Corpus overview


MeSH Disease

Human Phenotype


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    Age TRANS differences in clinical features and outcomes in patients with COVID-19, Jiangsu, China: a retrospective, multi-center cohort study

    Authors: Huanyuan Luo; Songqiao Liu; Yuancheng Wang; Penelope A. Phillips-Howard; Yi Yang; Shenghong Ju; Duolao Wang

    doi:10.1101/2020.06.01.20086025 Date: 2020-06-02 Source: medRxiv

    Objectives To determine the age TRANS-specific clinical presentations and incidence of adverse outcomes among patients with COVID-19 in Jiangsu, China. Design and setting This is a retrospective, multi-center cohort study performed at twenty-four hospitals in Jiangsu, China. Participants From January 10 to March 15, 2020, 625 patients with COVID-19 were involved. Results Of the 625 patients (median age TRANS, 46 years; 329 [52.6%] males TRANS), 37 (5.9%) were children TRANS (18 years or less), 261 (40%) young adults TRANS (19-44 years), 248 (39.7%) middle- aged TRANS adults TRANS (45-64 years), and 79 (12.6%) elderly TRANS (65 years or more). The incidence of hypertension MESHD hypertension HP, coronary heart disease MESHD disease, chronic obstructive pulmonary HP chronic obstructive pulmonary disease MESHD, and diabetes comorbidities increased with age TRANS (trend test, P < .0001, P = 0.0003, P < .0001, and P < .0001 respectively). Fever MESHD Fever HP, cough MESHD cough HP, and shortness of breath occurred more commonly among older patients, especially the elderly TRANS, compared to children TRANS (Chi-square test, P = 0.0008, 0.0146, and 0.0282, respectively). The quadrant score and pulmonary opacity HP score increased with age TRANS (trend test, both P < .0001). Older patients had significantly more abnormal values in many laboratory parameters than younger patients. Elderly TRANS patients contributed the highest proportion of severe or critically-ill cases (33.0%, Chi-square test P < 0.001), intensive care unit (ICU) (35.4%, Chi-square test P < 0.001), and respiratory failure HP (31.6%, Chi-square test P = 0.0266), and longest hospital stay (21 days, ANOVA-test P < 0.001). Conclusions Elderly TRANS ([≥]65) patients with COVID-19 had the highest risk of severe or critical illness MESHD, intensive care use, respiratory failure HP, and the longest hospital stay, which may be due partly to that they had higher incidence of comorbidities and poor immune responses to COVID-19.

    Epidemiologic, Clinical, and Laboratory Findings of the COVID-19 in the current pandemic: Systematic Review and Meta-analysis

    Authors: Yewei Xie; Zaisheng Wang; Huipeng Liao; Gifty Marley; Dan Wu; Weiming Tang

    doi:10.21203/ Date: 2020-05-11 Source: ResearchSquare

    Background: The COVID-19 pandemic has affected the world deeply, with more than 3,000,000 people infected and nearly 200,000 deaths MESHD. This review aimed to summarize the epidemiologic traits, clinical spectrum, CT results and laboratory findings of the COVID-19 pandemic.Methods: We scoped for relevant literatures published during 1st Dec 2019 to 23rd Apr 2020 based on four databases using English and Chinese languages. We reviewed and analyzed the relevant clinic outcomes of COVID-19.Results: The COVID-19 pandemic was found to have a higher transmission TRANS rate compared to SARS and MERS and involved 4 stages of evolution. The basic reproduction number TRANS ( R0 TRANS) is 3.32 (95% CI:3.24-3.39), the incubation period TRANS was 5.24 days (95% CI:3.97-6.50, 5 studies) on average, and the average time for symptoms onset TRANS varied by countries. Common clinical spectrums identified included fever MESHD fever HP (38.1-39.0℃), cough MESHD cough HP and fatigue MESHD fatigue HP, with Acute Respiratory Distress HP Syndrome MESHD (ARDS) being the most common complication reported. Body temperatures above 39.0 ℃, dyspnea MESHD dyspnea HP, and anorexia MESHD anorexia HP were more common symptoms in severe patients. Aged TRANS over 60 years old, having co-morbidities, and developing complications were the commonest high-risk factors associated with severe conditions. Leucopenia and lymphopenia MESHD lymphopenia HP were the most common signs of infection MESHD while liver and kidney damage were rare but may cause bad outcomes for patients. The bilateral, multifocal Ground-Glass Opacification (GGO) on peripheral, and the consolidative pulmonary opacity HP were the most frequent CT results and the tendency of mortality rates differed by region.Conclusions: We provided a bird’s-eye view of the COVID-19 during the current pandemic, which will help better understanding the key traits of the disease MESHD. The findings could be used for disease’s future research, control and prevention.

