Corpus overview


MeSH Disease

Delirium (17)

Infections (5)

Frailty (5)

Disease (5)

Fever (5)

Human Phenotype

Delirium (17)

Fever (5)

Cough (5)

Encephalitis (3)

Anxiety (2)


    displaying 1 - 10 records in total 17
    records per page

    Prevalence SERO of Depression, Anxiety HP, Delirium MESHD Delirium HP, and Post-Traumatic Stress Disorder Among COVID-19 Patients: Protocol for A Living Systematic Review

    Authors: Jiyuan Shi; Yuanyuan Li; Liang Zhao; Meili Yan; MingMing Niu; Yamin Chen; Ziwei Song; Gao Ya; Jinhui Tian

    doi:10.21203/ Date: 2020-07-23 Source: ResearchSquare

    BackgroundPrevious studies on the impact of COVID-19 on the mental health of the patients has been limited by the lack of relevant data. With the rapid and sustained growth of the publications on COVID-19 research, we will perform a living systematic review (LSR) to provide comprehensive and continuously updated data to explore the prevalence SERO of depression, anxiety HP, delirium MESHD delirium HP, and post-traumatic stress disorder (PTSD) among COVID-19 patients.MethodsWe will perform a comprehensive search of the following databases: Cochrane library, PubMed, Web of Science, Embase, and Chinese Biomedicine Literature to identify relevant studies. We will utilize different tools to examine the bias risks (quality) regarding studies of varying design types, such as the revised Cochrane risk-of-bias tool (RoB 2) for randomized controlled trials (RCT), the Newcastle-Ottawa Scale (NOS) for cohort and case-control studies, etc. The literature searches would be updated every month. We will perform meta-analysis if any new eligible studies or data are obtained and resubmit an updated systematic review if any change in outcomes and heterogeneity is determined after the addition of the new studies. There will be no restrictions on language or year of publication.DiscussionThis LSR would provide an in-depth and up-to-date summary of the psychological impact of COVID-19 diagnosis and treatment on the patients. Systematic review registrationPROSPERO CRD42020196610 

    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 Source: medRxiv

    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.

    High frequency of cerebrospinal fluid autoantibodies in COVID-19 patients with neurological symptoms

    Authors: Christiana Franke; Caroline Ferse; Jakob Kreye; Momsen Reincke; Elisa Sanchez-Sendin; Andrea Rocco; Mirja Steinbrenner; Stefan Angermair; Sascha Treskatsch; Daniel Zickler; Kai-Uwe Eckardt; Rick Dersch; Jonas Hosp; Heinrich J. Audebert; Matthias Endres; Christoph J. Ploner; Harald Pruess

    doi:10.1101/2020.07.01.20143214 Date: 2020-07-06 Source: medRxiv

    COVID-19 intensive care patients occasionally develop neurological symptoms. The absence of SARS-CoV-2 in most cerebrospinal fluid (CSF) samples suggests the involvement of further mechanisms including autoimmunity HP. We therefore determined whether anti-neuronal or anti-glial autoantibodies are present in eleven consecutive severely ill COVID-19 patients presenting with unexplained neurological symptoms. These included myoclonus MESHD myoclonus HP, cranial nerve involvement, oculomotor disturbance, delirium MESHD delirium HP, dystonia MESHD dystonia HP and epileptic seizures MESHD seizures HP. Most patients showed signs of CSF inflammation MESHD and increased levels of neurofilament light chain. All patients had anti-neuronal autoantibodies in serum SERO or CSF when assessing a large panel of autoantibodies against intracellular and surface antigens relevant for central nervous system diseases MESHD using cell-based assays and indirect immunofluorescence on murine brain sections. Antigens included proteins well-established in clinical routine, such as Yo or NMDA receptor, but also a variety of specific undetermined epitopes on brain sections. These included vessel endothelium, astrocytic proteins and neuropil of basal ganglia, hippocampus or olfactory bulb. The high frequency of autoantibodies targeting the brain in the absence of other explanations suggests a causal relationship to clinical symptoms, in particular to hyperexcitability ( myoclonus MESHD myoclonus HP, seizures MESHD seizures HP). While several underlying autoantigens still await identification in future studies, presence of autoantibodies may explain some aspects of multi-organ disease MESHD in COVID-19 and can guide immunotherapy in selected cases.

