Corpus overview


MeSH Disease

Human Phenotype


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    Clinical Characteristics and Severity of COVID-19 Disease MESHD in Patients from Boston Area Hospitals

    Authors: Hesamaddin Torabi Dashti; David Bates; Julie M Fiskio; Elise C Roche; Samia Mora; Olga Demler

    doi:10.1101/2020.07.27.20163071 Date: 2020-08-04 Source: medRxiv

    We summarize key demographic, clinical, and medical characteristics of patients with respect to the severity of COVID-19 disease MESHD using Electronic Health Records Data of 4,140 SARS-CoV-2 positive subjects from several large Boston Area Hospitals. We found that prior use of antihypertensive medications as well as lipid lowering and other cardiovascular drugs (such as direct oral anticoagulants and antiplatelets) all track with increased severity of COVID-19 and should be further investigated with appropriate adjustment for confounders such as age TRANS and frailty MESHD. The three most common prior comorbidities are hyperlipidemia MESHD hyperlipidemia HP, hypertension MESHD hypertension HP, and prior pneumonia MESHD pneumonia HP, all associated with increased severity.

    COVID-19 among people living with HIV: A systematic review

    Authors: Hossein Mirzaei; Willi McFarland; Mohammad Karamouzian; Hamid Sharifi

    doi:10.1101/2020.07.11.20151688 Date: 2020-07-14 Source: medRxiv

    This systematic review summarizes the evidence on the earliest patients with COVID-19-HIV co- infection MESHD. We searched PubMed, Scopus, Web of Science, Embase, preprint databases, and Google Scholar from December 01, 2019 to June 1, 2020. From an initial 547 publications and 75 reports, 25 studies provided specific information on COVID-19 patients living with HIV. Studies described 252 patients, 80.9% were male TRANS, mean age TRANS was 52.7 years, and 98% were on ART. Co-morbidities in addition to HIV and COVID-19 (multimorbidity) included hypertension MESHD hypertension HP (39.3%), obesity MESHD obesity HP or hyperlipidemia MESHD hyperlipidemia HP (19.3%), chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP (18.0%), and diabetes (17.2%). Two-thirds (66.5%) had mild to moderate symptoms, the most common being fever MESHD fever HP (74.0%) and cough MESHD cough HP (58.3%). Among patients who died, the majority (90.5%) were over 50 years old, male TRANS (85.7%), and had multimorbidity (64.3%). Our findings highlight the importance of identifying co- infections MESHD, addressing co-morbidities, and ensuring a secure supply of ART for PLHIV during the COVID-19 pandemic.

    The natural history of symptomatic COVID-19 in Catalonia, Spain: a multi-state model including 109,367 outpatient diagnoses, 18,019 hospitalisations, and 5,585 COVID-19 deaths MESHD among 5,627,520 people

    Authors: Edward Burn; Cristian Tebe; Sergio Fernandez-Bertolin; Maria Aragon; Martina Recalde; Elena Roel; Albert Prats-Uribe; Daniel Prieto-Alhambra; Talita Duarte-Salles

    doi:10.1101/2020.07.13.20152454 Date: 2020-07-14 Source: medRxiv

    Background The natural history of Coronavirus Disease MESHD 2019 (COVID-19) has yet to be fully described, with most previous reports focusing on hospitalised patients. Using linked patient-level data, we set out to describe the associations between age TRANS, gender TRANS, and comorbidities and the risk of outpatient COVID-19 diagnosis, hospitalisation, and/or related mortality. Methods A population-based cohort study including all individuals registered in Information System for Research in Primary Care (SIDIAP). SIDIAP includes primary care records covering > 80% of the population of Catalonia, Spain, and was linked to region-wide testing, hospital and mortality records. Outpatient diagnoses of COVID-19, hospitalisations with COVID-19, and deaths MESHD with COVID-19 were identified between 1st March and 6th May 2020. A multi-state model was used, with cause-specific Cox survival models estimated for each transition. Findings A total of 5,664,652 individuals were included. Of these, 109,367 had an outpatient diagnosis of COVID-19, 18,019 were hospitalised with COVID-19, and 5,585 died after either being diagnosed or hospitalised with COVID-19. Half of those who died were not admitted to hospital prior to their death MESHD. Risk of a diagnosis with COVID-19 peaked first in middle- age TRANS and then again for oldest ages TRANS, risk for hospitalisation after diagnosis peaked around 70 years old, with all other risks highest at oldest ages TRANS. Male TRANS gender TRANS was associated with an increased risk for all outcomes other than outpatient diagnosis. The comorbidities studied (autoimmune condition, chronic kidney disease HP kidney disease MESHD, chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP, dementia MESHD dementia HP, heart disease MESHD, hyperlipidemia MESHD hyperlipidemia HP, hypertension, malignant MESHD hypertension HP neoplasm MESHD neoplasm HP, obesity MESHD obesity HP, and type 2 diabetes) were all associated with worse outcomes. Interpretation There is a continued need to protect those at high risk of poor outcomes, particularly the elderly TRANS, from COVID-19 and provide appropriate care for those who develop symptomatic disease MESHD. While risks of hospitalisation and death MESHD are lower for younger populations, there is a need to limit their role in community transmission TRANS. These findings should inform public health strategies, including future vaccination campaigns.