    Can Nebulised Heparin Reduce Time to Extubation in SARS CoV 2 The CHARTER Study Protocol

    Authors: Barry Dixon; Roger Smith; Antonio Artigas; John Laffey; Bairbre McNicholas; Eric Schmidt; Quentin Nunes; Mark Andrew Skidmore; Marcelo Andrade de Lome; John Moran; Frank Van Haren; Gordon Doig; Sachin Gupta; Angajendra Ghosh; Simone Said; John Santamaria

    doi:10.1101/2020.04.28.20082552 Date: 2020-05-01 Source: medRxiv

    Introduction: COVID 19 is associated with the development of ARDS displaying the typical features of diffuse alveolar damage with extensive pulmonary coagulation activation resulting in fibrin deposition in the microvasculature and formation of hyaline membranes in the air sacs. The anticoagulant actions of nebulised heparin limit fibrin deposition and progression of lung injury MESHD. Serendipitously, unfractionated heparin also inactivates the SARS CoV 2 virus and prevents its entry into mammalian cells. Nebulisation of heparin may therefore limit both fibrin mediated lung injury MESHD and inhibit pulmonary infection MESHD by SARS CoV 2. For these reasons we have initiated a multicentre international trial of nebulised heparin in patients with COVID 19. Methods and intervention: Mechanically ventilated patients with confirmed or strongly suspected SARS CoV 2 infection MESHD, hypoxaemia and an acute pulmonary opacity HP in at least one lung quadrant on chest Xray, will be randomised to nebulised heparin 25,000 Units every 6 hours or standard care for up to 10 days while mechanically ventilated. The primary outcome is the time to separation from invasive ventilation to day 28, where non survivors to day 28 are treated as though not separated from invasive ventilation. Ethics and dissemination: The study protocol has been submitted to the human research and ethics committee of St Vincents Hospital, Melbourne, Australia. Submission is pending in other jurisdictions. Results of this study will be published in scientific journals and presented at scientific meetings.

    Clinical and Imaging Findings in COVID-19 Patients Complicated by Pulmonary Embolism MESHD Pulmonary Embolism HP

    Authors: Ting Li; Gregory Kicska; Paul E Kinahan; Chengcheng Zhu; Murat Alp Oztek; Wei Wu

