Corpus overview


MeSH Disease

Human Phenotype


    displaying 1 - 9 records in total 9
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    Intracerebral hemorrhage MESHD in COVID-19 patients with pulmonary failure MESHD – a propensity score matched registry study

    Authors: Corinna N. Lang; Johanna S. Dettinger; Michael Berchtold-Herz; Stefan Utzolino; Xavier Bemtgen; Viviane Zotzmann; Bonaventura Schmid; Paul M. Biever; Christoph Bode; Katharina Müller-Peltzer; Daniel Duerschmied; Tobias Wengenmayer; Wolf-Dirk Niesen; Dawid L. Staudacher

    doi:10.21203/ Date: 2020-08-09 Source: ResearchSquare

    Background: Hypercoagulopathy in coronavirus disease MESHD 2019 (COVID-19) causing deep vein thrombosis MESHD and pulmonary artery embolism MESHD necessitate systemic anticoagulation. Case reports of intracerebral hemorrhages MESHD in ventilated COVID-19 patients warrant precaution. It is unclear however, if COVID-19 patients with acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD) with and without extracorporeal membrane oxygenation therapy (ECMO) have more intracerebral hemorrhages MESHD ( ICH MESHD) compared to other ARDS MESHD patients.Methods: We conducted a retrospective observational single center study enrolling all patients with ARDS MESHD from 01/2018-05/2020. Patients with ARDS MESHD positive for SARS-CoV2 PCR were allocated to the COVID-19 group. Propensity score matching was performed for age TRANS, ECMO and risk of bleeding MESHD according to HAS-BLED score.Results: A total of 163, mostly severe ARDS MESHD patients were identified, 116 (71.2%) without COVID-19 and 47 (28.8%) positive for SARS-CoV-2. The two groups were comparable concerning the main confounders of ICH MESHD including age TRANS, HAS-BLED score, need for ECMO-therapy as well as anticoagulation levels reported. In 63/163 cases (38.7%), veno-venous ECMO therapy was required and ICU survival was 52.8%. Although HAS-BLED-score on admission was generally low (1.6±1.3), intracerebral hemorrhage MESHD was detected in 22 patients (13.5%) with no statistical difference between the groups (11.2 vs. 19.1% with and without SARS-CoV-2, respectively, p=0.21). Propensity score matching confirmed similar intracerebral bleeding MESHD rates in both groups (12.8 vs. 19.1% with and without SARS-CoV-2, respectively, p=0.57). Conclusions: Intracerebral hemorrhage MESHD was detectable in every tenth patient with ARDS MESHD. We found no statistically significant increased bleeding MESHD rate in patients with ARDS MESHD due to COVID-19 compared to other causes of ARDS MESHD.

    60-day survival of critically ill COVID-19 first comers

    Authors: Corinna N. Lang; V. Zotzmann; B. Schmid; M. Berchtold-Herz; S. Utzolino; P.M. Biever; T. Pottgießer; D. Duerschmied; C. Bode; T. Wengenmayer; D.L. Staudacher

    doi:10.21203/ Date: 2020-07-29 Source: ResearchSquare

    Background: Germany reported sufficient intensive care unit (ICU) resources throughout the first wave of coronavirus disease MESHD 2019 (COVID-19). The treatment of critically ill COVID-19 patients without rationing may improve the outcome. We therefore analyzed resources allocated to critically ill COVID-19 patients and their outcomes. Methods: Retrospectively, we enrolled SARS-CoV2 PCR positive patients with respiratory failure HP respiratory failure MESHD from 03/08/2020 to 04/08/2020 and followed until 05/28/2020 in the university hospital of Freiburg, Germany. Results: Thirty-four COVID-19 patients were admitted to the ICU in the defined interval with medium age TRANS of 67±13 (31-86) years. 6/34 (17.6%) were female TRANS. All patients suffered from moderate or severe acute respiratory distress syndrome MESHD respiratory distress HP syndrome ( ARDS MESHD), 91.2% of the patients were intubated and 23.5% required extracorporeal membrane oxygenation (ECMO). Proning was performed in 67.6%, renal replacement therapy (RRT) was required in 35.3%. 96% required more than 20 nursing hours per day. Mean ICU stay was 21±19 (1-81) days. 60-day survival of critically ill COVID-19 patients was 50.0% (17/34). Causes of death MESHD were multi-organ failure MESHD (52.9%), refractory ARDS MESHD (17.6%) and intracerebral hemorrhage MESHD (17.6%). Conclusions: Treatment of critically ill COVID-19 patients is protracted and resource intense. In a context without resources shortage, 50% of critically ill COVID-19 survived up to 60 days.

