Corpus overview


MeSH Disease

Human Phenotype

Pneumonia (451)

Fever (331)

Cough (263)

Hypertension (200)

Respiratory distress (113)


    displaying 11 - 20 records in total 4440
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    A diagnostic decision-making protocol combines a new-generation of serological assay SERO and PCR to fully resolve ambiguity in COVID-19 diagnosis

    Authors: Hu Cheng; Hao Chen; Yiting Li; Peiyan Zheng; Dayong Gu; Shiping He; Dongli Ma; Ruifang Wang; Jun Han; Zhongxin Lu; Xinyi Xia; Yi Deng; Lan Yang; Wenwen Xu; Shanhui Wu; Cuiying Liang; Hui Wang; Baoqing Sun; Nanshan Zhong; Hongwei Ma

    doi:10.1101/2020.08.11.20172452 Date: 2020-08-11 Source: medRxiv

    The capacity to accurately diagnosis COVID-19 is essential for effective public health measures to manage the ongoing global pandemic, yet no presently available diagnostic technologies or clinical protocols can achieve full positive predictive value SERO (PPV) and negative predictive value SERO (NPV) performance SERO. Two factors prevent accurate diagnosis: the failure of sampling methods (e.g., 40% false negatives from PCR testing of nasopharyngeal swabs) and sampling-time-dependent failures reflecting individual humoral responses of patients (e.g., serological testing SERO outside of the sero-positive stage). Here, we report development of a diagnostic protocol that achieves full PPV and NPV based on a cohort of 500 confirmed COVID-19 cases, and present several discoveries about the sero-conversion dynamics throughout the disease MESHD course of COVID-19. The fundamental enabling technology for our study and diagnostic protocol-termed SANE, for Symptom (dpo)- Antibody SERO-Nucleic acid-Epidemiological history-is our development of a peptide-protein hybrid microarray (PPHM) for COVID-19. The peptides comprising PPHMCOVID-19 were selected based on clinical sample data, and give our technology the unique capacity to monitor a patient's humoral response throughout the disease MESHD course. Among other assay-development related and clinically relevant findings, our use of PPHMCOVID-19 revealed that 5% of COVID-19 patients are from an "early sero-reversion" subpopulation, thus explaining many of the mis-diagnoses we found in our comparative testing using PCR, CLIA, and PPHMCOVID-19. Accordingly, the full SANE protocol incorporates orthogonal technologies to account for these patient variations, and successfully overcomes both the sampling method and sampling time limitations that have previously prevented doctors from achieving unambiguous, accurate diagnosis of COVID-19

    A Large-Scale Clinical Validation Study Using nCapp Cloud Plus Terminal by Frontline Doctors for the Rapid Diagnosis of COVID-19 and COVID-19 pneumonia MESHD pneumonia HP in China

    Authors: Dawei Yang; Tao Xu; Xun Wang; Deng Chen; Ziqiang Zhang; Lichuan Zhang; Jie Liu; Kui Xiao; Li Bai; Yong Zhang; Lin Zhao; Lin Tong; Chaomin Wu; Yaoli Wang; Chunling Dong; Maosong Ye; Yu Xu; Zhenju Song; Hong Chen; Jing Li; Jiwei Wang; Fei Tan; Hai Yu; Jian Zhou; Jinming Yu; Chunhua Du; Hongqing Zhao; Yu Shang; Linian Huang; Jianping Zhao; Yang Jin; Charles A. Powell; Yuanlin Song; Chunxue Bai

