Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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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.

    A Comprehensive Evaluation of Early Predictors of Disease Progression MESHD in Patients with COVID-19: A Case Control Study

    Authors: Qiang Tang; Yanwei Liu; Yingfeng Fu; Ziyang Di; Kailiang Xu; Bo Tang; Hui Wu; Maojun Di

    doi:10.21203/rs.3.rs-50527/v1 Date: 2020-07-29 Source: ResearchSquare

    Background: The 2019 coronavirus disease MESHD (COVID-19) has become an unprecedented public health crisis with nearly 16 million confirmed cases TRANS and 630,000 deaths MESHD worldwide. Methods: We retrospectively investigated the demographic, clinical, laboratory, radiological and treatment data of COVID-19 patients consecutively enrolled from January 18 to May 15, 2020, in Taihe and Jinzhou central hospital. Results: Of all 197 patients, the median age TRANS was 66.5 years (IQR 7-76), and 120 (60.9%) patients were males TRANS. We identified 88 (44.7%) of 197 COVID-19 patients as the disease progression MESHD (aggravation) cases. The aggravation cases tend to have more medical comorbidity: hypertension MESHD hypertension HP (34.1%), diabetes (30.7%), and presented with dyspnea MESHD dyspnea HP (34.1%), neutrophilia HP (60.2%), and lymphocytopenia (73.9%), compared with those without. And the patients with disease progression MESHD showed significantly higher level of Fibrinogen (Fbg), D-dimer, IL-6, C-reactive protein (CRP), procalcitonin (PCT), and serum SERO ferritin, and were more prone to develop organ damage in the liver, kidney, and heart (P<0.05). Multivariable regression showed that advanced age TRANS, comorbidities, lymphopenia MESHD lymphopenia HP, and elevated level of Fbg, lactate dehydrogenase (LDH), Cardiac troponin (CTnI), IL-6, serum SERO ferritin were the significant predictors of disease progression MESHD. Further, we investigated antibody SERO responses to SARS-CoV-2 and found that the levels of IgM and IgG were significantly higher in the disease progression MESHD cases compared to non-progression cases from 3 weeks after symptom onset TRANS. In addition, the disease progression MESHD group tended to peak later and has a more vigorous IgM/IgG response against SARS-CoV-2. Further, we performed Kaplan-Meier analysis and found that 61.6% of patients had not experienced ICU transfer or survival from hospital within 25 days from admission.Conclusions: Investigating the potential factors of advanced age TRANS, comorbidities and elevated level of IL-6, serum SERO ferritin and Kaplan-Meier analysis enables early identification and management of patients with poor prognosis. Detection of the dynamic antibody SERO may offer vital clinical information during the course of SARS-CoV-2 and provide prognostic value for patients infection MESHD.  

    Older adults TRANS hospitalized with Covid-19: Clinical characteristics and early outcomes from a single center in Istanbul, Turkey 

    Authors: Alpay Medetalibeyoğlu; Naci Senkal; Murat Kose; Yunus Catma; Emine Bilge Caparali; Mustafa Erelel; Mustafa Oral Oncul; Gulistan Bahat; Tufan Tukek

