Corpus overview


MeSH Disease

Human Phenotype


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    Association of Diabetes and Outcomes in Patients with COVID-19: A Propensity Score Matched Analyses from a French Retrospective Cohort

    Authors: Willy Sutter; Baptiste Duceau; Aurélie Carlier; Antonin Trimaille; Thibaut Pommier; Oriane Weizman; Joffrey Cellier; Laura Geneste; Vassili Panagides; Wassima Marsou; Antoine Deney; Sabir Attou; Thomas Delmotte; Sophie Ribeyrolles; Pascale Chemaly; Clément Karsenty; Gauthier Giordano; Alexandre Gautier; Corentin Chaumont; Pierre Guilleminot; Audrey Sagnard; Julie Pastier; maxime Vignac; delphine Mika; Charles Fauvel; Théo Pezel; Ariel Cohen; Guillaume Bonnet; Ronan Roussel; Louis POTIER

    doi:10.21203/ Date: 2020-07-31 Source: ResearchSquare

    Background: To compare the clinical outcomes between patients with and without diabetes admitted to hospital with COVID-19.Methods: Retrospective multicentre cohort study from 24 academic tertiary medical centres in France including 2851 patients (675 with diabetes) hospitalised for COVID-19 between February 26 and April 20, 2020. A propensity score matching method (1:1 matching including patient characteristics, medical history, vital signs, and laboratory results) was used to compare patients with and without diabetes (n=603 in each group). The primary outcome was admission to intensive care unit (ICU) or in-hospital death MESHD. Results: Patients with diabetes were older (71 ± 13 vs. 65 ± 18 years; p<0.001), were less often female TRANS (38% vs. 44%; p<0.001) and more likely to have comorbidities: hypertension MESHD hypertension HP (79% vs 42%; p<0.001), coronary heart disease MESHD (23% vs 9%; p<0.001), stroke MESHD stroke HP (13% vs 8%; p<0.001), heart failure MESHD (17% vs 9%; p<0.001), chronic kidney disease HP kidney disease MESHD (26% vs 10%; p<0.001), and chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP (7% vs 5%; p<0.05). The primary outcome occurred in 584 (36.4%) patients with diabetes compared to 246 (26.8%) in those without diabetes (p<0.001). After propensity score matching, the risk of primary outcome was similar in patients with and without diabetes (hazard ratio [HR] 1.16, 95%CI 0.95-1.41, p=0.14) and was 1.29 (95%CI 0.97 – 1.69) for in-hospital mortality, 1.26 (95%CI 0.93 – 1.72) for mortality without transfer in ICU, and 1.14 (95%CI 0.88 – 1.47) for transfer to ICU.Conclusions: In this retrospective cohort of patients hospitalised for COVID-19, diabetes was not significantly associated with a higher risk of COVID-19 severe outcomes after propensity score matching.Trial registration NCT04344327

    Molecular Basis of Kidney Defects in COVID-19 Patients

    Authors: Smartya Pulai; Madhurima Basu; Chinmay Saha; Nitai P. Bhattacharyya; Arpita Ray Chaudhury; Sujoy Ghosh

    id:10.20944/preprints202007.0452.v1 Date: 2020-07-20 Source:

    Background: Kidney damage is considered to be one of the risk factors for severity and mortality among COVID-19 patients. However, molecular nature of such observations remains unknown. Hypothesis: Altered gene expressions due to infection MESHD infection and in chronic HP and in chronic kidney disease MESHD could explain severity in COVID-19 with kidney defects. Methods: We collected gene expression data from publicly available resources Gene Expression Omnibus CKD, Enrichr for deregulated genes in SARS-CoV infected cells in vitro, DisGeNET and others and carried out enrichment analysis using Enrichr. Result: Number of common genes altered in chronic kidney disease HP kidney disease MESHD (CKD) and SARS-CoV infected cells was 2834. Enrichment analysis revealed that biological processes related viral life cycle and growth, cytokines, immunity, interferon, inflammation MESHD, apoptosis, autophagy, oxidative stress and others were significantly enriched with common deregulated genes. Similarly, significantly enriched pathways related to viral and bacterial infections MESHD, immunity and inflammation MESHD, cell cycle, ubiquitin mediated proteolysis, signaling pathways like Relaxin signaling pathway, mTOR signaling pathway, IL-17 signaling pathway, NF-kappa B signaling pathway were enriched with the common deregulated genes. These processes and pathways are known to be related to kidney damage. DisGeNET terms enriched include and related to Dengue MESHD fever MESHD fever HP, chronic Hepatitis MESHD chronic Hepatitis HP, measles MESHD, retroviridae infections MESHD, respiratory syncytial virus Infections MESHD and many others. Kidney dysfunction related terms ischemia MESHD of kidney, renal fibrosis HP fibrosis MESHD and diabetic nephropathy MESHD nephropathy HP. Conclusion: Common deregulated genes in SARS-CoV infected cells and chronic kidney disease HP kidney disease MESHD, as well as their enrichment with molecular processes and pathways relevant for viral pathogenesis and renal dysfunctions, could explain the severity of COVID-19 with kidney disease MESHD. This observation not only provides molecular relation of severity in COVID-19 with renal dysfunctions but might also help in the management and treatment targets for these cases.

