Corpus overview


Overview

MeSH Disease

Human Phenotype

Transmission

Seroprevalence
    displaying 1 - 10 records in total 15
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    Intracerebral hemorrhage MESHD in COVID-19 patients with pulmonary failure – 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/rs.3.rs-56258/v1 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 HP syndrome MESHD (ARDS) with and without extracorporeal membrane oxygenation therapy (ECMO) have more intracerebral hemorrhages MESHD (ICH) compared to other ARDS patients.Methods: We conducted a retrospective observational single center study enrolling all patients with ARDS from 01/2018-05/2020. Patients with ARDS 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 according to HAS-BLED score.Results: A total of 163, mostly severe ARDS 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 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 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. We found no statistically significant increased bleeding rate in patients with ARDS due to COVID-19 compared to other causes of ARDS.

    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/rs.3.rs-50651/v1 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 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 HP syndrome MESHD (ARDS), 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 (52.9%), refractory ARDS (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.

    Cerebral Microvascular Injury in Severe COVID-19

    Authors: John Conklin; Matthew P. Frosch; Shibani Mukerji; Otto Rapalino; Mary Maher; Pamela W. Schaefer; Michael H. Lev; Ramon G. Gonzalez; Sudeshna Das; Samantha N. Champion; Colin Magdamo; Pritha Sen; George Kyle Harrold; Haitham Alabsi; Erica Normandin; Bennett Shaw; Jacob Lemieux; Pardis Sabeti; John A. Branda; Emery N. Brown; M. Brandon Westover; Susie Y. Huang; Brian L Edlow

    doi:10.1101/2020.07.21.20159376 Date: 2020-07-24 Source: medRxiv

    IMPORTANCE: Microvascular lesions are common in patients with severe COVID-19. Radiologic-pathologic correlation in one case suggests a combination of microvascular hemorrhagic and ischemic lesions that may reflect an underlying hypoxic mechanism of injury, which requires validation in larger studies. OBJECTIVE: To determine the incidence, distribution, and clinical and histopathologic correlates of microvascular lesions in patients with severe COVID-19. DESIGN: Observational, retrospective cohort study: March to May 2020. SETTING: Single academic medical center. PARTICIPANTS: Consecutive patients (16) admitted to the intensive care unit with severe COVID-19, undergoing brain MRI for evaluation of coma MESHD coma HP or focal neurologic deficits. EXPOSURES: Not applicable. MAIN OUTCOME AND MEASURES: Hypointense microvascular lesions identified by a prototype ultrafast high-resolution susceptibility-weighted imaging (SWI) MRI sequence, counted by two neuroradiologists and categorized by neuroanatomic location. Clinical and laboratory data (most recent measurements before brain MRI). Brain autopsy and cerebrospinal fluid PCR for SARS-CoV 2 in one patient who died from severe COVID-19. RESULTS: Eleven of 16 patients (69%) had punctate and linear SWI lesions in the subcortical and deep white matter, and eight patients (50%) had >10 SWI lesions. In 4/16 patients (25%), lesions involved the corpus callosum. Brain autopsy in one patient revealed that SWI lesions corresponded to widespread microvascular injury, characterized by perivascular and parenchymal petechial hemorrhages MESHD and microscopic ischemic lesions. CONCLUSIONS AND RELEVANCE: SWI lesions are common in patients with neurological manifestations of severe COVID-19 ( coma MESHD coma HP and focal neurologic deficits). The distribution of lesions is similar to that seen in patients with hypoxic respiratory failure HP, sepsis MESHD sepsis HP, and disseminated intravascular coagulation MESHD disseminated intravascular coagulation HP. Collectively, these radiologic and histopathologic findings suggest that patients with severe COVID-19 are at risk for multifocal microvascular hemorrhagic and ischemic lesions in the subcortical and deep white matter.