    Clinical, Behavioral and Social Factors Associated with Racial Disparities in Hospitalized and Ambulatory COVID-19 Patients from an Integrated Health Care System in Georgia

    Authors: Felipe Lobelo; Alan X Bienvenida; Serena Leung; Armand N Mbanya; Elizabeth J. Leslie; Kate E Koplan; S. Ryan Shin

    doi:10.1101/2020.07.08.20148973 Date: 2020-07-10 Source: medRxiv

    Introduction: Racial and ethnic minorities have shouldered a disproportioned burden of coronavirus disease MESHD 2019 (COVID-19) infection MESHD to date in the US, but data on the various drivers of these disparities is limited. Objectives: To describe the characteristics and outcomes of COVID-19 patients and explore factors associated with hospitalization risk by race. Methods: Case series of 448 consecutive patients with confirmed COVID-19 seen at Kaiser Permanente Georgia (KPGA), an integrated health care system serving the Atlanta metropolitan area, from March 3 to May 12, 2020. KPGA members with laboratory-confirmed COVID-19. Multivariable analyses for hospitalization risk also included an additional 3489 persons under investigation (PUI) with suspected infection MESHD. COVID-19 treatment and outcomes, underlying comorbidities and quality of care management metrics, socio-demographic and other individual and community-level social determinants of health (SDOH) indicators. Results: Of 448 COVID-19 positive members, 68,3% was non-Hispanic Black (n=306), 18% non-Hispanic White (n=81) and 13,7% Other race (n=61). Median age TRANS was 54 [IQR 43-63) years. Overall, 224 patients were hospitalized, median age TRANS 60 (50-69) years. Black race was a significant factor in the Confirmed + PUI, female TRANS and male TRANS models (ORs from 1.98 to 2.19). Obesity MESHD Obesity HP was associated with higher hospitalization odds in the confirmed, confirmed + PUI, Black and male TRANS models (ORs from 1.78 to 2.77). Chronic disease MESHD control metrics (diabetes, hypertension MESHD hypertension HP, hyperlipidemia MESHD hyperlipidemia HP) were associated with lower odds of hospitalization ranging from 48% to 35% in the confirmed + PUI and Black models. Self-reported physical inactivity was associated with 50% higher hospitalization odds in the Black and Female TRANS models. Residence in the Northeast region of Atlanta was associated with lower hospitalization odds in the Confirmed + PUI, White and female TRANS models (ORs from 0.22 to 0.64) Conclusions: We found that non-Hispanic Black KPGA members had a disproportionately higher risk of infection TRANS risk of infection TRANS infection MESHD and, after adjusting for covariates, twice the risk of hospitalization compared to other race groups. We found no significant differences in clinical outcomes or mortality across race/ethnicity groups. In addition to age TRANS, sex and comorbidity burden, pre-pandemic self-reported exercise, metrics on quality of care and control of underlying cardio- metabolic diseases MESHD, and location of residence in Atlanta were significantly associated with hospitalization risk by race groups. Beyond well-known physiologic and clinical factors, individual and community-level social indicators and health behaviors must be considered as interventions designed to reduce COVID-19 disparities and the systemic effects of racism are implemented.

