoli; Luisella Spinelli; Lorenzo Vescovi; Silvia Frassini; Francesca Rubertà; Nadiane Paderno; Rosalba Della Nave; Elisa Da Re; Hamade Abdel Meneme; Delia Beatrice Bonzi; Alberto Mario Guglielmo Leone Tedeschi; Alessandro Iaculli; Giuseppe Nastasi; Pierpaolo Mariani; Antonio Piazzini Albani

    doi:10.21203/rs.3.rs-36513/v1 Date: 2020-06-19 Source: ResearchSquare

    Background: COVID-19 is a strikingly emerging disease MESHD caused by a new coronavirus (SARS-CoV-2) that has rapidly spread across all continents and affecting virtually every country. From a clinical, epidemiological, political and financial perspective, COVID-19 pandemic is now recognized as one of the worst disasters in modern era. In the North of Italy, Bergamo has been the European equal to Chinese City of Wuhan in terms of epidemiological impact of COVID-19. The first case of SARS-Cov-2 infection MESHD in Bergamo has been reported in Alzano District General Hospital (DGH), part of ASST Bergamo-Est Multi Hospitals Network. ASST Bergamo-Est comprises four Hospitals serving more than 50% of Bergamo Province and with a patient catchment of 387000 inhabitants. Methods: We retrospectively analyze the challenges and actual impact of the SARS-CoV-2 pandemic on the hospital capacity and performance SERO. Accordingly, we report the specific operational procedures and clinical governance implementation related to the transformation of our Institutions into “COVID-hospitals”. Results: From 1st of March to 20th of April, 4919 consecutive patients were assessed in ASST Bergamo-Est Hospitals as “COVID-Hospital” referral centre, of these 1412 patients were admitted with diagnosis of moderate to severe COVID-19 respiratory insufficiency MESHD respiratory insufficiency HP. Most of patients were high-risk individuals with a median age TRANS of 69 years. In-hospital mortality rate was 33.1%. Specific performance SERO improvements under the “COVID-19 Hospital model” capacity-expansion strategy were analysed. Conclusions: This paper informs on the experience of ASST Bergamo-Est Trust and the disaster-response strategy during the COVID-19 pandemic. The ASST Bergamo-Est data reported corroborates the recent call for action to Governments for promoting MCI improved management with focus on COVID-19 pandemic and its possible recurrence MESHD

    Lung Mechanics in Type L CoVID-19 Pneumonia MESHD Pneumonia HP: A Pseudo-Normal ARDS.

    Authors: Lorenzo Viola; Emanuele Russo; Marco Benni; Emiliano Gamberini; Alessandro Circelli; Luca Bissoni; Domenico Pietro Santonastaso; Giovanni Scognamiglio; Giuliano Bolondi; Luca Mezzatesta; Vanni Agnoletti

    doi:10.21203/rs.3.rs-37028/v1 Date: 2020-06-19 Source: ResearchSquare

    Since its outbreak, in January, 2020, it has been clear that CoVID-19 pneumonia MESHD pneumonia HP is atypical. Despite a full concordance to Berlin criteria for Acute Respiratory Distress HP Syndrome MESHD (ARDS), respiratory system mechanics is preserved [1]. Mechanical ventilation and muscular paralysis MESHD paralysis HP are recommended in worsening respiratory insufficiency MESHD respiratory insufficiency HP [2]; in a substantial number of cases, prone positioning significantly improves oxygenation.

    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 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 the lung, leading to a frequently lethal triad of respiratory insufficiency MESHD respiratory insufficiency HP, acute cardiovascular failure, and coagulopathy. 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 MESHD edema HP; the renin-angiotensin system, promoting cardiovascular instability; and the coagulation system, leading to thromboembolism MESHD thromboembolism HP. 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 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.

