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Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    Implications of Liver Injury in Risk-Stratification and Management of Patients with COVID-19

    Authors: Jiaofang Shao; Yuan Liang; Yan Li; Rong Ding; Mengyan Zhu; Wenhua You; Ziyu Wang; Bing Huang; Min Wu; Tingting Zhang; Kening Li; Wei Wu; Lingxiang Wu; Qianghu Wang; Xinyi Xia; Shukui Wang; Ling Lu

    doi:10.21203/rs.3.rs-53585/v1 Date: 2020-08-04 Source: ResearchSquare

    BackgroundInfection with SARS-CoV-2 has been associated with liver dysfunction, aggravation of liver burden, and liver injury. This study aimed to assess the effects of liver injuries on the clinical outcomes of patients with COVID-19.MethodsA total of 1,564 patients with severe or critical COVID-19 from Huoshenshan Hospital, Wuhan, were enrolled. Chronic liver disease MESHD (CLD) was confirmed by consensus diagnostic criteria. Laboratory test results were compared between different groups. scRNA-seq data and bulk gene expression profiles were used to identify cell types associated with liver injury.ResultsA total of 10.98% of patients with severe or critical COVID-19 developed liver injury after admission that was associated with significantly higher rates of mortality (21.74%, p<0.001) and intensive care unit admission (26.71%, p<0.001). A pre-existing CLD was not associated with a higher risk. However, fatty liver MESHD disease MESHD and cirrhosis HP were associated with higher risks, supported by evidences from single cell and bulk transcriptome analysis that showed more TMPRSS2+ cells in these tissues. By generating a model, we were able to predict the risk and severity of liver injury during hospitalization.ConclusionWe demonstrate that liver injury occurring during therapy in patients with COVID-19 is significantly associated with the severity of disease MESHD and mortality, but the presence of CLD is not associated. We provide a risk-score model that can predict whether patients with COVID-19 will develop liver injury or proceed to higher risk stages during subsequent hospitalizations. These findings may prove beneficial for the clinical management of patients infected with SARS-CoV-2.

    Pre-existing liver disease MESHD is associated with poor outcome in patients with SARS CoV2 infection MESHD; The APCOLIS Study (APASL COVID-19 Liver Injury Spectrum Study)

    Authors: Shiv Kumar Sarin; Ashok Choudhury; George K Lau; Ming-Hua Zheng; Dong Ji; Sherief Abd-Elsalam; Jaeseok Hwang; Xiaolong Qi; Ian Homer Cua; Jeong Ill Suh; Jun Gi Park; Opass Putcharoen; Apichat Kaewdech; Teerha Piratvisuth; Sombat Treeprasertsuk; Sooyoung Park; Salisa Wejnaruemarn; Diana A. Payawal; Oidov Baatarkhuu; Sang Hoon Ahn; Chang Dong Yeo; Uzziel Romar Alonzo; Tserendorj Chinbayar; Imelda M. Loho; Osamu Yokosuka; Wasim Jafri; Soeksiam Tan; Lau Ing Soo; Tawesak Tanwandee; Rino Gani; Lovkesh Anand; Eslam Saber Esmail; Mai Khalaf; Shahinul Alam; Chun-Yu Lin; Wan-Long Chuang; A S Soin; Hitendra K Garg; Kemal Kalista; Badamnachin Batsukh; Hery Djagat Purnomo; Vijay Pal Dara; Pravin Rathi; Mamun Al Mahtab; Akash Shukla; Manoj K Sharma; Masao Omata

