Corpus overview


MeSH Disease

Human Phenotype


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    Mitigating Arrhythmia HP Risk in Hydroxychloroquine and Azithromycin Treated COVID-19 Patients using Arrhythmia HP Risk Management Plan

    Authors: Kazimieras Maneikis M.D.; Ugne Ringeleviciute M.D.; Justinas Bacevicius M.D.; Egle Dieninyte-Misiune M.D.; Emilija Burokaite M.D.; Gintare Kazbaraite M.D.; Marta Monika Janusaite M.D.; Austeja Dapkeviciute M.D.; Andrius Zucenka M.D.; Valdas Peceliunas M.D. Ph.D.; Lina Kryzauskaite M.D.; Vytautas Kasiulevicius M.D. Ph.D.; Donata Ringaitiene M.D. Ph.D.; Birute Zablockiene M.D. Ph.D.; Tadas Zvirblis; Germanas Marinskis M.D. Ph.D.; Ligita Jancoriene M.D. Ph.D.; Laimonas Griskevicius M.D. Ph.D.

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

    Background: Hydroxychloroquine and Azithromycin use is associated with QT interval prolongation and arrhythmias HP. Despite ongoing multiple clinical trials for treatment of COVID19 infection MESHD, no definite cardiac safety protocols were proposed. The aim of our study was to assess cardiac safety in COVID-19 patients treated with the combination of Hydroxychloroquine and Azithromycin using close monitoring and arrhythmia HP risk management plan.Methods and results: We retrospectively examined arrhythmia HP safety of treatment with Hydroxychloroquine and Azithromycin in the setting of pre-defined cardiac arrhythmia MESHD arrhythmia HP risk management plan. 81 patients were included from March 23rd to May 10th 2020. The median age TRANS was 59 years, 58.0% were female TRANS. The majority of the study population (82.7%) had comorbidities, 98.8% had radiological signs of pneumonia MESHD pneumonia HP. 7 patients (8.6%) had QTc prolongation of ≥500 ms. The treatment was discontinued in 4 patients (4.9%). 14 patients (17.3%) experienced QTc≥480 ms and 16 patients (19.8%) had an increase of QTc≥60 ms. None of the patients developed ventricular tachycardia MESHD ventricular tachycardia HP. The risk factors significantly associated with QTc≥500 ms were hypokalemia MESHD hypokalemia HP (p = 0.032) and use of diuretics during the treatment (p = 0.020). Three patients had a lethal outcome; none of them associated with ventricular arrhythmias HP.Conclusion: We recorded a low incidence of QTc prolongation ≥500 ms and no ventricular tachycardia MESHD ventricular tachycardia HP events in COVID-19 patients treated with Hydroxychloroquine and Azithromycin using cardiac arrhythmia MESHD arrhythmia HP risk management plan.

    Hypokalemia MESHD Hypokalemia HP in Patients with COVID-19

    Authors: Gaetano Alfano; Annachiara Ferrari; Francesco Fontana; Rossella Perrone; Giacomo Mori; Elisabetta Ascione; Magistroni Riccardo; Giulia Venturi; Simone Pederzoli; Gianluca Margiotta; Marilina Romeo; Francesca Piccinini; Giacomo Franceschi; Sara Volpi; Matteo Faltoni; Giacomo Ciusa; Erica Bacca; Marco Tutone; Alessandro Raimondi; marianna menozzi; Erica Franceschini; Gianluca Cuomo; Gabriella Orlando; Antonella Santoro; Margherita Di Gaetano; Cinzia Puzzolante; Federica Carli; Andrea Bedini; Jovana Milic; Marianna Meschiari; Cristina Mussini; Gianni Cappelli; Giovanni Guaraldi