    doi:10.21203/rs.3.rs-47728/v1 Date: 2020-07-22 Source: ResearchSquare

    Objective: Older adults TRANS have been continuously reported to be at higher risk for adverse outcomes of Covid-19. We aimed to describe clinical characteristics and early outcomes of the older Covid-19 patients hospitalized in our center comparatively with the younger patients, and also to analyze the triage factors that were related to the in-hospital mortality of older adults TRANS.Design: Retrospective; observational studySetting: Istanbul Faculty of Medicine hospital, TurkeyParticipants: 362 hospitalized patients with laboratory-confirmed Covid-19 from March 11 to May 11, 2020.Measurements: The demographic information; associated comorbidities; presenting clinical, laboratory, radiological characteristics on admission and outcomes from the electronic medical records were analyzed comparatively between the younger (<65 years) and older (≥65 years) adults TRANS. Factors associated with in-hospital mortality of the older adults TRANS were analyzed by multivariate regression analyses.Results: The median age TRANS was 56 years (interquartile range [IQR], 46-67), and 224 (61.9%) were male TRANS. There were 104 (28.7%) patients ≥65 years of age TRANS. More than half of the patients (58%) had one or more chronic comorbidity. The three most common presenting symptoms in the older patients were fatigue MESHD fatigue HP/ myalgia MESHD myalgia HP (89.4%), dry cough MESHD cough HP (72.1%), and fever MESHD fever HP (63.5%). Cough MESHD Cough HP and fever MESHD fever HP were significantly less prevalent in older adults TRANS compared to younger patients (p=0.001 and 0.008, respectively). Clinically severe pneumonia MESHD pneumonia HP was present in 31.5% of the study population being more common in older adults TRANS (49% vs. 24.4%) (p<0.001). The laboratory parameters that were significantly different between the older and younger adults TRANS were as follows: the older patients had significantly higher CRP, D-dimer, TnT, pro-BNP, procalcitonin levels, higher prevalence SERO of lymphopenia MESHD lymphopenia HP, neutrophilia HP, increased creatinine, and lower hemoglobin, ALT, albumin level (p<0.05). In the radiological evaluation, more than half of the patients (54.6%) had moderate-severe pneumonia MESHD pneumonia HP, which was more prevalent in older patients (66% vs. 50%) (p=0.006). The adverse outcomes were significantly more prevalent in older adults TRANS compared to the younger patients (ICU admission, 28.8% vs. 8.9%; mortality, 23.1% vs. 4.3%, p<0.001).  Among the triage evaluation parameters, the only factor associated with higher mortality was the presence of clinically severe pneumonia MESHD pneumonia HP on admission (Odds Ratio=12.3, 95% confidence interval=2.7-55.5, p=0.001).Conclusion: Older patients presented with more prevalent chronic comorbidities, less prevalent symptomatology but more severe respiratory signs and laboratory abnormalities than the younger patients. Among the triage assessment factors, the clinical evaluation of pulmonary involvement came in front to help clinicians to stratify the patients for mortality risk.

    The Efficacy of IL-6 Inhibitor Tocilizumab in Reducing Severe COVID-19 Mortality: A Systematic Review

    Authors: Avi Gurion Kaye; Robert Siegel

    doi:10.1101/2020.07.10.20150938 Date: 2020-07-14 Source: medRxiv

    Without proven, targeted therapies against SARS-CoV-2, it is crucial to counter the known pathophysiological causes of severe COVID-19, potentially utilizing existing drugs. Severe COVID-19 is largely the result of a dysregulated immune response characterized by lymphocytopenia, neutrophilia HP and critical hypercytokinemia, also called a cytokine storm. The IL-6 inhibitor tocilizumab (TCZ) could potentially suppress effects of the pro-inflammatory cytokine which drives the cytokine storm and thereby lower mortality from the disease MESHD. This systematic analysis aimed to investigate and synthesize existing evidence for the efficacy of TCZ in reducing COVID-19 mortality. PubMed and SearchWorks searches were performed to locate clinical studies with primary data on TCZ treatment for severe COVID-19. 9 case-control studies comparing mortality between TCZ and standard of care (SOC) were identified for a qualitative synthesis. In all of the studies, the odds ratio of mortality from COVID-19 pointed towards lower fatality with TCZ versus the SOC and a combined random effects odds ratio calculation yielded an odds ratio of 0.482 (p<0.001, 95% CI 0.326-0.713). Additionally, 12 uncontrolled trials were identified for a qualitative analysis producing a raw combined mortality rate of 13.6%. Results from the systematic analysis provide positive evidence for the potential efficacy of TCZ, validating the merit and need for ongoing clinical trials of the drug to treat severe COVID-19.

    Lymphocytopenia and neutrophilia HP deteriorate at the lowest oxygenation index timepoint in COVID-19 patient

    Authors: Wei-jun Hong; Yi-wen Xu; Wei-ling Li; Chun-qiang Xu; Xiao-fei Hu; Mei-xian Zhang; Hui-hui Xu; En Wang; Shao-fa Ke; Xiao-ping Jin; Gang Wu; Xi-chang Liu