    doi:10.21203/rs.3.rs-36338/v1 Date: 2020-06-18 Source: ResearchSquare

    Background and Aims: COVID-19 is a dominant pulmonary disease MESHD, with multisystem involvement, depending upon co morbidities. Its profile in patients with pre-existing chronic liver disease MESHD (CLD) is largely unknown. We studied the liver injury patterns of SARS-Cov-2 in CLD patients, with or without cirrhosis HP. Methods: Data was collected from 13 Asian countries on patients with CLD, known or newly diagnosed, with confirmed COVID-19. Result: Altogether, 228 patients [185 CLD without cirrhosis HP and 43 with cirrhosis HP] were enrolled, with comorbidities in nearly 80%. Metabolism associated fatty liver MESHD disease MESHD (113, 61%) and viral etiology (26, 60%) were common. In CLD without cirrhosis HP, diabetes [57.7% vs 39.7%, OR=2.1(1.1-3.7), p=0.01] and in cirrhotics, obesity MESHD obesity HP, [64.3% vs. 17.2%, OR=8.1(1.9-38.8), p=0.002) predisposed more to liver injury than those without these. Forty three percent of CLD without cirrhosis HP presented as acute liver injury and 20% cirrhotics presented with either acute-on-chronic liver failure MESHD [5(11.6%)] or acute decompensation [4(9%)]. Liver related complications increased (p<0.05) with stage of liver disease MESHD; a Child TRANS-Turcotte Pugh score of 9 or more at presentation predicted high mortality [AUROC-0.94, HR=19.2(95CI 2.3-163.3), p<0.001, sensitivity SERO 85.7% and specificity 94.4%). In decompensated cirrhotics, the liver injury was progressive in 57% patients, with 43% mortality. Rising bilirubin and AST/ALT ratio predicted mortality among cirrhosis HP. Conclusions: SARS-Cov-2 infection MESHD causes significant liver injury in CLD patients, decompensating one fifth of cirrhosis HP, and worsening the clinical status of the already decompensated. The CLD patients with diabetes and obesity MESHD obesity HP are more vulnerable and should be closely monitored. 

    Significance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio for predicting clinical outcomes in COVID-19

    Authors: Ting Zhang; Shaoping Huang; Min Liu; Xiaolu Li; Zhiyin Shang; Hongzhou Lu

    doi:10.21203/rs.3.rs-34983/v1 Date: 2020-06-12 Source: ResearchSquare

    Background The epidemic of 2019 novel coronavirus (COVID-19) struck China in late December,2019, resulting in about 200000 deaths MESHD all over the world. Numerous observational studies have suggested that the neutrophil-to-lymphocyte ratio (NLR) and lymphocyte proportion and the platelet-to-lymphocyte ratio (PLR) are inflammatory markers. Our study aimed to detect the role of NLR, PLR in predicting the prognosis of COVID-19.Results Four hundred and fifteen consecutive patients were enrolled in Shanghai Public Health Clinical Center affiliated to Fudan University, between 20 January and 11 April 2020 with confirmed COVID-19,among which 386 (93%) patients were not severe, and 27 (7%) were severe. The proportion of males TRANS in severe cases is higher than in non-severe cases (75.86% vs. 50.52%, P = 0.008). The age TRANS between the two groups is different (p = 0.022). Compared with non-severe patients, severe patients exhibited more comorbidities, including hypertension MESHD hypertension HP (48.28% vs. 19.43%, p < 0.001), diabetes (20.69% vs. 6.99%, p = 0.009), chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP (51.72% vs. 6.22%, p < 0.001), and fatty liver MESHD (37.93% vs. 15.8%, p = 0.002), respectively. NLR and PLR showed significant difference (p < 0.001). Diabetes (OR 0.28; 95% CI 15.824-187.186), fatty liver MESHD (OR 21.469; 95% CI 2.306-199.872), coronary heart disease MESHD (OR 18.157; 95% CI 2.085-158.083), NLR (OR 1.729; 95% CI 1.050–2.847) were significantly associated with severe cases with COVID-19. The NLR of patients in severe group had a 1.729-fold higher than that of no-severe group (OR 1.729; 95% CI 1.050–2.847, P = 0.031).Conclusions NLR is an independent risk factor of severe COVID-19 patients. PLR, NLR were significantly different between severe and non-severe patients, so assessment of NLR, PLR may help identify high risk cases with COVID-19.

    HIGH LIVER FAT ASSOCIATES WITH HIGHER RISK OF DEVELOPING SYMPTOMATIC COVID-19 INFECTION MESHD - INITIAL UK BIOBANK OBSERVATIONS

