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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    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/rs.3.rs-52239/v1 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.

    The neutrophil-to-lymphocyte ratio determines clinical efficacy of corticosteroids therapy in patients with COVID-19

    Authors: Jingjing Cai; Haomiao Li; Ye-Mao Liu; Changjiang Zhang; Fang Lei; Juan-Juan Qin; Feng Zhou; Xiaohui Song; Liangjie Bai; Jianghua Zhou; Yan-Ci Zhao; Lihua Zhu; Peng Zhang; Xin Zhang; Juan Yang; Yan-Xiao Ji; Guang-Nian Zhao; Zhigang Lu; Liming Liu; Weiming Mao; Xiaofeng Liao; Haofeng Lu; Daihong Wang; Xigang Xia; Xiaodong Huang; Xiang Wei; Jiahong Xia; Bing-Hong Zhang; Yufeng Yuan; Yibin Wang; Xiao-Jing Zhang; Zhi-Gang She; Hongliang Li

    doi:10.21203/rs.3.rs-41841/v1 Date: 2020-07-13 Source: ResearchSquare

    Preliminary results from the RECOVERY trial indicated that dexamethasone usage markedly reduced death MESHD rate in COVID-19 patients receiving invasive mechanical ventilation. However, the overall reduction for the entire patient cohort in that trial was much more modest, indicating highly variable effects of corticosteroid usage among COVID-19 patients. While steroid treatment is known to have both clinical efficacy and detrimental adverse-effects, defining a clinic parameter that could guide the beneficial corticosteroid usage for treating COVID-19 remains an elusive, urgent, and critical unmet need in COVID-19 therapy. Here, we undertook a multicentered retrospective study on a cohort of 12,862 confirmed COVID-19 cases from 21 hospitals in Hubei Province, China, including 3,254 received corticosteroid treatment and 9,608 received usual care without corticosteroid. We uncovered that the clinical benefits of corticosteroid use were closely associated with the neutrophil-to-lymphocyte ratio (NLR) measured at admission. Among participants with NLR > 6.12 at admission, corticosteroid treatment was significantly associated with a lower risk of 60-day all-cause mortality of COVID-19 based on both Cox model with time-varying exposure and Marginal Structural Model. However, in patients with NLR ≤ 6.12 at admission, corticosteroid treatment was no longer associated with reduced risk of all-cause death MESHD, but rather with increased risks of severe adverse effects, particularly in hyperglycemia MESHD hyperglycemia HP and infection MESHD. In diabetic patients with COVID-19, corticosteroid treatment was associated with increased glycemia, but not with a higher risk of 60-day mortality. Therefore, our study has uncovered NLR as a clinical indicator to stratify COVID-19 patients in their response to corticosteroid therapy. This finding may assist clinical evaluation and future randomized controlled trials to establish proper guidelines for corticosteroid therapy in COVID-19 patients.

    COVID-19 Comorbidity and Metabolic Syndrome MESHD: Is There a Molecular Basis?

    Authors: Madhurima Basu; Chinmay Saha; Kamalika Roy Choudhury; Susmita Dutta; Sujoy Ghosh; Subhankar Chowdhury; Satinath Mukhopadhyay; Nitai P. Bhattacharyya

    id:10.20944/preprints202006.0245.v1 Date: 2020-06-21 Source: Preprints.org

    The risk factors associated with COVID-19 related severity, morbidity, and mortality, i.e., obesity MESHD obesity HP (often associated with NAFLD), hyperglycemia MESHD hyperglycemia HP, hypertension MESHD hypertension HP and dyslipidemia all cluster together as metabolic syndrome MESHD (MetS). Instead of studying association of these risk factors with COVID-19, it makes sense studying the association between MetS on one hand and COVID-19 on the other. This study explores a molecular basis underpinning the above association. Severity of COVID-19 patients with MetS could be due to functional alterations of host proteins due to their interactions with viral proteins. We collected data from Enrichr (https://amp.pharm.mssm.edu/Enrichr/), DisGeNET (https://www.disgenet.org/) and others and carried out enrichment analysis using Enrichr. Various biological processes and pathways associated with viral protein interacting partners are known to involve in metabolic diseases MESHD. The molecular pathways underlying insulin resistance MESHD insulin resistance HP, insulin signaling and insulin secretion are not only involved in diabetes but also in CVD and obesity MESHD obesity HP (associated with non-alcoholic fatty liver disease MESHD; NAFLD). Lipid metabolism/lipogenesis, fatty acid oxidation and inflammation MESHD are associated with MetS. Viral interacting host proteins are associated and enriched with terms like hyperglycemia MESHD hyperglycemia HP, coronary artery disease MESHD, hypertensive disease MESHD related to CVD and liver diseases MESHD in DisGeNET. Association of viral interacting proteins with disease MESHD-relevant biological processes, pathways and disease MESHD-related terms suggests that altered host protein function following interaction with viral proteins might contribute to frequent occurrence and/or severity of COVID-19 in subjects with MetS. Such analysis not only provides a molecular basis of comorbidity but also incriminates host proteins in viral replication, growth and identifies possible drug targets for intervention.

The ZB MED preprint Viewer preVIEW includes all COVID-19 related preprints from medRxiv and bioRxiv, from ChemRxiv, from ResearchSquare, from arXiv and from Preprints.org and is updated on a daily basis (7am CET/CEST).

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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