Corpus overview


MeSH Disease

Cough (507)

Fever (414)

Disease (249)

Infections (246)

Coronavirus Infections (168)

Human Phenotype

Cough (507)

Fever (414)

Fatigue (145)

Pneumonia (130)

Dyspnea (81)


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    An emerging marker predicting the severity of COVID-19: Neutrophil-Lymphocyte Count Ratio

    Authors: Minping Zhang; Enhua Xiao; Jiayi Liu; Yeyu Cai; Qizhi Yu

    doi:10.21203/ Date: 2020-05-14 Source: ResearchSquare

    Background: To analyze clinical features and laboratory indicators and identify the markers of exacerbation in COVID-19. Methods: We reviewed clinical histories of 177 patients with confirmed COVID-19. The patients were categorized into mild group (153 patients) and severe group (24 patients). The baseline demographic and laboratory indicators of all patients were collected, including the neutrophil-lymphocyte count ratio (NLCR) and C-reactive protein to albumin ratio (CAR). Receiver operating characteristic curve (ROC) analysis was performed to search for indicators predicting exacerbation in COVID-19 patients, and acquiring the area under the curves (AUCs), sensitivity SERO, specificity and cut-off value. Results: The age TRANS of the severe group were significantly older than those of the mild group (P <0.01). Fever MESHD Fever HP was the typical symptom in all COVID-19 patients. Cough MESHD Cough HP and fatigue MESHD fatigue HP were manifested in mild group, yet severe patients were more prominent in dyspnea MESHD dyspnea HP. The laboratory indicators showing that the mild group mainly had an elevated C-reactive protein; the severe group had a decreased lymphocyte count and lymphocyte ratio. WBC, neutrophil count, neutrophil ratio, D-dimer, AST, ALT, LDH,  BUN, CRP levels increased. Furthermore, compared to mild group, WBC, neutrophil count, neutrophil ratio (Neut%), D-dimer, total bilirubin, albumin, AST, ALT, LDH, BUN, creatine kinase, CRP, CAR, NLCR were significantly higher, the lymphocyte count, lymphocyte ratio, and APTT were significantly lower  in  severe group (P<0.05). The ROC indicating that NLCR, Neut%, CAR, CRP, and LDH were better at distinguishing mild and severe patients. The AUCs of NLCR was larger than others (NLCR>Neut%>CAR>CRP>LDH: 0.939>0.925>0.908>0.895>0.873), which suggested that NLCR was the optimal maker; a cut-off value for NLCR of  6.15  had 87.5% sensitivity SERO and 97.6% specificity for predicting exacerbation in COVID-19 patients. Conclusions: The different types of COVID-19 had significant differences in age TRANS, clinical symptoms and laboratory indicators, and severe patients might be easier to suffer from the multiple organ damage. An elevated NLCR may indicate that the disease MESHD was progressing towards exacerbation. It was essential to dynamically monitor the serum SERO NLCR levels which contributed to evaluate the patient's condition and efficacy. NLCR could be used as a novel, highly specific and sensitive marker for predicting severity of COVID-19 patients.

    Management of oncology patients receiving anti-cancer treatment in the COVID-19 pandemic

    Authors: Esat Namal; Nur Dinc; Sezer Saglam; Ali Vefa Ozturk; Safiye Koculu; Asiye Yir; Esin Cevik; Soheyl Sabet; Bedriye Koyuncu Sokmen; Nagihan Inan Gurcan; Yaman Tokat; Cavlan Ciftci

    doi:10.21203/ Date: 2020-05-14 Source: ResearchSquare

    Background/Aim: Severe acute respiratory syndrome MESHD coronavirus 2 (SARS CoV-2) has deeply affected life all over the World. The World Health Organization named this disease MESHD as COVID-19. The most important factor in the transmission TRANS of the disease is asymptomatic MESHD asymptomatic TRANS carriers TRANS. We’ve tested all oncology patients, that receive anti-cancer therapy, for COVİD-19 to prevent asymptomatic TRANS oncology patients from spreading infection MESHD and to make the decision to postpone chemotherapy in infected patients. Then, we analyzed the clinical and radiological findings of infected patients.Materials and Methods: Oncology patients who have indications of receiving anti-cancer treatment in the hospital were tested for COVID-19, two day prior to their treatment even if they were asymptomatic TRANS by collecting nasopharyngeal and oropharyngeal swab specimens for RT-PCR for viral RNA detection. Positive patients, underwent inspiratory phase of chest computed tomography (CT) examination. Infected patients were given the recommended treatment for COVID-19. Anti-cancer treatment of all patients that had positive PCR results was delayed for 14 days.Results: PCR test was positive in 28 of 312 patients that we tested, and the positivity rate was 8.9%. Three patients (10.7%) had symptoms; 2 of whom had dyspnea MESHD dyspnea HP and cough MESHD cough HP, and 1 had headache MESHD headache HP, and 25 patients (89.3%) had no symptoms.Conclusion: In oncology patients, who are receiving anti-cancer treatment, we have to recognize the asymptomatic TRANS COVID-19 infection MESHD. We recommend testing for COVID-19 in oncology patients receiving chemotherapy, periodically or before each anti-cancer treatment, in order to continue their treatment without any problems and to prevent the risk of transmission TRANS.

