Corpus overview


MeSH Disease

Cough (217)

Fever (178)

Disease (99)

Infections (99)

Coronavirus Infections (70)

Human Phenotype

Cough (217)

Fever (178)

Fatigue (65)

Pneumonia (52)

Dyspnea (29)


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    The emergence of COVID-19 in Indonesia: analysis of predictors of infection MESHD and mortality using independent and clustered data approaches

    Authors: Erlina Burhan; Ari Fahrial Syam; Ahmad Jabir Rahyussalim; Prasenohadi Prasenohadi; Navy G Lolong Wulung; Agus Dwi Susanto; I Gede Ketut Sajinadiyasa; Dewi Puspitorini; Dewi Lestari; Indah Suci Widyahening; Vivi Setiawaty; Dwiana Ocviyanti; Kartika Qonita Putri; Aswin Guntara; Davrina Rianda; Anuraj H Shankar; Rina Agustina

    doi:10.1101/2020.07.10.20147942 Date: 2020-07-11

    Background: Analyses of correlates of SARS-CoV-2 infection MESHD or mortality have usually assessed individual predictors. This study aimed to determine if patterns of combined predictors may better identify risk of infection TRANS risk of infection TRANS infection MESHD and mortality. Methods: For the period of March 2nd to 10th 2020, the first 9 days of the COVID-19 pandemic in Indonesia, we selected all 18 confirmed cases TRANS, of which 6 died, and all 60 suspected cases, of which 1 died; and 28 putatively negative patients with pneumonia MESHD pneumonia HP and no travel TRANS history. We recorded data for travel TRANS, contact history, symptoms, haematology, comorbidities, and chest x-ray. Hierarchical cluster analyses (HCA) and principal component analyses (PCA) identified cluster and covariance patterns for symptoms or haematology which were analysed with other predictors of infection MESHD or mortality using logistic regression. Results: For univariate analyses, no significant association with infection MESHD was seen for fever MESHD fever HP, cough MESHD cough HP, dyspnoea, headache MESHD headache HP, runny nose, sore throat, gastrointestinal complaints (GIC), or haematology. A PCA symptom component for fever MESHD fever HP, cough MESHD cough HP, and GIC tended to increase risk of infection TRANS risk of infection TRANS infection MESHD (OR 3.41; 95% CI 1.06 - 14; p=0.06), and a haematology component with elevated monocytes decreased risk (OR 0.26; 0.07 - 0.79; 0.027). Multivariate analysis revealed that an HCA cluster of 3-5 symptoms, typically fever MESHD fever HP, cough MESHD cough HP, headache MESHD headache HP, runny nose, sore throat but little dyspnoea and no GIC tended to reduce risk (aOR 0.048; <0.001 - 0.52; 0.056). In univariate analyses for death MESHD, an HCA cluster of cough MESHD cough HP, fever MESHD fever HP and dyspnoea had increased risk (OR 5.75; 1.06 - 31.3, 0.043), but no other individual predictor, cluster or component was associated. Other significant predictors of infection MESHD were age TRANS >= 45, international travel TRANS, contact with COVID-19 patient, and pneumonia MESHD pneumonia HP. Diabetes and history of contact were associated with higher mortality. Conclusions: Cluster groups and co-variance patterns may be stronger correlates of SARS-CoV-2 infection MESHD than individual predictors. Comorbidities may warrant careful attention as would COVID-19 exposure levels.

    Diagnostic value of skin manifestation MESHD of SARS-CoV-2 infection MESHD

    Authors: Veronique Bataille; Alessia Visconti; Niccolo' Rossi; Benjamin Murray; Abigail Bournot; Jonathan Wolf; Sebastien Ourselin; Claire Steves; Timothy Spector; Mario Falchi

    doi:10.1101/2020.07.10.20150656 Date: 2020-07-11

    SARS-CoV-2 causes multiple immune-related reactions at various stages of the disease MESHD. The wide variety of skin presentations has delayed linking these to the virus. Previous studies had attempted to look at the prevalence SERO and timing of SARS-COV-2 rashes but were based on mostly hospitalized severe cases and had little follow up. Using data collected on a subset of 336,847 eligible UK users of the COVID Symptom Study app, we observed that 8.8% of the swab positive cases (total: 2,021 subjects) reported either a body rash or an acral rash, compared to 5.4% of those with a negative swab test (total: 25,136). Together, these two skin presentations showed an odds ratio (OR) of 1.67 (95% confidence interval [CI]: 1.41-1.96) for being swab positive. Skin rashes HP were also predictive in the larger untested group of symptomatic app users (N=54,652), as 8.2% of those who had reported at least one classical COVID-19 symptom, i.e., fever MESHD fever HP, persistent cough MESHD cough HP, and/or anosmia HP, also reported a rash. Data from an independent online survey of 11,546 respondents with a rash showed that in 17% of swab positive cases, the rash was the initial presentation. Furthermore, in 21%, the rash was the only clinical sign. Skin rashes HP cluster with other COVID-19 symptoms, are predictive of a positive swab test and occur in a significant number of cases, either alone or before other classical symptoms. Recognising rashes is important in identifying new and earlier COVID-19 cases.