    doi:10.21203/rs.3.rs-37626/v1 Date: 2020-06-23 Source: ResearchSquare

    BackgroundCoronavirus disease MESHD 2019 (COVID-19) spread throughout the world and caused hundreds of thousands of infected people to death MESHD. However, the pathogenesis of severe acute respiratory syndrome MESHD coronavirus-2 (SARS COV-2) is poorly understood. The objective of this study is to retrospectively explore the pathogenesis of COVID-19 from clinical laboratory findings, taking disease progression MESHD into account.MethodsA single-centered, retrospective study was carried out, which included moderate (n=76) and severe COVID-19 cases (n=22). The difference of laboratory findings from blood SERO routine examination and hepatorenal function test were retrospectively evaluated between the state of moderate and severe. The disease progression MESHD was indicated by oxygenation index.ResultsAge is a risk factor for disease progression MESHD from moderate to severe. Lymphocytopenia, neutrophilia HP, liver and kidney function decreasement occurred in severe patients on admission, compared with moderate patients. Lymphocytopenia and neutrophilia HP deteriorated at the lowest oxygenation index timepoint in the severe patients. And the oxygenation index was associated with ratio of lymphocyte and neutrophil in COVID-19 patients.ConclusionsLymphocytopenia and neutrophilia HP, which deteriorate in the progression of severe patients, are the main pathogenesis of COVID-19. More measures need to be taken to control lymphocytopenia and neutrophilia HP in severe COVID-19. Oxygenation index presented potentiality as predictor on the progression of COVID-19.  

    Analysis of the Primary Presenting Symptoms and Hematological Findings of COVID-19 Patients in Bangladesh

    Authors: Abu Taiub Mohammed Mohiuddin Chowdhury; Md Rezaul Karim; H.M. Hamidullah Mehedi; Mohammad Shahbaz; Md Wazed Chowdhury; Guo Dan; Shuixiang He

    id:10.20944/preprints202006.0275.v1 Date: 2020-06-21 Source: Preprints.org

    Objective: SARS-Cov-2 infection MESHD or COVID-19 is a global pandemic. From the time of identification to till, multiple clinical symptoms and parameters have been identified by the researchers of various countries and regions regarding the diagnosis and presentations of COVID-19 disease MESHD. In this manuscript, we investigated the primary symptoms and basic hematological presentations of SARS-CoV-2 infection MESHD among the Bangladeshi patients. Methodology: We have collected the disease MESHD history of mild to moderate degree of COVID-19 patients; hematological and biochemical on admission reports of moderate degree COVID-19 patients. All of them were tested positive for SARS-CoV-2 by RT-PCR in different institutes in Bangladesh. Results: According to this study though COVID-19 patients in Bangladesh commonly presented with fever MESHD fever HP, cough MESHD cough HP, fatigue MESHD fatigue HP, shortness of breath, and sore throat, but symptoms like myalgia MESHD myalgia HP, diarrhea MESHD diarrhea HP, skin rash HP, headache MESHD headache HP, Abdominal pain MESHD Abdominal pain HP/cramp, nausea MESHD nausea, vomiting HP, vomiting MESHD, restlessness HP, and a higher temperature of >1000F have a greater presentation rate and more frequent than other published studies. CRP and Prothrombin time was found to increase in all the patients. Serum SERO ferritin, ESR, SGPT, and D-Dimer were found increased among 53.85%, 80.43, 44%, and 25% patients respectively. 17.39% of the patients had leukocytosis MESHD leukocytosis HP and neutrophilia HP. 28.26% of patients presented with lymphocytopenia. 62.52% of patients had mild erythrocytopenia. Conclusion: Despite some similarities, our study has evaluated a different expression in presenting symptoms in the case of COVID-19 patients in Bangladesh. CRP, Prothrombin time, serum SERO ferritin, ESR, SGPT, D-Dimer, erythrocytopenia, and lymphocytopenia can be initial diagnostic hematological findings and assessment for prognosis COVID-19 disease MESHD. Also, gender TRANS variations have a different scenario of clinical and laboratory appearance in this region.

    Risk factors for the critical illness MESHD in SARS-CoV-2 infection MESHD: a multicenter retrospective cohort study

    Authors: Sijing Cheng; Dingfeng Wu; Jie Li; Yifeng Zou; Yunle Wan; Lihan Shen; Lixin Zhu; Mang Shi; Linlin Hou; Tao Xu; Na Jiao; Yichen Li; Yibo Huang; Zhipeng Tang; Mingwei Xu; Shusong Jiang; Maokun Li; Guangjun Yan; Ping Lan; Ruixin Zhu