    doi:10.1101/2020.08.07.20163402 Date: 2020-08-11 Source: medRxiv

    Background The outbreak of coronavirus disease MESHD 2019 (COVID-19) has become a global pandemic acute infectious disease MESHD, especially with the features of possible asymptomatic TRANS carriers TRANS and high contagiousness. It causes acute respiratory distress HP syndrome MESHD and results in a high mortality rate if pneumonia MESHD pneumonia HP is involved. Currently, it is difficult to quickly identify asymptomatic TRANS cases or COVID-19 patients with pneumonia MESHD pneumonia HP due to limited access to reverse transcription-polymerase chain reaction (RT-PCR) nucleic acid tests and CT scans, which facilitates the spread of the disease TRANS disease MESHD at the community level, and contributes to the overwhelming of medical resources in intensive care units. Goal This study aimed to develop a scientific and rigorous clinical diagnostic tool for the rapid prediction of COVID-19 cases based on a COVID-19 clinical case database in China, and to assist global frontline doctors to efficiently and precisely diagnose asymptomatic TRANS COVID-19 patients and cases who had a false-negative RT-PCR test result. Methods With online consent, and the approval of the ethics committee of Zhongshan Hospital Fudan Unversity (approval number B2020-032R) to ensure that patient privacy is protected, clinical information has been uploaded in real-time through the New Coronavirus Intelligent Auto-diagnostic Assistant Application of cloud plus terminal (nCapp) by doctors from different cities (Wuhan, Shanghai, Harbin, Dalian, Wuxi, Qingdao, Rizhao, and Bengbu) during the COVID-19 outbreak in China. By quality control and data anonymization on the platform, a total of 3,249 cases from COVID-19 high-risk groups were collected. These patients had SARS-CoV-2 RT-PCR test results and chest CT scans, both of which were used as the gold standard for the diagnosis of COVID-19 and COVID-19 pneumonia MESHD pneumonia HP. In particular, the dataset included 137 indeterminate cases who initially did not have RT-PCR tests and subsequently had positive RT-PCR results, 62 suspected cases who initially had false-negative RT-PCR test results and subsequently had positive RT-PCR results, and 122 asymptomatic TRANS cases who had positive RT-PCR test results, amongst whom 31 cases were diagnosed. We also integrated the function of a survey in nCapp to collect user feedback from frontline doctors. Findings We applied the statistical method of a multi-factor regression model to the training dataset (1,624 cases) and developed a prediction model for COVID-19 with 9 clinical indicators that are fast and accessible: 'Residing or visiting history in epidemic regions', 'Exposure history to COVID-19 patient', 'Dry cough MESHD cough HP', ' Fatigue MESHD Fatigue HP', 'Breathlessness', 'No body temperature decrease after antibiotic treatment', 'Fingertip blood SERO oxygen saturation<=93%', ' Lymphopenia MESHD Lymphopenia HP', and 'C-reactive protein (CRP) increased'. The area under the receiver operating characteristic (ROC) curve (AUC) for the model was 0.88 (95% CI: 0.86, 0.89) in the training dataset and 0.84 (95% CI: 0.82, 0.86) in the validation dataset (1,625 cases). To ensure the sensitivity SERO of the model, we used a cutoff value of 0.09. The sensitivity SERO and specificity of the model were 98.0% (95% CI: 96.9%, 99.1%) and 17.3% (95% CI: 15.0%, 19.6%), respectively, in the training dataset, and 96.5% (95% CI: 95.1%, 98.0%) and 18.8% (95% CI: 16.4%, 21.2%), respectively, in the validation dataset. In the subset of the 137 indeterminate cases who initially did not have RT-PCR tests and subsequently had positive RT-PCR results, the model predicted 132 cases, accounting for 96.4% (95% CI: 91.7%, 98.8%) of the cases. In the subset of the 62 suspected cases who initially had false-negative RT-PCR test results and subsequently had positive RT-PCR results, the model predicted 59 cases, accounting for 95.2% (95% CI: 86.5%, 99.0%) of the cases. Considering the specificity of the model, we used a cutoff value of 0.32. The sensitivity SERO and specificity of the model were 83.5% (95% CI: 80.5%, 86.4%) and 83.2% (95% CI: 80.9%, 85.5%), respectively, in the training dataset, and 79.6% (95% CI: 76.4%, 82.8%) and 81.3% (95% CI: 78.9%, 83.7%), respectively, in the validation dataset, which is very close to the published AI model. The results of the online survey 'Questionnaire Star' showed that 90.9% of nCapp users in WeChat mini programs were 'satisfied' or 'very satisfied' with the tool. The WeChat mini program received a significantly higher satisfaction rate than other platforms, especially for 'availability and sharing convenience of the App' and 'fast speed of log-in and data entry'. Discussion With the assistance of nCapp, a mobile-based diagnostic tool developed from a large database that we collected from COVID-19 high-risk groups in China, frontline doctors can rapidly identify asymptomatic TRANS patients and avoid misdiagnoses of cases with false-negative RT-PCR results. These patients require timely isolation or close medical supervision. By applying the model, medical resources can be allocated more reasonably, and missed diagnoses can be reduced. In addition, further education and interaction among medical professionals can improve the diagnostic efficiency for COVID-19, thus avoiding the transmission TRANS of the disease from asymptomatic MESHD asymptomatic TRANS patients at the community level.