    Anesthesia for an emergency MESHD gastrorrhagia operation in a patient suspected with COVID-19: a case report

    Authors: Yu Chen; Hao Lv

    doi:10.21203/rs.3.rs-44673/v1 Date: 2020-07-17 Source: ResearchSquare

    BackgroundThe spread of the Coronavirus Disease MESHD 2019 (COVID-19) in China since December 2019 was very grave. According to Chinese govenment's guidelines, patients can be divided into confirmed cases TRANS and suspected cases. The protective measures for both are the same.Case summaryWe report a case of an emergency MESHD gastrorrhagia operation for a patient suspected to have contracted COVID-19. A 54-year-old man with massive gastric hemorrhage MESHD was scheduled for an emergency MESHD operation for exploratory hemostasis. COVID-19 infection MESHD, however, could not be ruled out, and the patient was treated as a suspected case. All the protective measures were based on patients infected or suspected to be infected with COVID-19. Before the operation, we carried out a series of protective measures, such as preparing the operating room and wearing personal protective gear. We increased the dose of neuromuscular blocking agents during the induction of anesthesia to prevent the splashing of secretions by coughing MESHD coughing HP. The operation went smoothly, and the patient was transferred to an intensive care unit (ICU) in the isolation ward for extubation. Seven days later, the patient was ruled out for COVID-19 infection MESHD. ConclusionThe patient recovered successfully from the massive gastric hemorrhage MESHD, and the medical staff were not infected.

    Pulmonary alveolar regrowth in an adult TRANS COVID-19 patient

    Authors: Jingyu Chen; Huijuan Wu; Yuanyuan Yu; Nan Tang

    doi:10.1101/2020.05.10.20097634 Date: 2020-06-01 Source: medRxiv

    We detected active alveolar regrowth in the lung of a 58-year-old COVID-19 patient who underwent lung transplantation due to severe lung hemorrhage MESHD. Specifically, immunohistological and scanning electronic microscopy analyses revealed that alveolar type II epithelial cells (AT2 cells) accumulate in response to viral pneumonia MESHD pneumonia HP and that these AT2 cells actively proliferate and differentiate into squamous AT1-like alveolar epithelial cells. Thus, our work establishes that alveolar regrowth does occur in post-COVID-19 injury adult TRANS human lungs.

    Retroperitoneal Hemorrhage MESHD During Veno-Venous Extracorporeal Membrane Oxygenation in COVID-19 Patientss: Clinical Experience and Review of Literature

    Authors: Jingchen Zhang; Xujian He; Jia Hu; Tong Li

    doi:10.21203/rs.3.rs-32685/v1 Date: 2020-05-30 Source: ResearchSquare

    Background: Retroperitoneal hemorrhage MESHD is a rare and severe complication in patients undergoing extracorporeal membrane oxygenation (ECMO). Retroperitoneal hematoma MESHD after the operation of multiple ECMO in a single center at the same time is extremely rare. The causes and treatment options can provide clinical experience and bring some inspiration.Case presentation: Three cases of retroperitoneal hemorrhage MESHD patients with Corona Virus Disease MESHD-19 (COVID-19) are introduced; they had respiratory failure HP and were treated with veno-venous ECMO or veno-arterial-venous ECMO. Retroperitoneal hemorrhage MESHD occurred during ECMO treatment. Among the three cases, 2 cases were found due to abdominal pain MESHD abdominal pain HP, and 1 case was found because of a decrease in ECMO circuit flow rate and hemoglobin level. 2 cases were treated with transcatheter arterial embolization, and 1 case was treated conservatively. The hemorrhage MESHD in each of the 3 cases did not deteriorate. Through early diagnosis and treatment, satisfactory treatment results were achieved for these 3 patients.Conclusions: During the period of ECMO treatment, there is a low incidence of retroperitoneal hematoma MESHD, yet it comes with a high risk. This is due to anticoagulant use and some local mechanical injuries. If a decline in blood SERO flow velocity and hemoglobin is detected, retroperitoneal hematoma MESHD should be taken into consideration, and early aggressive therapy should be started.

    Analysis of 4 imaging features in patients with COVID-19

    Authors: JUN JIN; De-hong Gao; Xin Mo; Si-ping Tan; Zhen-xia Kou; Yi-bo Chen; Jin-bo Cao; Wen-jing Chen; Ya-ming Zhang; Bing-qing Li; Kuan-long Huang; Bing-ren Xu; Xiao-li Tang; Yu-li Wang

