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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    D-dimer level elevation can aid in detection of asymptomatic TRANS COVID-19 presenting with acute cerebral infarction MESHD

    Authors: Takeru Umemura; Hirohisa Kondo; Hirotsugu Ohta; Koichiro Futatsuya; Takamitsu Mizobe

    doi:10.21203/rs.3.rs-36445/v1 Date: 2020-06-19 Source: ResearchSquare

    Coronavirus disease MESHD 2019 (COVID-19) mainly manifests as a respiratory syndrome MESHD, besides causing other complications. Severe COVID-19 may also present with coagulopathy, leading to venous thrombosis MESHD venous thrombosis and cerebral HP and cerebral infarction MESHD. Stroke MESHD Stroke HP is one of the complications associated with severe COVID-19. Generally, acute stroke MESHD stroke HP is the second complication in patients with respiratory syndrome MESHD. Here, we present a case of COVID-19 in an 84-year-old female TRANS patient who did not manifest any respiratory symptoms; however, she presented with acute stroke MESHD stroke HP. The patient had no cough MESHD cough HP or fever MESHD fever HP before the stroke MESHD stroke HP onset, but the COVID-19 PCR was positive. The patient also had markedly elevated D-dimer levels. Our findings suggest that coagulopathy can occur, even in a patient with asymptomatic TRANS COVID-19 infection MESHD. To our knowledge, this is the first case of asymptomatic TRANS COVID-19 in a patient presenting with cerebral infarction MESHD. We concluded that elevation of D-dimer levels is one of the tools to ascertain COVID-19 infection MESHD in such patients.

    Olfactory transmucosal SARS-CoV-2 invasion as port of Central Nervous System entry in COVID-19 patients

    Authors: Jenny Meinhardt; Josefine Radke; Carsten Dittmayer; Ronja Mothes; Jonas Franz; Michael Laue; Julia Schneider; Sebastian Bruenink; Olga Hassan; Werner Stenzel; Marc Windgassen,; Larissa Roessler; Hans-Hilmar Goebel; Hubert Martin; Andreas Nitsche; Walter Schulz-Schaeffer; Samy Hakroush; Martin S Winkler; Bjoern Tampe; Sefer Elezkurtaj; David Horst; Lars Oesterhelweg; Michael Tsokos; Barbara Ingold Heppner; Christine Stadelmann; Christian Drosten; Victor M Corman; Helena Radbruch; Frank L Heppner

    doi:10.1101/2020.06.04.135012 Date: 2020-06-04 Source: bioRxiv

    The newly identified severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) causes COVID-19, a pandemic respiratory disease MESHD presenting with fever MESHD fever HP, cough MESHD cough HP, and often pneumonia MESHD pneumonia HP. Moreover, thromboembolic events throughout the body including the central nervous system (CNS) have been described. Given first indication for viral RNA presence in the brain and cerebrospinal fluid and in light of neurological symptoms in a large majority of COVID-19 patients, SARS-CoV-2-penetrance of the CNS is likely. By precisely investigating and anatomically mapping oro- and pharyngeal regions and brains of 32 patients dying from COVID-19, we not only describe CNS infarction due to cerebral MESHD thromboembolism MESHD thromboembolism HP, but also demonstrate SARS-CoV-2 neurotropism. SARS-CoV-2 enters the nervous system via trespassing the neuro-mucosal interface in the olfactory mucosa by exploiting the close vicinity of olfactory mucosal and nervous tissue including delicate olfactory and sensitive nerve endings. Subsequently, SARS-CoV-2 follows defined neuroanatomical structures, penetrating defined neuroanatomical areas, including the primary respiratory and cardiovascular control center in the medulla oblongata.

    Acutely Altered Mental Status as the Main Clinical Presentation of Multiple Strokes MESHD Strokes HP in Critically Ill Patients With COVID-19.

    Authors: Carolina Díaz-Pérez; Carmen Ramos; Alberto López-Cruz; José Muñoz Olmedo; Jimena Lázaro González; Enrique de Vega-Ríos; Carmen González-Ávila; Carlos Hervás; Santiago Trillo; José Vivancos

