Corpus overview


MeSH Disease

Human Phenotype


    displaying 1 - 10 records in total 182
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    Alveolitis in severe SARS-CoV-2 pneumonia MESHD pneumonia HP is driven by self-sustaining circuits between infected alveolar macrophages and T cells

    Authors: Rogan A Grant; Luisa Morales-Nebreda; Nikolay S Markov; Suchitra Swaminathan; Estefany R Guzman; Darryl A Abbott; Helen K Donnelly; Alvaro Donayre; Isaac A Goldberg; Zasu M Klug; Nicole Borkowski; Ziyan Lu; Hermon Kihshen; Yuliya Politanska; Lango Sichizya; Mengjia Kang; Ali Shilatifard; Chao Qi; A Christine Argento; Jacqueline M Kruser; Elizabeth S Malsin; Chiagozie O Pickens; Sean Smith; James M Walter; Anna E Pawlowski; Daniel Schneider; Prasanth Nannapaneni; Hiam Abdala-Valencia; Ankit Bharat; Cara J Gottardi; GR Scott Budinger; Alexander A Misharin; Benjamin David Singer; Richard G Wunderink; - The NU SCRIPT Study Investigators

    doi:10.1101/2020.08.05.238188 Date: 2020-08-05 Source: bioRxiv

    Some patients infected with Severe Acute Respiratory Syndrome MESHD Coronavirus-2 (SARS-CoV-2) develop severe pneumonia MESHD pneumonia HP and the acute respiratory distress HP syndrome MESHD (ARDS). Distinct clinical features in these patients have led to speculation that the immune response to virus in the SARS-CoV-2-infected alveolus differs from other types of pneumonia MESHD pneumonia HP. We collected bronchoalveolar lavage fluid samples from 86 patients with SARS-CoV-2-induced respiratory failure HP and 252 patients with known or suspected pneumonia MESHD pneumonia HP from other pathogens and subjected them to flow cytometry and bulk transcriptomic profiling. We performed single cell RNA-Seq in 5 bronchoalveolar lavage fluid samples collected from patients with severe COVID-19 within 48 hours of intubation. In the majority of patients with SARS-CoV-2 infection MESHD at the onset of mechanical ventilation, the alveolar space is persistently enriched in alveolar macrophages and T cells without neutrophilia HP. Bulk and single cell transcriptomic profiling suggest SARS-CoV-2 infects alveolar macrophages that respond by recruiting T cells. These T cells release interferon-gamma to induce inflammatory cytokine release from alveolar macrophages and further promote T cell recruitment. Our results suggest SARS-CoV-2 causes a slowly unfolding, spatially-limited alveolitis in which alveolar macrophages harboring SARS-CoV-2 transcripts and T cells form a positive feedback loop that drives progressive alveolar inflammation MESHD.

    Automatic load-distributing band CPR (AutoPulseTM) in prone position: A feasibility study in a mechanical model

    Authors: Urs Pietsch; Jürgen Knapp; Volker Wenzel; Volker Lischke; Roland Albrecht

    doi:10.21203/ Date: 2020-08-03 Source: ResearchSquare

    Background: Due to SARS-CoV-2 respiratory failure HP, prone positioning of patients with respiratory and hemodynamic instability has become a frequent intervention in intensive care units (ICUs), and even in patients undergoing transfer in an ambulance or helicopter. The question becomes how to perform safe and effective CPR in prone position, achieving both an optimal outcome for the patient and optimal protection of staff from infection MESHD.Materials and Methods: We conducted a feasibility study to assess the effects of CPR with an automatic load-distributing band (AutoPulseTM) in prone position. Results: In supine position, AutoPulseTM generated a constant pressure depth of 3 cm at a frequency of 84/min. In prone position, AutoPulseTM generated a constant pressure depth of 2.6 cm at a frequency of 84/min.Conclusion: We found that AutoPulseTM CPR was feasible in manikins in both prone and supine positions.