    Clustering of age TRANS standardised COVID-19 infection MESHD fatality ratios and death MESHD trajectories

    Authors: Thu-Lan Kelly; Greer Humphrey; Caroline Miller; Jacqueline A Bowden; Joanne Dono; Paddy A Phillips

    doi:10.1101/2020.08.11.20172478 Date: 2020-08-11 Source: medRxiv

    Background An accurate measure of the impact of COVID-19 is the infection MESHD fatality ratio, or the proportion of deaths MESHD among those infected, which does not depend on variable testing rates between nations. The risk of mortality from COVID-19 depends strongly on age TRANS and current estimates of the infection MESHD fatality ratio do not account for differences in national age TRANS profiles. Comparisons of cumulative death MESHD trajectories allow the effect and timing of public health interventions to be assessed. Our purpose is to (1) determine whether countries are clustered according to infection MESHD fatality ratios and (2) compare interventions to slow the spread of the disease TRANS disease MESHD by clustering death MESHD trajectories. Methods National age TRANS standardised infection MESHD fatality ratios were derived from age TRANS stratified estimates from China and population estimates from the World Health Organisation. The IFRs were clustered into groups using Gaussian mixture models. Trajectory analysis clustered cumulative death MESHD rates in two time windows, 50 and 100 days after the first reported death MESHD. Findings Infection MESHD fatality ratios from 201 nations were clustered into three groups: young, medium and older, with corresponding means (SD) of 0.20% (0.03%), 0.38% (0.11%) and 0.93% (0.21%). At 50 and 100 days after the first reported death MESHD, there were two clusters of cumulative death MESHD trajectories from 113 nations with at least 25 deaths MESHD reported at 100 days. The first group had slowly increasing or stable cumulative death MESHD rates, while the second group had accelerating rates at the end of the time window. Fifty-two nations changed group membership between the time windows. Conclusion A cluster of younger nations have a lower estimated infection MESHD fatality ratio than older nations. The effect and timing of public health interventions in preventing the spread of the disease TRANS disease MESHD can be tracked by clustering death MESHD rate trajectories into stable or accelerating and comparing changes over time.

    A Systematic Review of the Cardiovascular Manifestations and Outcomes in the Setting of Coronavirus-19 Disease MESHD

    Authors: Samarthkumar Thakkar; Shilpkumar Arora; Ashish Kumar; Rahul Jaswaney; Mohammed Faisaluddin; Mohammad Ammad Ud Din; Mariam Shariff; Kirolos Barssoum; Harsh P. Patel; Nirav Arora; Chinmay Jani; Sejal Savani; Christopher DeSimone; Siva Mulpuru; Abhishek Deshmukh

    doi:10.1101/2020.08.09.20171330 Date: 2020-08-11 Source: medRxiv

    The impact of coronavirus disease MESHD, 2019 (COVID-19), has been profound. Though COVID-19 primarily affects the respiratory system, it has also been associated with a wide range of cardiovascular (CV) manifestations portending extremely poor prognosis. The principal hypothesis for CV involvement is through direct myocardial infection MESHD and systemic inflammation MESHD. We conducted a systematic review of the current literature to provide a foundation for understanding the CV manifestations and outcomes of COVID-19. PubMed and EMBASE databases were electronically searched from the inception of the databases through April 27th, 2020. A second literature review was conducted to include major trials and guidelines that were published after the initial search but before submission. The inclusion criteria for studies to be eligible were case reports, case series, and observation studies reporting CV outcomes among patients with COVID-19 infection MESHD. This review of the current COVID-19 disease MESHD and CV outcomes literature revealed a myriad of CV manifestations with potential avenues for treatment and prevention. Future studies are required to understand on a more mechanistic level the effect of COVID-19 on the myocardium and thus provide avenues to improve mortality and morbidity.

    Impact of COVID-19 on Urology Practice in Saudi Arabia

    Authors: Meshari Alzahrani; Mohammad Alkhamees; Sulaiman Almutairi; Ahmed Aljuhayman; Sultan Alkhateeb

    id:10.20944/preprints202008.0261.v1 Date: 2020-08-11 Source:

    From the moment the World Health Organization (WHO) declared COVID-19 to be a pandemic disease MESHD, COVID-19 began to affect the lives of many healthcare providers worldwide. In response to this pandemic, urology departments and training residency programs implemented urgent measures to reduce outpatient clinics, adopted the use of telemedicine, regulated emergency MESHD and outpatient urological procedures, promoted the use of operating theatres, and developed the use of sustainable e-learning alternatives to traditional urology resident/staff educational activities. Here, we review the response of urologists in Saudi Arabia to the COVID-19 pandemic and how they applied both for the patients and for the healthcare of urologist personnel.