    doi:10.21203/rs.3.rs-31769/v1 Date: 2020-05-26 Source: ResearchSquare

    Background and aims: Cerebral infarction MESHD in COVID-19 patients might be associated with a hypercoagulable state related to a systemic inflammatory response. Its diagnosis might be challenging. We present two critically ill patients with COVID-19 who presented acutely altered mental status as the main manifestation of multiple strokes MESHD strokes HP.Methods:Clinical presentation and diagnostic work-up of the patients.Results:Two patients in their sixties were hospitalized with a bilateral pneumonia MESHD pneumonia HP COVID-19. They developed respiratory failure HP and were admitted to ICU for mechanical ventilation and intense medical treatment. They were started on low-molecular-weight heparin since admission. Their laboratory results showed lymphopenia MESHD lymphopenia HP and increased levels of C-reactive protein and D-dimer. Case 1 developed hypofibrinogenemia HP and presented several cutaneous lesions with biopsy features of thrombotic vasculopathy. Case 2 was performed a CT pulmonary angiogram at ICU showing a bilateral pulmonary embolism MESHD pulmonary embolism HP. When waking up, both patients were conscious but with a remarkable global altered mental status without focal neurological deficits. A brain MRI revealed multiple acute bilateral ischemic lesions with areas of hemorrhagic transformation in both patients (Case 1: affecting the left frontal and temporal lobes and both occipital lobes; Case 2: affecting both frontal and left occipital lobes). Cardioembolic source and acquired antiphospholipid syndrome MESHD were ruled out. COVID-19-associated coagulopathy was suspected as the possible main etiology of the strokes MESHD strokes HP.Conclusion:Acutely altered mental status might be the main manifestation of multiple brain infarctions MESHD in critically ill COVID-19 patients. It should be specially considered in those with suspected COVID-19-associated coagulopathy. Full-dose anticoagulation and clinical-radiological monitoring might reduce their neurological consequences.

    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) 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 MESHD dementia HP (18.9%), 10 had acute cerebral infarction MESHD (9.4%), 5 had sequelae of cerebral haemorrhage (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 (0.9%). Fever MESHD Fever HP (n = 62, 58.5%) was the most common symptom. The most common neurological symptoms were myalgia MESHD myalgia HP (n = 26, 24.5%), followed by extremity paralysis MESHD paralysis HP (n = 20, 18.9%), impaired consciousness (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 MESHD had an advanced age TRANS, a high rate of severe illness, 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 characteristics of 25 death MESHD cases infected with COVID-19 pneumonia MESHD pneumonia HP: a retrospective review of medical records in a single medical center, Wuhan, China

    Authors: Xun Li; Luwen Wang; Shaonan Yan; Fan Yang; Longkui Xiang; Jiling Zhu; Bo Shen; Zuojiong Gong

    doi:10.1101/2020.02.19.20025239 Date: 2020-02-25 Source: medRxiv

    Summary Background The pneumonia MESHD pneumonia HP caused by the 2019 novel coronavirus (SARS-CoV-2) is a highly infectious disease MESHD, which was occurred in Wuhan, Hubei Province, China in December 2019. As of February 13, 2020, a total of 59883 cases of COVID-19 in China have been confirmed and 1368 patients have died from the disease MESHD. However, the clinical characteristics of the dyed patients were still not clearly clarified. This study aims to summarize the clinical characteristics of death MESHD cases with COVID-19 and to identify critically ill patients of COVID-19 early and reduce their mortality. Methods The clinical records, laboratory findings and radiologic assessments included chest X-ray or computed tomography were extracted from electronic medical records of 25 died patients with COVID-19 in Renmin Hospital of Wuhan University from Jan 14 to Feb 13, 2020. Two experienced clinicians reviewed and abstracted the data. Findings The mean age TRANS of the dead was 71.48 years, the average course of the disease MESHD was 10.56 days, all patients eventually died of respiratory failure HP. All of those who died had underlying diseases MESHD, the most common of which was hypertension MESHD hypertension HP (16/25, 64%), followed by diabetes (10/25, 40%), heart diseases MESHD (8/25, 32%), kidney diseases MESHD (5/25, 20%), cerebral infarction MESHD (4/25, 16%), chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP (COPD, 2/25, 8%), malignant tumors (2/25, 8%) and acute pancreatitis HP pancreatitis MESHD (1/25, 4%). The most common organ damage outside the lungs was the heart, followed by kidney and liver. In the patients' last examination before death MESHD, white blood SERO cell and neutrophil counts were elevated in 17 patients (17/25, 68%) and 18 patients (18/25, 72%), lymphocyte counts were decreased in 22 patients (22/25, 88%). Most patients' PCT, CRP and SAA levels were elevated, the percentages were 90.5% (19/21), 85% (19/20) and 100% (21/21) respectively. The levels of the last test of neutrophils (15/16, 93.8%), PCT (11/11, 100%), CRP (11/13, 84.6%), cTnI (8/9, 88.9%), D-Dimer (11/12, 91.6%) and LDH (9/9, 100%) were increased as compared to the first test, while the levels of lymphocytes were decreased (14/16, 87.5%). Interpretation The age TRANS and underlying diseases MESHD ( hypertension MESHD hypertension HP, diabetes, etc.) were the most important risk factors for death MESHD of COVID-19 pneumonia MESHD pneumonia HP. Bacterial infections MESHD may play an important role in promoting the death MESHD of patients. Malnutrition MESHD Malnutrition HP was common to severe patients. Multiple organ dysfunction can be observed, the most common organ damage was lung, followed by heart, kidney and liver. The rising of neutrophils, SAA, PCT, CRP, cTnI, D-Dimer and LDH levels can be used as indicators of disease progression MESHD, as well as the decline of lymphocytes counts.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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