    Liver Injury in patients with COVID-19: Clinical Profiles, CT findings and their Correlation with the Severity

    Authors: Ping Lei; Lan Zhang; Ping Han; Chuansheng Zheng; Qiaoxia Tong; Haitao Shang; Fan Yang; Yu Hu; Xin Li; Yuhu Song

    doi:10.21203/ Date: 2020-05-13 Source: ResearchSquare

    BACKGROUND & AIMS: Liver injury is found in some of patients with COVID-19. Liver injury of patients based on severity grading and abdominal radiological signs have not been reported until now. The aim of our study is to determine clinical profiles of the patients based on severity grading, describe abdominal radiological signs, and investigate the correlations of the severity with clinical profiles and radiological signs.METHODS: This retrospective cohort study included 115 patients with COVID-19 from Jan 2020 to Feb 2020. Medical records of the patients were collected and CT images were reviewed.RESULTS: Common clinical manifestations of the patients with COVID-19 were fever MESHD fever HP (68.70%), cough MESHD cough HP (56.52%), fatigue MESHD fatigue HP (31.30%); some of them had gastrointestinal symptoms ( diarrhea MESHD diarrhea HP,12.17%; nausea MESHD nausea or vomiting HP or vomiting MESHD 7.83%; inappetence, 7.83%). Abnormal liver function was observed in some of the patients with COVID-19. Significant differences in the levels of AST, albumin,CRP were observed among different groups classified by the severity. Common findings of upper abdominal CT scan were liver hypodensity (26.09%) and pericholecystic fat stranding (21.27%); liver hypodensity were more frequently found in critical cases (58.82%). The semi-quantitative CT score of pulmonary lesions, CT-quantified liver/spleen attenuation ratio correlated with severity grading in patients with COVID-19.CONCLUSIONS: Some of patients with COVID-19 displayed liver damage revealed by liver functional tests and upper abdominal CT imaging, and some of liver functional tests and CT signs correlate with severity grading; thus, it will allow an earlier identification of high-risk patients for early effective intervention.

    Epidemiological, socio-demographic and clinical features of the early phase of the COVID-19 epidemic in Ecuador

    Authors: Esteban Ortiz-Prado; katherine Simbana-Rivera; Ana Maria Diaz; Alejandra Barreto; Carla Moyano; Vanessa Arcos; Eduardo Vasconez-Gonzalez; Clara Paz; Fernanda Simbana-Guaycha; Martin Molestina-Luzuriaga; Raul Fernandez-Naranjo; javier Feijoo; Aquiles Rodrigo Henriquez; Lila Adana; Andres Lopez-Cortes Sr.; Isabel Fletcher; Rachel Lowe; Lenin Gomez-Barreno

    doi:10.1101/2020.05.08.20095943 Date: 2020-05-13 Source: medRxiv

    Background: The SARS-CoV-2 virus has spread rapidly around the globe. Nevertheless, there is limited information describing the characteristics and outcomes of COVID-19 patients in Latin America. Methods: We conducted a cross-sectional analysis of 9,468 confirmed COVID-19 cases reported in Ecuador. We calculated overall incidence, mortality, case fatality rates, disability adjusted life years, attack and crude mortality rates, as well as relative risk and relative odds of death MESHD, adjusted for age TRANS, sex and presence of comorbidities. Results: A total of 9,468 positive COVID-19 cases and 474 deaths MESHD were included in the analysis. Men accounted for 55.4% (n = 5, 247) of cases and women for 44.6% (n = 4, 221). We found the presence of comorbidities, being male TRANS and older than 65 years were important determinants of mortality. Coastal regions were most affected by COVID-19, with higher mortality rates than the highlands. Fatigue MESHD Fatigue HP was reported in 53.2% of the patients, followed by headache MESHD headache HP (43%), dry cough MESHD cough HP (41.7%), ageusia MESHD (37.1%) and anosmia HP (36.1%). Conclusion: We present the first analysis of the burden of COVID-19 in Ecuador. Our findings show that men are at higher risk of dying from COVID-19 than women, and risk increases with age TRANS and the presence of comorbidities. We also found that blue-collar workers and the unemployed are at greater risk of dying. These early observations offer clinical insights for the medical community to help improve patient care and for public health officials to strengthen Ecuador s response to the outbreak. Keywords: COVID-19; SARS-CoV-2; Ecuador; Epidemiology; Latin America

