Corpus overview


MeSH Disease

Human Phenotype


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    Clinical Course and Management of 73 Hospitalized Moderate Patients with COVID-19 Outside Wuhan

    Authors: Xiaojuan Peng; Qi Liu; Zhaolin Chen; Guiyan Wen; Qing Li; Yanfang Chen; Jie Xiong; Xinzhou Meng; Yuanjin Ding; Ying Shi; Shaohui Tang

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

    Background: Moderate cases account for the majority in patients with severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection MESHD and can also progress to severe/critical condition. Here, we investigated the clinical course and management of hospitalized moderate SARS-CoV-2 patients.Methods: The medical records and follow-up data were analyzed from the SARS-CoV-2 patients outside Wuhan.Results: A total of 73 moderate patients (38 men, 35 women) were included, with median age TRANS of 47.0 (38.5-57.5) years. Among them, only one patient (1.4%) died using active treatment to improve symptoms. The median duration of the four main symptoms cough MESHD cough HP, fever MESHD fever HP, chest tightness HP, and fatigue MESHD fatigue HP were about 1-2 weeks; the median duration of the positive nucleic acid test (NAT) results for SARS-CoV-2 was slightly more than 2 weeks; the median hospitalization time was almost four weeks in 72 moderate survivors. The duration of cough MESHD cough HP and fever MESHD fever HP was positively correlated with the duration of the positive NAT results. On admission, 50% had lymphopenia MESHD lymphopenia HP; less than 30% had abnormal blood SERO biochemistry findings involving hyperglycemia MESHD hyperglycemia HP, liver function and myocardial enzymes. At discharge, the laboratory indexes were substantially improved. Two weeks after discharge, 5.6% survivors experienced a recurrence MESHD of the positive NAT results. Conclusions: Moderate SARS-CoV-2 patients have a good prognosis by the active treatment. After discharge, it is necessary that moderate survivors undergo at least a 2-week collective medical observation in quarantine places, which can identify and treat a proportion of patients with re-positive NAT results and to prevent the spread of the potential sources of infection MESHD.

    The neutrophil-to-lymphocyte ratio determines clinical efficacy of corticosteroids therapy in patients with COVID-19

    Authors: Jingjing Cai; Haomiao Li; Ye-Mao Liu; Changjiang Zhang; Fang Lei; Juan-Juan Qin; Feng Zhou; Xiaohui Song; Liangjie Bai; Jianghua Zhou; Yan-Ci Zhao; Lihua Zhu; Peng Zhang; Xin Zhang; Juan Yang; Yan-Xiao Ji; Guang-Nian Zhao; Zhigang Lu; Liming Liu; Weiming Mao; Xiaofeng Liao; Haofeng Lu; Daihong Wang; Xigang Xia; Xiaodong Huang; Xiang Wei; Jiahong Xia; Bing-Hong Zhang; Yufeng Yuan; Yibin Wang; Xiao-Jing Zhang; Zhi-Gang She; Hongliang Li

    doi:10.21203/ Date: 2020-07-13 Source: ResearchSquare

    Preliminary results from the RECOVERY trial indicated that dexamethasone usage markedly reduced death MESHD rate in COVID-19 patients receiving invasive mechanical ventilation. However, the overall reduction for the entire patient cohort in that trial was much more modest, indicating highly variable effects of corticosteroid usage among COVID-19 patients. While steroid treatment is known to have both clinical efficacy and detrimental adverse-effects, defining a clinic parameter that could guide the beneficial corticosteroid usage for treating COVID-19 remains an elusive, urgent, and critical unmet need in COVID-19 therapy. Here, we undertook a multicentered retrospective study on a cohort of 12,862 confirmed COVID-19 cases from 21 hospitals in Hubei Province, China, including 3,254 received corticosteroid treatment and 9,608 received usual care without corticosteroid. We uncovered that the clinical benefits of corticosteroid use were closely associated with the neutrophil-to-lymphocyte ratio (NLR) measured at admission. Among participants with NLR > 6.12 at admission, corticosteroid treatment was significantly associated with a lower risk of 60-day all-cause mortality of COVID-19 based on both Cox model with time-varying exposure and Marginal Structural Model. However, in patients with NLR ≤ 6.12 at admission, corticosteroid treatment was no longer associated with reduced risk of all-cause death MESHD, but rather with increased risks of severe adverse effects, particularly in hyperglycemia MESHD hyperglycemia HP and infection MESHD. In diabetic patients with COVID-19, corticosteroid treatment was associated with increased glycemia, but not with a higher risk of 60-day mortality. Therefore, our study has uncovered NLR as a clinical indicator to stratify COVID-19 patients in their response to corticosteroid therapy. This finding may assist clinical evaluation and future randomized controlled trials to establish proper guidelines for corticosteroid therapy in COVID-19 patients.