    doi:10.21203/rs.3.rs-32496/v3 Date: 2020-05-29 Source: ResearchSquare

    Background : The aim of this was to analyze 4 chest CT imaging features of patients with coronavirus disease MESHD 2019 (COVID-19) in Shenzhen, China so as to improve the diagnosis of COVID-19.   Methods: Chest CT of 34 patients with COVID-19 confirmed by the nucleic acid test (NAT) were retrospectively analyzed. Analyses were performed to investigate the pathological basis of four imaging features(“feather sign”,“dandelion sign”,“pomegranate sign”, and “rime sign”) and to summarize the follow-up results.   Results: There were 22 patients (65.2 %) with typical “feather sign”and 18 (52.9%) with “dandelion sign”, while few patients had “pomegranate sign” and “rime sign”. The “feather sign” and “dandelion sign” were composed of stripe or round ground-glass opacity(GGO), thickened blood SERO vessels, and small-thickened interlobular septa. The “pomegranate sign” was characterized as follows: the increased range of GGO, the significant thickening of the interlobular septum, complicated with a small amount of punctate alveolar hemorrhage MESHD. The “rime sign” was characterized by numerous alveolar edemas MESHD edemas HP. Microscopically, the wall thickening, small vascular proliferation, luminal stenosis, and occlusion, accompanied by interstitial infiltration of inflammatory cells, as well as numerous pulmonary interstitial fibrosis MESHD and partial hyaline degeneration were observed. Repeated chest CT revealed the mediastinal lymphadenectasis in one patient. Re-examination of the NAT showed another positive anal swab in two patients.   Conclusion: “Feather sign” and “dandelion sign” were typical chest CT features in patients with COVID-19; “pomegranate sign” was an atypical feature, and “rime sign” was a severe feature. In clinical work, accurate identification of various chest CT signs can help to improve the diagnostic accuracy of COVID-19 and reduce the misdiagnosis or missed diagnosis rate.

    Vascular Obliteration Due To Endothelial And Myointimal Growth In COVID-19

    Authors: Jara Valtueña; Gerardo Martínez-García; Daniel Ruiz-Sánchez; María Garayar-Cantero; Carlos Dueñas; Ángel Aguado-García; Jose María Prieto de Paula; Pilar Manchado López

    doi:10.21203/rs.3.rs-32241/v2 Date: 2020-05-28 Source: ResearchSquare

    Background: Severe coronavirus disease MESHD 2019 (Covid-19) is a systemic multi-organ viral invasion. Previous studies found that many patients had a procoagulant state and/or severe hypoxemia HP with relatively well-preserved lung mechanics. Mechanisms underlying the vascular and its surrounding tissue are not well known yet.  Histological data in Covid-19 tissues´ patients are still limited and mainly focused on post-mortem analysis. Since SARS-CoV-2 largely affects cutaneous tissue, we aim to examine in depth skin lesions related to Covid-19 in order to understand better how the disease MESHD might affect living tissue.Methods: Five skin lesions from Covid-19 adult TRANS patients were selected for histological tissue examination. Vast amount of data of immunohistochemistry (IHC) and direct immunofluorescent (DIF) were part of the assessment. Results: A common strong vasculopathic reaction pattern based on prominent vascular endothelial and myointimal cellgrowth was identified. Endothelial cell distortion generated vascular lumen obliteration and a strike erythrocyte and serum SERO extravasation. Extensive significant vascular C4d and C3 deposition throughout vascular cell wall was also identified. A regenerative epidermal hyperplasia MESHD with tissue structure preservation was found. Conclusions: Covid-19 could comprise an obliterative micro-angiopathy consisting on endothelial and myointimal intensive growth with complement activation. This mechanism, together with increased vascular permeability identified, could contribute to obliterative vascular lumen and hemorrhage MESHD in Covid-19. Activation of the complement and angiogenic pathways could have an important role in inducing and maintaining this vasculopathic reaction pattern. Thus, anticoagulation by itself could not completely reverse vascular lumen obliteration, with consequent hemorrhagic increased risk associated. Skin is the largest organ in the body, the most accessible one and can mirror other organs of the body. Findings of this study could contribute to a better understanding of physio-pathological mechanisms underlying SARS-CoV-2 infection MESHD on living tissue and could help further studies find potential targets for specific therapeutic interventions in Covid-19 severe patients. 