    Association of hyperlipidemia MESHD hyperlipidemia HP and statin use with severity of COVID-19

    Authors: Wilnard YT Tan; Barnaby E Young; David Chien Lye; Daniel EK Chew; Rinkoo Dalan

    doi:10.21203/ Date: 2020-07-03 Source: ResearchSquare

    Background and Aims: We aim to study the association of hyperlipidemia and statin use with COVID-19 severity.Methods: We analysed a retrospective cohort of 717 patients admitted to a tertiary centre in Singapore for COVID-19 infection MESHD. Clinical outcomes of interest were oxygen saturation ≤94% requiring supplemental oxygen, intensive-care unit (ICU) admission , invasive mechanical-ventilation and death MESHD. Logistic regression models were used to study the  association between hyperlipidemia MESHD hyperlipidemia HP and clinical outcomes adjusted for age TRANS, gender TRANS and ethnicity.  Statin treatment effect was determined , in a nested case-control design, through logistic treatment models with 1:3 propensity matching for age TRANS, gender TRANS and ethnicity. All statistical tests were two-sided, and statistical significance was taken as p < 0.05.Results: One hundred fifty-six (21.8%) patients had hyperlipidemia MESHD hyperlipidemia HP and 97% were on statins. There were no significant associations between hyperlipidemia MESHD hyperlipidemia HP and clinical outcomes. Logistic treatment models showed a lower chance of ICU admission for statin users when compared to non-statin users (ATET: b-0.12(-0.23,-0.01); p=0.028). There were no other significant differences in other outcomes.Conclusion: Treated hyperlipidemia MESHD hyperlipidemia HP was not an independent risk factor for severe COVID-19. Statin use independently associated with lower ICU admission. This supports current practice to continue prescription of statins in COVID-19 patients.

    Impact of COVID-19 on Neurological Manifestations: An Overview of Stroke MESHD Stroke HP Presentation in Pandemic.

    Authors: Nida Fatima; Maher Saqqur; Ashfaq Shauib

    doi:10.21203/ Date: 2020-06-18 Source: ResearchSquare

    Introduction: Corona virus disease MESHD 2019 (COVID-19) pandemic has become a globally challenging issue after its emergence in December 2019 from Wuhan, China. Despite its common presentation as respiratory distress HP, patients with COVID-19 have also shown neurological manifestation especially stroke MESHD stroke HP. Therefore, the authors sought to determine the etiology, underlying risk factors, and outcomes among patients with COVID-19 presenting with stroke MESHD stroke HP. Methods: We conducted a systematic review of the electronic database (PubMed, Google Scholar, Scopus, Medline, EMBASE, and Cochrane library) using different MeSH terms from January 2000 to June 2020. Results: A total of 39 patients with stroke MESHD stroke HP from 6 studies were included. The mean age TRANS of our included patients was 61.4±14.2 years. Majority of the patients (92.3%) with COVID-19 had ischemic stroke HP stroke MESHD, 5.1% had hemorrhagic stroke MESHD stroke HP, and 2.6% had cerebral venous thrombosis HP venous thrombosis MESHD at the time of initial clinical presentation. Almost all of the patients presented had underlying risk factors predisposing to stroke MESHD stroke HP which included, diabetes mellitus MESHD diabetes mellitus HP, hyperlipidemia MESHD hyperlipidemia HP, hypertension MESHD hypertension HP, and previous history of cerebrovascular disease MESHD. 51.2% of the included patients infected with COVID-19 with stroke MESHD stroke HP died, while remaining patients were either discharged home or transferred to a rehabilitation unit.  Conclusion: Exploring the neurological manifestation in terms of stroke MESHD stroke HP among patients with COVID-19 is a step towards better understanding of the virus, preventing further spread, and treating the patients affected by this pandemic.

    Plasma SERO levels of soluble ACE2 are associated with sex, Metabolic Syndrome MESHD, and its biomarkers in a large cohort, pointing to a possible mechanism for increased severity in COVID-19

    Authors: Sergey A Kornilov; Isabelle Lucas; Kathleen Jade; Chengzhen L Dai; Jennifer C Lovejoy; Andrew T Magis

    doi:10.1101/2020.06.10.20127969 Date: 2020-06-12 Source: medRxiv

    We examined the associations between plasma SERO concentrations of soluble ACE2 and biomarkers of Metabolic Syndrome MESHD in a large (N=2,051) sample of individuals who participated in a commercial wellness program and who underwent deep molecular phenotyping. sACE2 levels were significantly higher in men, compared to women, and in individuals with Metabolic Syndrome MESHD, compared to controls. sACE2 levels showed reliable associations with all individuals components of Metabolic Syndrome MESHD, including obesity MESHD obesity HP, hypertension MESHD hypertension HP, insulin resistance MESHD insulin resistance HP, hyperlipidemia MESHD hyperlipidemia HP, and as well as markers of liver damage. This profile of associations was statistically significantly stronger in men, compared to women, and suggests that preexisting cardiometabolic conditions might confer increased severity of symptoms in some COVID-19 patients through increased expression of ACE2 in the liver.

