Corpus overview


MeSH Disease

Human Phenotype


    displaying 111 - 120 records in total 254
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    Clinical characteristics of patients hospitalized with COVID-19 in Spain: results from the SEMI-COVID-19 Network.

    Authors: José Manuel Casas Rojo; Juan Miguel Antón Santos; Jesús Millán Núñez-Cortés; Carlos Lumbreras Bermejo; José Manuel Ramos Rincón; Emilia Roy-Vallejo; Arturo Artero Mora; Francisco Arnalich Fernández; José Miguel García Bruñén; Juan Antonio Vargas Núñez; Santiago J Freire Castro; Luis Manzano; Isabel Perales Fraile; Anxela Crestelo Vieitez; Francesc Puchades; Enrique Rodilla; Marta Nataya Solís Marquínez; David Bonet Tur; María del Pilar Fidalgo Moreno; Eva M Fonseca Aizpuru; Franscisco Javier Carrasco Sánchez; Elisa Rabadán Pejenaute; Manuel Rubio-Rivas; José David Torres Peńa; Ricardo Gómez Huelgas

    doi:10.1101/2020.05.24.20111971 Date: 2020-05-26 Source: medRxiv

    Background. Spain has been one of the countries most affected by the COVID-19 pandemic. Objective. To create a registry of patients with COVID-19 hospitalized in Spain in order to improve our knowledge of the clinical, diagnostic, therapeutic, and prognostic aspects of this disease MESHD. Methods. A multicentre retrospective cohort study, including consecutive patients hospitalized with confirmed COVID-19 throughout Spain. Epidemiological and clinical data, additional tests at admission and at seven days, treatments administered, and progress at 30 days of hospitalization were collected from electronic medical records. Results. Up to April 30th 2020, 6,424 patients from 109 hospitals were included. Their median age TRANS was 69.1 years (range: 18-102 years) and 56.9% were male TRANS. Prevalences SERO of hypertension MESHD hypertension HP, dyslipidemia, and diabetes mellitus MESHD diabetes mellitus HP were 50.2%, 39.7%, and 18.7%, respectively. The most frequent symptoms were fever MESHD fever HP (86.2%) and cough MESHD cough HP (76.5%). High values of ferritin (72.4%), lactate dehydrogenase (70.2%), and D-dimer (61.5%), as well as lymphopenia MESHD lymphopenia HP (52.6%), were frequent. The most used antiviral drugs were hydroxychloroquine (85.7%) and lopinavir/ritonavir (62.4%). 31.5% developed respiratory distress HP. Overall mortality rate was 21.1%, with a marked increase with age TRANS (50-59 years: 4.2%, 60-69 years: 9.1%, 70-79 years: 21.4%, 80-89 years: 42.5%, [≥] 90 years: 51.1%). Conclusions. The SEMI-COVID-19 Network provides data on the clinical characteristics of patients with COVID-19 hospitalized in Spain. Patients with COVID-19 hospitalized in Spain are mostly severe cases, as one in three patients developed respiratory distress HP and one in five patients died. These findings confirm a close relationship between advanced age TRANS and mortality.

    Emergence of Low-density Inflammatory Neutrophils Correlates with Hypercoagulable State and Disease MESHD Severity in COVID-19 Patients

    Authors: Samantha M Morrissey; Anne E Geller; Xiaoling Hu; David Tieri; Elizabeth A Cooke; Chuanlin Ding; Matthew Woeste; Huang-ge Zhange; Rodrigo Cavallazi; Sean P Clifford; James Chen; Maiying Kong; Corey T Watson; Jiapeng Huang; Jun Yan

