Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Plasma SERO tissue plasminogen activator and plasminogen activator inhibitor-1 in hospitalized COVID-19 patients

    Authors: Yu Zuo; Mark Warnock; Alyssa Harbaugh; Srilakshmi Yalavarthi; Kelsey Gockman; Melanie Zuo; Jacqueline A. Madison; Jason S. Knight; Yogendra Kanthi; Daniel A. Lawrence; Laura Vanessa Montes Fontalvo; Roger Hernandez; Carolin Chavez; Francisco Eduardo Campos; Fadia Uribe; Olguita del Aguila; JORGE ALBERTO RIOS AIDA; Andrea Parra Buitrago; Lina Maria Betancur Londono; Leon Felipe Mendoza Vega; Carolina Almeida Hernandez; Michela Sali; JULIAN HIGUITA PALACIO; Jessica Gomez-Vargas; Adriana Yock Corrales; Danilo Buonsenso

    doi:10.1101/2020.08.29.20184358 Date: 2020-09-02 Source: medRxiv

    Background: Patients with coronavirus disease MESHD 19 (COVID-19) are at high risk for thrombotic arterial and venous occlusions MESHD venous occlusions HP, while lung histopathology often reveals fibrin-based occlusion of small vessels in patients who succumb to the disease. At the same time, bleeding MESHD complications have been observed in some patients. Better understanding the balance between coagulation and fibrinolysis will help inform optimal approaches to thrombosis MESHD prophylaxis and potential utility of fibrinolytic-targeted therapies. Objective: To evaluate fibrinolysis among a large cohort of hospitalized COVID-19 patients. Patients and methods: 118 hospitalized COVID-19 patients and 30 healthy controls were included in the study. We measured plasma SERO antigen levels of tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) and performed spontaneous clot lysis assays. Results: We found markedly elevated levels of tPA and PAI-1 among patients hospitalized with COVID-19. Both factors demonstrated a strong correlation with neutrophil counts and markers of neutrophil activation, but not with D-dimer. High levels of tPA and PAI-1 were associated with worse respiratory status. High levels of tPA, in particular, were also strongly correlated with mortality and with a significant enhancement in spontaneous ex vivo clot lysis. Conclusion: While both tPA and PAI-1 are elevated among COVID-19 patients, extremely high levels of tPA enhance spontaneous fibrinolysis and are significantly associated with mortality in some patients. These data indicate that fibrinolytic homeostasis in COVID-19 is complex with a subset of patients expressing a balance of factors that may favor fibrinolysis and suggests that further study of tPA as a potential biomarker is warranted.

    SARS-CoV-2 and Stroke HP Stroke MESHD Characteristics: A Report from the Multinational COVID-19 Stroke HP Stroke MESHD Study Group

    Authors: Shima Shahjouei; Georgios Tsivgoulis; Rohan Arora; Mohammad Hossein Harirchian; Nasrin Rahimian; Afshin Borhani-Haghighi; Stefania Mondello; Arash Kia; Alireza Vafaei Sadr; Ashkhan Mowla; Venkatesh Avula; Saeed Ansari; Ramin Zand; Vida Abedi; Ghasem Farahmand; Eric Koza; Martin Punter; Annemarei Ranta; Achille Cernigliaro; Alaleh Vaghefi Far; Afshin Borhani-Haghighi; Jiang Li; Oluwaseyi Olulana; Durgesh Chaudhary

    doi:10.1101/2020.08.05.20169169 Date: 2020-08-07 Source: medRxiv

    Background: Stroke HP Stroke MESHD is reported as a consequence of SARS-CoV-2 infection MESHD. However, there is a lack of regarding comprehensive stroke HP stroke MESHD phenotype and characteristics Methods: We conducted a multinational observational study on features of consecutive acute ischemic stroke MESHD ischemic stroke HP ( AIS MESHD), intracranial hemorrhage HP intracranial hemorrhage MESHD ( ICH MESHD), and cerebral venous or sinus thrombosis MESHD ( CVST MESHD) among SARS-CoV-2 infected MESHD patients. We further investigated the association of demographics, clinical data, geographical regions, and countrie's health expenditure among AIS MESHD patients with the risk of large vessel occlusion (LVO), stroke HP stroke MESHD severity as measured by National Institute of Health stroke HP stroke MESHD scale (NIHSS), and stroke HP stroke MESHD subtype as measured by the TOAST criteria. Additionally, we applied unsupervised machine learning algorithms to uncover possible similarities among stroke HP stroke MESHD patients. Results: Among the 136 tertiary centers of 32 countries who participated in this study, 71 centers from 17 countries had at least one eligible stroke HP stroke MESHD patient. Out of 432 patients included, 323(74.8%) had AIS MESHD, 91(21.1%) ICH MESHD, and 18(4.2%) CVST MESHD. Among 23 patients with subarachnoid hemorrhage HP subarachnoid hemorrhage MESHD, 16(69.5%) had no evidence of aneurysm MESHD. A total of 183(42.4%) patients were women, 104(24.1%) patients were younger than 55 years, and 105(24.4%) patients had no identifiable vascular risk factors. Among 380 patients who had known interval onset of the SARS-CoV-2 and stroke HP stroke MESHD, 144(37.8%) presented to the hospital with chief complaints of stroke HP stroke MESHD-related symptoms, with asymptomatic TRANS or undiagnosed SARS-CoV-2 infection MESHD. Among AIS MESHD patients 44.5% had LVO; 10% had small artery occlusion MESHD according to the TOAST criteria. We observed a lower median NIHSS (8[3-17], versus 11[5-17]; p=0.02) and higher rate of mechanical thrombectomy (12.4% versus 2%; p<0.001) in countries with middle to high-health expenditure when compared to countries with lower health expenditure. The unsupervised machine learning identified 4 subgroups, with a relatively large group with no or limited comorbidities. Conclusions: We observed a relatively high number of young, and asymptomatic TRANS SARS-CoV-2 infections MESHD among stroke HP stroke MESHD patients. Traditional vascular risk factors were absent among a relatively large cohort of patients. Among hospitalized patients, the stroke HP stroke MESHD severity was lower and rate of mechanical thrombectomy was higher among countries with middle to high-health expenditure.