    Clinical, laboratory, and radiologic findings associated with mortality in COVID-19: A systematic review and meta-analysis

    Authors: Hoo Jung Rhim; Jin Hyun Park; Yuna Lee; Seung Chan Kwon; Min Gyu Yu; Hunju Lee; Solam Lee; Yeon-Soon Ahn

    doi:10.21203/ Date: 2020-07-01 Source: ResearchSquare

    Although there has been a surge in reports on coronavirus disease MESHD 2019 (COVID-19), the clinical signs and findings associated with fatal outcomes have rarely been studied. This systematic review and meta-analysis aimed to investigate the clinical, laboratory, and radiologic features associated with mortality in COVID-19. A comprehensive search was performed using PubMed, Embase, Web of Science, and other databases including government sources, for articles and reports published until May 1, 2020. We extracted the number of events (mortality and non-mortality) from case series and case-control and cross-sectional studies. Hazard ratios (HR) of each finding were extracted from studies with time-to-outcome analysis. In total, 23 studies met the inclusion criteria. Of them, 18 studies were case-control, cross-sectional, and case series study. Whereas, only 5 studies included time-to-outcome analysis. Male TRANS sex, age TRANS over 80 years, dyspnea, cardiovascular disease MESHD disease, chronic kidney HP kidney disease MESHD, increased troponin I level, acute respiratory distress HP syndrome MESHD, acute kidney injury MESHD acute kidney injury HP, and need of invasive mechanical ventilation were significantly associated with mortality. The identification of patients at higher risk of mortality has an utmost importance to achieve better treatment outcomes. The findings from our study may aid the prioritization in times of severe shortages of medical resources. Further studies analyzing diverse demographic and geographic populations are needed to generalize the findings from this study. 

    Association of Smoking Status with Outcomes in Hospitalized COVID-19 Patients

    Authors: Muhammad Adrish; Sridhar Chilimuri; Nikhitha Mantri; Haozhe Sun; Maleeha Zahid; Sudharsan Gongati; Ked Fortuzi; Abhishrut Pramod Jog; Pravish Purmessur; Ravish Singhal

    doi:10.21203/ Date: 2020-07-01 Source: ResearchSquare

    Introduction: Smoking causes inflammation MESHD of the lung epithelium by releasing cytokines and impairing muco-ciliary clearance. Some studies have linked smoking with severity of illness of COVID-19 whereas others have found no such association.Methods: This was a retrospective analysis of all adults TRANS hospitalized with COVID-19 from March 09 to May 18, 2020. Results: 1173 patients met the study criteria. 837 patients never smoked and 336 patients were either current smokers or past smoker and were grouped together in smokers group. Patients in smokers group were more likely to be male TRANS and had higher incidence of underlying COPD (19% vs. 6%, p<0.001), human immunodeficiency HP virus infection MESHD (11% vs. 5%,p<0.001), cancer (11% vs. 6%, p=0.005), congestive heart failure HP heart failure MESHD (15% vs. 8%, p<0.001), coronary artery disease MESHD (15% vs. 9%, p=0.027), chronic kidney disease HP kidney disease MESHD (11% vs. 8%, p=0.037), and end-stage renal disease MESHD (10% vs. 6%, p=0.009) compared to non-smokers. Smokers were more likely to develop critical illness MESHD requiring mechanical ventilation (47% vs. 37% p=0.005). Univariate Cox model for survival analysis by smoking status showed that smokers only current smokers had higher risk of death MESHD compared to never-smokers (HR 1.61, 95% confidence interval 1.22–2.12, p<0.001). In the multivariate approach Cox model for the survival, female TRANS sex, age TRANS, LDH and systemic steroid use were associated with overall survival.Conclusion: In our large single center retrospective database of patients hospitalized with COVID-19, smoking was associated with development of critical illness MESHD and higher likelihood of death MESHD