    doi:10.1101/2020.05.22.20106724 Date: 2020-05-26 Source: medRxiv

    Severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) is a novel viral pathogen that causes a clinical disease MESHD called coronavirus disease MESHD 2019 (COVID-19). Approximately 20% of infected patients experience a severe manifestation of the disease MESHD, causing bilateral pneumonia MESHD pneumonia HP and acute respiratory distress HP syndrome MESHD. Severe COVID-19 patients also have a pronounced coagulopathy with approximately 30% of patients experiencing thromboembolic complications. However, the etiology driving the coagulopathy remains unknown. Here, we explore whether the prominent neutrophilia HP seen in severe COVID-19 patients contributes to inflammation MESHD-associated coagulation. We found in severe patients the emergence of a CD16IntCD44lowCD11bInt low-density inflammatory band (LDIB) neutrophil population that trends over time with changes in disease MESHD status. These cells demonstrated spontaneous neutrophil extracellular trap (NET) formation, phagocytic capacity, enhanced cytokine production, and associated clinically with D-dimer and systemic IL-6 and TNF- levels, particularly for CD40+ LDIBs. We conclude that the LDIB subset contributes to COVID-19-associated coagulopathy (CAC) and could be used as an adjunct clinical marker to monitor disease MESHD status and progression. Identifying patients who are trending towards LDIB crisis and implementing early, appropriate treatment could improve all-cause mortality rates for severe COVID-19 patients.


    Authors: Maximiliano Lucius; Martin Belvisi; Carlos Maria Galmarini

    doi:10.1101/2020.05.19.20106336 Date: 2020-05-26 Source: medRxiv

    COVID-19 can exponentially precipitate life-threatening emergencies MESHD as witnessed during the recent spreading of a novel coronavirus infection MESHD which can rapidly evolve into lung collapse and respiratory distress HP (among other various severe clinical conditions). Our study evaluates the performance SERO of a tailor-designed deep convolutional network on the tasks of early detection and localization of radiological signs associated to COVID-19 on frontal chest X-rays. We also asses the frameworks capacity in differentiating the above-mentioned signs, which are usually confused with the more usual common bacterial and viral pneumonias MESHD pneumonias HP. Open-source chest X-ray images categorized as Normal, Non-COVID-19 and COVID-19 pneumonias MESHD pneumonias HP were downloaded from the NIH (n=2,259), RSNA (n=600) and HM Hospitales (n=2,307). Our algorithmic framework was able to precisely detect the images with COVID19- related radiological findings (mean Accuracy: 90.5%; Sensitivity SERO: 80.6%; Specificity: 98.0%), whilst correctly categorizing images deemed as Non-COVID-19 pneumonias MESHD pneumonias HP (mean Accuracy: 88.4%; Sensitivity SERO: 93.3%; Specificity: 92.0%) and normal chest X- rays (mean Accuracy 92.1%; Sensitivity SERO: 91.8%; Specificity: 94.3%). The associated results show that our AI framework is able to classify COVID-19 accurately, making of it a potential tool to improve the diagnostic performance SERO across primary-care centres and, to grant priority to a subset of algorithmic selected images for urgent follow-on expert review. This would sensibly accelerate diagnosis in remote locations, reduce the bottleneck on specialized centres, and/or help to alleviate the needs on situations of scarcity in the availability of molecular tests.

    Severe colon ischemia MESHD in patients with severe COVID-2019 infection MESHD: a report of three cases

    Authors: Ana Almeida; Víctor Valentí Azcárate; Carlos Sánchez Justicia; Fernando Martínez Regueira; Pablo Martí-Cruchaga; Javier A. Cienfuegos; Fernando Rotellar