    doi:10.21203/rs.3.rs-35957/v2 Date: 2020-06-16 Source: ResearchSquare

    Background: Prior studies reported that 5~32% COVID-19 patients were critically ill, a situation that poses great challenge for the management of the patients and ICU resources. We aim to identify independent risk factors to serve as prediction markers for critical illness MESHD of SARS-CoV-2 infection MESHD. Methods : Fifty-two critical and 200 non-critical SARS-CoV-2 nucleic acid positive patients hospitalized in 15 hospitals outside Wuhan from January 19 to March 6, 2020 were enrolled in this study. Multivariable logistic regression and LASSO logistic regression were performed to identify independent risk factors for critical illness MESHD.Results: Age TRANS older than 60 years, dyspnea MESHD dyspnea HP, respiratory rate > 24 breaths per min, leukocytosis MESHD leukocytosis HP >9.5 X109/L, neutrophilia HP >6.3 X109/L, lymphopenia MESHD lymphopenia HP <1.1 X109/L, neutrophil-to-lymphocyte ratio >3.53, fibrinogen >4g/L, d-dimer >0.55 µg/mL, blood SERO urea nitrogen >7.1 mM, elevated aspartate transaminase, elevated alanine aminotransferase, total bilirubin >21 µM, and Sequential Organ Failure Assessment (SOFA) score ≥2 were identified as risk factors for critical illness MESHD. LASSO logistic regression identified the best combination of risk factors as SOFA score, age TRANS, dyspnea MESHD dyspnea HP, and leukocytosis MESHD leukocytosis HP. The Area Under the Receiver-Operator Curve values for the risk factors in predicting critical illness MESHD were 0.921 for SOFA score, 0.776 for age TRANS, 0.764 for dyspnea MESHD dyspnea HP, 0.658 for leukocytosis MESHD leukocytosis HP, and 0.960 for the combination of the four risk factors.Conclusions: Our findings advocate the use of risk factors SOFA score ≥2, age TRANS >60, dyspnea MESHD dyspnea HP and leukocytosis MESHD leukocytosis HP >9.5 X109/L on admission, alone or in combination, to determine the optimal management of the patients and health care resources.

    "Analysis of the Primary Presenting Symptoms and Hematological Findings of COVID19 Patients in Bangladesh"

    Authors: Abu Taiub Mohammed Mohiuddin Chowdhury; Md Rezaul Karim; H.M.Hamidullah Mehedi; Mohammad Shahbaz; Md Wazed Chowdhury; Dan Guo; Shuixiang He

    doi:10.21203/rs.3.rs-35016/v1 Date: 2020-06-12 Source: ResearchSquare

    Background:SARS-Cov-2 infection MESHD or COVID-19 is a global pandemic. From the time of identification to till, multiple clinical symptoms and parameters have been identified by the researchers of various countries and regions regarding the diagnosis and presentations of COVID19 disease MESHD. In this manuscript, we investigated the primary symptoms and basic hematological presentations of SARS-CoV-2 infection MESHD among the Bangladeshi patients. Methodology: We have collected the disease MESHD history of mild to moderate degree of COVID19 patients; hematological and biochemical on admission reports of moderate degree COVID19 patients.  All of them were tested positive for SARS-CoV-2 by RT PCR in different institutes in Bangladesh. Results: According to this study though COVID19 patients in Bangladesh commonly presented with fever MESHD fever HP, cough MESHD cough HP, fatigue MESHD fatigue HP, shortness of breath, and sore throat, but symptoms like myalgia MESHD myalgia HP, diarrhea MESHD diarrhea HP, skin rash HP, headache MESHD headache HP, Abdominal pain MESHD Abdominal pain HP/cramp, nausea MESHD nausea, vomiting HP, vomiting MESHD, restlessness HP, and a higher temperature of >1000F have a greater presentation rate and more frequent than other published studies. CRP and Prothrombin time was found to increase in all the patients. Serum SERO ferritin, ESR, SGPT, and D-Dimer were found increased among 53.85%, 80.43, 44%, and 25% patients respectively. 17.39% of the patients had leucocytosis and neutrophilia HP. 28.26% of patients presented with lymphocytopenia. 62.52% of patients had mild erythrocytopenia. Conclusion: Despite some similarities, our study has evaluated a different expression in presenting symptoms in the case of COVID19 patients in Bangladesh. CRP, Prothrombin time, serum SERO ferritin, ESR, SGPT, D-Dimer, erythrocytopenia, and lymphocytopenia can be initial diagnostic hematological findings and assessments for prognosis COVID19 disease MESHD. Also, Gender TRANS variation has a different scenario of clinical and laboratory appearance in this region.