    COVID-19 Comorbidity and Metabolic Syndrome MESHD: Is There a Molecular Basis?

    Authors: Madhurima Basu; Chinmay Saha; Kamalika Roy Choudhury; Susmita Dutta; Sujoy Ghosh; Subhankar Chowdhury; Satinath Mukhopadhyay; Nitai P. Bhattacharyya

    id:10.20944/preprints202006.0245.v1 Date: 2020-06-21 Source:

    The risk factors associated with COVID-19 related severity, morbidity, and mortality, i.e., obesity MESHD obesity HP (often associated with NAFLD), hyperglycemia MESHD hyperglycemia HP, hypertension MESHD hypertension HP and dyslipidemia all cluster together as metabolic syndrome MESHD (MetS). Instead of studying association of these risk factors with COVID-19, it makes sense studying the association between MetS on one hand and COVID-19 on the other. This study explores a molecular basis underpinning the above association. Severity of COVID-19 patients with MetS could be due to functional alterations of host proteins due to their interactions with viral proteins. We collected data from Enrichr (, DisGeNET ( and others and carried out enrichment analysis using Enrichr. Various biological processes and pathways associated with viral protein interacting partners are known to involve in metabolic diseases MESHD. The molecular pathways underlying insulin resistance MESHD insulin resistance HP, insulin signaling and insulin secretion are not only involved in diabetes but also in CVD and obesity MESHD obesity HP (associated with non-alcoholic fatty liver disease MESHD; NAFLD). Lipid metabolism/lipogenesis, fatty acid oxidation and inflammation MESHD are associated with MetS. Viral interacting host proteins are associated and enriched with terms like hyperglycemia MESHD hyperglycemia HP, coronary artery disease MESHD, hypertensive disease MESHD related to CVD and liver diseases MESHD in DisGeNET. Association of viral interacting proteins with disease MESHD-relevant biological processes, pathways and disease MESHD-related terms suggests that altered host protein function following interaction with viral proteins might contribute to frequent occurrence and/or severity of COVID-19 in subjects with MetS. Such analysis not only provides a molecular basis of comorbidity but also incriminates host proteins in viral replication, growth and identifies possible drug targets for intervention.

    GLUCOCOVID: A controlled trial of methylprednisolone in adults TRANS hospitalized with COVID-19 pneumonia MESHD pneumonia HP

    Authors: Luis Corral; Alberto Bahamonde; Francisco Arnaiz delas Revillas; Julia Gomez-Barquero; Jesica Abadia-Otero; Carmen Garcia-Ibarbia; Victor Mora; Ana cerezo-hernandez; Jose L Hernandez; Graciela Lopez-Muniz; Fernando Hernandez-Blanco; Jose M Cifrian; Jose M Olmos; Miguel Carrascosa; maria Carmen farinas; Jose A Riancho; - Glucocovid investigators

    doi:10.1101/2020.06.17.20133579 Date: 2020-06-18 Source: medRxiv

    Background. We aimed to determine whether a 6-day course of intravenous methylprednisolone (MP) improves outcome in patients with SARS CoV-2 infection MESHD infection at risk TRANS infection at risk TRANS at risk of developing Acute Respiratory Distress HP Syndrome MESHD (ARDS). Methods. Multicentric, partially randomized, preference, open-label trial, including adults TRANS with COVID-19 pneumonia MESHD pneumonia HP, impaired gas exchange and biochemical evidence of hyper- inflammation MESHD. Patients were assigned to standard of care (SOC), or SOC plus intravenous MP [40mg/12h 3 days, then 20mg/12h 3 days]. The primary endpoint was a composite of death MESHD, admission to the intensive care unit (ICU) or requirement of non-invasive ventilation (NIV). Results. We analyzed 85 patients (34, randomized to MP; 22, assigned to MP by clinician preference; 29, control group). Patient age TRANS (mean 68{+/-}yr) was related to outcome. The use of MP was associated with a reduced risk of the composite endpoint in the intention-to-treat, age TRANS-stratified analysis (combined risk ratio -RR- 0.55 [95% CI 0.33-0.91]; p=0.024). In the per-protocol analysis, RR was 0.11 (0.01-0.83) in patients aged TRANS 72 yr or less, 0.61 (0.32-1.17) in those over 72 yr, and 0.37 (0.19-0.74, p=0.0037) in the whole group after age TRANS-adjustment by stratification. The decrease in C-reactive protein levels was more pronounced in the MP group (p=0.0003). Hyperglycemia MESHD Hyperglycemia HP was more frequent in the MP group. Conclusions A short course of MP had a beneficial effect on the clinical outcome of severe COVID-19 pneumonia MESHD pneumonia HP, decreasing the risk of the composite end point of admission to ICU, NIV or death MESHD.