    Efficacy and harms of remdesivir for the treatment of COVID-19: a systematic review and meta-analysis

    Authors: Alejandro Piscoya; Luis F. Ng-Sueng; Angela Parra del Riego; Renato Cerna-Viacava; Vinay Pasupuleti; Yuani M Roman; Priyaleela Thota; C. Michael White; Adrian V Hernandez

    doi:10.1101/2020.05.26.20109595 Date: 2020-05-27 Source: medRxiv

    Background: We evaluated the efficacy and safety of remdesivir for the treatment of COVID-19. Methods: Systematic review in five engines, pre-print webpages and RCT registries until May 22, 2020 for randomized controlled trials (RCTs) and observational studies evaluating remdesivir on confirmed, COVID-19 adults TRANS with pneumonia MESHD pneumonia HP and/or respiratory insufficiency MESHD respiratory insufficiency HP. Primary outcomes were all-cause mortality, clinical improvement or recovery, need for invasive ventilation, and serious adverse events (SAE). Secondary outcomes included length of hospital stay, progression of pneumonia MESHD pneumonia HP, and adverse events (AE). Inverse variance random effects meta-analyses were performed. Results: Two placebo-controlled RCTs (n=1300) and two case series (n=88) were included. All studies used remdesivir 200mg IV the first day and 100mg IV for 9 more days, and followed up until 28 days. Wang et al. RCT was stopped early due to AEs; ACTT-1 was preliminary reported at 15-day follow up. Time to clinical improvement was not decreased in Wang et al. RCT, but median time to recovery TRANS was decreased by 4 days in ACTT-1. Remdesivir did not decrease all-cause mortality (RR 0.71, 95%CI 0.39 to 1.28) and need for invasive ventilation at 14 days (RR 0.57, 95%CI 0.23 to 1.42), but had fewer SAEs (RR 0.77, 95%CI 0.63 to 0.94). AEs were similar between remdesivir and placebo arms. Risk of bias ranged from some concerns to high risk in RCTs. Interpretation: There is paucity of adequately powered and fully reported RCTs evaluating effects of remdesivir in adult TRANS, hospitalized COVID-19 patients. Remdesivir should not be recommended for the treatment of severe COVID-19.

    Underreporting of death MESHD by COVID-19 in Brazil's second most populous state

    Authors: Thiago Henrique Evangelista Alves; Tafarel Andrade de Souza; Samyla de Almeida Silva; Nayani Alves Ramos; Stefan Vilges de Oliveira

    doi:10.1101/2020.05.20.20108415 Date: 2020-05-23 Source: medRxiv

    The COVID-19 pandemic brings to light the reality of the Brazilian health system. The underreporting of COVID-19 deaths MESHD in the state of Minas Gerais (MG), where is concentrated the second largest population of the country, reveals government unpreparedness, as there is a low capacity of testing in the population, which prevents the real understanding of the general panorama of Sars-Cov-2 dissemination. The goals of this research are to analyze the causes of deaths MESHD in the different Brazilian government databases (ARPEN and SINAN) and to assess whether there are sub-records shown by the unexpected increase in the frequency of deaths MESHD from causes clinically similar to COVID-19. A descriptive and quantitative analysis of the number of COVID-19 deaths MESHD and similar causes was made in different databases. Ours results demonstrate that the different official sources had a discrepancy of 209.23% between these data referring to the same period. There was also a 648.61% increase in SARS deaths MESHD in 2020, when compared to the average of previous years. Finally, it was shown that there was an increase in the rate of pneumonia MESHD pneumonia HP and respiratory insufficiency MESHD respiratory insufficiency HP (RI) by 5.36% and 5.72%, respectively. In conclusion, there is an underreporting of COVID-19 deaths MESHD in MG due to the unexplained excess of SARS deaths MESHD, Respiratory insufficiency MESHD Respiratory insufficiency HP and pneumonia MESHD pneumonia HP compared to previous years.