    Population perspective comparing COVID-19 to all and common causes of death MESHD in seven European countries

    Authors: Bayanne Olabi; Jayshree Bagaria; Sunil Bhopal; Gwenetta Curry; Nazmy Villarroel; Raj Bhopal

    doi:10.1101/2020.08.07.20170225 Date: 2020-08-11 Source: medRxiv

    Background: Mortality statistics on the COVID-19 pandemic have led to widespread concern and fear. To contextualise these data, we compared mortality related to COVID-19 with all and common causes of death MESHD, stratifying by age TRANS and sex. We also calculated deaths MESHD as a proportion of the population by age TRANS and sex. Methods: COVID-19 related mortality and population statistics from seven European countries were extracted: England and Wales, Italy, Germany, Spain, France, Portugal and Netherlands. Available data spanned 14-16 weeks since the first recorded deaths MESHD in each country, except Spain, where only comparable stratified data over an 8-week time period was available. The Global Burden of Disease MESHD database provided data on all deaths MESHD and those from pneumonia MESHD pneumonia HP, cardiovascular disease MESHD combining ischaemic heart disease MESHD and stroke MESHD stroke HP, chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP, cancer, road traffic accidents and dementia MESHD dementia HP. Findings: Deaths MESHD related to COVID-19, while modest overall, varied considerably by age TRANS. Deaths MESHD as a percentage of all cause deaths MESHD during the time period under study ranged from <0.01% in children TRANS in Germany, Portugal and Netherlands, to as high as 41.65% for men aged TRANS over 80 years in England and Wales. The percentage of the population who died from COVID-19 was less than 0.2% in every age group TRANS under the age TRANS of 80. In each country, over the age TRANS of 80, these proportions were: England and Wales 1.27% males TRANS, 0.87% females TRANS; Italy 0.6% males TRANS, 0.38% females TRANS; Germany 0.13% males TRANS, 0.09% females TRANS; France 0.39% males TRANS, 0.2% females TRANS; Portugal 0.2% males TRANS, 0.15% females TRANS; and Netherlands 0.6% males TRANS, 0.4% females TRANS. Interpretation: Mortality rates from COVID-19 remains low including when compared to other common causes of death MESHD and will likely decline further while control measures are maintained. These data may help people contextualise their risk and policy makers in decision-making.

    Janus Kinase-Inhibitor and Type I Interferon Ability to Produce Favorable Clinical Outcomes in COVID-19 Patients: A Systematic Review and Meta-Analysis

    Authors: Lucas Walz; Avi J. Cohen; Andre P. Rebaza; James Vanchieri; Martin D. Slade; Charles S. Dela Cruz; Lokesh Sharma

    doi:10.1101/2020.08.10.20172189 Date: 2020-08-11 Source: medRxiv

    Background Novel coronavirus (SARS-CoV-2) has infected over 17 million. Novel therapies are urgently needed. Janus-kinase (JAK) inhibitors and Type I interferons have emerged as potential antiviral candidates for COVID-19 patients for their proven efficacy against diseases MESHD with excessive cytokine release and by their ability to promote viral clearance in past coronaviruses, respectively. We conducted a systemic review and meta-analysis to evaluate role of these therapies in COVID-19 patients. Methods MEDLINE and MedRxiv were searched until July 30th, 2020, including studies that compared treatment outcomes of humans treated with JAK-inhibitor or Type I interferon against controls. Inclusion necessitated data with clear risk estimates or those that permitted back-calculation. Results We searched 733 studies, ultimately including four randomized and eleven non-randomized clinical trials. JAK-inhibitor recipients had significantly reduced odds of mortality (OR, 0.12; 95%CI, 0.03-0.39, p=0.0005) and ICU admission (OR, 0.05; 95%CI, 0.01-0.26, p=0.0005), and had significantly increased odds of hospital discharge (OR, 22.76; 95%CI, 10.68-48.54, p<0.00001), when compared to standard treatment group. Type I interferon recipients had significantly reduced odds of mortality (OR, 0.19; 95%CI, 0.04-0.85, p=0.03), and increased odds of discharge bordering significance (OR, 1.89; 95%CI, 1.00-3.59, p=0.05). Conclusions JAK-inhibitor treatment is significantly associated with positive clinical outcomes regarding mortality, ICU admission, and discharge. Type I interferon treatment is associated with positive clinical outcomes regarding mortality and discharge. While these data show promise, additional randomized clinical trials are needed to further elucidate the efficacy of JAK-inhibitors and Type I interferons and clinical outcomes in COVID-19.