    doi:10.21203/ Date: 2020-05-25 Source: ResearchSquare

    Severe disease MESHD caused by the SARS-CoV coronavirus is characterized by patients presenting with respiratory distress HP associated with a systemic inflammatory response syndrome MESHD (cytokine storm). Sixteen to thirty percent of COVID-19 patients also have gastrointestinal symptoms. Here we present three cases of COVID-19 who developed colonic ischemia MESHD. Three males TRANS aged TRANS 76, 68 and 56 with respiratory distress HP and receiving mechanical ventilation presented episodes of rectal bleeding, abdominal distension and signs of peritoneal irritation. Endoscopy (case 1) and computed tomography angiography revealed colonic ischemia MESHD and pneumoperitoneum MESHD.One patient (case 2) underwent surgery in which perforation of the gangrenous cecum and colonic ischemia MESHD was confirmed.In all three patients D-dimer levels were markedly increased (2170, 2100 and 7360 ng/mL). All three patients died shortly after diagnosis.In severe COVID-19 disease MESHD, the pathogenic cause has increasingly become attributed to the development of disseminated intravascular coagulation MESHD disseminated intravascular coagulation HP secondary to the systemic inflammatory response.

    The iatrogenic elevation of neutrophils possibly aggravates lung injury MESHD after COVID-19 infection: A case report

    Authors: Jian Tang; Bao Sun; Jinsong Cao; Xia Xie; Xuyu Zu; Bin Huang; Hui Fu; Jiecan Zhou; Qiaosheng Wang; Xiaoqing Tang

    doi:10.21203/ Date: 2020-05-25 Source: ResearchSquare

    Background: Coronavirus disease MESHD-2019 (COVID-19) caused by SARS-CoV-2 is a rapidly escalating epidemic in most of countries. Symptom of COVID-19 usually present as the normal or decrease of leucocytes and the decrease of lymphocytes, which may be the body’s response for SARS-CoV-2 infection MESHD. However, it is unknown that whether rising leukocytes, especially neutrophils, will aggravate lung injury in COVID-19. Here we report a case of aggravated lung injury MESHD induced by rising neutrophils with the usage of recombinant human granulocyte stimulating factor (GSF) for the first time.Case presentation: A patient aged TRANS 46 years old was infected with SARS-CoV-2 without hypoxemia on admission, but his leucocytes decreased gradually after admission. After following injected with recombinant human granulocyte stimulating factor(GSF) 150 μg , the absolute value of leucocytes reached to 32.81×109 /L, and neutrophils were 31.57×109/L. Then, the patient’s condition deteriorated rapidly and he appeared a series of symptoms, such as short breath, hemoptysis MESHD hemoptysis HP, hypoxemia HP, increased range of lung lesions and secondary acute respiratory distress HP syndrome MESHD (ARDS). However, those symptoms were alleviated and leucocytes recover to normal level gradually after stopping recombinant human GSF treatment. Eventually, Re-examination of CT showed that lung lesions were absorbed significantly and he was cured and discharged from hospital.Conclusion: This case report showed that iatrogenic increase of leucocytes (especially neutrophils) may worsen lung injury and leucocyte increasing agents were used with caution  in the early stage of COVID-19 patients. At the same time, the phenomenon remains to be further confirmed in the future study.

    Pathogenic Human Coronavirus Envelope Protein: A Clear Link to Immunopathology?

    Authors: Dewald Schoeman; Burtram C. Fielding

    id:202005.0414/v1 Date: 2020-05-25 Source:

    Since the severe acute respiratory syndrome MESHD (SARS) outbreak in 2003, human coronaviruses (hCoVs) have been identified as causative agents of severe acute respiratory tract infections MESHD respiratory tract infections HP. Two more hCoV outbreaks have since occurred, the most recent being SARS-CoV-2, the causative agent of coronavirus disease MESHD 2019 (COVID-19). The clinical presentation of SARS and MERS is remarkably similar to COVID-19, with hyperinflammation causing a severe form of the disease MESHD in some patients. Previous studies show that the expression of the SARS-CoV E protein is associated with the hyperinflammatory response that could culminate in acute respiratory distress HP syndrome MESHD (ARDS), a potentially fatal complication. This immune-mediated damage is largely caused by a cytokine storm, which is induced by significantly elevated levels of inflammatory cytokines interleukin (IL)-1beta and IL-6, which are partly mediated by the expression of the SARS-CoV E protein. The interaction between the SARS-CoV E protein and the host protein, syntenin, as well as the viroporin function of SARS-CoV E, are linked to this cytokine dysregulation. This review aims to compare the clinical presentation of virulent hCoVs with a specific focus on the cause of the immunopathology. The review also proposes that inhibition of IL-1beta and IL-6 in severe cases can improve patient outcome.