    Erythrocytes Reveal Complement Activation in Patients with COVID-19

    Authors: LK Metthew Lam; Sophie J. Murphy; Leticia Kuri-Cervantes; Ariel R. Weisman; Caroline A. G. Ittner; John P. Reilly; M. Betina Pampena; Michael R. Betts; E. John Wherry; Wen-Chao Song; John D. Lambris; Douglas B. Cines; Nuala J. Meyer; Nilam S. Mangalmurti

    doi:10.1101/2020.05.20.20104398 Date: 2020-05-22 Source: medRxiv

    COVID-19, the disease MESHD caused by the SARS-CoV-2 virus, can progress to multi-organ failure characterized by respiratory insufficiency MESHD respiratory insufficiency HP, arrhythmias HP, thromboembolic complications and shock MESHD shock HP. The mortality of patients hospitalized with COVID-19 is unacceptably high and new strategies are urgently needed to rapidly identify and treat patients at risk for organ failure. Clinical epidemiologic studies demonstrate that vulnerability to organ failure is greatest after viral clearance from the upper airway, which suggests that dysregulation of the host immune response is a critical mediator of clinical deterioration MESHD and death MESHD. Autopsy and pre-clinical evidence implicate aberrant complement activation in endothelial injury and organ failure. A potential therapeutic strategy warranting investigation is to inhibit complement, with case reports of successful treatment of COVID-19 with inhibitors of complement. However, this approach requires careful balance between the host protective and potential injurious effects of complement activation, and biomarkers to identify the optimal timing and candidates for therapy are lacking. Here we report the presence of complement activation products on circulating erythrocytes from hospitalized COVID-19 patients using flow cytometry. These findings suggest that novel erythrocyte-based diagnostics provide a method to identify patients with dysregulated complement activation.

    Early outcomes of tocilizumab in adults TRANS hospitalized with severe COVID19. An initial report from the Vall dHebron COVID19 prospective cohort study.

    Authors: Adrian Sanchez-Montalva; Julia Selares-Nadal; Juan Espinosa-Pereiro; Nuria Fernandez-Hidalgo; Santiago Perez-Hoyos; Fernando Salvador; Xavier Dura-Miralles; Marta Miarons; Andres Anton; Simeon Eremiev; Abiu Sempere-Gonzalez; Pau Bosch-Nicolau; Arnau Monforte-Pallares; Salvador Augustin; Julia Sampol; Alfredo Guillen-del-Castillo; Benito Almirante

    doi:10.1101/2020.05.07.20094599 Date: 2020-05-12 Source: medRxiv

    Background: Modulation of the immune system to prevent lung injury MESHD is being widely used against the new coronavirus disease MESHD (COVID19) despite the scarcity of evidence. Methods: We report preliminary results from the Vall dHebron prospective cohort study at Vall dHebron University Hospital, in Barcelona (Spain), including all consecutive patients who had a confirmed infection TRANS infection MESHD infection with the severe HP with the severe acute respiratory syndrome MESHD coronavirus2 (SARSCoV2) and who were treated with tocilizumab until March 25th. The primary endpoint was mortality at 7 days after tocilizumab administration. Secondary endpoints were admission to the intensive care unit, development of ARDS and respiratory insufficiency MESHD respiratory insufficiency HP among others. Results: 82 patients with COVID19 received at least one dose of tocilizumab. The mean (SD) age TRANS was 59.1 (19.8) years, 63% were male TRANS, 22% were of non Spanish ancestry, and the median (IQR) ageadjusted Charlson index at baseline was 3 (1 to 4) points. Respiratory failure HP and ARDS developed in 62 (75.6%) and 45 (54.9%) patients, respectively. Median time from symptom onset TRANS to ARDS development was 8 (5 to 11) days. The median time from symptom onset TRANS to the first dose of tocilizumab was 9 (7 to 11) days. Mortality at 7 days was 26.8%. Hazard ratio for mortality was 3.3; 95% CI, 1.3 to 8.5 ( age TRANS adjusted hazard ratio for mortality 2.1; 95% CI, 0.8 to 5.8) if tocilizumab was administered after the onset of ARDS. Conclusion: Time from lung injury MESHD onset to tocilizumab administration may be critical to patient recovery. Our preliminary data could inform bedside decisions until more data from clinical trials becomes available.

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

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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