    Clinical and epidemiological characteristics of children TRANS with SARS-CoV-2 infection MESHD: case series in Sinaloa

    Authors: Giordano Perez Gaxiola; Rosalino Flores Rocha; Julio Cesar Valadez Vidarte; Melissa Hernandez Alcaraz; Gilberto Herrera Mendoza; Miguel Alejandro Del Real Lugo

    doi:10.1101/2020.07.07.20146332 Date: 2020-07-11

    Background: The SARS-CoV-2 virus may affect both adults TRANS and children TRANS. Although the disease MESHD, named COVID-19, has a lower prevalence SERO in infancy and has been described as mild, the clinical characteristics may vary and there is a possibility of complications. Objectives: To describe the clinical and epidemiological characteristics of pediatric cases confirmed TRANS in the state of Sinaloa, Mexico, during the first three months of the pandemic, and of children TRANS admitted with COVID-19 to a secondary hospital. Methods: This case series includes all patients with SARS-CoV-2 infection MESHD infection confirmed TRANS confirmed by PCR testing, identified in the state epidemiological surveillance system between March 1 and May 31, 2020. Confirmed patients admitted to the Sinaloa Pediatric Hospital (HPS) during the same dates are also described. Results: Fifty one children TRANS with SARS-CoV-2 were included, 10 of the admitted to HPS. The median age TRANS was 10 years. The more frequent symptoms were fever MESHD fever HP (78%), cough MESHD cough HP (67%) and headache MESHD headache HP (57%). Most cases were mild or asymptomatic TRANS. Three patients with comorbidities died. Only 4 of 10 patients identified in HPS had been admitted with the diagnosis of possible COVID-19. Conclusions: SARS-CoV-2 infection MESHD in children TRANS was mostly mild or asymptomatic TRANS, but with a wide range of clinical presentations.

    Risk Factors Prediction, Clinical Outcomes, and Mortality of COVID-19 Patients

    Authors: Roohallah Alizadehsani; Zahra Alizadeh sani; Mohaddeseh Behjati; Zahra Roshanzamir; Sadiq Hussain; Niloofar Abedini; Fereshteh Hasanzadeh; Abbas Khosravi; Afshin Shoeibi; Mohamad Roshanzamir; Pardis Moradnejad; Saeid Nahavandi; Fahime Khozeimeh; Assef Zare; Maryam Panahiazar; U. Rajendra Acharya; Sheikh Mohammed Shariful Islam

    doi:10.1101/2020.07.07.20148569 Date: 2020-07-09

    Background: Preventing communicable diseases MESHD requires understanding the spread, epidemiology, clinical features, progression, and prognosis of the disease MESHD. Early identification of risk factors and clinical outcomes might help to identify critically ill patients, provide proper treatment and prevent mortality. Methods: We conducted a prospective study in patients with flu-like symptoms referred to the imaging department of a tertiary hospital in IRAN between 3 March 2020 and 8 April 2020. Patients with COVID-19 were followed up to check their health condition after two months. The categorical data between groups were analyzed by Fisher exact test and continuous data by Wilcoxon Rank-Sum Test. Findings: 319 patients (mean age TRANS 45.48 years, 177 women) were enrolled. Fever MESHD Fever HP, dyspnea MESHD dyspnea HP, weakness, shivering HP, C-reactive protein (CRP), fatigue MESHD fatigue HP, dry cough MESHD cough HP, anorexia MESHD anorexia HP, anosmia HP, ageusia MESHD, dizziness MESHD, sweating and age TRANS were the most important symptoms of COVID-19 infection MESHD. Traveling TRANS in past three months, asthma MESHD asthma HP, taking corticosteroids, liver disease MESHD, rheumatological disease MESHD, cough MESHD cough HP with sputum, eczema MESHD eczema HP, conjunctivitis MESHD conjunctivitis HP, tobacco use, and chest pain MESHD chest pain HP did not have any relationship with COVID-19. Interpretation: Finding clinical symptoms for early diagnosis of COVID-19 is a critical part of prevention. These symptoms can help in the assessment of disease progression MESHD. To the best of our knowledge, some of the effective features on the mortality due to COVID-19 are investigated for the first time in this research. Funding: None

