Corpus overview


MeSH Disease

Fatigue (193)

Fever (150)

Cough (148)

Disease (100)

Infections (81)

Human Phenotype

Fatigue (193)

Fever (150)

Cough (148)

Pneumonia (51)

Myalgia (50)


    displaying 1 - 10 records in total 193
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    COVID-19 Vaccine Candidates by Identification of B and T Cell Multi-Epitopes Against SARS-COV-2

    Authors: Suresh Kumar; Sarmilah Mathavan; Wee Jia Jin; Nur Azznira Bt Azman; Devindren Subramanaiam; Nur Afiqah Binti Zainalabidin; Dhivashini Lingadaran; Zainah Binti Abdul Sattar; Danniya Lakshmi Manickam; Priscilla Sheba Anbananthan; Johan Ahmad Taqiyuddin; Yuvapriya Thevarajan

    id:10.20944/preprints202008.0092.v1 Date: 2020-08-04 Source:

    Coronavirus disease MESHD (COVID-19) is a new discovered strain where WHO officially declares the disease MESHD as COVID-19 while the virus responsible for it called Severe Acute Respiratory Syndrome MESHD Coronavirus 2 or SARS-CoV-2. The incubation period TRANS of this disease MESHD is between 14 days. Ordinary clinical symptoms that reported around the world include fever MESHD fever HP, cough MESHD cough HP, fatigue MESHD fatigue HP, diarrhoea and vomiting MESHD vomiting HP as well as asymptomatic TRANS for certain people. Infection MESHD is spread mainly through broad droplets. In early March 2020, WHO again has announced that COVID-19 is a pandemic with currently no specific treatment. The potential use of SARS-COV-2 proteome as a vaccine candidate by analysing through B-cell and T-cell antigenicity by using a immunoinformatics approach as a vaccine development early stage. In this study, we used consensus sequence for SARS-COV-2 proteome that was retrieved from NCBI database. VaxiJen 2.0 was mainly used to identify the antigenic property of SARS-COV-2 proteins. IEDB then used to analyse the B-cell epitope, the presence of T cell immunogenic epitope in SARS-COV-2 proteins was obtained by using compromise method of MHC class I and II tools that accessible respectively using ProPred-1 server and MHC II Binding Prediction in IEDB database. The best epitopes of B and T-cell epitopes were predicted with high antigencity and the information is disseminated through web-based database resource ( This study will be useful to find a new epitope-based candidate for SARS-COV-2. However, further study needs to be done for the next stages of vaccine development.

    Clinical Course and Management of 73 Hospitalized Moderate Patients with COVID-19 Outside Wuhan

    Authors: Xiaojuan Peng; Qi Liu; Zhaolin Chen; Guiyan Wen; Qing Li; Yanfang Chen; Jie Xiong; Xinzhou Meng; Yuanjin Ding; Ying Shi; Shaohui Tang

    doi:10.21203/ Date: 2020-08-01 Source: ResearchSquare

    Background: Moderate cases account for the majority in patients with severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection MESHD and can also progress to severe/critical condition. Here, we investigated the clinical course and management of hospitalized moderate SARS-CoV-2 patients.Methods: The medical records and follow-up data were analyzed from the SARS-CoV-2 patients outside Wuhan.Results: A total of 73 moderate patients (38 men, 35 women) were included, with median age TRANS of 47.0 (38.5-57.5) years. Among them, only one patient (1.4%) died using active treatment to improve symptoms. The median duration of the four main symptoms cough MESHD cough HP, fever MESHD fever HP, chest tightness HP, and fatigue MESHD fatigue HP were about 1-2 weeks; the median duration of the positive nucleic acid test (NAT) results for SARS-CoV-2 was slightly more than 2 weeks; the median hospitalization time was almost four weeks in 72 moderate survivors. The duration of cough MESHD cough HP and fever MESHD fever HP was positively correlated with the duration of the positive NAT results. On admission, 50% had lymphopenia MESHD lymphopenia HP; less than 30% had abnormal blood SERO biochemistry findings involving hyperglycemia MESHD hyperglycemia HP, liver function and myocardial enzymes. At discharge, the laboratory indexes were substantially improved. Two weeks after discharge, 5.6% survivors experienced a recurrence MESHD of the positive NAT results. Conclusions: Moderate SARS-CoV-2 patients have a good prognosis by the active treatment. After discharge, it is necessary that moderate survivors undergo at least a 2-week collective medical observation in quarantine places, which can identify and treat a proportion of patients with re-positive NAT results and to prevent the spread of the potential sources of infection MESHD.