    doi:10.1101/2020.04.20.20064105 Date: 2020-04-24 Source: medRxiv

    Objective: To describe clinical, and imaging findings including the evolution pattern in COVID-19 pneumonia MESHD pneumonia HP complicated by pulmonary embolism MESHD pulmonary embolism HP (PE). Methods: Eleven of 1453 patients with a probable diagnosis of COVID-19 pneumonia MESHD pneumonia HP were retrospectively selected for the presence of PE. Clinical and laboratory data were recorded. All cross-sectional CT imaging was qualitatively scored for the first 28 days after onset of symptoms TRANS. Results: Of 24 patients underwent CTA-PE, 11 were confirmed with PE. All 11 patients developed acute respiratory distress HP syndrome MESHD (ARDS). We observed an evolution pattern of predominant findings with ground-glass opacities (GGO) to GGO with crazy paving in 3 patients, then to consolidation with linear densities, or to reticulation in 9 patients. Lung cysts MESHD or traction bronchiectasis MESHD bronchiectasis HP could be seen from day 5 to 9 after symptoms and reticulation, subpleural curvilinear lines were more common from day 20. The pulmonary opacities HP were predominantly peripheral in distribution with relative sparing of nondependent lungs. The severity of lung involvement was high with an average score of 9.7 in the first phase, 18 in the second phase plateauing in the next two phases, with a slight decrease to 16.9 in the late phase. The pulmonary emboli were most common in segmental and subsegmental pulmonary arteries. Conclusion: The incidence of PE among suspected patients in COVID-19 was high. Our study suggests PE may occur with increased frequency in the ARDS subgroup. The evolution of radiographic abnormalities showed a general pattern, but are also unique with more extensive lung injury MESHD and specific imaging features.

    Clinical characteristics and risk factors of patients with severe COVID-19 in Jiangsu province, China: a retrospective multicentre cohort study

    Authors: Songqiao Liu; Huanyuan Luo; Yuancheng Wang; Luis E. Cuevas; Duolao Wang; Shenghong Ju; Yi Yang

    doi:10.21203/ Date: 2020-04-20 Source: ResearchSquare

    Background: Coronavirus Disease MESHD-2019 (COVID-19) has become a major health event that endangers people health throughout China and the world. Understanding the factors associated with COVID-19 disease MESHD severity could support the early identification of patients with high risk for disease progression MESHD, inform prevention and control activities, and potentially reduce mortality. This study aims to describe the characteristics of patients with COVID-19 and factors associated with severe or critically ill presentation.Methods: Multicentre retrospective cohort study of all individuals with confirmed Severe Acute Respiratory Syndrome MESHD Coronavirus-2 (SARS-CoV-2) infections MESHD diagnosed at 24 COVID-19-designated hospitals in Jiangsu province between the 10th January and 15th March 2020. Demographic, clinical, laboratory, and radiological data were collected at hospital admission and data on disease MESHD severity were collected at from admission. Patients were categorised as asymptomatic TRANS/mild/moderate, and severe/critically ill according to the worst level of COVID-19 recorded during hospitalisation.Results: A total of 625 patients, 64 (10.2%) were severe/critically ill and 561 (89.8%) were asymptomatic TRANS/mild/moderate. All patients were discharged and no patients died. Patients with severe/critically ill COVID-19 were more likely to be older, to be single onset (i.e. not to a cluster of cases in family/community), to have a medical history of hypertension MESHD hypertension HP and diabetes; had higher temperature, faster respiratory rates, lower peripheral capillary oxygen saturation (SpO2), and higher CT image quadrant scores and pulmonary opacity HP percentage; had increased C-reactive protein, fibrinogen, and D-dimer on admission; and had lower white blood SERO cells, lymphocyte, and platelet counts and albumin on admission than asymptomatic TRANS/mild/moderate cases. Multivariable regression showed that odds of being a severe/critically ill case were associated with age TRANS (year) (OR 1.06, 95%CI 1.03-1.09), lymphocyte count (109/L) (OR 0.25, 95%CI 0.08-0.74), and pulmonary opacity HP in CT (per 5%) on admission (OR 1.31, 95%CI 1.15-1.51).Conclusions: Severe or critically ill patients with COVID-19 is about one-tenths of patients in Jiangsu. Age TRANS, lymphocyte count, and pulmonary opacity HP in CT on admission were associated with risk of severe or critically ill COVID-19.