    Atypical Presentations of COVID-19 in Care Home Residents presenting to Secondary Care: A UK Single Centre Study

    Authors: Mark James Rawle; Deborah Lee Bertfield; Simon Edward Brill

    doi:10.1101/2020.07.07.20148148 Date: 2020-07-08

    Background: The United Kingdom (UK) care home population has experienced high mortality during the COVID-19 pandemic. Atypical presentations of COVID-19 are being reported in older adults TRANS and may pose difficulties for early isolation and treatment, particularly in institutional care settings. We aimed to characterise the presenting symptoms and associated mortality of COVID-19 in older adults TRANS, with a focus on care home residents and older adults TRANS living in the community. Methods: This was a retrospective cohort study of consecutive inpatients over 80 years old hospitalised with PCR confirmed COVID-19 between 10th March 2020 and 8th April 2020. Symptoms at presentation, including those associated with frailty MESHD, were analysed. Differences between community dwelling and care home residents, and associations with mortality, were assessed using between-group comparisons and logistic regression. Results: Care home residents were less likely to experience cough MESHD cough HP (46.9% vs 72.9%, p=0.002) but more likely to present with delirium MESHD delirium HP (51.6% vs 31.4%, p=0.018), particularly hypoactive delirium MESHD delirium HP (40.6% vs 24.3%, p=0.043). Mortality was more likely in the very frail (OR 1.25, 95% CI 1.00, 1.58, p=0.049) and those presenting with anorexia MESHD anorexia HP (OR 3.20, 95% CI 1.21, 10.09, p=0.028). There were no differences in either mortality or length of stay between those admitted from care homes and community dwelling older adults TRANS. Conclusion: COVID-19 in those over 80 does not always present with typical symptoms, particularly in those admitted from institutional care. These individuals have a reduced incidence of cough MESHD cough HP and increased hypoactive delirium MESHD delirium HP. Individuals presenting atypically, especially with anorexia MESHD anorexia HP, have higher mortality.

    Reconstructing the global dynamics of under-ascertained COVID-19 cases and infections MESHD

    Authors: Nick Golding; Timothy W Russell; Sam Abbott; Joel Hellewell; Carl A B Pearson; Kevin van Zandvoort; Christopher I Jarvis; Hamish Gibbs; Yang Liu; Rosalind M Eggo; John W Edmunds; Adam J Kucharski

    doi:10.1101/2020.07.07.20148460 Date: 2020-07-08

    Background: Asymptomatic TRANS or subclinical SARS-CoV-2 infections MESHD are often unreported, which means that confirmed case TRANS counts may not accurately reflect underlying epidemic dynamics. Understanding the level of ascertainment (the ratio of confirmed symptomatic cases to the true number of symptomatic individuals) and undetected epidemic progression is crucial to informing COVID-19 response planning, including the introduction and relaxation of control measures. Estimating case ascertainment over time allows for accurate estimates of specific outcomes such as seroprevalence SERO, which is essential for planning control measures. Methods: Using reported data on COVID-19 cases and fatalities globally, we estimated the proportion of symptomatic cases (i.e. any person with any of fever MESHD fever HP >= to 37.5C, cough MESHD cough HP, shortness of breath, sudden onset of anosmia HP, ageusia MESHD or dysgeusia MESHD illness) that were reported in 210 countries and territories, given those countries had experienced more than ten deaths MESHD. We used published estimates of the case fatality ratio (CFR) as an assumed baseline. We then calculated the ratio of this baseline CFR to an estimated local delay-adjusted CFR to estimate the level of under-ascertainment in a particular location. We then fit a Bayesian Gaussian process model to estimate the temporal pattern of under-ascertainment. Results: We estimate that, during March 2020, the median percentage of symptomatic cases detected across the 84 countries which experienced more than ten deaths MESHD ranged from 2.38% (Bangladesh) to 99.6% (Chile). Across the ten countries with the highest number of total confirmed cases TRANS as of 6th July 2020, we estimated that the peak number of symptomatic cases ranged from 1.4 times (Chile) to 17.8 times (France) larger than reported. Comparing our model with national and regional seroprevalence SERO data where available, we find that our estimates are consistent with observed values. Finally, we estimated seroprevalence SERO for each country. Despite low case detection in some countries, our results that adjust for this still suggest that all countries have had only a small fraction of their populations infected as of July 2020. Conclusions: We found substantial under-ascertainment of symptomatic cases, particularly at the peak of the first wave of the SARS-CoV-2 pandemic, in many countries. Reported case counts will therefore likely underestimate the rate of outbreak growth initially and underestimate the decline in the later stages of an epidemic. Although there was considerable under-reporting in many locations, our estimates were consistent with emerging serological data, suggesting that the proportion of each country's population infected with SARS-CoV-2 worldwide is generally low.