    Identification of Immune complement function as a determinant of adverse SARS-CoV-2 infection MESHD outcome

    Authors: Vijendra Ramlall; Phyllis Thangaraj; Cem Meydan; Jonathan Foox; Daniel Butler; Ben May; Jessica de Freitas; Benjamin S Glicksberg; Christopher Mason; Nicholas P Tatonetti; Sagi D Shapira

    doi:10.1101/2020.05.05.20092452 Date: 2020-05-13 Source: medRxiv

    Understanding the pathophysiology of SARS-CoV-2 infection MESHD is critical for therapeutics and public health intervention strategies. Viral-host interactions can guide discovery of regulators of disease MESHD outcomes, and protein structure function analysis points to several immune pathways, including complement and coagulation, as targets of the coronavirus proteome. To determine if conditions associated with dysregulation of the complement or coagulation systems impact adverse clinical outcomes, we performed a retrospective observational study of 11,116 patients who presented with suspected SARS-CoV-2 infection MESHD. We found that history of macular degeneration MESHD macular degeneration HP (a proxy for complement activation disorders) and history of coagulation disorders ( thrombocytopenia MESHD thrombocytopenia HP, thrombosis MESHD, and hemorrhage MESHD) are risk factors for morbidity and mortality in SARS-CoV-2 infected patients - effects that could not be explained by age TRANS, sex, or history of smoking. Further, transcriptional profiling of nasopharyngeal (NP) swabs from 650 control and SARS-CoV-2 infected patients demonstrated that in addition to innate Type-I interferon and IL-6 dependent inflammatory immune responses, infection MESHD results in robust engagement and activation of the complement and coagulation pathways. Finally, we conducted a candidate driven genetic association study of severe SARS-CoV-2 disease MESHD. Among the findings, our scan identified putative complement and coagulation associated loci including missense, eQTL and sQTL variants of critical regulators of the complement and coagulation cascades. In addition to providing evidence that complement function modulates SARS-CoV-2 infection MESHD outcome, the data point to putative transcriptional genetic markers of susceptibility. The results highlight the value of using a multi-modal analytical approach, combining molecular information from virus protein structure-function analysis with clinical informatics, transcriptomics, and genomics to reveal determinants and predictors of immunity, susceptibility, and clinical outcome associated with infection MESHD.

    Identification of Immune complement function as a determinant of adverse SARS-CoV-2 infection MESHD outcome

    Authors: Vijendra Ramlall; Phyllis M. Thangara; Nicholas P. Tatonetti; Sagi D. Shapira

    doi:10.21203/rs.3.rs-26451/v1 Date: 2020-05-01 Source: ResearchSquare

    Understanding the pathophysiology of SARS-CoV-2 infection MESHD is critical for therapeutics and public health intervention strategies. Viral-host interactions can guide discovery of regulators of disease MESHD outcomes, and protein structure function analysis points to several immune pathways, including complement and coagulation, as targets of the coronavirus proteome. To determine if conditions associated with dysregulation of the complement or coagulation systems impact adverse clinical outcomes associated with SARS-CoV-2 infection MESHD, we performed a retrospective observational study of 11,116 patients suspected of SARS-CoV-2 infection MESHD. We found that history of macular degeneration MESHD macular degeneration HP (a proxy for complement activation disorders) and history of coagulation disorders ( thrombocytopenia MESHD thrombocytopenia HP, thrombosis MESHD, and hemorrhage MESHD) are risk factors for morbidity and mortality in SARS-CoV-2 infected patients – effects that could not be explained by age TRANS or sex. In addition, using data from the UK Biobank, we implemented a candidate driven approach to evaluate linkage between severe SARS-CoV-2 disease MESHD and genetic variation associated with complement and coagulation pathways. Among our findings, our scan identified an eQTL for CD55 (a negative regulator of complement activation) and SNPs in Complement Factor H (CFH) and Complement Component 4 Binding Protein Alpha (C4BPA), which play central roles in complement activation and innate immunity and were previously linked to Age TRANS Related Macular Degeneration MESHD Macular Degeneration HP (AMD) in a Genome-Wide Association Study (GWAS). In addition to providing evidence that complement function modulates SARS-CoV-2 infection MESHD outcome, the data point to several putative genetic markers of susceptibility. The results highlight the value of using a multi-modal analytical approach, combining molecular information from virus protein structure-function analysis with clinical informatics and genomics to reveal determinants and predictors of immunity, susceptibility, and clinical outcome associated with infection MESHD.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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