    Laboratory findings in coronavirus disease MESHD 2019 (COVID-19) patients: a comprehensive systematic review and meta-analysis

    Authors: Mohammad Karimian; Amirreza Jamshidbeigi; Gholamreza Badfar; Milad Azami

    doi:10.1101/2020.06.07.20124602 Date: 2020-06-08 Source: medRxiv

    Background: In early December 2019, the first patient with COVID-19 pneumonia MESHD pneumonia HP was found in Wuhan, Hubei Province, China. Recent studies have suggested the role of primary laboratory tests in addition to clinical symptoms for suspected patients, which play a significant role in the diagnosis of COVID-19. Therefore, the present study was conducted to evaluate laboratory findings in COVID-19 patients. Material and methods: The present meta-analysis was reported in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. This protocol is registered with the code CRD42019145410 in PROSPERO International Database. Results: Finally, 52 studies involving 5490 patients with COVID-19 entered the meta-analysis process. The prevalence SERO of leukopenia MESHD leukopenia HP, lymphopenia MESHD lymphopenia HP, elevated c-reactive protein (CRP), elevated erythrocyte sedimentation rate HP (ESR), elevated serum SERO amyloid A, elevated ferritin was estimated to be 20.9% (95%CI: 17.9-24.3), 51.6% (95%CI: 44.0-59.1), 63.6% (95%CI: 57.0-69.8), 62.5% (95%CI: 50.1-73.5), 63.6% (95%CI: 57.0-69.8), 62.5% (95%CI: 50.1-73.5), 74.7% (95%CI: 50.0-89.7), and 72.6% (95%CI: 58.1-83.5), respectively. The prevalence SERO of elevated interleukin-6 was 59.9% (95%CI: 48.2-70.5), CD3 was 68.3% (95%CI: 50.1-82.2), reduced CD4 was 62.0% (95%CI: 51.1-71.6), reduced CD8 was 42.7% (95%CI: 32.2-53.9). The prevalence SERO of elevated troponin-I was 20.6% (95%CI: 9.0-40.5), elevated creatine kinase-MB (CKMB) was 14.7% (95%CI: 7.1-28.0), elevated brain natriuretic peptide (BNP) was 48.9% (95%CI: 30.4-67.7), elevated blood SERO urea nitrogen was 13.1% (95%CI: 6.6-24.4),, elevated creatinine was 7.2% (95%CI: 4.4-11.8), elevated lactate dehydrogenase (LDH) was 53.1% (95%CI: 43.6-62.4), hyperglycemia MESHD hyperglycemia HP was 41.1% (95% CI: 28.2-55.5), elevated total bilirubin was 48.9% (95%CI: 30.4-67.7), reduced albumin was 54.7% (95%CI: 38.1-70.2), reduced pre-albumin was 49.0% (95%CI: 26.6-71.8), and reduced PT was 53.1% (95% CI: 43.6-62.4), and D-dimer was 44.9% (95%CI: 31.0-59.6). Conclusion This study provides a comprehensive description of laboratory characteristics in patients with COVID-19. The results show that lymphopenia MESHD lymphopenia HP, elevated CRP, elevated ESR, elevated ferritin, elevated serum SERO amyloid A, elevated BNP, reduced albumin, reduced pre-albumin, reduced CD3, reduced CD4, reduced CD8, elevated D-dimer, reduced PT, elevated interleukin-2, elevated interleukin-6, elevated LDH and hyperglycemia MESHD hyperglycemia HP are the common findings at the time of admission.