    Examining the protection efficacy of face shields against cough MESHD cough HP aerosol droplets using water sensitive papers

    Authors: Ayala Ronen; Hadar Rotter; Shmuel Elisha; Sagi Sevilia; Batya Parizer; Nir Hafif; Alon Manor

    doi:10.1101/2020.07.06.20147090 Date: 2020-07-07

    Simple plastic face shields have many advantages compared to regular medical masks. They are easily cleaned for reuse and comfortable to wear. In light of the spreading COVID-19 pandemic, the potential of face shields as a substitution for medical masks, as a recommendation to the general population, was tested. Testing the efficacy of the protective equipment utilized a cough MESHD cough HP simulator that was carefully tuned to replicate human cough MESHD cough HP in terms of droplet size distribution and outlet velocity. The tested protective equipment was worn on a manikin head simulating human breathing. An Aerodynamic Particle Sizer (APS) was used to analyze the concentration and size distribution of small particles that reach the manikin head respiration pathways. Additionally, Water sensitive papers were taped over and under the tested protective equipment, and were subsequently photographed and analyzed. For droplets larger than 3m by diameter, the efficiency of shields to block cough MESHD cough HP droplets was found to be comparable to that of regular medical masks, with enhanced protection on face parts the mask does not cover. Additionally, for finer particles, of the order 0.3 to few microns, a shield was found to perform even better, blocking about 10 times more fine particles than the medical mask. This implies that for the general population that is not intendedly exposed to confirmed infected individuals, recommending the use of face shields as an alternative to medical masks should be considered.

    COVID-19 presenting as anosmia HP and dysgeusia MESHD in New York City emergency MESHD departments, March - April, 2020

    Authors: Tina Z. Wang; Jessica Sell; Don Weiss; Ramona Lall

    doi:10.1101/2020.07.06.20147751 Date: 2020-07-07

    Background: Increasing evidence has been emerging of anosmia HP and dysgeusia MESHD as frequently reported symptoms in COVID-19. Improving our understanding of these presenting symptoms may facilitate the prompt recognition of the disease MESHD in emergency MESHD departments and prevent further transmission TRANS. Methods: We examined a cross-sectional cohort using New York City emergency MESHD department syndromic surveillance data for March and April 2020. Emergency MESHD department visits for anosmia HP and/or dysgeusia MESHD were identified and subsequently matched to the Electronic Clinical Laboratory Reporting System to determine testing results for SARS-CoV-2. Results: Of the 683 patients with anosmia HP and/or dysgeusia MESHD included, SARS-CoV-2 testing was performed for 232 (34%) and 168 (72%) were found to be positive. Median age TRANS of all patients presenting with anosmia HP and/or dysgeusia MESHD symptoms was 38, and 54% were female TRANS. Anosmia HP and/or dysgeusia MESHD was the sole complaint of 158 (23%) patients, of whom 35 were tested for SARS-CoV-2 and 23 (66%) were positive. While the remaining patients presented with at least one other symptom, nearly half of all patients (n=334, 49%) and more than a third of those who tested positive (n=62, 37%) did not have any of the CDC-established symptoms used for screening of COVID-19 such as fever MESHD fever HP, cough MESHD cough HP, shortness of breath, or sore throat. Conclusions and Relevance: Anosmia HP and/or dysgeusia MESHD have been frequent complaints among patients presenting to emergency MESHD departments during the COVID-19 pandemic, and, while only a small proportion of patients ultimately underwent testing for SARS-CoV-19, the majority of patients tested have been positive. Anosmia HP and dysgeusia MESHD likely represent underrecognized symptoms of COVID-19 but may have important future implications in disease MESHD diagnosis and surveillance.