    Early predictors and screening tool developing for severe patients with COVID-19

    Authors: Le Fang; Huashan Xie; Lingyun Liu; Shijun Lu; Fangfang Lv; Jiancang Zhou; Yue Xu; Huiqing Ge; Min Yu; Limin Liu

    doi:10.21203/ Date: 2020-06-29 Source: ResearchSquare

    Background Coronavirus disease MESHD 2019 (COVID-19) is a declared global pandemic, causing a lot of death MESHD. How to quickly screen risk population for severe patients is essential for decreasing the mortality. Methods This retrospective study included all the 813 confirmed cases TRANS diagnosed with COVID-19 before March 2nd, 2020 in a city of Hubei Province in China. Data of the COVID-19 patients including clinical and epidemiological features were collected through Chinese Disease MESHD Control and Prevention Information System. Predictors were selected by logistic regression, and then categoried to four different level risk factor. A screening tool for severe patient with COVID-19 was developed and tested by ROC curve. Results Seven early predictors for severe patients with COVID-19 were selected, including chronic kidney disease HP kidney disease MESHD (OR=14.7), age TRANS above 60 (OR=5.6), lymphocyte count less than <0.8 × 109 per L (OR=2.5), Neutrophile to Lymphocyte Ratio larger than 4.7 (OR=2.2), high fever MESHD fever HP with temperature ≥38.5℃ (OR=2.2), male TRANS (OR=2.2), cardiovascular related diseases MESHD (OR=2.0). The Area Under the Curve of the screening tool developed by above seven predictors was 0.798 (95%CI: 0.747~0.849), and its best cut-off value is >4.5, with sensitivity SERO 72.0% and specificity 75.3%. Conclusions  This newly developed screening tool can be a good choice for early prediction and alert for severe case especially in the condition of overload health service. 

    A survival analysis of COVID-19 in the Mexican population

    Authors: Guillermo Salinas-Escudero; María Fernanda Carrillo-Vega; Víctor Granados-García; Silvia Martínez-Valverde; Filiberto Toledano-Toledano; Juan Garduño-Espinosa

    doi:10.21203/ Date: 2020-06-29 Source: ResearchSquare

    Background. At present, the Americas region contributes to the largest number of cases of COVID-19 worldwide. In this area, Mexico is in third place respecting deaths MESHD (20,781 total deaths MESHD), rate that may be explained by the high proportion of the population over 50 years and the rate of chronic diseases MESHD. The aim of the present work was estimate the risk factors associated with the death MESHD rate, considering the time between symptoms onset TRANS and the death MESHD occurrence, in the Mexican population. Methods. Information of all the confirmed cases TRANS for COVID-19 reported on the public dataset released by the Epidemiological Surveillance System for Viral Respiratory Diseases MESHD of the Mexican Ministry of Health was analyzed. Kapplan-Meier curves were plotted, and a Cox proportional hazard model was constructed. Results. The analysis included 16,752 registries of confirmed cases TRANS of COVID-19 with mean age TRANS 46.55±15.55 years; 58.02% (n=9719) men and 9.37% (n=1,569) died. Men (H.R. 1.21, p<0.01, 95% C.I. 1.09-1.35), older age TRANS (H.R. 8.24, p<0.01, 95% C.I. 4.22-16.10), CKD (H.R. 1.85, p<0.01, 95% C.I. 1.51-2.25), pneumonia MESHD pneumonia HP (H.R. 2.07, p<0.01, 95% C.I. 1.81-2.38), hospitalization and ICU admissions (H.R. 5.86, p<0.01, 95% C.I. 4.81-7.14, and H.R. 1.32, p<0.01, 95% C.I. 1.12-1.55, respectively), intubation (H.R. 2.93, p<0.01, 95% C.I. 2.50-3.45) and health care in public health services (more than twice the risk, p<0.01), were independent factors increasing the risk of death MESHD due to COVID-19. Conclusions. The risk of dying at any time during follow-up was especially higher in men, individuals at the older age groups TRANS, with chronic kidney disease HP kidney disease MESHD and people hospitalized in the public health services.