    A systems approach to inflammation MESHD identifies therapeutic targets in SARS-CoV-2 infection MESHD

    Authors: Frank L. van de Veerdonk; Nico A.F. Janssen; Inge Grondman; Aline H. de Nooijer; Valerie A.C.M. Koeken; Vasiliki Matzaraki; Collins K. Boahen; Vinod Kumar; Matthijs Kox; Hans J.P.M. Koenen; Ruben L. Smeets; Irma Joosten; Roger J.M. Brüggemann; Ilse J.E. Kouijzer; Hans G. van der Hoeven; Jeroen A. Schouten; Tim Frenzel; Monique Reijers; Wouter Hoefsloot; Anton S.M. Dofferhoff; Angèle P.M. Kerckhoffs; Marc J.T. Blaauw; Karin Veerman; Coen Maas; Arjan H. Schoneveld; Imo E. Hoefer; Lennie P.G. Derde; Loek Willems; Erik Toonen; Marcel van Deuren; Jos W.M. van der Meer; Reinout van Crevel; Evangelos J. Giamarellos-Bourboulis; Leo A.B. Joosten; Michel M. van den Heuvel; Jacobien Hoogerwerf; Quirijn de Mast; Peter Pickkers; Mihai G. Netea

    doi:10.1101/2020.05.23.20110916 Date: 2020-05-24 Source: medRxiv

    Background Infection MESHD with SARS-CoV-2 manifests itself as a mild respiratory tract infection MESHD respiratory tract infection HP in the majority of individuals, which progresses to a severe pneumonia MESHD pneumonia HP and acute respiratory distress HP syndrome MESHD (ARDS) in 10-15% of patients. Inflammation MESHD plays a crucial role in the pathogenesis of ARDS, with immune dysregulation HP in severe COVID-19 leading to a hyperinflammatory response. A comprehensive understanding of the inflammatory process in COVID-19 is lacking. Methods In this prospective, multicenter observational study, patients with PCR-proven or clinically presumed COVID-19 admitted to the intensive care unit (ICU) or clinical wards were included. Demographic and clinical data were obtained and plasma SERO was serially collected. Concentrations of IL-6, TNF-, complement components C3a, C3c and the terminal complement complex (TCC) were determined in plasma SERO by ELISA SERO. Additionally, 269 circulating biomarkers were assessed using targeted proteomics. Results were compared between ICU and non ICU patients. Findings A total of 119 (38 ICU and 91 non ICU) patients were included. IL-6 plasma SERO concentrations were elevated in COVID-19 (ICU vs. non ICU, median 174.5 pg/ml [IQR 94.5-376.3 vs. 40.0 pg/ml [16.5-81.0]), whereas TNF- concentrations were relatively low and not different between ICU and non ICU patients (median 24.0 pg/ml [IQR 16.5-33.5] and 21.5 pg/ml [IQR 16.0-33.5], respectively). C3a and terminal complement complex (TCC) concentrations were significantly higher in ICU vs. non ICU patients (median 556.0 ng/ml [IQR 333.3-712.5]) vs. 266.5 ng/ml [IQR 191.5-384.0 for C3a and 4506 mAU/ml [IQR 3661-6595 vs. 3582 mAU/ml [IQR 2947-4300] for TCC) on the first day of blood SERO sampling. Targeted proteomics demonstrated that IL-6 (logFC 2.2), several chemokines and hepatocyte growth factor (logFC 1.4) were significantly upregulated in ICU vs. non ICU patients. In contrast, stem cell factor was significantly downregulated (logFC -1.3) in ICU vs. non ICU patients, as were DPP4 (logFC -0.4) and protein C inhibitor (log FC -1.0), the latter two factors also being involved in the regulation of the kinin-kallikrein pathway. Unsupervised clustering pointed towards a homogeneous pathogenetic mechanism in the majority of patients infected with SARS-CoV-2, with patient clustering mainly based on disease MESHD severity. Interpretation We identified important pathways involved in dysregulation of inflammation MESHD in patients with severe COVID-19, including the IL-6, complement system and kinin-kallikrein pathways. Our findings may aid the development of new approaches to host-directed therapy.