    Persistent fatigue MESHD fatigue HP following SARS-CoV-2 infection MESHD is common and independent of severity of initial infection MESHD

    Authors: Liam Townsend; Adam H Dyer; Karen Jones; Jean Dunne; Rachel Kiersey; Fiona Gaffney; Laura O'Connor; Aoife Mooney; Deirdre Leavy; Katie Ridge; Catherine King; Fionnuala Cox; Kate O'Brien; Joanne Dowds; Jamie Sugrue; David Hopkins; Patricia Byrne; Tara Kingston; Cliona Ni Cheallaigh; Parthiban Nadarajan; Anne Marie McLaughlin; Nollaig M Bourke; Colm Bergin; Cliona O'Farrelly; Ciaran Bannan; Niall Conlon

    doi:10.1101/2020.07.29.20164293 Date: 2020-07-30 Source: medRxiv

    Fatigue MESHD Fatigue HP is a common symptom in those presenting with symptomatic COVID-19 infection MESHD. However, it is unknown if COVID-19 results in persistent fatigue MESHD fatigue HP in those recovered from acute infection MESHD. We examined the prevalence SERO of fatigue MESHD fatigue HP in individuals recovered from the acute phase of COVID-19 illness using the Chalder Fatigue MESHD Fatigue HP Score (CFQ-11). We further examined potential predictors of fatigue MESHD fatigue HP following COVID-19 infection MESHD, evaluating indicators of COVID-19 severity, markers of peripheral immune activation and circulating pro-inflammatory cytokines. Of 128 participants (49.5 {+/-} 15 years; 54% female TRANS), more than half reported persistent fatigue MESHD fatigue HP (52.3%; 45/128) at 10 weeks (median) after initial COVID-19 symptoms. There was no association between COVID-19 severity (need for inpatient admission, supplemental oxygen or critical care) and fatigue MESHD fatigue HP following COVID-19. Additionally, there was no association between routine laboratory markers of inflammation MESHD and cell turnover (leukocyte, neutrophil or lymphocyte counts, neutrophil-to-lymphocyte ratio, lactate dehydrogenase, C-reactive protein) or pro-inflammatory molecules (IL-6 or sCD25) and fatigue MESHD fatigue HP post COVID-19. Female TRANS gender TRANS and those with a pre-existing diagnosis of depression/ anxiety HP were over-represented in those with fatigue MESHD fatigue HP. Our findings demonstrate a significant burden of post-viral fatigue MESHD fatigue HP in individuals with previous SARS-CoV-2 infection MESHD after the acute phase of COVID-19 illness. This study highlights the importance of assessing those recovering from COVID-19 for symptoms of severe fatigue MESHD fatigue HP, irrespective of severity of initial illness, and may identify a group worthy of further study and early intervention.

    Fighting COVID-19 spread among nursing home residents even in absence of molecular diagnosis: a retrospective cohort study.

    Authors: Alessio Strazzulla; Paul Tarteret; Maria Concetta Postorino; Marie Picque; Astrid de Pontfarcy; Nicolas Vignier; Catherine Chakvetadze; Coralie Noel; Cecile Drouin; Zine Eddine Benguerdi; Sylvain Diamantis