    Prognostic factors in patients admitted to an urban teaching hospital with COVID-19 infection MESHD

    Authors: Donogh Maguire; Marylynne Woods; Conor Richards; Ross Dolan; Jesse Wilson Veitch; Wei MJ Sim; Olivia EH Kemmett; David C Milton; Sophie LW Randall; Ly D Bui; Nicola Goldmann; Allan Cameron; Barry Laird; Dinesh Talwar; Ian Godber; Alan Davidson; Donald C McMillan

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

    BackgroundSevere COVID-19 infection MESHD results in a systemic inflammatory response (SIRS). This SIRS response shares similarities to the changes observed during the peri-operative period that are recognised to be associated with the development of multiple organ failure MESHD. MethodsElectronic patient records for patients who were admitted to an urban teaching hospital during the initial 7-week period of the COVID-19 pandemic in Glasgow, U.K. (17th March 2020 - 1st May 2020) were examined for routine clinical, laboratory and clinical outcome data. Age TRANS, sex, BMI and documented evidence of COVID-19 infection MESHD at time of discharge or death MESHD certification were considered minimal criteria for inclusion.ResultsOf the 224 patients who fulfilled the criteria for inclusion, 52 (23%) had died at 30-days following admission. COVID-19 related respiratory failure HP (75%) and multiorgan failure (12%) were the commonest causes of death MESHD recorded. Age TRANS>70 years (p<0.001), past medical history of cognitive impairment HP (p<0.001), previous delirium MESHD delirium HP (p<0.001), clinical frailty MESHD score>3 (p<0.001), hypertension MESHD hypertension HP (p<0.05), heart failure MESHD (p<0.01), national early warning score (NEWS) >4 (p<0.01), positive CXR (p<0.01), and subsequent positive COVID-19 swab (p<0.001) were associated with 30-day mortality. CRP>80 mg/L (p<0.05), albumin <35g/L (p<0.05), peri-operative Glasgow Prognostic Score (poGPS) (p<0.05), lymphocytes <1.5 109/l (p<0.05), neutrophil lymphocyte ratio (p<0.001), haematocrit (<0.40 L/L ( male TRANS) / <0.37 L/L ( female TRANS)) (p<0.01), urea>7.5 mmol/L (p<0.001), creatinine >130 mmol/L (p<0.05) and elevated urea: albumin ratio (<0.001) were also associated with 30-day mortality.On analysis, age TRANS >70 years (O.R. 3.9, 95% C.I. 1.4 – 8.2, p<0.001), past medical history of heart failure MESHD (O.R. 3.3, 95% C.I. 1.2 – 19.3, p<0.05), NEWS >4 (O.R. 2.4, 95% C.I. 1.1 – 4.4, p<0.05), positive initial CXR (O.R. 0.4, 95% C.I. 0.2-0.9, p<0.05) and poGPS (O.R. 2.3, 95% C.I. 1.1 – 4.4, p<0.05) remained independently associated with 30-day mortality. Among those patients who tested PCR COVID-19 positive (n=122), age TRANS >70 years (O.R. 4.7, 95% C.I. 2.0 - 11.3, p<0.001), past medical history of heart failure MESHD (O.R. 4.4, 95% C.I. 1.2 – 20.5, p<0.05) and poGPS (O.R. 2.4, 95% C.I. 1.1- 5.1, p<0.05) remained independently associated with 30-days mortality.ConclusionAge > 70 years and severe systemic inflammation MESHD as measured by the peri-operative Glasgow Prognostic Score are independently associated with 30-day mortality among patients admitted to hospital with COVID-19 infection MESHD.

    The clinical spectrum of encephalitis MESHD encephalitis HP in COVID-19 disease MESHD: the ENCOVID multicentre study

    Authors: Andrea Pilotto; Stefano Masciocchi; Irene Volonghi; Elisabetta del Zotto; Eugenio Magni; Valeria De Giuli; Francesca Caprioli; Nicola Rifino; Maria Sessa; Michele Gennuso; Maria Sofia Cotelli; Marinella Turla; Ubaldo Balducci; Sara Mariotto; Sergio Ferrari; Alfonso Ciccone; Fabrizio Fiacco; Alberto Imarisio; Barbara Risi; Alberto Benussi; Emanuele Foca'; Francesca Caccuri; Matilde Leonardi; Roberto Gasparotti; Francesco Castelli; Gianluigi Zanusso; Alessandro Pezzini; Alessandro Padovani