    Assessing the Impact of COVID-19 on the Objective and Analysis of Oncology Clinical Trials -- Application of the Estimand Framework

    Authors: Evgeny Degtyarev; Kaspar Rufibach; Yue Shentu; Godwin Yung; Michelle Casey; Stefan Englert; Feng Liu; Yi Liu; Oliver Sailer; Jonathan Siegel; Steven Sun; Rui Tang; Jiangxiu Zhou

    id:2006.04480v2 Date: 2020-06-08 Source: arXiv

    COVID-19 outbreak has rapidly evolved into a global pandemic. The impact of COVID-19 on patient journeys in oncology represents a new risk to interpretation of trial results and its broad applicability for future clinical practice. We identify key intercurrent events that may occur due to COVID-19 in oncology clinical trials with a focus on time-to-event endpoints and discuss considerations pertaining to the other estimand attributes introduced in the ICH MESHD E9 addendum. We propose strategies to handle COVID-19 related intercurrent events, depending on their relationship with malignancy MESHD and treatment and the interpretability of data after them. We argue that the clinical trial objective from a world without COVID-19 pandemic remains valid. The estimand framework provides a common language to discuss the impact of COVID-19 in a structured and transparent manner. This demonstrates that the applicability of the framework may even go beyond what it was initially intended for.

    Pulmonary Thromboembolic Disease MESHD in Patients with COVID-19 Undergoing Computed Tomography Pulmonary Angiography (CTPA): Incidence and Relationship with Pulmonary Parenchymal Abnormalities MESHD

    Authors: Cheng Fang; Giorgio Garzillo; Bhavna Batohi; James T Teo; Marko Berovic; Paul Sidhu; Hasti Robbie

    doi:10.1101/2020.06.01.20118505 Date: 2020-06-02 Source: medRxiv

    Purpose This study aims to report the incidence, severity and extent of pulmonary thromboembolic disease MESHD ( PTD MESHD) in patients with confirmed COVID-19 who have undergone CT pulmonary angiography (CTPA) in a tertiary centre. Materials and Methods This is a retrospective analysis of all patients undergoing CTPA between 23rd March 2020 and 19th April 2020 in a tertiary centre. The presence of PTD MESHD, location and involved pulmonary lobes MESHD were documented. The pattern and extent of pulmonary parenchymal abnormalities MESHD including the presence of fibrosis MESHD, lymph node enlargement MESHD and pleural effusion HP pleural effusion MESHD were evaluated by two experienced observers independently and consensus was achieved for the most disparate results. Inter-observer agreement was assessed using Kappa statistics. Student t-test, Chi square and Mann-Whitney U tests were used to compare imaging features between PTD MESHD and non- PTD MESHD sub-groups. Results During the study period, 2157 patients were confirmed with COVID-19, 297/2157 (13.8%) had CT imaging, 100/2157 (4.6%) were CTPA studies, 93 studies were analysed, excluding sub-optimal studies. Overall incidence of PTD MESHD was 41/93 (44%) with a third of patients showing segmental and subsegmental PTD MESHD (n=28/93, 30%,). D-dimer was elevated in 90/93 (96.8%) of cases. High Wells score did not differentiate between PE and non-PE groups (p=0.801). The inter-observer agreement was fair (Kappa=0.659) for parenchymal pattern and excellent (Kappa = 0.816) for severity. Lymph node enlargement was found in 34/93 of cases (36.6%) with 29/34 (85.3%) showing no additional source of infection MESHD. Fibrosis MESHD was seen in 16/93 (17.2%) of cases, mainly demonstrating fibrotic organising pneumonia HP pneumonia MESHD. Conclusion There is a high incidence of PTD MESHD in COVID -19 patients undergoing CTPA, complicated by lack of a valid risk stratification tool. Our data indicates a much higher suspicion of PTD MESHD is needed in severe COVID-19 patients. The concomitant presence of fibrotic features on CT indicates the need for follow-up for evaluation of chronic pulmonary complications MESHD.

    Decline of emergency admissions for cardiovascular and cerebrovascular events after the outbreak of COVID-19