    The Epidemiology of COVID-19 and applying Non Pharmaceutical interventions by using the Susceptible, Infectious Recovered epidemiological Model in Pakistan.

    Authors: Abdul Wahid; Amjad Khan; Qaiser Iqbal; Asad Khan; Nazar Mohammad

    doi:10.1101/2020.05.08.20095794 Date: 2020-05-13 Source: medRxiv

    Introduction: The COVID-19 is caused by the virus known as sever acute respiratory syndrome MESHD corona virus 2 (SARS-CoV-2) having the common symptoms such as Flue, fever MESHD fever HP, dry cough MESHD cough HP and shortness of breath. The first case was reported in WUHAN city china in December 2019 and it spread to the whole world, WHO declared as world pandemic on 11th march 2020. SIR Epidemiological Model: The first case in Pakistan was confirmed on 26th Feb 2020 as by the 8th April 2020 the total no of confirmed cases TRANS 4187 with 58 deaths MESHD and 467 recoveries throughout the country. The upcoming situation of the COVID-19 in Pakistan is forecasted by using SIR epidemiological, which is one of the mathematical derivative models with great accuracy rate prediction used for infectious disease MESHD. This model was introduced in the early 20th century. Results: Pakistan is will be having a heavy burden of patients 80000 plus infected patients 45000 recoveries 10000 hospitalized 3000 ICU and 800 plus deaths MESHD in the next 20 days. A complete lock down, social distancing and imposing curfew to keep every person at home can save Pakistan from a very huge number 1000000 infected patients with huge number of causalities with next 2 months. Key words: COVID-19, Coronavirus COV2, Pakistan, SIR model

    On the Front (Phone) Lines: Results of a COVID-19 Hotline in Northeast Ohio

    Authors: David Margolius; Mary Hennekes; Jimmy Yaho; Douglas Einstadter; Douglas Gunzler; Nabil Chehade; Ashwini R Sehgal; Yasir Tarabichi; Adam T Perzynski

    doi:10.1101/2020.05.08.20095745 Date: 2020-05-13 Source: medRxiv

    ABSTRACT Importance: Severe acute respiratory syndrome MESHD coronavirus (SARS-CoV-2) and the associated coronavirus disease MESHD of 2019 (COVID-19) have presented immense challenges for health care systems. Many regions have struggled to adapt to disruptions to health care practice and employ systems that effectively manage the demand for services. Objective: To examine the effectiveness of the first five weeks of a 24/7 physician-staffed COVID-19 hotline. Design: Cohort study using electronic health records. Setting: A single large health care system in Northeast Ohio. Participants: During 5 weeks of operation, 10,112 patients called the hotline (callers) and were evaluated by a registered nurse (RN) using standardized protocols. Of these, 4,213 (42%) were referred for a physician telehealth visit (telehealth patients). The mean age TRANS of callers was 42 years. 67% were female TRANS, 51% white, and 46% were on Medicaid or uninsured. Intervention: Physician telehealth visits for COVID-19. Main Outcomes and Measures: We describe clinical diagnosis, patient characteristics ( age TRANS, sex race/ethnicity, smoking status, insurance status), and visit disposition. We use logistic regression to evaluate associations between patient characteristics, visit disposition and subsequent emergency MESHD department use, hospitalization, and SARS-Cov-2 PCR testing. Results: Common caller concerns included cough MESHD cough HP, fever MESHD fever HP, and shortness of breath. Most telehealth patients (79%) were advised to self-isolate at home, 14% were determined to be unlikely to have COVID-19, 3% were advised to seek emergency MESHD care, and 4% had miscellaneous other dispositions. A total of 287 (7%) patients had a subsequent ED visit, and 44 (1%) were hospitalized with a COVID-19 diagnosis. Of the callers, 482 (5%) had a COVID-19 test reported with 69 (14%) testing positive. Among patients advised to stay at home, 83% had no further face-to-face visits. In multivariable results, only a physician recommendation to seek emergency MESHD care was associated with emergency MESHD room use (OR=4.73, 95%CI 1.37-16.39, p=.014). Only older age TRANS was associated with having a positive test result. Conclusions and Relevance: Robust, physician-directed telehealth services can meet a wide range of needs during the acute phase of a pandemic, conserving scarce resources such as personal protective equipment and testing supplies and preventing the spread of infections MESHD to patients and health care workers.