    doi:10.1101/2020.06.19.20133991 Date: 2020-06-20 Source: medRxiv

    Background: Several preclinical and clinical investigations have argued for nervous system involvement in SARS-CoV-2 infection MESHD. Some sparse case reports have described various forms of encephalitis MESHD encephalitis HP in COVID-19 disease MESHD, but very few data have focused on clinical presentations, clinical course, response to treatment and outcomes yet. Objective: to describe the clinical phenotype, laboratory and neuroimaging findings of encephalitis MESHD encephalitis HP associated with SARS-CoV-2 infection MESHD, their relationship with respiratory function and inflammatory parameters and their clinical course and response to treatment. Design: The ENCOVID multicentre study was carried out in 13 centres in northern Italy between February 20th and May 31st, 2020. Only patients with altered mental status and at least two supportive criteria for encephalitis MESHD encephalitis HP with full infectious screening, CSF, EEG, MRI data and a confirmed diagnosis of SARS-CoV-2 infection MESHD were included. Clinical presentation and laboratory markers, severity of COVID-19 disease MESHD, response to treatment and outcomes were recorded. Results: Out of 45 cases screened, twenty-five cases of encephalitis MESHD encephalitis HP positive for SARS-CoV-2 infection MESHD with full available data were included. The most common symptoms at onset TRANS were delirium MESHD delirium HP (68%), aphasia MESHD aphasia HP/ dysarthria MESHD dysarthria HP (24%) and seizures MESHD seizures HP (24%). CSF showed hyperproteinorrachia and/or pleocytosis in 68% of cases whereas SARS-CoV-2 RNA by RT-PCR resulted negative. Based on MRI, cases were classified as ADEM (n=3), limbic encephalitis MESHD encephalitis HP (LE, n=2), encephalitis MESHD encephalitis HP with normal imaging (n=13) and encephalitis MESHD encephalitis HP with MRI alterations (n=7). ADEM and LE cases showed a delayed onset compared to the other encephalitis MESHD encephalitis HP (p=0.001) and were associated with previous more severe COVID-19 respiratory involvement. Patients with MRI alterations exhibited worse response to treatment and final outcomes compared to other encephalitis MESHD encephalitis HP. Conclusions and relevance: We found a wide clinical spectrum of encephalitis MESHD encephalitis HP associated with COVID19 infection MESHD, underlying different pathophysiological mechanisms. Response to treatment and final outcome strongly depended on specific CNS-manifestations.

    Potential involvement of monoamine oxidase activity in SARS-COV2 infection MESHD and delirium MESHD delirium HP onset

    Authors: Miroslava Cuperlovic-Culf; Emma L Cunningham; Anuradha Surendra; Xiaobei Pan; Steffany A.L. Bennett; Mijin Jung; Bernadette McGuiness; Anthony Peter Passmore; Danny McAuley; David Beverland; Brian D. Green

    doi:10.1101/2020.06.16.20128660 Date: 2020-06-19 Source: medRxiv

    Abstract Severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) causes a range of extra- respiratory signs and symptoms MESHD. One such manifestation is delirium MESHD delirium HP, an acute confusional state occurring in 60-70% of severe SARS-CoV-2 cases. Delirium MESHD Delirium HP is also a common clinical syndrome MESHD following planned orthopedic surgery. This investigation initially explored the underlying role of metabolism in delirium MESHD delirium HP-susceptibility in this setting. Metabolomics profiles of cerebrospinal fluid (CSF) and blood SERO taken prior to surgery found significant concentration differences of several amino acids, acylcarnitines and polyamines were observed in delirium MESHD delirium HP-prone patients. Phenethylamine (PEA) concentrations in delirium MESHD delirium HP-prone patients was significantly lower in CSF than in blood SERO, whilst in age TRANS- and gender TRANS-matched controls the opposite was observed (adjusted p values: 1.8x10-6 (control) and 1.788x10-10 ( delirium MESHD delirium HP)). PEA is metabolised by monoamine oxidase B (MAOB), a putative enzyme target for the treatment of Alzheimers disease MESHD Alzheimers disease HP, Parkinsons disease MESHD and depression. Our computational structural comparisons of MAOB and angiotensin converting enzyme (ACE) 2 found high similarity, specifically within the SARS-CoV-2 spike protein. MAOB structural alignment to ACE2 was 51% overall, but this was over 95% in the ACE2-spike protein binding region. Thus, it is possible that the spike protein interacts with MAOB on a molecular level. A previously published metabolomic dataset of control subjects and patients with either mild or severe COVID-19 was then analysed. Major concentration differences in some metabolites attributed to altered MAO activity were detected. Therefore, our hypothesis is that the SARS-CoV-2 influences MAOB activity, which is one potential cause for the many observed neurological and platelet based complications of SARS-CoV-2 infection MESHD. Further research is required to establish what effect MAOB inhibitors might have on these pathways. There is no evidence at present to support the withholding of MAOB inhibitors.