    Authors: Adriana Roca-Fernandez; Andrea Dennis; Rowan Nicolls; John McGonigle; Matthew Kelly; Rajarshi Banerjee

    doi:10.1101/2020.06.04.20122457 Date: 2020-06-05 Source: medRxiv

    Background A high proportion of COVID-19 patients develop acute liver dysfunction. Early research has suggested that pre-existing fatty liver MESHD disease MESHD may be a significant risk factor for hospitalisation. Liver fat, in particular, is a modifiable parameter and can be a target for public health policy and individual patient plans. In this study we aimed to assess pre-existing liver disease MESHD as a risk factor for developing symptomatic COVID-19. Methods From 502,506 participants from the UK Biobank, 42,146 underwent MRI ( aged TRANS 45-82), and had measures of liver fat, liver fibroinflammatory disease and liver MESHD iron. Patients were censored on May 28th to determine how many had tested for COVID-19 with symptomatic disease MESHD. UK testing was restricted to those with symptoms in hospital. COVID-19 symptoms included fever MESHD fever HP, dry cough MESHD cough HP, sore throat, diarrhoea and fatigue MESHD fatigue HP. Univariate analysis was performed on liver phenotypic biomarkers to determine if these variables increased risk of symptomatic COVID-19, and compared to previously described risk factors associated with severe COVID-19, including to age TRANS, ethnicity, gender TRANS and obesity MESHD obesity HP, Findings Increased liver fat was associated with a higher risk for symptomatic confirmed COVID-19 in this population in univariate analysis(OR:1.85, p=0.03). In obese participants, only those with concomitant fatty liver MESHD([≥]10%) were at increased risk(OR:2.96, p=0.02), with those having normal liver fat (<5%) showing no increased risk(OR:0.36, p=0.09). Conclusions UK Biobank data demonstrated an association between pre-existing liver disease MESHD and obesity MESHD obesity HP with severe COVID-19, with higher proportions of liver fat in obese individuals a likely risk factor for symptomatic disease MESHD and severity. Public policy measures to protect patients with liver disease MESHD who may have almost double the risk of the general population should be considered, especially as dietary and pharmacological strategies to reduce body weight MESHD and liver fat already exist. Funding University of Oxford, Innovate UK, UK Biobank. Authors are employees of Perspectum Ltd.

    Significance of neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio for predicting clinical outcomes in COVID-19

    Authors: Shaoping Huang; Min Huang; Xiaolu Li; Ting Zhang; Hongzhou Lu

    doi:10.1101/2020.05.04.20090431 Date: 2020-05-08 Source: medRxiv

    Background: The epidemic of 2019 novel coronavirus (COVID-19) struck China in late December, 2019, resulting in about 200000 deaths MESHD all over the world. Numerous observational studies have suggested that the neutrophil-to-lymphocyte ratio (NLR) and lymphocyte proportion and the platelet-to-lymphocyte ratio (PLR) are inflammatory markers. Our study aimed to detect the role of NLR, PLR in predicting the prognosis of COVID-19. Methods: Four hundred and fifteen consecutive patients were enrolled in Shanghai Public Health Clinical Center affiliated to Fudan University, between 20 January and 11 April 2020 with confirmed COVID-19. Epidemiology, symptoms, signs MESHD, and laboratory examinations during the hospital stay were collected and compared between non-severe and severe patients. Statistical analysis was performed by SPSS 25.0 software. Results: Four hundred and fifteen laboratory-confirmed COVID-19 patients were included in our study, among which 386 (93%) patients were not severe, and 27 (7%) were severe. The proportion of males TRANS in severe cases is higher than in non-severe cases (75.86% vs. 50.52%, P=0.008). The age TRANS between the two groups is different (p=0.022). Compared with non-severe patients, severe patients exhibited more comorbidities, including hypertension MESHD hypertension HP (48.28% vs. 19.43%, p<0.001), diabetes (20.69% vs. 6.99%, p=0.009), chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP (51.72% vs. 6.22%, p<0.001), and fatty liver MESHD (37.93% vs. 15.8%, p=0.002), respectively. NLR and PLR showed significant difference (p<0.001). Diabetes (OR 0.28; 95% CI 15.824-187.186), fatty liver MESHD (OR 21.469; 95% CI 2.306-199.872), coronary heart disease MESHD (OR 18.157; 95% CI 2.085-158.083), NLR (OR 1.729; 95% CI 1.050-2.847) were significantly associated with severe cases with COVID-19. The NLR of patients in severe group had a 1.729-fold higher than that of no-severe group (OR 1.729; 95% CI 1.050-2.847, P=0.031). Conclusions: NLR is an independent risk factor of severe COVID-19 patients. PLR, NLR were significantly different between severe and non-severe patients, so assessment of NLR, PLR may help identify high risk cases with COVID-19. Key words: Neutrophil-to-lymphocyte ratio, Platelet-to-lymphocyte ratio, COVID-19, Severity

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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