    doi:10.21203/ Date: 2020-07-30 Source: ResearchSquare

    Background Access to molecular diagnosis was limited out-of-hospital in France during the 2020 coronavirus disease MESHD 2019 (COVID-19) epidemic. This study describes the evolution of COVID-19 outbreak in a nursing home in absence of molecular diagnosis. Methods A monocentric prospective study was conducted in a French nursing home from March 17th, 2020 to June 11th, 2020. Because of lack of molecular tests for severe acute respiratory syndrome MESHD 2 (SARS-Cov2) infection MESHD, probable COVID-19 cases were early identified considering only respiratory and not-respiratory symptoms and therefore preventing measures and treatments were enforced. Once available, serology tests were performed at the end of the study.A chronologic description of new cases and deaths MESHD was made together with a description of COVID-19 symptoms. Data about personal characteristics and treatments were collected and the following comparisons were performed: i) probable COVID-19 cases vs asymptomatic TRANS residents; ii) SARS-Cov2 seropositive residents vs seronegative residents. Results Overall, 32/66 (48.5%) residents and 19/39 (48.7%) members of health-care personnel were classified as probable COVID-19 cases. A total of 34/61 (55.7%) tested residents resulted seropositive. Death MESHD occurred in 4/66 (6%) residents. Diagnosis according to symptoms had 65% of sensitivity SERO, 78% of specificity, 79% of positive predictive value SERO and 64% of negative predictive value SERO.In resident population, the following symptoms were registered: 15/32 (46.8%) lymphopenia MESHD lymphopenia HP, 15/32 (46.8%) fever MESHD fever HP, 8/32 (25%) fatigue MESHD fatigue HP, 8/32 (25%) cough MESHD cough HP, 6/32 (18.8%) diarrhoea, 4/32 (12.5%) severe respiratory distress HP requiring oxygen therapy, 4/32 (12.5%) fall HP, 3/32 (9.4%) conjunctivitis MESHD conjunctivitis HP, 2/32 (6.3%) abnormal pulmonary noise at chest examination and 2/32 (6,25%) abdominal pain MESHD abdominal pain HP. Probable COVID-19 cases were older (81.3 vs 74.9; p=0.007) and they had higher prevalence SERO of atrial fibrillation MESHD atrial fibrillation HP (8/32, 25% vs 2/34, 12%; p=0.030); insulin treatment (4/34, 12% vs 0, 0%; p=0.033) and positive SARS-Cov2 serology (22/32, 69% vs 12/34, 35%; p=0.001) than asymptomatic TRANS residents. Seropositive residents had lower prevalence SERO of diabetes (4/34, 12% vs 9/27, 33%; p=0.041) and angiotensin-converting-enzyme inhibitors’ intake (1/34, 1% vs 5/27, 19%; p=0.042). Conclusions During SARS-Cov2 epidemic, early detection of respiratory and not-respiratory symptoms allowed to enforce extraordinary measures. They achieved limiting contagion and deaths MESHD among nursing home residents, even in absence of molecular diagnosis.

    Examining Australian's beliefs, misconceptions, and sources of information for COVID-19: A national online survey

    Authors: Rae Thomas; Hannah Greenwood; Zoe A Michaleff; Eman Abukmail; Tammy Hoffmann; Kirsten J McCaffery; Leah Hardiman; Paul Glasziou

    doi:10.1101/2020.07.27.20163204 Date: 2020-07-29 Source: medRxiv

    Objective: Public cooperation to practice preventive health behaviours is essential to manage the transmission TRANS of infectious diseases MESHD such as COVID-19. We aimed to investigate beliefs about COVID-19 diagnosis, transmission TRANS and prevention that have the potential to impact the uptake of recommended public health strategies. Design: An online cross-sectional survey conducted May 8 to May 11 2020. Participants: A national sample of 1500 Australian adults TRANS with representative quotas for age TRANS and gender TRANS provided by online panel provider. Main outcome measure: Proportion of participants with correct/incorrect knowledge of COVID-19 preventive behaviours and reasons for misconceptions. Results: Of the 1802 potential participants contacted, 289 were excluded, 13 declined, and 1500 participated in the survey (response rate 83%). Most participants correctly identified washing your hands regularly with soap and water (92%) and staying at least 1.5m away from others (90%) could help prevent COVID-19. Over 40% (incorrectly) considered wearing gloves outside of the home would prevent them contracting COVID-19. Views about face masks were divided. Only 66% of participants correctly identified that regular use of antibiotics would not prevent COVID-19. Most participants (90%) identified fever MESHD fever HP, fatigue MESHD fatigue HP and cough MESHD cough HP as indicators of COVID-19. However, 42% of participants thought that being unable to hold your breath for 10 seconds without coughing MESHD coughing HP was an indicator of having the virus. The most frequently reported sources of COVID-19 information were commercial television channels (56%), the Australian Broadcasting Corporation (43%), and the Australian Government COVID-19 information app (31%). Conclusions: Public messaging about hand hygiene and physical distancing to prevent transmission TRANS appear to have been effective. However, there are clear, identified barriers for many individuals that have the potential to impede uptake or maintenance of these behaviours in the long-term. Currently these non-drug interventions are our only effective strategy to combat this pandemic. Ensuring ongoing adherence to is critical.