    Authors: Viktoria Schwarz; Felix Mahfoud; Lucas Lauder; Wolfgang Reith; Stefanie Behnke; Sigrun Smola; Jürgen Rissland; Thorsten Pfuhl; Bruno Scheller; Michael Böhm; Sebastian Ewen

    doi:10.21203/ Date: 2020-05-19 Source: ResearchSquare

    Background The spread of the novel coronavirus SARS-CoV-2 and the guidance from authorities for social distancing and media reporting lead to significant uncertainty in Germany. As concerns have been expressed regarding the underdiagnosing of harmful diseases. We explored the rates of emergency presentations for acute coronary syndrome MESHD ( ACS MESHD) and acute cerebrovascular events (ACVE) before and after spread of SARS-CoV-2. Methods We analyzed all-cause visits at a tertiary university emergency department and admissions for ACS MESHD and ACVE before (calendar weeks 1 to 9, 2020) and after (calendar weeks 10 to 16, 2020) the first coronavirus disease MESHD (COVID-19) case in the region of the Saarland, Germany. The data were compared with the same period of the previous year. Results In 2020 an average of 346 patients per week presented at the emergency department whereas in 2019 an average of 400 patients presented up to calendar week 16 (p=0.018; whole year 2019 = 395 patients per week). After the first COVID-19 diagnosis in the region, emergency department visit volume decreased by 30% compared with the same period in 2019 (p=0.0012). Admissions due to ACS MESHD decreased by 41% (p=0.0023 for all; Δ -71% (p=0.007) for unstable angina MESHD, Δ -25% (p=0.42) for myocardial infarction HP myocardial infarction MESHD with ST-elevation and Δ -17% (p=0.28) without ST-elevation) compared with the same period in 2019 and decreased from 142 patients in calendar weeks 1 to 9 to 62 patients in calendar weeks 10 to 16. ACVE decreased numerically by 20% (p=0.25 for all; transient ischemic attack HP ischemic MESHD attack: Δ -32% (p=0.18), ischemic stroke HP ischemic stroke MESHD: Δ -23% (p=0.48), intracerebral haemorrhage MESHD: Δ +57% (p=0.4)). There was no significant change in ACVE per week (p=0.7) comparing calendar weeks 1 to 9 (213 patients) and weeks 10 to 16 (147 patients). Testing of 3756 samples was performed to detect 58 SARS-CoV-2 positive patients ( prevalence SERO 1,54%, thereof one patient with myocardial and two with cerebral ischemia HP cerebral ischemia MESHD) up to calendar week 16 in 2020. Conclusions The COVID-19 pandemic was associated with a significant decrease in all-cause admission and admissions due to cardiovascular events MESHD in the emergency department. Regarding acute cerebrovascular events there was a numerical decrease but no significant difference.

    COVID-19 associated meningoencephalitis MESHD complicated with intracranial hemorrhage HP intracranial hemorrhage MESHD. A case report.

    Authors: Mohammad Alolama; Anas Rashid; Debora Garozzo

    doi:10.21203/ Date: 2020-05-10 Source: ResearchSquare

    Introduction: The Coronavirus pandemic that started in December 2019 is mainly related to clinical pictures consistent with respiratory symptoms; nevertheless, reports about neurological complications have recently appeared in the medical literature.The case: we describe a case of a 36 years old Coronavirus-positive patient that was admitted on emergency basis; his clinical presentation included neurological symptoms such as drowsiness HP drowsiness MESHD and mild confusion HP confusion MESHD. Imaging revealed findings consistent with meningoencephalitis MESHD complicated by intracerebral hematoma MESHD and subdural hematoma MESHD. The latter was surgically evacuated after it became chronic and evidence of Coronavirus was found in the fluid.  Conclusion: our experience confirms that neurological complications MESHD might be a likely event in COVID-19. Although uncommon, the possible occurrence of meningoencephalitis MESHD should be kept in mind by physicians involved in the management of COVID-19 patients. Early recognition of brain involvement may provide better prognosis, preventing evolution into intracerebral hemorrhagic MESHD events.

    Clinical characteristics of 106 patients with neurological diseases MESHD and co-morbid coronavirus disease MESHD 2019: a retrospective study

    Authors: Rong Yin; Zhiqi Yang; Yaxuan Wei; Yuanming Li; Hui Chen; Zhao Liu; Bo Zhao; Dandan Ma; Meiling Dan; Yingjie Zhang; Xuan Liu; Huiceng Leng; Dawei Xiang