    doi:10.1101/2020.06.14.20131169 Date: 2020-06-16 Source: medRxiv

    Patients with COVID-19 may experience multiple conditions (e.g., fever MESHD fever HP, hyperventilation MESHD hyperventilation HP, anorexia MESHD anorexia HP, gastroenteritis MESHD, acid-base disorder) that may cause electrolyte imbalances. Hypokalemia MESHD Hypokalemia HP is a concerning electrolyte disorder that may increase the susceptibility to various kinds of arrhythmia HP. This study aimed to estimate prevalence SERO, risk factors and outcome of hypokalemia MESHD hypokalemia HP in a cohort of non-critically ill patients. A retrospective analysis was conducted on 290 hospitalized patients with confirmed COVID-19 infection MESHD at the tertiary teaching hospital of Modena, Italy. Hypokalemia MESHD Hypokalemia HP (<3.5 mEq/L) was detected in 119 patients (41%). The decrease of serum SERO potassium level was of mild entity (3-3.4 mEq/L) and occurred in association with hypocalcemia MESHD hypocalcemia HP (P=0.001) and lower level of serum SERO magnesium (P=0.028) compared to normokaliemic patients. Urine K: creatinine ratio, measured in a small subset of patients (n=45; 36.1%), showed an increase of urinary potassium HP excretion in the majority of the cases (95.5%). Causes of kaliuria were diuretic therapy (53.4%) and corticosteroids (23.3%). In the remaining patients, urinary potassium loss was associated with normal serum SERO magnesium, low sodium excretion (FENa< 1%) and metabolic alkalosis HP alkalosis MESHD. Risk factors for hypokalemia MESHD hypokalemia HP were female TRANS gender TRANS (P=0.002; HR 0.41, 95%CI 0.23-0.73) and diuretic therapy (P=0.027; HR 1.94, 95%CI 1.08-3.48). Hypokalemia MESHD Hypokalemia HP, adjusted for sex, age TRANS and SOFA score, resulted not associated with ICU admission (P=0.131, 95% CI 0.228-1.212) and in-hospital mortality (P=0.474; 95% CI 0,170-1,324) in our cohort of patients. Hypokalemia MESHD Hypokalemia HP is a frequent disorder in COVID-19 patients and urinary potassium loss may be the main cause of hypokalemia MESHD hypokalemia HP. The disorder was mild in the majority of the patients and was unrelated to poor outcomes. Nevertheless, hypokalemic patients required potassium supplements to dampen the risk of arrhythmias HP.

    Clinical characteristics of 116 hospitalized patients with COVID-19 in Wuhan, China: a single-centered, retrospective, observational study

    Authors: Shiqiang Xiong; Lin Liu; Feng Lin; Jinhu Shi; Lei Han; Huijian Liu; Lewei He; Qijun Jiang; Zeyang Wang; Wenbo Fu; Zhigang Li; Qing Lu; Zhinan Chen; Shifang Ding