    Delirium MESHD Delirium HP is a presenting symptom of COVID-19 in frail, older adults TRANS: a cohort study of 322 hospitalised and 535 community-based older adults TRANS

    Authors: Maria Beatrice Zazzara; Rose S. Penfold; Amy L. Roberts; Karla Lee; Hannah Dooley; Carole H. Sudre; Carly Welch; Ruth C. E. Bowyer; Alessia Visconti; Massimo Mangino; Maxim B. Freydin; Julia S. El-Sayed Moustafa; Kerrin Small; Benjamin Murray; Marc Modat; Jonathan Wolf; Sebastien Ourselin; Finbarr C. Martin; Claire J. Steves; Mary Ni Lochlainn

    doi:10.1101/2020.06.15.20131722 Date: 2020-06-17 Source: medRxiv

    Background: Frailty MESHD, increased vulnerability to physiological stressors, is associated with adverse outcomes. COVID-19 exhibits a more severe disease MESHD course in older, co-morbid adults TRANS. Awareness of atypical presentations is critical to facilitate early identification. Objective: To assess how frailty MESHD affects presenting COVID-19 symptoms in older adults TRANS. Design: Observational cohort study of hospitalised older patients and self-report data for community-based older adults TRANS. Setting: Admissions to St Thomas' Hospital, London with laboratory-confirmed COVID-19. Community-based data for 535 older adults TRANS using the COVID Symptom Study mobile application. Subjects: Hospital cohort: patients aged TRANS 65 and over (n=322); unscheduled hospital admission between March 1st, 2020 - May 5th, 2020; COVID-19 confirmed by RT-PCR of nasopharyngeal swab. Community-based cohort: participants aged TRANS 65 and over enrolled in the COVID Symptom Study (n=535); reported test-positive for COVID-19 from March 24th (application launch)- May 8th, 2020. Methods: Multivariate logistic regression analysis performed on age TRANS-matched samples from hospital and community-based cohorts to ascertain association of frailty MESHD with symptoms of confirmed COVID-19. Results: Hospital cohort: significantly higher prevalence SERO of delirium MESHD delirium HP in the frail sample, with no difference in fever MESHD fever HP or cough MESHD cough HP. Community-based cohort: significantly higher prevalence SERO of probable delirium MESHD delirium HP in frailer, older adults TRANS, and fatigue MESHD fatigue HP and shortness of breath. Conclusions: This is the first study demonstrating higher prevalence SERO of delirium MESHD delirium HP as a COVID-19 symptom in older adults TRANS with frailty MESHD compared to other older adults TRANS. This emphasises need for systematic frailty MESHD assessment and screening for delirium MESHD delirium HP in acutely ill older patients in hospital and community settings. Clinicians should suspect COVID-19 in frail adults TRANS with delirium MESHD delirium HP.

    Functional and cognitive outcomes after COVID-19 delirium MESHD delirium HP

    Authors: Benjamin C Mcloughlin; Amy Miles; Thomas E Webb; Paul Knopp; Clodagh Eyres; Ambra Fabbri; Fiona Humphries; Daniel Davis

    doi:10.1101/2020.06.07.20115188 Date: 2020-06-09 Source: medRxiv

    Purpose To ascertain delirium MESHD delirium HP prevalence SERO and outcomes in COVID-19. Methods We conducted a point- prevalence SERO study in a cohort of COVID-19 inpatients at University College Hospital. Delirium MESHD Delirium HP was defined by DSM-IV criteria. The primary outcome was all-cause mortality at 4 weeks; secondary outcomes were physical and cognitive function. Results In 71 patients, 31 (42%) had delirium MESHD delirium HP, of which only 19 had been recognised by the clinical team. At 4 weeks, 20 (28%) had died, 26 (36%) were interviewed by telephone and 21 (30%) remained as inpatients. Physical function was substantially worse in people after delirium MESHD delirium HP (-39 points on functional scale/166, 95% CI -92 to -21, p=0.01) (Table 2). Mean cognitive scores at follow-up were similar and delirium MESHD delirium HP was not associated with mortality in this sample. Conclusions Our findings indicate that delirium MESHD delirium HP is common, yet under-recognised. Delirium MESHD Delirium HP is associated with functional impairments in the medium-term.