    Are Patients with Elevated Inflammatory Indications are at Higher Risk for Developing the Severe form of COVID-19?

    Authors: Mohsen Rokni; Kazem Ahmadikia; Somaye Asghari; Shahabodin Mashaei; Fahimeh Hassanali

    doi:10.21203/rs.3.rs-34994/v1 Date: 2020-06-12 Source: ResearchSquare

    BackgroundSince December 2019, when SARS-CoV-2 emerged with a cluster of unknown pneumonia MESHD pneumonia HP cases in Wuhan city and rapidly spread throughout in worldwide and Iran, data have been needed on the clinical and diagnostic features of the affected Iranian patients.MethodsWe extracted data regarding 233 patients with laboratory-confirmed COVID-19 from Buali Hospital in Iran; clinical/praclinical and inflammatory indexes data were collected and analyzed. The data of laboratory examinations and chest CT findings were compared between death MESHD and non-severe patients.ResultsThe mean age TRANS of the patients was 49 years, (63%) of the patients were male TRANS. The acute respiratory distress HP syndrome MESHD occurred in 64 patients, including 53 who were admitted to the ICU and underwent invasive mechanical ventilation, and 28 who died. On the admission in death MESHD group, lymphopenia MESHD lymphopenia HP (79%), neutrophilia HP (79%), and thrombocytopenia MESHD thrombocytopenia HP (21%) were usually observed. Most patients had a high SII index of > 500 (68%), increased CRP level (88%). A high level of inflammatory index’s such as NLR, PLR and SII in death MESHD comparison with moderate groups were observed (P < 0.001). The most common symptoms were fever MESHD fever HP (70%) and cough MESHD cough HP (63%) on admission. Headache MESHD Headache HP was uncommon (11%). On admission, ground-glass opacity with consolidation (mixed) was the most common radiologic finding on chest CT (51%). No radiographic or CT abnormality was found in 15 of 204 patients (7%). In ConclusionThese patients often presented without fever MESHD fever HP, and some did not have abnormal radiologic findings. Elevated NLR, PLR and SII can be considered as prognostic and risk stratifying factor of severe form of disease MESHD.

    Infliximab Attenuates Paediatric Inflammatory Multisystem Syndrome MESHD in SARS-CoV-2 (PIMS-TS)

    Authors: Joseph Meredith; Cher-Antonia Khedim; Paul Henderson; David C. Wilson; Richard K. Russell

    id:10.20944/preprints202006.0118.v1 Date: 2020-06-09 Source: Preprints.org

    Paediatric inflammatory multisystem syndrome MESHD temporally associated with SARS-CoV-2 (PIMS-TS) is a newly described condition. It has a spectrum of presentations related to hyperinflammation and cytokine storm. We report the first case of PIMS-TS in a child TRANS on established anti-Tumor Necrosis MESHD Factor-alpha (anti-TNF-α) therapy; a 10 year-old girl with ulcerative colitis MESHD ulcerative colitis HP treated with infliximab. The patient had 6-weeks of daily fever MESHD fever HP with mucocutaneous, gastrointestinal, renal and hematologic involvement. Biomarkers of hyperinflammation were present including: hyperferritinaemia (up to 691 µ/L; normal 15-80 µg/L), C-reactive protein (CRP) (>100mg/L for >10 days, normal 0-5 mg/L), erythrocyte sedimentation rate (ESR) consistently >100mm/hr (normal 0-15 mm/hr), raised white cell count with neutrophilia HP, elevated D-dimer and lactate dehydrogenase (LDH), anaemia and Mott cells on bone marrow analysis. Extensive investigations for alternative diagnoses for pyrexia of unknown origin (PUO) were negative. The condition was refractory to treatment with intravenous immunoglobulin (IVIG) but improved within 24hrs of high dose methylprednisolone. Infliximab treatment followed and the patient has remained well at follow up. Polymerase chain reaction (PCR) and serology for SARS-CoV-2 were negative. Current series report such negative findings in up to half of cases. The patient experienced a milder clinical phenotype without cardiac involvement, shock MESHD shock HP or organ failure. It is postulated that prior anti-TNF-α therapy attenuated the disease MESHD course. Infliximab therapy may interfere with serology testing and produce false negative results. This case supports the need for investigation into infliximab as primary therapy for PIMS-TS.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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