    Children TRANS with COVID-19 like symptoms in Italian Pediatric Surgeries: the dark side of the coin

    Authors: Gianfranco Trapani; Vassilios Fanos; Enrico Bertino; Giulia Maiocco; Osama Al Jamal; Michele Fiore; VIncenzo Bembo; Domenico Careddu; Lando Barberio; Luisella Zanino; Giuseppe Verlato

    doi:10.1101/2020.07.27.20149757 Date: 2020-07-29 Source: medRxiv

    BACKGROUND: Symptoms of SARS-CoV-2 infection MESHD in children TRANS are nonspecific and shared with other common acute viral illnesses ( fever MESHD fever HP, respiratory or gastrointestinal symptoms, and cutaneous signs), thus making clinical differential diagnosis tricky. In Italy, first line management of pediatric care is handed over to Primary Care Pediatricians (PCPs), who were not allowed to directly perform diagnostic tests during the recent COVID-19 outbreak. Without a confirmatory diagnosis, PCPs could only collect information on ''COVID-19 like symptoms'' rather than identify typical COVID-19 symptoms. AIM: To evaluate the prevalence SERO of COVID-19 like symptoms in outpatient children TRANS, during Italian lockdown. To provide PCPs a risk score to be used in clinical practice during the differential diagnosis process. METHODS: A survey was submitted to 50 PCPs (assisting 47,500 children TRANS) from 7 different Italian regions between the 4th of March and the 23rd of May 2020 (total and partial lockdown period). COVID-19 like symptoms in the assisted children TRANS were recorded, as well as presence of confirmed/suspected cases in children TRANS's families, which was taken as proxy of COVID-19. Multivariable logistic regression was accomplished to estimate the risk of having suspected/ confirmed cases TRANS in families, considering symptoms as potential determinants. RESULTS: 2,300 children TRANS (4.8% of overall survey population) fell HP ill with COVID-19 like symptoms, 3.1% and 1.7% during total and partial lockdown period respectively. The concurrent presence of fatigue MESHD fatigue HP, cough MESHD cough HP, and diarrhea MESHD diarrhea HP in children TRANS, in absence of sore throat/ earache MESHD and abnormal skin signs, represents the maximum risk level of having a suspected/ confirmed case TRANS of COVID-19 at home. CONCLUSIONS: The percentage of children TRANS presenting COVID-19 like symptoms at home has been remarkable also during the total lockdown period. The present study identified a pattern of symptoms which could help, in a cost-effective perspective, PCPs in daily clinical practice to define priorities in addressing children TRANS to the proper diagnostic procedure.

    Older adults TRANS hospitalized with Covid-19: Clinical characteristics and early outcomes from a single center in Istanbul, Turkey 

    Authors: Alpay Medetalibeyoğlu; Naci Senkal; Murat Kose; Yunus Catma; Emine Bilge Caparali; Mustafa Erelel; Mustafa Oral Oncul; Gulistan Bahat; Tufan Tukek

    doi:10.21203/ Date: 2020-07-22 Source: ResearchSquare

    Objective: Older adults TRANS have been continuously reported to be at higher risk for adverse outcomes of Covid-19. We aimed to describe clinical characteristics and early outcomes of the older Covid-19 patients hospitalized in our center comparatively with the younger patients, and also to analyze the triage factors that were related to the in-hospital mortality of older adults TRANS.Design: Retrospective; observational studySetting: Istanbul Faculty of Medicine hospital, TurkeyParticipants: 362 hospitalized patients with laboratory-confirmed Covid-19 from March 11 to May 11, 2020.Measurements: The demographic information; associated comorbidities; presenting clinical, laboratory, radiological characteristics on admission and outcomes from the electronic medical records were analyzed comparatively between the younger (<65 years) and older (≥65 years) adults TRANS. Factors associated with in-hospital mortality of the older adults TRANS were analyzed by multivariate regression analyses.Results: The median age TRANS was 56 years (interquartile range [IQR], 46-67), and 224 (61.9%) were male TRANS. There were 104 (28.7%) patients ≥65 years of age TRANS. More than half of the patients (58%) had one or more chronic comorbidity. The three most common presenting symptoms in the older patients were fatigue MESHD fatigue HP/ myalgia MESHD myalgia HP (89.4%), dry cough MESHD cough HP (72.1%), and fever MESHD fever HP (63.5%). Cough MESHD Cough HP and fever MESHD fever HP were significantly less prevalent in older adults TRANS compared to younger patients (p=0.001 and 0.008, respectively). Clinically severe pneumonia MESHD pneumonia HP was present in 31.5% of the study population being more common in older adults TRANS (49% vs. 24.4%) (p<0.001). The laboratory parameters that were significantly different between the older and younger adults TRANS were as follows: the older patients had significantly higher CRP, D-dimer, TnT, pro-BNP, procalcitonin levels, higher prevalence SERO of lymphopenia MESHD lymphopenia HP, neutrophilia HP, increased creatinine, and lower hemoglobin, ALT, albumin level (p<0.05). In the radiological evaluation, more than half of the patients (54.6%) had moderate-severe pneumonia MESHD pneumonia HP, which was more prevalent in older patients (66% vs. 50%) (p=0.006). The adverse outcomes were significantly more prevalent in older adults TRANS compared to the younger patients (ICU admission, 28.8% vs. 8.9%; mortality, 23.1% vs. 4.3%, p<0.001).  Among the triage evaluation parameters, the only factor associated with higher mortality was the presence of clinically severe pneumonia MESHD pneumonia HP on admission (Odds Ratio=12.3, 95% confidence interval=2.7-55.5, p=0.001).Conclusion: Older patients presented with more prevalent chronic comorbidities, less prevalent symptomatology but more severe respiratory signs and laboratory abnormalities than the younger patients. Among the triage assessment factors, the clinical evaluation of pulmonary involvement came in front to help clinicians to stratify the patients for mortality risk.