    Application of Optimal Control to Long Term Dynamics of COVID-19 Disease MESHD in South Africa

    Authors: Farai Nyabadza; Williams Chukwu; Faraimunashe Chirove; fatmawati fatmawati; Princess Gatyeni

    doi:10.1101/2020.08.10.20172049 Date: 2020-08-11 Source: medRxiv

    SARS-CoV-2 (COVID-19) belongs to the beta-coronavirus family, these include; the severe acute respiratory syndrome MESHD coronavirus (SARS-CoV) and the Middle East respiratory syndrome MESHD coronavirus (MERS-CoV). Since its resurgence in South Africa in March 2020, it has lead to high mortality and thousands of people contracting the virus. In this study, we use a set of five differential equations to analyse the effects on long term dynamics of COVID-19 pandemic with optimal control measures. Mathematical analyses of the model without control were done and the basic reproduction number TRANS ( R0 TRANS) of the COVID-19 for the South African epidemic determined. The model steady states were also determined, and their analyses presented based on R0 TRANS: We introduced permissible control measures and formulated an optimal control problem using the Pontraygain Maximum Principle. Our numerical findings suggest that joint implementation of effective mask usage, physical distancing and active screening and testing are effective measures to curtail the spread of the disease TRANS disease on undiagnosed MESHD humans. The results obtained in this paper are of public health importance in the control and management of the spread for the novel coronavirus, SARS-CoV-2, in South Africa.

    Effective reproduction number TRANS for COVID-19 in Aotearoa New Zealand

    Authors: Rachelle N Binny; Audrey Lustig; Ann Brower; Shaun C Hendy; Alex James; Matthew Parry; Michael J Plank; Nicholas Steyn

    doi:10.1101/2020.08.10.20172320 Date: 2020-08-11 Source: medRxiv

    The effective reproduction number TRANS, Reff, is the average number of secondary cases TRANS infected by a primary case TRANS, a key measure of the transmission TRANS potential for a disease MESHD. Compared to many countries, New Zealand has had relatively few COVID-19 cases, many of which were caused by infections MESHD acquired overseas. This makes it difficult to use standard methods to estimate Reff. In this work, we use a stochastic model to simulate COVID-19 spread in New Zealand and report the values of Reff from simulations that gave best fit to case data. We estimate that New Zealand had an effective reproduction number TRANS Reff = 1.8 for COVID-19 transmission TRANS prior to moving into Alert Level 4 on March 25 2020 and that after moving into Alert level 4 this was reduced to Reff = 0.35. Our estimate Reff = 1.8 for reproduction number TRANS before Alert Level 4, is relatively low compared to other countries. This could be due, in part, to measures put in place in early- to mid-March, including: the cancellation of mass gatherings, the isolation of international arrivals, and employees being encouraged to work from home.

    Long-term exposure to air-pollution and COVID-19 mortality in England: a hierarchical spatial analysis

    Authors: Garyfallos Konstantinoudis; Tullia Padellini; James E Bennett; Bethan Davies; Majid Ezzati; Marta Blangiardo

    doi:10.1101/2020.08.10.20171421 Date: 2020-08-11 Source: medRxiv

    Background: Recent studies suggested a link between long-term exposure to air-pollution and COVID-19 mortality. However, due to their ecological design, based on large spatial units, they neglect the strong localised air-pollution patterns, and potentially lead to inadequate confounding adjustment. We investigated the effect of long-term exposure to NO2 and PM2.5 on COVID-19 deaths MESHD up to June 30, 2020 in England using high geographical resolution. Methods: We included 38 573 COVID-19 deaths MESHD up to June 30, 2020 at the Lower Layer Super Output Area level in England (n=32 844 small areas). We retrieved averaged NO2 and PM2.5 concentration during 2014-2018 from the Pollution Climate Mapping. We used Bayesian hierarchical models to quantify the effect of air-pollution while adjusting for a series of confounding and spatial autocorrelation. Findings: We find a 0.5% (95% credible interval: -0.2%-1.2%) and 1.4% (-2.1%-5.1%) increase in COVID-19 mortality rate for every 1g/m3 increase in NO2 and PM2.5 respectively, after adjusting for confounding and spatial autocorrelation. This corresponds to a posterior probability of a positive effect of 0.93 and 0.78 respectively. The spatial relative risk at LSOA level revealed strong patterns, similar for the different pollutants. This potentially captures the spread of the disease TRANS disease MESHD during the first wave of the epidemic. Interpretation: Our study provides some evidence of an effect of long-term NO2 exposure on COVID-19 mortality, while the effect of PM2.5 remains more uncertain. Funding: Medical Research Council, Wellcome Trust, Environmental Protection Agency and National Institutes of Health.

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MeSH Disease
Human Phenotype

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