    doi:10.1101/2020.04.29.20085415 Date: 2020-05-05 Source: medRxiv

    Objectives:To describe the clinical characteristics of patients with coronavirus disease MESHD 2019 (COVID-19) with co-morbid neurological symptoms. Design:Retrospective case series. Setting:Huoshenshan Hospital in Wuhan, China. Participants:From 4 February to 14 April 2020, 106 patients with neurological diseases MESHD were enrolled from all patients in the hospital with confirmed COVID-19 and divided into a severe group and a nonsevere group according to their COVID-19 diagnosis. Main outcome measures:Clinical characteristics, laboratory results, imaging findings, and treatment methods were all retrieved through an electronic medical records system and recorded in spreadsheets. Results:The mean (standard deviation, SD MESHD) age TRANS of patients was 72.7 (11.8) years, and 64 patients were male TRANS (60.4%). Among patients with co-morbid neurological diseases MESHD, 81 had a previous cerebral infarction MESHD (76.4%), 20 had dementia HP dementia MESHD (18.9%), 10 had acute cerebral infarction MESHD (9.4%), 5 had sequelae of cerebral haemorrhage MESHD (4.7%), 4 had intracranial mass lesions (3.8%), 3 had epilepsy MESHD (2.8%), 2 had Parkinsons disease MESHD (1.9%), and 1 had myelopathy HP myelopathy MESHD (0.9%). Fever HP Fever MESHD (n = 62, 58.5%) was the most common symptom. The most common neurological symptoms were myalgia HP myalgia MESHD (n = 26, 24.5%), followed by extremity paralysis MESHD paralysis HP (n = 20, 18.9%), impaired consciousness MESHD (n = 17, 16%), and positive focal neurological signs (n = 42, 39.6%). Eight patients (7.5%) died. There were more patients with altered mental status in the severe group than in the non-severe group (6 [10.2%] vs. 0, P = 0.033). The inflammatory response in the severe group was more significant than that in the non-severe group. There were more patients taking anticoagulant drugs (25 [42.4%] vs. 4 [8.5%], P < 0.001) and sedative drugs (22 [37.3%] vs. 9 [19.1%], P = 0.041) in the severe group than in the non-severe group. Amid all 93 patients with cerebrovascular diseases MESHD, only 32 (34.4%) were taking aspirin, 13 (14%) taking clopidogrel, and 33 (35.5%) taking statins. Conclusions:Patients with COVID-19 with co-morbid neurological diseases had an advanced age TRANS, a high rate of severe illness MESHD, and a high mortality rate. Among the neurological symptoms, altered mental status was more common in patients with severe COVID-19 with co-morbid neurological diseases MESHD.

    Clinical Features of COVID‐19 in a Young Man with Massive Cerebral Hemorrhage HP Cerebral Hemorrhage MESHD: Case Report

    Authors: Yi Bao; Shu Yu Lin; Zhao Hui Cheng; Jun Xia; Yan Peng Sun; Qi Zhao; Guang Jian Liu

    doi:10.21203/ Date: 2020-04-29 Source: ResearchSquare

    COVID-19 is currently a pandemic in the world, can invade multiple systems, and has a high morbidity and mortality. So far, no cases of acute cerebrovascular disease MESHD have been reported. This article reports the clinical features of a COVID-19 patient whose first symptom was cerebral hemorrhage HP cerebral hemorrhage MESHD. More importantly, after the craniotomy, the patient had high fever HP fever MESHD and it was difficult to retreat. After cerebrospinal fluid testing, it was determined that an intracranial infection MESHD had occurred. After anti-infection and plasma SERO infusion of the recovered person, the patient's symptoms gradually improved. This case suggests that COVID-19 may infringe on cerebral blood SERO vessels and cause cerebral hemorrhage HP cerebral hemorrhage MESHD. Transfusion of plasma SERO from rehabilitation patients is effective for critically ill MESHD patients.

    A Novel RP-HPLC-DAD Method Development for Anti-Malarial MESHD and COVID-19 Hydroxy Chloroquine Sulfate Tablets and Profiling of In-Vitro Dissolution in Multimedia.

    Authors: THIRUPATHI DONGALA; Santhosh Kumar Ettaboina; Naresh Kumar Katari

    doi:10.21203/rs.3.pex-880/v2 Date: 2020-04-03 Source: ResearchSquare

    Hydroxychloroquine sulfate is one of a large series of 4-aminoquinolines with antimalarial activity. Moreover, it is used for the treatment of rheumatoid arthritis HP rheumatoid arthritis MESHD. Sometimes Hydroxychloroquine sulfate is very effective for the treatment of autoimmune diseases MESHD. Based on the recent clinical experiments it is exploiting for the treatment of COVID-19, corona virus across the globe. A Reverse phase RP-HPLC method have been developed and validated as per the current ICH MESHD guidelines for estimation of Hydroxychloroquine sulfate tablets. As part of method validation specificity, linearity, precision and recovery parameters were verified. The concentration and area relationships were linear (R2 > 0.999), over the concentration range of 25 to 300 µg mL-1 for HCQ. The relative standard deviations for precision and intermediate precision were less than 1.5%. The proposed RP-HPLC generic method was applied successfully for evaluation of invitro dissolution profile with different pH conditions like 0.1N HCl, pH 4.5 Acetate buffer and pH 6.8 Phosphate buffers of US marketed reference product.

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MeSH Disease
Human Phenotype

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