    Death MESHD by SARS-CoV 2 - a Romanian COVID-19 multi-centre comorbidity study

    Authors: Anca Pantea Stoian; Mihaela Pricop-Jeckstadt; Adrian Pana; Bogdan-Vasile Ileanu; Ruxandra Schitea; Marius Geanta; Doina Catrinoiu; Andra Iulia Suceveanu; Cristian Serafinceanu; Silviu Pituru; Catalina Poiana; Bogdan Timar; Cornelia Nitipir; Simona Parvu; Andreea Arsene; Laura Mazilu; Antonela Toma; Razvan Hainarosie; Antonio Ceriello; Manfredi Rizzo; Viorel Jinga

    doi:10.21203/ Date: 2020-06-27 Source: ResearchSquare

    Evidence regarding the relation between SARS-CoV-2 mortality and the underlying medical condition is scarce. We conducted an observational, retrospective study based on Romanian official data about location, age TRANS, sex and comorbidities for COVID-19 fatalities. Our findings indicate that males TRANS, hypertension MESHD hypertension HP, diabetes, obesity MESHD obesity HP and chronic kidney disease HP kidney disease MESHD were most frequent in the COVID-19 fatalities, that the burden of disease MESHD was low, and that the prognosis for 1-year survival probability was high in the sample. Evidence shows that age TRANS-dependent pairs of comorbidities could be a negative prognosis factor for the severity of disease MESHD  for  the SARS-CoV 2 infection MESHD.

    Exploiting an Early Warning Nomogram for Predicting the Risk of ICU Admission in COVID-19 patients: A Multi-Center Study in China

    Authors: Yiwu Zhou; Yanqi He; Huan Yang; He Yu; Ting Wang; Zhu Chen; Rong Yao; Zongan Liang

    doi:10.21203/ Date: 2020-06-19 Source: ResearchSquare

    Background Novel corona virus disease MESHD 2019 (COVID-19) is an urgent event in the worldwide. We aimed to develop and validate a practical model for early identifying and predicting which patients will be admitted to intensive care unit (ICU) based on a multi-center cohort in China. Methods Data from 1087 patients of laboratory-confirmed COVID-19 were collected from 49 sites between January 2 and February 28 2020 in Sichuan and Wuhan. Patients were randomly divided into the training and validation cohorts (7:3). The least absolute shrinkage and selection operator (LASSO) analysis and logistic regression analysis were employed for the development account. The performance SERO of the nomogram was evaluated for the C-index, calibration, discrimination, and clinical usefulness. The nomogram was further assessed in a different cohort as external validation. Results The individualized prediction nomogram included 6 predictors, including age TRANS, respiratory rate, systolic blood SERO pressure, smoking status, fever MESHD fever HP and chronic kidney disease HP kidney disease MESHD. The model showed high discrimination ability in the training cohort (C-index = 0.829), which was confirmed in the external validation cohort (C-index = 0.776). In addition, the calibration plots confirmed good concordance for prediction the risk of ICU admission. Decision curve analysis showed that the prediction nomogram was clinically useful.Conclusion We established an early prediction model incorporating clinical characteristics that could be quickly obtained on hospital admission even in community health center. This model can be conveniently used to facilitate predicting the individual risk for ICU admission of COVID-19 patients and optimizing use of limited resources. 