    Brief Report: Rapid Clinical Recovery from Critical COVID-19 with Respiratory Failure HP in a Lung Transplant Patient Treated with Intravenous Vasoactive Intestinal Peptide

    Authors: Jihad Georges Youssef; Faisal Zahiruddin; Mukhtar Al-Saadi; Simon Yau; Ahmad Goodarzi; Howard J. Huang; Jonathan C. Javitt

    id:10.20944/preprints202007.0178.v2 Date: 2020-08-02 Source:

    RLF-100 (Aviptadil), a synthetic form of Vasoactive Intestinal Peptide (VIP) is shown to block replication of the SARS-CoV-2 virus and has been granted Fast Track Designation by the US FDA for the treatment of Critical COVID-19 with Respiratory Failure HP. We describe the clinical course of the first patient treated with this investigational medication in an open label manner -- a 54 year old patient suffering antibody SERO-mediated rejection of his double lung transplant who contracted COVID-19 with respiratory failure HP refractory to all currently available therapies. He received three infusions of RLF-100 under an FDA-approved emergency MESHD use IND. Within 24 hours of the third infusion, substantial improvement in oxygen saturation and radiographic improvement in characteristic COVID-19 pneumonitis was noted. He was discharged from intensive care at that point and scheduled for discharge to home at 1 week on room air. Despite an intervening hospitalization for trauma, he remains alive and free of respiratory failure HP at 28 days post treatment.

    Effect of early versus delayed or no intubation on clinical outcomes of patients with COVID-19 

    Authors: Ilias Siempos; Elena Xourgia; Theodora K. Ntaidou; Dimitris Zervakis; Eleni E. Magira; Anastasia Kotanidou; Christina Routsi; Spyros G. Zakynthinos

    doi:10.21203/ Date: 2020-08-02 Source: ResearchSquare

    Background: Optimal timing of initiation of invasive mechanical ventilation in patients with acute hypoxemic respiratory failure HP due to COVID-19 is unknown. Thanks to early flattening of the epidemiological curve, ventilator demand in Greece was kept lower than supply throughout the pandemic, allowing for unbiased comparison of the outcomes of patients undergoing early intubation versus delayed or no intubation.Methods: We conducted an observational study including all adult TRANS patients with laboratory-confirmed COVID-19 consecutively admitted in Evangelismos Hospital, Athens, Greece between March 11, 2020 and April 15, 2020. Patients subsequently admitted in the intensive care unit (ICU) were categorized into the “early intubation” versus the “delayed or no intubation” group.Results: During the study period, a total of 101 patients (37% female TRANS, median age TRANS 65 years) were admitted in the hospital. Fifty-nine patients (58% of the entire cohort) were exclusively hospitalized in general wards with a mortality of 3% and median length of stay of 7 days. Forty-two patients (19% female TRANS, median age TRANS 65 years, 62% with at least one comorbidity, 14% never intubated) were admitted in the ICU; all with acute hypoxemic respiratory failure HP. Early intubation was not associated with higher ICU-mortality (21% versus 33%), fewer ventilator-free days (3 versus 2 days) or fewer ICU-free days than delayed or no intubation.Conclusions: A strategy of early intubation was not associated with worse clinical outcomes compared to delayed or no intubation. Given that early intubation may presumably reduce virus aerosolization, these results may justify further research with a randomized controlled trial. 