    Deposition distribution of the new coronavirus (SARS-CoV-2) in the human airways upon exposure to cough MESHD cough HP-generated aerosol

    Authors: Balázs G. Madas; Péter Füri; Árpád Farkas; Attila Nagy; Aladár Czitrovszky; Imre Balásházy; Gusztáv G. Schay; Alpár Horváth

    id:2005.05882v1 Date: 2020-05-12 Source: arXiv

    The new coronavirus disease MESHD 2019 (COVID-19) has been emerged as a rapidly spreading pandemic. The disease MESHD is thought to spread mainly from person-to-person through respiratory droplets produced when an infected person coughs MESHD coughs HP, sneezes MESHD sneezes HP, or talks. The pathogen of COVID-19 is the severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2). It infects the cells binding to the angiotensin-converting enzyme 2 receptor (ACE2) which is expressed by cells throughout the airways as targets for cellular entry. Although the majority of persons infected with SARS-CoV-2 experience symptoms of mild upper respiratory tract infection MESHD respiratory tract infection HP, in some people infections MESHD of the peripheral airways result in severe, potentially fatal pneumonia MESHD pneumonia HP. However, the induction of COVID-19 pneumonia MESHD pneumonia HP requires that SARS-CoV-2 reaches the peripheral airways. While huge efforts have been made to understand the spread of the disease TRANS disease as well MESHD as the pathogenesis following cellular entry, much less attention is paid how SARS-CoV-2 from the environment reach the receptors of the target cells. The aim of the present study is to characterize the deposition distribution of SARS-CoV-2 in the airways upon exposure to cough MESHD cough HP-generated aerosol. For this purpose, the Stochastic Lung Deposition Model has been applied. Aerosol size distribution and breathing parameters were taken from the literature supposing normal breathing through the nose. We found that the probability of direct infection MESHD of the peripheral airways due to inhalation of aerosol generated by a bystander cough MESHD cough HP is very low. As the number of pathogens deposited in the extrathoracic airways is ~10 times higher than in the peripheral airways, we concluded that in most cases COVID-19 pneumonia MESHD pneumonia HP must be preceded by SARS-CoV-2 infection MESHD of the upper airways. Our results suggest that without the enhancement of viral load in the upper airways, COVID-19 would be much less dangerous...

    Facemasks prevent influenza-like illness: implications for COVID-19

    Authors: Jie Wei; Michael Doherty; Monica S.M. Persson; Subhashisa Swain; Changfu Kuo; CHAO ZENG; guanghua Lei; Weiya Zhang

    doi:10.1101/2020.05.07.20094912 Date: 2020-05-12 Source: medRxiv

    The coronavirus disease MESHD 2019 (COVID-19) pandemic is causing a huge toll on individuals, families, communities and societies across the world. Currently, whether wearing facemasks in public should be a measure to prevent transmission TRANS of severe acute respiratory syndrome MESHD coronavirus-2 (SARS-CoV-2) remains contraversial.1 This is largely because there have been no randomized controlled trials (RCTs) for coronavirus to directly support this. However, lessons may be taken from published RCTs examining influenza-like illness (ILI).2,3 Recent studies suggested that SARS-CoV-2 shares similar transmission TRANS route with influenza virus,4 and the incidence of community transmission TRANS of SARS-CoV-2 in individuals with ILI is high.5 Therefore, we undertook this meta-analysis of RCTs examining the efficacy of wearing facemasks to prevent ILI in community settings, irrespective of confirmatory testing for the causative virus. We undertook a systematic literature search for RCTs related to facemasks and ILI between 1966 and April 2020 using PUBMED, EMBASE, and Cochrane library. RCTs undertaken in community (not hospital) settings comparing wearing and not wearing facemasks for ILI were included. Incidence of ILI (e.g., fever MESHD fever HP, cough MESHD cough HP, headache MESHD headache HP, sore throat, aches or pains MESHD pains HP in muscles or joints) was estimated per group. Relative risk (RR) and 95% confidence interval (CI) were calculated. We screened 899 related abstracts and eventually included 8 RCTs (Figure S1). Basic characteristics and quality of included RCTs are listed in Supplement. Participants wearing facemasks had a significantly lower risk of developing ILI than those not wearing facemasks (pooled RR=0.81, 95% CI: 0.70-0.95) and there was no heterogeneity (Figure 1). The decreased risk of ILI was more pronounced if everyone wore facemask irrespective of whether they were infected or not (RR=0.77, 95% CI: 0.65-0.91), compared to those wearing facemasks when infected (RR=0.95, 95% CI: 0.58-1.56) or uninfected (RR=1.26, 95% CI: 0.69-2.31). This study shows that wearing facemasks, irrespective of infection MESHD status, is effective in preventing ILI spread in the community. This situation mirrors what is happening now in public settings where we do not know who has been infected and who has not. Although there are no RCTs of facemasks for SARS-CoV-2, as with other simple measures such as social distancing and handwashing, these data support the recommendation to wear facemasks in public to further reduce transmission TRANS of SARS-CoV-2 and flatten the curve of this pandemic, especially when social distancing is impractical, such as shopping, or travelling TRANS with public transport for work that cannot be done from home.