    The impact of COVID-19 on ischemic stroke HP stroke MESHD: A case report

    Authors: Pan Zhai; Yanbing Ding; Yiming Li

    doi:10.21203/ Date: 2020-03-31 Source: ResearchSquare

    BackgroundThe outbreak of a novel coronavirus since December 2019 in Wuhan, became an emergency MESHD of major international concern. As of March 5, 2020, the SARS-CoV-2 epidemic has caused 80,565 confirmed infections TRANS infections MESHD with 3,015 fatal cases in China. The SARS-CoV-2 outbreak is a major challenge for clinicians. In our clinic, we found a rare case that a COVID-19 patient combined with ischemic stroke HP stroke MESHD.Case PresentationA 79-year-old man was admitted to the Hubei Provincial Hospital of Chinese Traditional Medicine due to right limb weakness for 1 day and slight cough MESHD cough HP for 1 week. At presentation, his body temperature was 37.3°C (99.0°F) with some moist rales. Neurological examination showed right limb weakness, and the limb muscle HP strength was grade 4. The left leg and arms were unaffected. In addition, runs of speech were not fluent enough with tongue deviation. Laboratory studies showed lymphopenia MESHD lymphopenia HP and eosinophilic granulocytopenia HP. Chest CT revealed bilateral pulmonary parenchymal ground-glass and consolidative pulmonary opacities HP, with a peripheral lung distribution. Real-time polymerase chain reaction (RT-PCR) from throat swab sample was positive for SARS-CoV-2 nucleic acid. This patient was treated with antiviral drugs and anti-inflammatory drugs with supportive care until his discharge. Clopidogrel (75 mg) and atorvastatin (20 mg) were administered orally to treat acute ischemic stroke HP stroke MESHD. After twelve days of treatment, he can walk normally and communicate with near fluent language.ConclusionWe report an even more unusual case, a patient who was hospitalized for right limb weakness and was later diagnosed with COVID-19. Here, SARS-CoV-2 infection MESHD caused hypoxemia HP and excessive secretion of inflammatory cytokines, which contribute to the occurrence and development of ischemic stroke HP stroke MESHD. Once COVID-19 patients show acute ischemic stroke HP stroke MESHD, neurologists should cooperate with infectious disease MESHD doctors to help patients.

    Clinical and CT Characteristics of Medical Personnel with the Coronavirus Disease MESHD-2019 (COVID-19) in Wuhan

    Authors: Ying Xiong; Qiang Zhang; Dong Sun; Xiaoming Li; Wenzhen Zhu

    doi:10.21203/ Date: 2020-03-06 Source: ResearchSquare

    Objectives: To investigate the clinical and chest CT characteristics of medical personnel infected with the Coronavirus Disease MESHD-2019 (COVID-19).Methods: The clinical, laboratory test and computed tomography (CT) features of 30 medical personnel (MP group, 26-65 years, 16 males TRANS) with COVID-19 were retrospectively analyzed, and compared to 33 non-medical related patients (non-MP group, 26-74 years, 19 males TRANS). Follow-up CT characteristics were analyzed to assess the changes of the COVID-19 infection MESHD in the period of hospitalization.Results: At admission, the main complaints of MP group, including fever MESHD fever HP (86.7%), fatigue MESHD fatigue HP (53.3%) and cough MESHD cough HP (43.3%), were similar to the non-MP group; the C-reactive protein, erythrocyte sedimentation rate and lactate dehydrogenase levels of the non-MP group (55.6±45.9mg/L, 34.7±26.3mm/H and 321±117U/L) were higher than that of the MP group (17.8±19.9mg/L, 18.6±21.3mm/H and 219±54.2U/L, respectively, all p<0.05). Ground-grass opacities, consolidation, interstitial thickening were common CT features of both groups. The days from illness onset to the first CT exam, and the severity of opacities on initial CT were less in the MP group than that of the non-MP group (p<0.05). However, the days from onset to observation of the most obvious pulmonary opacities HP, according to CT findings, were similar in the MP group (11.5±5.9 days) and the non-MP group (12.2±3.1 days, p=0.55).Conclusions: Like the general population, medical personnel are also susceptible to the COVID-19, although with more professional knowledge and protective equipment. Occupational exposure is a very important factor. Medical personnel have a higher vigilance about the infection MESHD in the early stage of the disease MESHD.

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MeSH Disease
Human Phenotype

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