    Low Diaphragm Muscle Mass Predicts Adverse Outcome in Patients Hospitalized for Covid-19 Pneumonia MESHD Pneumonia HP

    Authors: Francesco Corradi; Alessandro Isirdi; Claudia Brusasco; Gregorio Santori; Marco Falcone; Luna Gargani; Chiara Romei; Greta Barbieri; Fabio Guarracino; Luigi Vetrugno; Giovanni Landoni; Francesco Forfori

    doi:10.21203/ Date: 2020-08-01 Source: ResearchSquare

    Purpose: The aim of this study was to evaluate whether measurement of diaphragm thickness by ultrasonography may be a clinically useful noninvasive method for identifying patients at risk of adverse outcomes defined as need of invasive mechanical ventilation or death MESHD. Methods: We retrospectively reviewed the records of consecutive of 77 patients with laboratory-confirmed Covid-19 infection MESHD admitted to our intermediate care unit in Pisa between March 5 and March 30, 2020, with follow up until hospital discharge or death MESHD. Logistic regression was used identify variables potentially associated with adverse outcomes and those P<0.10 were entered into a multivariate logistic regression model. Cumulative probability for lack of adverse outcomes in patients with or without low baseline diaphragm muscle mass was calculated with the Kaplan–Meier product-limit estimator.Results: The main findings of this study are that 1) patients who developed adverse outcomes had thinner diaphragm than those who did not (2.0 vs 2.2 mm, p:0.001), 2) DT and lymphocyte count were independent significant predictors of adverse outcomes, with end-expiratory DT being the strongest (-708, OR: 0.492, p: 0.018).Conclusion: Diaphragmatic ultrasound may be a valid tool to evaluate the risk of respiratory failure HP. Evaluating the need of mechanical ventilation treatment should be based not only on PaO2/FiO2, but on a more comprehensive assessment including DT because if the lungs become less compliant a thinner diaphragm, albeit free of intrinsic abnormality, may become exhausted, thus contributing to severe respiratory failure HP

    Design and rationale of a randomized, double-blind, placebo-controlled, Phase 2/3 study to evaluate the safety and efficacy of dociparstat sodium (DSTAT) in adults TRANS with acute lung injury MESHD associated with severe COVID-19

    Authors: Joseph A. Lasky; Jyotsna Fuloria; Marion E. Morrison; Randall Lanier; Odin Naderer; Tom Brundage; Allen Melemed

    doi:10.21203/ Date: 2020-08-01 Source: ResearchSquare

    Background: The COVID-19 Global Pandemic caused by the novel coronavirus, SARS-CoV-2, and the consequent morbidity and mortality attributable to progressive hypoxemia HP and subsequent respiratory failure HP, threaten to overrun hospital critical care units globally. New agents that can address the hyperinflammatory “cytokine storm” and hypercoagulable pathology seen in these patients may be a promising approach to treat patients, minimize hospital stays, and ensure hospital wards and critical care units are able to operate effectively.  Dociparstat sodium (DSTAT) is a glycosaminoglycan derivative of heparin with robust anti-inflammatory properties, including the potential to address underlying causes of coagulation disorders with substantially reduced risk of bleeding complications compared to commercially available forms of heparin. Methods: This study is a randomized, double-blind, placebo-controlled, Phase 2/3 trial to determine the safety and efficacy of DSTAT added to standard of care versus placebo, in adults TRANS with COVID-19 who require hospitalization and supplemental oxygen therapy. The Phase 2 portion will enroll 12 participants in each of two dose escalating cohorts, to confirm the safety of DSTAT in this population. Following a data monitoring committee review of the data, an additional 50 participants will be enrolled. Contingent upon positive results, the Phase 3 portion of the study will enroll approximately 450 participants randomized 1:1 to DSTAT or placebo. The primary endpoint, agreed on by the US FDA, is the proportion of participants who survive and do not require mechanical ventilation through day 28. Discussion: Advances in standard of care regimens and the recent emergency MESHD use authorization of remdesivir and positive data with dexamethasone, has likely contributed to an increasing proportion of patients who are surviving without the need for mechanical ventilation. Therefore, examining the time to improvement of NIAID score will be essential to provide a more continuous measure of drug effect on recovery. Additional analysis of other endpoints, including supportive biomarkers (e.g., IL-6, HMGB1, soluble RAGE, D-dimer) will be performed at the conclusion of Phase 2 to further define the effect of DSTAT in patients hospitalized with COVID-19 infection MESHD. Trial Registration: identifier NCT04389840, Registered 13 May 2020,