    doi:10.21203/ Date: 2020-05-01 Source: ResearchSquare

    Background A cluster of acute respiratory illness, now known as Corona Virus Disease MESHD 2019 (COVID-19) caused by 2019 novel coronavirus (SARS-CoV-2), has become a global pandemic. Aged TRANS population with cardiovascular diseases MESHD are more likely be to infected with SARS-CoV-2 and result in more severe outcomes and elevated case-fatality rate. Meanwhile, cardiovascular diseases MESHD have a high prevalence SERO in the middle- aged TRANS and elderly TRANS population. However, despite of several researches in COVID-19, cardiovascular implications related to it still remains largely unclear. Therefore, a specific analysis in regard to cardiovascular implications of COVID-19 patients is in great need.Methods In this single-centered, retrospective, observational study, 116 patients with laboratory-confirmed COVID-19 were enrolled, who admitted to the General Hospital of Central Theater Command (Wuhan, China) from January 20 to March 8, 2020. The demographic data, underlying comorbidities, clinical symptoms and signs MESHD, laboratory findings, chest computed tomography, treatment measures, and outcome data were collected from electronic medical records. Data were compared between non-severe and severe cases. Results Of 116 hospitalized patients with COVID-19, the median age TRANS was 58.5 years (IQR, 47.0-69.0), and 36 (31.0%) were female TRANS. Hypertension MESHD Hypertension HP (45 [38.8%]), diabetes (19 [16.4%]), and coronary heart disease MESHD (17 [14.7%]) were the most common coexisting conditions. Common symptoms included fever MESHD fever HP [99 (85.3%)], dry cough MESHD cough HP (61 [52.6%]), fatigue MESHD fatigue HP (60 [51.7%]), dyspnea MESHD dyspnea HP (52 [44.8%]), anorexia MESHD anorexia HP (50 [43.1%]), and chest discomfort (50 [43.1%]). Local and/or bilateral patchy shadowing were the typical radiological findings on chest computed tomography. Lymphopenia MESHD Lymphopenia HP (lymphocyte count, 1.0 × 109/L [IQR, 0.7-1.3]) was observed in 66 patients (56.9%), and elevated lactate dehydrogenase (245.5 U/L [IQR, 194.3-319.8]) in 69 patients (59.5%). Hypokalemia MESHD Hypokalemia HP occurred in 24 (20.7%) patients. Compared with non-severe cases, severe cases were older (64.0 years [IQR, 53.0-76.0] vs 56.0 years [IQR, 37.0-64.0]), more likely to have comorbidities (35 [63.6%] vs 24 [39.3%]), and more likely to develop acute cardiac injury (19 [34.5%] vs 4 [6.6%]), acute heart failure MESHD (18 [32.7%] vs 3 [4.9%]), and ARDS (20 [36.4%] vs 0 [0%]). During hospitalization, the prevalence SERO of new onset hypertension MESHD hypertension HP was significantly higher in severe patients (55.2% vs 19.0%) than in non-severe ones.Conclusions In this single-centered, retrospective, observational study, we found that the infection MESHD of SARS-CoV-2 was more likely to occur in middle and aged TRANS population with cardiovascular comorbidities. Cardiovascular complications, including new onset hypertension MESHD hypertension HP and heart injury MESHD were common in severe patients with COVID-19. More detailed researches in cardiovascular involvement in COVID-19 are urgently needed to further understand the disease MESHD.

    The differences of clinical characteristics and outcomes between imported and local patients of COVID-19 in Hunan: A two-center retrospective study

    Authors: Chang Wang; Lizhi Zhou; Juan Chen; Yong Yang; Tianlong Huang; Min Fu; Ya Li; Daniel George; Xiangyu Chen

    doi:10.21203/ Date: 2020-04-16 Source: ResearchSquare

    Background: The clinical characteristics and outcomes of the 2019 novel coronavirus (COVID-19) pneumonia MESHD pneumonia HP are different in Hubei compared to other regions in China. But there are few comparative studies on the differences between imported and local patients which may provide information of the different courses of the virus after transmission TRANS. Methods: We investigated 169 cases of COVID-19 pneumonia MESHD pneumonia HP in two centers in Hunan Province, and divided them into two groups according to epidemiological history, "imported patients" refers to patient with a clear history of travel TRANS in Wuhan within 14 days before onset, and " local patients” refers to local resident without a recent history of travel TRANS in Wuhan, aiming to analyze the difference in clinical characteristics and outcomes between the two groups. All the epidemiological, clinical, imaging, and laboratory data were analyzed and contrasted. Results: The incidence of fever MESHD fever HP on admission in imported patients was significantly higher than local patients. There was a significantly higher proportion of abnormal pulmonary signs, hypokalemia MESHD hypokalemia HP, hyponatremia MESHD hyponatremia HP, prolonged PT, elevated D-dimer and elevated blood SERO glucose in imported patients. Compared with local patients, the proportion using antibiotics, glucocorticoids and gamma globulin were significantly higher in imported patients. The moderate type was more common in local patients, and the severe type were more frequent in imported patients. In addition, the median duration of viral clearance was longer in imported patients. Conclusions: In summary, we found that imported cases were more likely to develop into severe cases, compared with local patients and required more powerful treatments.Trial registration: Registered 21st March 2020, and this study has been approved by the Medical Ethics Committee (Approved Number. 2020017). 