    Vital signs assessed in initial clinical encounters predict COVID-19 mortality in an NYC hospital system

    Authors: Elza Rechtman; Paul Curtin; Esmeralda Navarro; Sharon Nirenberg; Megan K Horton

    doi:10.21203/ Date: 2020-06-10 Source: ResearchSquare

    Timely and effective clinical decision-making for COVID-19 requires rapid identification of risk factors for disease MESHD outcomes. Our objective was to identify characteristics available immediately upon first clinical evaluation related COVID-19 mortality. We conducted a retrospective study of 8770 laboratory- confirmed cases TRANS of SARS-CoV-2 from a network of 53 facilities in New-York City. We analysed 3 classes of variables; demographic, clinical, and comorbid factors, in a two-tiered analysis that included traditional regression strategies and machine learning. COVID-19 mortality was 12.7%. Logistic regression identified older age TRANS (OR, 1.69 [95%CI, 1.66-1.92]), male TRANS sex (OR, 1.57 [95%CI, 1.30-1.90]), higher BMI (OR, 1.03 [95%CI, 1.102-1.05]), higher heart rate (OR, 1.01 [95%CI, 1.00-1.01]), higher respiratory rate (OR, 1.05 [95%CI, 1.03-1.07]), lower oxygen saturation (OR, 0.94 [95%CI, 0.93-0.96]), and chronic kidney disease HP kidney disease MESHD (OR, 1.53 [95%CI, 1.20-1.95]) were associated with COVID-19 mortality. Using gradient-boosting machine learning, these factors predicted COVID-19 related mortality (AUC=0.86) following cross-validation in a training set. Immediate, objective and culturally generalizable measures accessible upon clinical presentation are effective predictors of COVID-19 outcome. These findings may inform rapid response strategies to optimize health care delivery in parts of the world who have not yet confronted this epidemic, as well as in those forecasting a possible second outbreak.

    Factors Associated with the Poor Outcomes in Diabetic Patients with COVID-19

    Authors: Hadith Rastad; Hanieh-Sadat Ejtahed; Armita Mahdavi Ghorabi; Anis Safari; Ehsan Shahrestanaki; Mohammad Rezaei; Mohammad Mahdi Niksima; Akram Zakani; Seyede Hanieh Dehghan Manshadi; Fatemeh Ochi; Shabnam saedi; Zeinab Khodaparast; Neda Shafiabadi Hassani; Mehdi Azimzadeh; Mostafa Qorbani

    doi:10.21203/ Date: 2020-06-08 Source: ResearchSquare

    Background: Diabetic’s patients are supposed to experience higher rates of COVID-19 related poor outcomes. We aimed to determined factors predicting poor outcomes in hospitalized diabetic patients with COVID-19. Methods: This retrospective cohort study included all adult TRANS diabetic patients with radiological or laboratory confirmed COVID-19 who hospitalized between 20 February 2020 and 27 April 2020 in Alborz province, Iran. Data on demographic, medical history, and laboratory test at presentation were obtained from electronic medical records. Diagnosis of diabetes mellitus MESHD diabetes mellitus HP was self-reported. Comorbidities including cancer, rheumatism, immunodeficiency HP, or chronic diseases MESHD of respiratory, liver, and blood SERO were classified as “other comorbidities” due to low frequency. The assessed poor outcomes were in-hospital mortality, need to ICU care, and receiving invasive mechanical ventilation. Self-reported. Multivariate logistic regression models were fitted to quantify the predictors of in-hospital mortality from COVID-19 in patients with DM. Results: Of 455 included patients, 98(21.5%) received ICU care, 65(14.3%) required invasive mechanical ventilation, and 79 (17.4%) dead. In the multivariate model, significant predictors of “death of COVID-19” were age TRANS  65 years or older (OR (95% CI): 2.0 (1.16-3.44), chronic kidney disease HP kidney disease MESHD (CKD) (2.05 (1.16 -3.62), presence of “other comorbidities” (2.20 (1.04-4.63)), neutrophil count ≥ 8.0 × 10⁹/L )6.62 (3.73-11.7 ((, Hb level <12.5 g/dl (2.05 (1.13-3.72)(, and creatinine level ≥1.36 mg/dl (3.10 (1.38-6.98)). (All p –values < 0.05). Some of these factors were also associated with other assessed poor outcomes, e.g., need to ICU care or invasive mechanical ventilation.Conclusions: Diabetic patients with age TRANS 65 years or older, comorbidity CKD, “other comorbidities”, as well as neutrophil count ≥ 8.0 × 10⁹/L, Hb level <12.5 g/dl, and creatinine level ≥1.36 mg/dl, were more likely to dead after COVID-19. Presence of hypertension MESHD hypertension HP and cardiovascular disease MESHD were associated with none of the poor outcomes.

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MeSH Disease
Human Phenotype

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