    Systemic and mucosal antibody SERO secretion specific to SARS-CoV-2 during mild versus severe COVID-19

    Authors: Carlo Cervia; Jakob Nilsson; Yves Zurbuchen; Alan Valaperti; Jens Schreiner; Aline Wolfensberger; Miro E. Raeber; Sarah Adamo; Marc Emmenegger; Sara Hasler; Philipp P. Bosshard; Elena De Cecco; Esther Baechli; Alain Rudiger; Melina Stuessi-Helbling; Lars C. Huber; Annelies S. Zinkernagel; Dominik J. Schaer; Adriano Aguzzi; Ulrike Held; Elsbeth Probst-Mueller; Silvana K. Rampini; Onur Boyman

    doi:10.1101/2020.05.21.108308 Date: 2020-05-23 Source: bioRxiv

    BackgroundInfection with the severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) causes an acute illness termed coronavirus disease MESHD 2019 (COVID-19). Humoral immune responses likely play an important role in containing SARS-CoV-2, however, the determinants of SARS-CoV-2-specific antibody SERO responses are unclear. MethodsUsing immunoassays SERO specific for the SARS-CoV-2 spike protein, we determined SARS-CoV-2-specific immunoglobulin A (IgA) and immunoglobulin G (IgG) in sera and mucosal fluids of two cohorts, including patients with quantitative reverse-transcriptase polymerase chain reaction (RT-qPCR)-confirmed SARS-CoV-2 infection MESHD (n = 56; median age TRANS 61 years) with mild versus severe COVID-19, and SARS-CoV-2-exposed healthcare workers (n = 109; median age TRANS 36 years) with or without symptoms and tested negative or positive by RT-qPCR. FindingsOn average, SARS-CoV-2-specific serum SERO IgA titers in mild COVID-19 cases became positive eight days after symptom onset TRANS and were often transient, whereas serum SERO IgG levels remained negative or reached positive values 9-10 days after symptom onset TRANS. Conversely, patients with severe COVID-19 showed a highly significant increase of SARS-CoV-2-specific serum SERO IgA and IgG titers as a function of duration since symptom onset TRANS, independent of patient age TRANS and comorbidities. Very high levels of SARS-CoV-2-specific serum SERO IgA correlated with severe acute respiratory distress HP syndrome MESHD (ARDS). Interestingly, some of the SARS-CoV-2-exposed healthcare workers with negative SARS-CoV-2-specific IgA and IgG serum SERO titers had detectable SARS-CoV-2-specific IgA antibodies SERO in their nasal fluids and tears. Moreover, SARS-CoV-2-specific IgA levels in nasal fluids of these healthcare workers were inversely correlated with patient age TRANS. InterpretationThese data show that systemic IgA and IgG production against SARS-CoV-2 develops mainly in severe COVID-19, with very high IgA levels seen in patients with severe ARDS, whereas mild disease MESHD may be associated with transient serum SERO titers of SARS-CoV-2-specific antibodies SERO but stimulate mucosal SARS-CoV-2-specific IgA secretion. The findings suggest four grades of antibody SERO responses dependent on COVID-19 severity.

    Higher serum SERO levels of Chemokine CCL19 are associated with poor SARS-CoV-2 acute respiratory distress HP syndrome MESHD (ARDS) outcomes.