    Key to successful treatment of COVID-19: accurate identification of severe risks and early intervention of disease progression MESHD

    Authors: meizhu chen; changli tu; Cuiyan Tan; Xiaobin Zheng; xiaohua wang; jian wu; Yiying Huang; zhenguo wang; yan yan; zhonghe li; hong shan; Jing Liu; jin huang

    doi:10.1101/2020.04.06.20054890 Date: 2020-04-11 Source: medRxiv

    Abstract Background COVID-19 is a new and highly contagious respiratory disease MESHD that has caused global spread, high case fatality rate in severe patients, and a huge medical burden due to invasive mechanical ventilation. The current diagnosis and treatment guidelines are still need to be improved, and more excellent clinical experience is needed to provide reference. Methods We analyzed and summarized clinical data of 97 confirmed COVID-19 adult TRANS patients (including 26 severe cases) admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from January 17, 2020 to March 10, 2020,included laboratory examination results, imaging findings, treatment effect, prognosis , etc, in order to put forward prediction index of severe COVID-19 patients, principles of early intervention and methylprednisolone usages in COVID-19 patients. Results 1. Hypoxemia HP, hyperlactic acid, hypoproteinemia MESHD hypoproteinemia HP, and hypokalemia MESHD hypokalemia HP were prevalent in COVID-19 patients.The significant low lymphocyte count, hypoproteinemia MESHD hypoproteinemia HP, hypokalemia MESHD hypokalemia HP, the persistent or worsen high CRP, high D-dimer, and high BNP, and the occurrence of hemoptysis MESHD hemoptysis HP and novel coronavirus (SARS-CoV-2) viremia MESHD viremia HP were important indicators for early diagnosis and prediction of severe disease progression MESHD. 2.Characteristic images of lung CT had a clear change in COVID - 19, Ground-glass opacity (GGO) and high-density linear combinations may indicate different pathological changes. Rapid lobular progression of GGO suggests the possibility of severe disease MESHD. 3.Basic principles of early intervention treatment of COVID-19: on the premise of no effective antiviral drugs, treatment is based on supportive and symptomatic therapy (albumin supplementation, supplement of potassium, supplement blood SERO plasma SERO, etc.) in order to maintain the stability of the intracellular environment and adequately reactivate body immunity to clean up SARS-CoV-2 . 4. According to severity, oxygenation index, body weight MESHD, age TRANS, underlying diseases MESHD, appropriate amount methylprednisolone application on severe/critical COVID-19 patients on demand, improved blood SERO oxygen and reduced the utilization rate of invasive mechanical ventilation, case fatality rate and medical burden significantly. The most common indications for invasive mechanical ventilation should be strictly control in critical COVID-19 patients. Conclusions: 1.Accurate and timely identification of clinical features in severe risks, and early and appropriate intervention can block disease progression MESHD. 2.Appropriate dose of methylprednisolone can effectively avoid invasive mechanical ventilation and reduce case fatality rate in critical COVID-19 patients.

    Analysis of early renal injury in COVID-19 and diagnostic value of multi-index combined detection

    Authors: Xu-wei Hong; Ze-pai Chi; Guo-yuan Liu; Hong Huang; Shun-qi Guo; Jing-ru Fan; Xian-wei Lin; Liao-zhun Qu; Rui-lie Chen; Ling-jie Wu; Liang-yu Wang; Qi-chuan Zhang; Su-wu Wu; Ze-qun Pan; Hao Lin; Yu-hua Zhou; Yong-hai Zhang