    A tertiary center experience of multiple myeloma MESHD multiple myeloma HP patients with COVID-19: lessons learned and the path forward

    Authors: Bo Wang; Oliver Van Oekelen; Tarek Mouhieddine; Diane Marie Del Valle; Joshua Richter; Hearn Jay Cho; Shambavi Richard; Ajai Chari; Sacha Gnjatic; Miriam Merad; Sundar Jagannath; Samir Parekh; Deepu Madduri

    doi:10.1101/2020.06.04.20122846 Date: 2020-06-05 Source: medRxiv

    Background: The COVID-19 pandemic, caused by SARS-CoV-2 virus, has resulted in over 100,000 deaths MESHD in the United States. Our institution has treated over 2,000 COVID-19 patients during the pandemic in New York City. The pandemic directly impacted cancer patients and the organization of cancer care. Mount Sinai Hospital has a large and diverse multiple myeloma MESHD multiple myeloma HP (MM) population. Herein, we report the characteristics of COVID-19 infection MESHD and serological response in MM patients in a large tertiary care institution in New York. Methods: We performed a retrospective study on a cohort of 58 patients with a plasma SERO-cell disorder (54 MM, 4 smoldering MM) who developed COVID-19 between March 1, 2020 and April 30, 2020. We report epidemiological, clinical and laboratory characteristics including persistence of viral detection by polymerase chain reaction (PCR) and anti- SARS-CoV-2 antibody SERO testing, treatments initiated, and outcomes. Results: Of the 58 patients diagnosed with COVID-19, 36 were hospitalized and 22 were managed at home. The median age TRANS was 67 years; 52% of patients were male TRANS and 63% were non-white. Hypertension MESHD Hypertension HP (64%), hyperlipidemia MESHD hyperlipidemia HP (62%), obesity MESHD obesity HP (37%), diabetes mellitus MESHD diabetes mellitus HP (28%), chronic kidney disease HP kidney disease MESHD (24%) and lung disease MESHD (21%) were the most common comorbidities. In the total cohort, 14 patients (24%) died. Older age TRANS (>70 years), male TRANS sex, cardiovascular risk, and patients not in complete remission (CR) or stringent CR were significantly (p<0.05) associated with hospitalization. Among hospitalized patients, laboratory findings demonstrated elevation of traditional inflammatory markers (CRP, ferritin, D-dimer) and a significant (p<0.05) association between elevated inflammatory markers, severe hypogammaglobulinemia, non-white race, and mortality. Ninety-six percent (22/23) of patients developed antibodies to SARS-CoV-2 SERO at a median of 32 days after initial diagnosis. Median time to PCR negativity was 43 (range 19-68) days from initial positive PCR. Conclusions: Drug exposure and MM disease MESHD status at the time of contracting COVID-19 had no bearing on mortality. Mounting a severe inflammatory response to SARS-CoV-2 and severe hypogammaglobulinemia were associated with higher mortality. The majority of patients mounted an antibody SERO response to SARS-CoV-2. These findings pave a path to identification of vulnerable MM patients who need early intervention to improve outcome in future outbreaks of COVID-19.

    Seek COVER: Development and validation of a personalized risk calculator for COVID-19 outcomes in an international network

    Authors: Ross D. Williams; Aniek F. Markus; Cynthia Yang; Talita Duarte Salles; Scott L Duvall; Thomas Falconer; Jitendra Jonnagaddala; Chungsoo Kim; Yeunsook Rho; Andrew Williams; Amanda Alberga; Min Ho An; María Aragón; Carlos Areia; Edward Burn; Young Choi; Iannis Drakos; Maria Fernandes Abrahão; Sergio Fernández-Bertolín; George Hripcsak; Benjamin Kaas-Hansen; Prasanna Kandukuri; Jan A. Kors; Kristin Kostka; Siaw-Teng Liaw; Kristine E Lynch; Michael E Matheny; Gerardo Machnicki; Daniel Morales; Fredrik Nyberg; Rae Woong Park; Albert Prats-Uribe; Nicole Pratt; Gowtham Rao; Christian G. Reich; Marcela Rivera; Tom Seinen; Azza Shoaibi; Matthew E. Spotnitz; Ewout W. Steyerberg; Marc A Suchard; Seng Chan You; Lin Zhang; Lili Zhou; Patrick B. Ryan; Daniel Prieto-Alhambra; Jenna M. Reps; Peter R. Rijnbeek