    Impaired glucose metabolism in patients with diabetes, prediabetes and obesity MESHD obesity HP is associated with severe Covid-19

    Authors: Stephen Smith; Avinash Boppana; Julie A Traupman; Enrique Unson; Daniel A Maddock; Kathy Y Chao; David P Dobesh; Ruth I Connor

    doi:10.1101/2020.06.04.20122507 Date: 2020-06-05 Source: medRxiv

    Background: Identification of risk factors of severe Covid-19 is critical for improving therapies and understanding SARS-CoV-2 pathogenesis. Methods: We analyzed 184 patients hospitalized for Covid-19 in Livingston, New Jersey for clinical characteristics associated with severe disease MESHD. Results: The majority of Covid-19 patients had diabetes mellitus MESHD diabetes mellitus HP (DM) (62.0%), Pre-DM (23.9%) with elevated FBG, or a BMI > 30 with normal HbA1C (4.3%). SARS-CoV-2 infection MESHD was associated with new and persistent hyperglycemia MESHD hyperglycemia HP in 29 patients, including several with normal HbA1C levels. Forty-four patients required intubation, which occurred significantly more often in patients with DM as compared to non-diabetics. Conclusions: Severe Covid-19 occurs in the presence of impaired glucose metabolism in patients with SARS-CoV-2 infection MESHD. The association of dysregulated glucose metabolism and severe Covid-19 suggests a previously unrecognized manifestation of primary SARS-CoV-2 infection MESHD. Exploration of pathways by which SARS-CoV-2 impacts glucose metabolism is critical for understanding disease MESHD pathogenesis and developing therapies.

    Negative impact of hyperglycemia MESHD hyperglycemia HP on Tocilizumab therapy in COVID-19 patients

    Authors: Raffaele Marfella; Pasquale Paolisso; Celestino Sardu; Luca Bergamaschi; Emanuela Concetta D' Angelo; Michelangela Barbieri; Maria Rosaria Rizzo; Vincenzo Messina; Paolo Maggi; Nicola Coppola; Carmine Pizzi; Maurizio Biffi; Pier Luigi Viale; Nazzareno Galie; Giuseppe Paolisso

    doi:10.1101/2020.04.29.20076570 Date: 2020-05-04 Source: medRxiv

    Tocilizumab is used for treating moderate-severe Covid-19 pneumonia MESHD pneumonia HP by targeting IL-6 receptors (IL-6R) and reducing cytokine release, but the pooled rate ratio among diabetic patients with adverse vs those with the more favorable course was 2.26. To date, the hyperglycemia MESHD hyperglycemia HP has been shown to increase IL-6 and IL-6R, which has been suggested as a severity predictor in lung diseases MESHD of Covid-19 patients. However, there are no data about the effects of tocilizumab therapy on outcomes of hyperglycemic Covid-19 patients with pneumonia MESHD pneumonia HP. To investigate this unsolved need, 475 Covid-19 positive patients were retrospectively studied since March 1st, 2020. Among them, 78 patients with pneumonia MESHD pneumonia HP disease MESHD and treated with tocilizumab were further evaluated for a severe outcome (encompassing both the use of mechanical ventilation and/or death MESHD). Thirty-one (39.7%) hyperglycemic and 47 (60.3%) normoglycemic Covid-19 positive patients ( blood SERO glucose levels >140 mg/dl, at admission and/or during hospital stay) were evaluated. Noteworthy, 20 (64%) of hyperglycemic and 11 (23.4%) of normoglycemic patients were also diabetics (P<0.01). At admission, more elevated IL-6 levels in hyperglycemic patients were found and persists even after Tocilizumab administration. In a risk adjusted Cox-regression analysis, Tocilizumab in hyperglycemic did not attenuate the risks of severe outcome as did in normoglycemic patients (p<0.009). Therefore, we could conclude that reduced effects of Tocilizumab in hyperglycemic patients may due to the higher plasma SERO IL-6 levels. Interestingly, when we added IL-6 levels in a Cox regression model the significance for the tocilizumab effect was lost (p<0.07). In this context, our observations evidence that optimal Covid-19 infection MESHD management with tocilizumab is not achieved during hyperglycemia MESHD hyperglycemia HP both in diabetic and non-diabetic patients.

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MeSH Disease
Human Phenotype

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