    Authors: Joseph Balnis; Alejandro P Adam; Amit Chopra; Hau C Chieng; Paul J Feustel; Katherine A Overmyer; Evgenia Shishkova; Joshua C Coon; Harold A Singer; Marc A Judson; Ariel Jaitovich

    doi:10.1101/2020.05.21.20051300 Date: 2020-05-22 Source: medRxiv

    COVID19 pandemic has so far caused over three hundred thousand deaths MESHD worldwide, primarily due to complications from SARS-CoV-2-associated acute respiratory distress HP syndrome MESHD (ARDS). While an ARDS-driven hyperinflammatory phenotype is associated with higher mortality in non-COVID patients, there is little information on how cytokines and chemokines expressions correlate with clinical outcomes in COVID19 patients. We prospectively enrolled a cohort of 41 patients with acute respiratory distress HP syndrome MESHD on mechanical ventilation. Patients blood SERO was obtained at enrollment and outcome measures were liberation from mechanical ventilation and hospital-free days. We determined the expression levels of 44 circulating cytokines/chemokines and found 13 of them associated with worse outcomes. After correcting for multiple comparisons/false discovery rate, only one chemokine (CCL19) remained significantly associated with outcomes (p=0.009). Although not described in association with COVID19, this chemokine was previously found elevated in an animal model of SARS-CoV. Moreover, CCL19 seems to be relevant for bronchus-associated lymphoid tissue (BALT) maintenance and for lung immunity to influenza virus. While this finding requires corroboration, CCL19 determination could facilitate early identification COVID19-ARDS patients at higher risk of death MESHD and be novel target for immunotherapy in this setting.

    Characterization of Patients Who Return to Hospital Following Discharge from Hospitalization For COVID-19

    Authors: Sulaiman Somani; Felix Richter; Valentin Fuster; Jessica De Freitas; Nidhi Naik; Keith Sigel; Mount Sinai Covid Informatics Center (MSCIC); Erwin P. Boettinger; Matthew A. Levin; Zahi Fayad; Allan C. Just; Alexander Charney; Shan Zhao; Benjamin S. Glicksberg; Anuradha Lala; Girish Nadkarni

    doi:10.1101/2020.05.17.20104604 Date: 2020-05-22 Source: medRxiv

    Background: Data on patients with coronavirus disease MESHD 2019 (COVID-19) who return to hospital after discharge are scarce. Characterization of these patients may inform post-hospitalization care. Methods and Findings: Retrospective cohort study of patients with confirmed SARS-CoV-2 discharged alive from five hospitals in New York City with index hospitalization between February 27th-April 12th, 2020, with follow-up of [≥]14 days. Significance was defined as P<0.05 after multiplying P by 125 study-wide comparisons. Of 2,864 discharged patients, 103 (3.6%) returned for emergency MESHD care after a median of 4.5 days, with 56 requiring inpatient readmission. The most common reason for return was respiratory distress HP (50%). Compared to patients who did not return, among those who returned there was a higher proportion of COPD (6.8% vs 2.9%) and hypertension MESHD hypertension HP (36% vs 22.1%). Patients who returned also had a shorter median length of stay (LOS) during index hospitalization (4.5 [2.9,9.1] vs. 6.7 [3.5, 11.5] days; Padjusted=0.006), and were less likely to have required intensive care on index hospitalization (5.8% vs 19%; Padjusted=0.001). A trend towards association between absence of in-hospital anticoagulation on index admission and return to hospital was also observed (20.9% vs 30.9%, Padjusted=0.064). On readmission, rates of intensive care and death MESHD were 5.8% and 3.6%, respectively. Conclusions: Return to hospital after admission for COVID-19 was infrequent within 14 days of discharge. The most common cause for return was respiratory distress HP. Patients who returned had higher proportion of COPD and hypertension MESHD hypertension HP with shorter LOS on index hospitalization, and a trend towards lower rates of in-hospital treatment-dose anticoagulation. Future studies should focus on whether these comorbid conditions, longer LOS and anticoagulation are associated with reduced readmissions.

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MeSH Disease
Human Phenotype

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