    Heart Rate Variability in a Patient with Coronavirus Disease MESHD 2019

    Authors: Christoph Baumann; Reiner Buchhorn; Christian Willaschek

    id:10.20944/preprints202005.0209.v1 Date: 2020-05-12 Source:

    This case study investigates the heart rate (HR) and heart rate variability (HRV) in a patient with coronavirus disease MESHD 2019 (COVID-19). We report the case of a 58-year old male TRANS who contracted COVID-19. During his disease MESHD, 24-hour Holter electrocardiography (ECG) was performed continuously. For comparison, his 24-hour Holter ECGs from the previous 10 years were available. In this patient, COVID-19 was associated with a decrease in HR and a paradoxical decline in HRV. An abrupt decline in HRV and a decrease in HR may signal the onset of COVID-19 before common symptoms such as dry cough MESHD cough HP or fever MESHD fever HP appear. In addition, HRV and HR measurements may help to evaluate the course of the disease MESHD.


    Authors: yale tung chen; Milagros Marti de Gracia; Aurea DiezTascon; Sergio Agudo-Fernandez; Rodrigo Alonso-Gonzalez; Pablo Rodriguez Fuertes; Luz Parra-Gordo; Silvia Ossaba-Velez; Rafael Llamas Fuentes

    doi:10.1101/2020.05.08.20095117 Date: 2020-05-12 Source: medRxiv

    INTRODUCTION: There is growing evidence regarding the imaging findings of Coronavirus Disease MESHD 2019 (COVID-19), in chest X-ray and Computed Tomography scan (CT). At this moment, the role of Lung Ultrasonography (LUS) has yet to be explored. OBJECTIVES: The main purpose of this study is to evaluate the correlation between LUS findings and chest CT in confirmed (positive RT-PCR) or clinically highly suspicious ( dyspnea MESHD dyspnea HP, fever MESHD fever HP, myasthenia, gastrointestinal symptoms, dry cough MESHD cough HP, ageusia MESHD or anosmia HP) of COVID-19 patients. METHODS: Prospective study carried out in the emergency MESHD department (ED) of confirmed or clinically highly suspicious COVID-19 patients who were subjected to a chest CT and concurrent LUS exam. An experienced ED physician performed the LUS exam blind to the clinical history and results of the CT scan, which were reviewed by two radiologists in consensus for signs compatible with COVID-19 (bilateral ground-glass opacities in peripheral distribution). Compatible LUS exam was considered a bilateral pattern of B-lines, irregular pleural line and subpleural consolidations. RESULTS: Between March and April 2020, fifty-one patients were consecutively enrolled. The indication for CT was a negative or indeterminate RT-PCR test (49.0%) followed by suspicion of pulmonary embolism MESHD pulmonary embolism HP (41.2%). Radiological signs compatible with COVID-19 were present in thirty-seven patients (72.5%) on CT scan and forty patients (78.4%) on LUS exam. The presence of LUS findings was correlated with a positive CT scan suggestive of COVID-19 (OR: 13.3, 95%CI: 4.5-39.6, p<0.001) with a sensitivity SERO of 100.0% and a specificity of 78.6%, positive predictive value SERO of 92.5% and negative of 100.0%. There was no missed diagnosis of COVID-19 with LUS compared to CT in our cohort. The LUS Score had a good correlation with CT total severity score (ICC 0.803, 95% CI 0.60-0.90, p<0.001). CONCLUSION: LUS presents similar accuracy compared to chest CT to detect lung abnormalities in COVID-19 patients.

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MeSH Disease
Human Phenotype

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