    doi:10.1101/2020.05.26.20112649 Date: 2020-05-27 Source: medRxiv

    Abstract Importance COVID-19 is causing high mortality worldwide. Developing models to quantify the risk of poor outcomes in infected patients could help develop strategies to shield the most vulnerable during de-confinement. Objective To develop and externally validate COVID-19 Estimated Risk (COVER) scores that quantify a patient's risk of hospital admission (COVER-H), requiring intensive services (COVER-I), or fatality (COVER-F) in the 30-days following COVID-19 diagnosis. Design Multinational, distributed network cohorts. Setting We analyzed a federated network of electronic medical records and administrative claims data from 13 data sources and 6 countries, mapped to a common data model. Participants Model development used a patient population consisting of >2 million patients with a general practice (GP), emergency MESHD room (ER), or outpatient (OP) visit with diagnosed influenza or flu-like symptoms any time prior to 2020. The model was validated on patients with a GP, ER, or OP visit in 2020 with a confirmed or suspected COVID-19 diagnosis across four databases from South Korea, Spain and the United States. Outcomes Age TRANS, sex, historical conditions, and drug use prior to index date were considered as candidate predictors. Outcomes included i) hospitalization with pneumonia MESHD pneumonia HP, ii) hospitalization with pneumonia MESHD pneumonia HP requiring intensive services or death MESHD, and iii) death MESHD in the 30 days after index date. Results Overall, 43,061 COVID-19 patients were included for model validation, after initial model development and validation using 6,869,127 patients with influenza or flu-like symptoms. We identified 7 predictors (history of cancer, chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP, diabetes, heart disease MESHD, hypertension MESHD hypertension HP, hyperlipidemia MESHD hyperlipidemia HP, and kidney disease MESHD) which combined with age TRANS and sex could discriminate which patients would experience any of our three outcomes. The models achieved high performance SERO in influenza. When transported to COVID-19 cohorts, the AUC ranges were, COVER-H: 0.73-0.81, COVER-I: 0.73-0.91, and COVER-F: 0.82-0.90. Calibration was overall acceptable, with overestimated risk in the most elderly TRANS and highest risk strata. Conclusions and relevance A 9-predictor model performs well for COVID-19 patients for predicting hospitalization, intensive services and death MESHD. The models could aid in providing reassurance for low risk patients and shield high risk patients from COVID-19 during de-confinement to reduce the virus' impact on morbidity and mortality.

    Development and Validation of a Nomogram to Predict Deteriorating Trajectory in Patients with COVID-19 Infection MESHD: A Population-Based Prospective Study

    Authors: Wei Chen; Menglin Zhu; Jian Li; Cuiping Pan; Demian Zhao; Yuting Jin; Manxiu Li; Shun Wu; Yaojun Feng; Tiejun Wang

    doi:10.21203/ Date: 2020-05-21 Source: ResearchSquare

    Background Most of the patients with COVID-19 infection MESHD are mild to moderate initially. However, there is no effective prediction for the patients to develop into severe or extremely severe. This study aims to develop an effective clinical prediction model.Methods A single-center, retrospective, observational study conducted. A nomogram was conducted based on the results of multivariate logistic regression analysis.  Results A total of 483 patients diagnosed mild to moderate were included, among these patients 62 developed severe or extremely critical illness MESHD. Seven variables including hyperlipidemia MESHD hyperlipidemia HP, vomiting MESHD vomiting HP, diarrhea MESHD diarrhea HP, lymphocyte, imaging and mentality were associated with deteriorating trajectory. The ROC curve showed that model was robust, for which the area under the curve of the training set and the validation set are 0.873 and 0.813.Conclusions For patients with mild to moderate COVID-19 infection MESHD, nomogram score can effectively predict the possibility of patients developing into severe or extremely critical.

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MeSH Disease
Human Phenotype

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