    Presenting features of COVID-19 in older people: relationships with frailty MESHD, inflammation MESHD and mortality

    Authors: Paul Knopp; Amy Miles; Thomas E Webb; Benjamin C Mcloughlin; Imran Mannan; Nadia Raja; Bettina Wan; Daniel Davis

    doi:10.1101/2020.06.07.20120527 Date: 2020-06-09 Source: medRxiv

    Purpose To describe the clinical features of COVID-19 in older adults TRANS, and relate these to outcomes. Methods Cohort study of 217 individuals ([≥]70 years) hospitalised with COVID-19, followed up for allcause mortality. Secondary outcomes included cognitive and physical function at discharge. C-reactive protein and neutrophil : lymphocyte ratio were used as measures of immune activity. Results Cardinal COVID-19 symptoms ( fever MESHD fever HP, dyspnoea, cough MESHD cough HP) were common but not universal. Inflammation MESHD on hospitalisation was lower in frail older adults TRANS. Fever MESHD Fever HP, dyspnoea, delirium MESHD delirium HP and inflammation MESHD were associated with mortality. Delirium MESHD Delirium HP at presentation was an independent risk factor for cognitive decline at discharge. Conclusions COVID-19 may present without cardinal symptoms as well as implicate a possible role for agerelated changes in immunity in mediating the relationship between frailty MESHD and mortality.

    Drug-Drug interactions between COVID-19 treatments and antipsychotics drugs: integrated evidence from 4 databases and a systematic review

    Authors: Beatriz Oda Plasencia-Garcia; Gonzalo Rodriguez-Menendez; Maria Isabel Rico-Rangel; Ana Rubio-Garcia; Jaime Torello-Iserte; Benedicto Crespo-Facorro

    doi:10.1101/2020.06.04.20122416 Date: 2020-06-08 Source: medRxiv

    Relevance: Management of symptoms like anxiety HP, delirium MESHD delirium HP and agitation HP cannot be neglected in COVID-19 patients. Antipsychotics are usually used for the pharmacological management of delirium MESHD delirium HP, and confusion MESHD confusion HP and behavioral disturbances. The selection of concomitant COVID-19 medications and antipsychotics should be evidence-based and closely monitored Objective: To systematically review evidence-based available on drug-drug interactions between COVID-19 treatments and antipsychotics. Evidence Review: Three databases were consulted: (a) Lexicomp Drug Interactions, (b) Micromedex Solutions Drugs Interactions, (c) Liverpool Drug Interaction Group for COVID-19 therapies. To acquire more information on QT prolongation and TdP, the CredibleMeds QTDrugs List was searched. Based on the information collected, the authors made a recommendation agreed to by consensus. In addition, a systematic review was conducted to find the clinical outcomes of drug-drug interactions between COVID-19 treatments and antipsychotics Results: The main interaction between COVID-19 drugs and antipsychotics are the risk of QT prolongation and TdP, and CYP interactions. Remdesivir, favipiravir, baricinitib, and anakinra can be used concomitantly with antipsychotics with no risk of drug-drug interaction (except for hematological risk with clozapine and baricinitib). Tocilizumab is rather safe to use in combination with antipsychotics, although it can restore the activity of CYP3A4 and therefore its substrate metabolism may increase. The most demanding COVID-19 treatments for co-administration with antipsychotics are chloroquine, hydroxychloroquine, azithromycin (all prolong QT interval HP) and lopinavir / ritonavir (CYP interaction and risk of QT prolongation). Conclusions: We urge to development of evidence-based guidelines that can help clinicians decide the safest treatment combination and monitoring necessary for each particular patient. The selection of concomitant COVID-19 medications and antipsychotics should be evidence-based and closely monitored.

The ZB MED preprint Viewer preVIEW includes all COVID-19 related preprints from medRxiv and bioRxiv, from ChemRxiv, from ResearchSquare, from arXiv and from and is updated on a daily basis (7am CET/CEST).



MeSH Disease
Human Phenotype

Export subcorpus as Endnote

This service is developed in the project nfdi4health task force covid-19 which is a part of nfdi4health.

nfdi4health is one of the funded consortia of the National Research Data Infrastructure programme of the DFG.