    Doxycycline and Pentoxifylline for Mild and Mild-To-Moderate Covid-19

    Authors: Emil Toma

    id:10.20944/preprints202006.0293.v1 Date: 2020-06-24 Source: Preprints.org

    We are proposing, for any interested investigator, a randomized open clinical trial for mild and mild-to-moderate Covid-19 comparing a treatment regimen with standard of care, and eventually with another investigational regimen, if ongoing or will be implemented. The patients could be hospitalized or ambulatory but not requiring admission to intensive care units and mechanical ventilation. The proposed therapeutic regimen consists of doxycycline (an antimicrobial having also anti-inflammatory properties, probable antioxidant and possible some antiviral effects), and pentoxifylline, a hemorheological compound used in occlusive arterial diseases MESHD but also having proven anti-inflammatory properties. Doxycycline is included in the WHO’s list of essential medicine being an effective, safe, widely available, and inexpensive medication and widely accessible. It will be administered at a dosage of 100 mg orally twice daily for ten days. Pentoxifylline, in clinical use since 1972, and also widely accessible, will be given at a dosage of 400 mg orally, also twice daily, for ten days. The primary outcome measures are: 1) Progression of disease to a severe form requiring intensive care admission and mechanical ventilation; 2) Fatality rates and 3) Time to clinical recovery.This proposal was presented to the National Directors and Core Leads meeting of the Canadian Trials Network (CTN) on May 6, 2020. The interventional trial template suggested by CTN was used for designing the trial.

    Prothrombotic antiphospholipid antibodies SERO in COVID-19

    Authors: Yu Zuo; Shanea K. Estes; Alex A. Gandhi; Srilakshmi Yalavarthi; Ramadan A. Ali; Hui Shi; Gautam Sule; Kelsey Gockman; Jacqueline A. Madison; Melanie Zuo; Wrenn Woodard; Sean P. Lezak; Njira L. Lugogo; Yogendra Kanthi; Jason S. Knight

    doi:10.1101/2020.06.15.20131607 Date: 2020-06-17 Source: medRxiv

    Patients with coronavirus disease MESHD 19 (COVID-19) are at high risk for thrombotic arterial and venous occlusions MESHD venous occlusions HP. At the same time, lung histopathology often reveals fibrin-based occlusion of small vessels in patients who succumb to the disease. Antiphospholipid syndrome MESHD ( APS MESHD) is an acquired and potentially life-threatening thrombophilia MESHD in which patients develop pathogenic autoantibodies (aPL) targeting phospholipids and phospholipid-binding proteins. Small case series have recently detected aPL in patients with COVID-19. Here, we measured eight types of aPL (anticardiolipin IgG/IgM/IgA, anti-beta-2 glycoprotein I IgG/IgM/IgA, and anti- phosphatidylserine/prothrombin (PS/PT) IgG/IgM) in the sera of 172 patients hospitalized with COVID-19. We detected anticardiolipin IgM antibodies SERO in 23%, anti-PS/PT IgG in 24%, and anti-PS/PT IgM in 18%. Any aPL was present in 52% of patients using the manufacturer's threshold and in 30% using a more stringent cutoff (>40 units). Higher levels of aPL were associated with neutrophil hyperactivity HP (including the release of neutrophil extracellular traps/NETs), higher platelet count, more severe respiratory disease MESHD, and lower glomerular filtration rates. Similar to patients with known and longstanding APS MESHD, IgG fractions isolated from patients with COVID-19 promoted NET release from control neutrophils. Furthermore, injection of these COVID-19 IgG fractions into mice accelerated venous thrombosis HP venous thrombosis MESHD. Taken together, these studies suggest that a significant percentage of patients with COVID-19 become at least transiently positive for aPL and that these aPL are potentially pathogenic.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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