    Clinical Features and Histopathological Changes of Skeletal Muscle in Patients with COVID-19: Two Case reports

    Authors: Mei-Yan Liao; Ping Duan; Zhen-Yu Pan; Yu-Xiang Cai; Wei Fan; An-Song Ping

    doi:10.21203/ Date: 2020-07-19 Source: ResearchSquare

    BackgroundTo the best of our knowledge, muscle soreness is a common manifestation for the coronavirus disease MESHD-19 (COVID-19) patients, but the mechanism of the severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) injury to skeletal muscle remains unclear, there has been no publication focused on muscle involvement in COVID-19 patients.Case presentationWe present the case of two Chinese men with COVID-19, whose common symptoms were fatigue MESHD fatigue HP and muscle soreness. They went through different treatments, patient 1, 81-year-old, eventually died of multi-organ failure, and patient 2, 53-year-old, underwent amputation of the mid-lower section of left thigh. Laboratory tests in both patients showed abnormal biochemical parameters associated with skeletal muscle injury. We obtained skeletal muscle samples from these two patients, one from postmortem biopsy of gastrocnemius muscle and the other from a resected left lower limb due to thrombosis MESHD. The pathological findings in patient 1 were mainly scattered atrophic muscles, while fiber necrosis HP necrosis MESHD and minor inflammation MESHD were identified in patient 2, and the mild infiltrations were confirmed by CD68 and LCA staining to be predominantly macrophages and lymphocytes.ConclusionsWe report the clinical and laboratory features together with histopathological findings in skeletal muscle tissues from two COVID-19 cases and speculate that the SARS-CoV-2 may cause skeletal muscle injury. Due to the particularity of individual differences in case reports, the background of chronic neuromuscular disease MESHD in patient 1 and a minimal compartment syndrome MESHD caused by thrombosis MESHD in patient 2 need to be excluded prior to the conclusion that the skeletal muscles have been involved in COVID-19.

    Acute Demyelinating Encephalomyelitis MESHD (ADEM) in COVID-19 infection MESHD: A Case Series.

    Authors: Michaela McCuddy; Praful Kelkar; Yu Zhao; David Wicklund

    doi:10.1101/2020.07.15.20126730 Date: 2020-07-17 Source: medRxiv

    Objective: To report three patients infected with COVID-19 with severe respiratory syndrome MESHD requiring intubation, who developed acute demyelinating encephalomyelitis MESHD (ADEM). Method: Patient data were obtained from medical records from the North Memorial Health Hospital, Robbinsdale, MN, USA Results: Three patients (two men and one woman, aged TRANS 38 - 63) presented with fatigue MESHD fatigue HP, cough MESHD cough HP and fever MESHD fever HP leading to development of acute respiratory distress HP syndrome MESHD secondary to COVID-19 infection MESHD requiring intubation and ventilatory support. Two patients were unresponsive, one with strong eye deviation to the left and the third patient had severe diffuse weakness. MRI in all patients showed findings consistent with ADEM. CSF showed elevated protein in all patients with normal cell count and no evidence of infection MESHD, including negative COVID-19 PCR. All three of the patients received Convalescent plasma SERO therapy for COVID-19. All patients were treated with intravenous corticosteroids and improved, although two responded minimally. Two patients treated with IVIG showed no further improvement. Conclusion: Neurological complications from COVID-19 are being rapidly recognized. Our three cases highlight the occurrence of ADEM as a postinfectious/immune mediated complication of COVID-19 infection MESHD, which may be responsive to corticosteroid treatment. Early recognition of this complication and treatment is important to avoid long term complications.