    doi:10.1101/2020.03.07.20032599 Date: 2020-03-10 Source: medRxiv

    Objectives The aim of the study was to analyze the incidence of COVID-19 with early renal injury, and to explore the value of multi-index combined detection in diagnosis of early renal injury in COVID-19. Design The study was an observational, descriptive study. Setting This study was carried out in a tertiary hospital in Guangdong, China. Participants 12 patients diagnosed with COVID-19 from January 20, 2020 to February 20, 2020. Primary and secondary outcome measures The primary outcome was to evaluate the incidence of early renal injury in COVID-19. In this study, the estimated glomerular filtration rate (eGFR), endogenous creatinine clearance (Ccr) and urine microalbumin / urinary creatinine ratio (UACR) were calculated to assess the incidence of early renal injury. Secondary outcomes were the diagnostic value of urine microalbumin (UMA), 1-microglobulin (A1M), urine immunoglobulin-G (IGU), urine transferring (TRU) alone and in combination in diagnosis of COVID-19 with early renal injury. Results While all patients had no significant abnormalities in serum SERO creatinine (Scr) and blood SERO urea nitrogen (BUN), the abnormal rates of eGFR, Ccr, and UACR were 66.7%, 41.7%, and 41.7%, respectively. Urinary microprotein detection indicated that the area under curve (AUC) of multi-index combined to diagnose early renal injury in COVID-19 was 0.875, which was higher than UMA (0,813), A1M (0.813), IGU (0.750) and TRU (0.750) alone. Spearman analysis showed that the degree of early renal injury was significantly related to C-reactive protein (CRP) and neutrophil ratio (NER), suggesting that the more severe the infection HP infection MESHD, the more obvious the early renal injury. Hypokalemia MESHD Hypokalemia HP and hyponatremia MESHD hyponatremia HP were common in patients with COVID-19, and there was a correlation with the degree of renal injury. Conclusions Early renal injury was common in patients with COVID-19. Combined detection of UMA, A1M, IGU, and TRU was helpful for the diagnosis of early renal injury in COVID-19.

    Hypokalemia MESHD Hypokalemia HP and Clinical Implications in Patients with Coronavirus Disease MESHD 2019 (COVID-19)

    Authors: dong chen Jr.; Xiaokuni Li; qifa song Sr.; Chenchan Hu Jr.; Feifei Su; Jianyi Dai

    doi:10.1101/2020.02.27.20028530 Date: 2020-02-29 Source: medRxiv

    BACKGROUND: SARS-CoV-2 has caused a series of COVID-19 globally. SARS-CoV-2 binds angiotensin I converting enzyme 2 (ACE2) of renin-angiotensin system (RAS) and causes prevalent hypokalemia MESHD hypokalemia HP METHODS: The patients with COVID-19 were classified into severe hypokalemia MESHD hypokalemia HP, hypokalemia MESHD hypokalemia HP, and normokalemia group. The study aimed to determine the relationship between hypokalemia MESHD hypokalemia HP and clinical features, the underlying causes and clinical implications of hypokalemia MESHD hypokalemia HP. RESULTS: By Feb 15, 2020, 175 patients with COVID-19 (92 women and 83 men; median age TRANS, 46 [IQR, 34-54] years) were admitted to hospital in Wenzhou, China, consisting 39 severe hypokalemia MESHD hypokalemia HP-, 69 hypokalemia MESHD hypokalemia HP-, and 67 normokalemia patients. Gastrointestinal symptoms were not associated with hypokalemia MESHD hypokalemia HP among 108 hypokalemia MESHD hypokalemia HP patients (P>0.05). Body temperature, CK, CK-MB, LDH, and CRP were significantly associated with the severity of hypokalemia MESHD hypokalemia HP (P<0.01). 93% of severe and critically ill patients had hypokalemia MESHD hypokalemia HP which was most common among elevated CK, CK-MB, LDH, and CRP. Urine K+ loss was the primary cause of hypokalemia MESHD hypokalemia HP. severe hypokalemia MESHD hypokalemia HP patients was given 3 g/day, adding up to an average of 34 (SD=4) g potassium during hospital stay. The exciting finding was that patients responded well to K+ supplements when they were inclined to recovery. CONCLUSIONS: Hypokalemia MESHD Hypokalemia HP is prevailing in patients with COVID-19. The correction of hypokalemia MESHD hypokalemia HP is challenging because of continuous renal K+ loss resulting from the degradation of ACE2. The end of urine K+ loss indicates a good prognosis and may be a reliable, in-time, and sensitive biomarker directly reflecting the end of adverse effect on RAS system.

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MeSH Disease
Human Phenotype

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