    Exposure assessment for airborne transmission TRANS of SARS-CoV-2 via breathing, speaking, coughing MESHD coughing HP and sneezing MESHD sneezing HP

    Authors: Jack F. Schijven; Lucie C Vermeulen; Arno Swart; Adam Meijer; Erwin Duizer; Ana Maria de Roda Husman

    doi:10.1101/2020.07.02.20144832 Date: 2020-07-05

    Background Evidence for indoor airborne transmission TRANS of SARS-CoV-2 is accumulating. If SARS-CoV-2 also spreads via aerosols, this has implications for measures taken to limit transmission TRANS. Objectives The aim of this study is to assess exposure to airborne SARS-CoV-2 particles from breathing, speaking, coughing MESHD coughing HP and sneezing MESHD sneezing HP in an indoor environment. Methods An exposure assessment model was developed to estimate numbers of SARS-CoV-2 particles in aerosol droplets, expelled during breathing, speaking, coughing MESHD coughing HP and sneezing MESHD sneezing HP by an infected person in an unventilated indoor environment, and subsequent inhalation by one or more persons. Scenarios encompass a range of virus concentrations, room sizes and exposure times. Results The calculated total volume of expelled aerosol droplets was highest for a sneeze MESHD sneeze HP, followed by a cough MESHD cough HP and speaking for 20 minutes, and lastly breathing for 20 minutes. A few to as much as tens of millions of virus particles were expelled. Exposure probability strongly depends on the viral concentration in mucus, as well as on the scenario. Exposure probabilities were generally below 1% at a virus concentration in mucus below 10^5 per mL for all scenarios, increasing steeply at different higher concentrations. According to nose / throat swab data collected from patients, 75%, 50% and 5% of infected individuals carry an estimated number of SARS-CoV-2 per mL mucus of at least 10^5, 10^6 and 10^8, respectively. Discussion Exposure to SARS-CoV-2 via aerosols generated during breathing, speaking, coughing MESHD coughing HP and sneezing MESHD sneezing HP in an unventilated indoor environment is possible. This study forms a basis to estimate probabilities of exposure to SARS-Cov-2 by airborne transmission TRANS in indoor spaces. As long as it is uncertain what fraction of the airborne virus particles is infectious and as long as a dose response relation is lacking, it is recommended to be precautious.

    Health-care workers with COVID-19 living in Mexico City: clinical characterization and related outcomes

    Authors: Neftali Eduardo Antonio-Villa; Omar Yaxmehen Bello-Chavolla; Arsenio Vargas-Vazquez; Carlos A. Fermin-Martinez; Alejandro Marquez-Salinas; Jessica Paola Bahena-Lopez

    doi:10.1101/2020.07.02.20145169 Date: 2020-07-04

    BACKGROUND: Health-care workers (HCWs) have increased risk for SARS-CoV-2 infection MESHD. Information about the prevalence SERO and risk factors for adverse outcomes in HCWs is scarce in Mexico. Here, we aimed to explore prevalence SERO of SARS-CoV-2, symptoms, and risk factors associated with adverse outcomes in HCWs in Mexico City. METHODS: We explored data collected by the National Epidemiological Surveillance System in Mexico City. All cases underwent real-time RT-PCR test. We explored outcomes related to severe COVID-19 in HCWs and the diagnostic performance SERO of symptoms to detect SARS-CoV-2 infection MESHD in HCWs. RESULTS: As of July 2nd, 2020, 34,263 HCWs were tested for SARS-CoV-2, and 10,925 were confirmed (31.9%). Overall, 4,200 were nurses (38.4%), 3,244 physicians (29.7%), 126 dentists (1.15%) and 3,355 laboratory personnel and other HCWs (30.7%). After follow-up, 992 HCWs required hospitalization (9.08%), 206 developed severe outcomes (1.89%), and 90 required mechanical-ventilatory support (0.82%). Lethality was recorded in 224 (2.05%) cases. Symptoms associated with SARS-CoV-2 positivity were fever MESHD fever HP, cough MESHD cough HP, malaise, shivering HP, myalgias MESHD myalgias HP at evaluation but neither had significant predictive value. We also identified 333 asymptomatic TRANS SARS-CoV-2 infections MESHD (3.05%). Older HCWs with chronic non- communicable diseases MESHD, pregnancy, and severe respiratory symptoms were associated with higher risk for adverse outcomes. Physicians had higher risk for hospitalization and for severe outcomes compared with nurses and other HCWs. CONCLUSIONS: We report a high prevalence SERO of SARS-CoV-2 in HCWs in Mexico City. No symptomatology can accurately discern HCWs with SARS-CoV-2 infection MESHD. Particular attention should focus on HCWs with risk factors to prevent adverse outcomes and reduce infection MESHD infection risk TRANS infection risk TRANS risk.

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MeSH Disease
Human Phenotype

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