    Clinical characteristics of children TRANS and young people hospitalised with covid-19 in the United Kingdom: prospective multicentre observational cohort study

    Authors: Olivia V Swann; Karl A Holden; Lance Turtle; Louisa Pollock; Cameron J Fairfield; Thomas M Drake; Sohan Seth; Conor Egan; Hayley Hardwick; Sophie Halpin; Michelle Girvan; Chloe Donohue; Mark G Pritchard; Latifa Patel; Shamez Ladhani; Louise Sigfrid; Ian P Sinha; Piero L Olliaro; Jonathan S Nguyen-Van-Tam; Peter W Horby; Laura Merson; Gail Carson; W Jake Dunning; Peter JM Openshaw; J Kenneth Baillie; Ewen M Harrison; Annemarie B Docherty; Malcolm Gracie Semple; - ISARIC Coronavirus Clinical Characterisation Consortium (ISARIC4C) Investigators

    doi:10.1101/2020.07.14.20153320 Date: 2020-07-17 Source: medRxiv

    Objective To characterise the clinical features of children TRANS and young people admitted to hospital with laboratory-confirmed severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection MESHD in the UK, and explore factors associated with admission to critical care, mortality, and development of multisystem inflammatory syndrome MESHD in children TRANS and adolescents temporarily related to covid-19 (MIS-C). Design Prospective observational cohort study with rapid data gathering and near real time analysis. Setting 260 acute care hospitals in England, Wales, and Scotland between 17th January and 5th June 2020, with a minimal follow-up time of two weeks (to 19th June 2020). Participants 451 children TRANS and young people aged TRANS less than 19 years admitted to 116 hospitals and enrolled into the International Severe Acute Respiratory and emergency MESHD Infections MESHD Consortium (ISARIC) WHO Clinical Characterisation Protocol UK study with laboratory-confirmed SARS-CoV-2. Main Outcome Measures Admission to critical care (high dependency or intensive care), in-hospital mortality, or meeting the WHO preliminary case definition for MIS-C. Results Median age TRANS was 3.9 years [interquartile range (IQR) 0.3-12.9 years], 36% (162/451) were under 12 months old, and 57% (256/450) were male TRANS. 56% (224/401) were White, 12% (49/401) South Asian and 10% (40/401) Black. 43% (195/451) had at least one recorded comorbidity. A muco-enteric cluster of symptoms was identified, closely mirroring the WHO MIS-C criteria. 17% of children TRANS (72/431) were admitted to critical care. On multivariable analysis this was associated with age TRANS under one month odds ratio 5.05 (95% confidence interval 1.69 to 15.72, p=0.004), age TRANS 10 to 14 years OR 3.11 (1.21 to 8.55, p=0.022) and Black ethnicity OR 3.02 (1.30 to 6.84, p=0.008). Three young people died (0.7 %, 3/451) aged TRANS 16 to 19 years, all of whom had profound comorbidity. Twelve percent of children TRANS (36/303) met the WHO MIS-C criteria, with the first patient developing symptoms in mid-March. Those meeting MIS-C criteria were older, (median age TRANS 10.8 years ([IQR 8.4-14.1] vs 2.0 [0.2-12.6]), p<0.001) and more likely to be of non-White ethnicity (70% (23/33) vs 43% (101/237), p=0.005). Children TRANS with MIS-C were four times more likely to be admitted to critical care (61% (22/36) vs 15% (40/267, p<0.001). In addition to the WHO criteria, children TRANS with MIS-C were more likely to present with headache MESHD headache HP (45% (13/29) vs 11% (19/171), p<0.001), myalgia MESHD myalgia HP (39% (11/28) vs 7% (12/170), p<0.001), sore throat (37% (10/27) vs (13% (24/183, p = 0.004) and fatigue MESHD fatigue HP (57% (17/30) vs 31% (60/192), p =0.012) than children TRANS who did not and to have a platelet count of less than 150 x109/L (30% (10/33) vs 10% (24/232), p=0.004). Conclusions Our data confirms less severe covid-19 in children TRANS and young people than in adults TRANS and we provide additional evidence for refining the MIS-C case definition. The identification of a muco-enteric symptom cluster also raises the suggestion that MIS-C is the severe end of a spectrum of disease MESHD. Study registration ISRCTN66726260

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MeSH Disease
Human Phenotype

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