    Markers of NETosis and DAMPs are altered in critically ill COVID-19 patients

    Authors: Joram Huckriede; Sara Bülow Anderberg; Albert Morales; Femke de Vries; Michael Hultström; Anders Bergqvist; José T. Ortiz; Jan Willem Sels; Kanin Wichapong; Miklos Lipcsey; Marcel van de Poll; Anders Larsson; Tomas Luther; Chris Reutelingsperger; Pablo Garcia de Frutos; Robert Frithiof; Gerry A.F. Nicolaes

    doi:10.21203/ Date: 2020-08-01 Source: ResearchSquare

    Background Coronavirus disease MESHD 19 (COVID-19) is known to present with disease MESHD severities of varying degree. In its most severe form, infection MESHD may lead to respiratory failure HP and multi-organ dysfunction. Here we study the levels of extracellular histone H3 (H3), neutrophil elastase (NE) and cfDNA in relation to other plasma SERO parameters, including the immune modulators GAS6 and AXL, ICU scoring systems and mortality in patients with severe COVID-19.Methods We measured plasma SERO H3, NE, cfDNA, GAS6 and AXL concentration in plasma SERO of 83 COVID-19-positive and 11 COVID-19-negative patients at admission to the Intensive Care Unit (ICU) at the Uppsala University hospital, a tertiary hospital in Sweden and a total of 333 samples obtained from these patients during the ICU-stay. We determined their correlation with disease MESHD severity, organ failure, mortality and other blood SERO parameters.Results H3, NE, cfDNA, GAS6 and AXL were increased in plasma SERO of COVID-19 patients compared to controls. cfDNA and GAS6 decreased in time in in patients surviving to 30 days post ICU admission. Plasma SERO H3 was a common feature of COVID-19 patients, detected in 40% of the patients at ICU admission. Although these measures were not predictive of the final outcome of the disease MESHD, they correlated well with parameters of tissue damage (H3 and cfDNA) and neutrophil counts (NE). A subset of samples displayed H3 processing, possibly due to proteolysis.Conclusions Elevated H3 and cfDNA levels in COVID-19 patients illustrate the severity of the cellular damage observed in critically ill COVID-19 patients. The increase in NE indicates the important role of neutrophil response and the process of NETosis in the disease MESHD. GAS6 appears as part of an early activated mechanism of response in Covid-19.

    Obesity MESHD Obesity HP and Severity in Patients with COVID-19: A Scoping Review Protocol

    Authors: Marcela Larissa Costa; Carlos Adriano Santos Souza; Ana Caroline Cardoso Silva; Dayane Franciely Conceição Santos; Edilene Fernandes Nonato; Francismayne Batista Santana; Giselle dos Santos Dias; Jessyca Teles Barreto; Laís Santos Costa; Maria Carolina Barros Costa; Tamila das Neves Ferreira; Jeniffer Santos Santana; Raquel Simões Mendes Netto; Tereza Virgínia Silva Bezerra do Nascimento; Marco Antônio Prado Nunes; Márcia Ferreira Cândido de Souza

    doi:10.21203/ Date: 2020-07-30 Source: ResearchSquare

    Background: Coronavirus disease MESHD (COVID-19), caused by the SARS-CoV-2 strain, was first identified in late 2019, in China. A greater number of countries were affected in 2020, with a consequent increase in the disease MESHD's epidemiological curve. The outcomes of patients affected by the virus can worsen, developing acute respiratory failure HP and other serious complications, especially when related to older individuals and people of all ages TRANS with obesity MESHD obesity HP and comorbidities. Some studies have shown that obese infected with COVID-19 had a high frequency risk of hospitalization in the Intensive Care Unit and the need to use Invasive Mechanical Ventilation, in addition to the association between a higher death MESHD rate. Thus, obese patients tend to have a more severe course of COVID-19. In this sense, this review aims to synthesize the evidence in the literature that associates COVID-19 and the severity of the prognosis in infected obese patients. Methods: This protocol will include all study articles that can be used as instruments to assess the severity of clinical outcomes in obese patients infected by 2019-nCoV. There will be no time limitation when searching for articles. Studies in any environment or country for inclusion will be considered.Discussion: There are still not enough studies to characterize the evidence and its strength in the prognosis of the disease MESHD. Therefore, given the need for early detection of the possible implications and treatment for patients with obesity MESHD obesity HP, the evidence will be useful for directing the conduct and optimization of therapies in these patients by the multiprofessional teams.Scoping review registration: Open Science Framework:

    60-day survival of critically ill COVID-19 first comers

    Authors: Corinna N. Lang; V. Zotzmann; B. Schmid; M. Berchtold-Herz; S. Utzolino; P.M. Biever; T. Pottgießer; D. Duerschmied; C. Bode; T. Wengenmayer; D.L. Staudacher

    doi:10.21203/ Date: 2020-07-29 Source: ResearchSquare

    Background: Germany reported sufficient intensive care unit (ICU) resources throughout the first wave of coronavirus disease MESHD 2019 (COVID-19). The treatment of critically ill COVID-19 patients without rationing may improve the outcome. We therefore analyzed resources allocated to critically ill COVID-19 patients and their outcomes. Methods: Retrospectively, we enrolled SARS-CoV2 PCR positive patients with respiratory failure HP from 03/08/2020 to 04/08/2020 and followed until 05/28/2020 in the university hospital of Freiburg, Germany. Results: Thirty-four COVID-19 patients were admitted to the ICU in the defined interval with medium age TRANS of 67±13 (31-86) years. 6/34 (17.6%) were female TRANS. All patients suffered from moderate or severe acute respiratory distress HP syndrome MESHD (ARDS), 91.2% of the patients were intubated and 23.5% required extracorporeal membrane oxygenation (ECMO). Proning was performed in 67.6%, renal replacement therapy (RRT) was required in 35.3%. 96% required more than 20 nursing hours per day. Mean ICU stay was 21±19 (1-81) days. 60-day survival of critically ill COVID-19 patients was 50.0% (17/34). Causes of death MESHD were multi-organ failure (52.9%), refractory ARDS (17.6%) and intracerebral hemorrhage MESHD (17.6%). Conclusions: Treatment of critically ill COVID-19 patients is protracted and resource intense. In a context without resources shortage, 50% of critically ill COVID-19 survived up to 60 days.

    Characterization and Outcomes of ARDS secondary to pneumonia MESHD pneumonia HP in patients with and without SARS-CoV-2: A single center experience

    Authors: Rahul Y. Mahida; Minesh Chotalia; Joseph Alderman; Chhaya Patel; Amber Hayden; Ruchi Desai; Emily Beesley; Louise E. Crowley; Mansoor N. Bangash; Dhruv Parekh; Jaimin M. Patel; David R. Thickett

    doi:10.21203/ Date: 2020-07-27 Source: ResearchSquare

    ARDS is the major cause of mortality in patients with SARS-CoV-2 pneumonia MESHD pneumonia HP. We report a single-centre study comparing the characteristics of ARDS patients with and without SARS-CoV-2. A greater proportion of SARS-CoV-2 patients were from an Asian ethnic group (p=0.002). SARS-CoV-2 patients had lower circulating leukocytes, neutrophils and monocytes (p<0.0001), but higher CRP (p=0.016) on ICU admission. SARS-CoV-2 patients required a longer duration of mechanical ventilation (p=0.01), but had lower vasopressor requirements (p=0.016). While the clinical syndromes MESHD of SARS-CoV-2 and CAP-ARDS are similar, the dysregulated inflammation MESHD observed in SARS-CoV-2 may contribute to the increased duration of respiratory failure HP.

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MeSH Disease
Human Phenotype

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