Corpus overview


Overview

MeSH Disease

Human Phenotype

Hypertension (15)

Fever (8)

Cough (8)

Fatigue (7)

Obesity (7)


Transmission

Seroprevalence
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    Outcomes of COVID-19 related hospitalisation among people with HIV in the ISARIC WHO Clinical Characterisation Protocol UK Protocol: prospective observational study

    Authors: Anna Maria Geretti; Alexander Stockdale; Sophie Kelly; Muge Cevik; Simon Collins; Laura Waters; Giovanni Villa; Annemarie B Docherty; Ewen M Harrison; Lance Turtle; Peter JM Openshaw; Kenneth Baillie; Caroline Sabin; Malcolm Gracie Semple

    doi:10.1101/2020.08.07.20170449 Date: 2020-08-11 Source: medRxiv

    Background. There is conflicting evidence about how HIV infection MESHD influences COVID-19. We compared the presentation characteristics and outcomes of people with and without HIV hospitalised with COVID-19 at 207 centres across the United Kingdom. Methods. We analysed data from people with laboratory confirmed or highly likely COVID-19 enrolled into the ISARIC CCP-UK study. The primary endpoint was day-28 mortality after presentation. We used Kaplan-Meier methods and Cox regression to describe the association with HIV status after adjustment for sex, ethnicity, age TRANS, indeterminate/probable hospital acquisition of COVID-19 (definite hospital acquisition excluded), presentation date, and presence/absence of ten comorbidities. We additionally adjusted for disease MESHD severity at presentation as defined by hypoxia MESHD/oxygen therapy. Findings. Among 47,539 patients, 115 (0.24%) had confirmed HIV-positive status and 103/115 (89.6%) had a record of antiretroviral therapy. At presentation, relative to the HIV-negative group, HIV-positive people were younger (median 55 versus 74 years; p<0.001), had a higher prevalence SERO of obesity MESHD obesity HP and moderate/severe liver disease MESHD, higher lymphocyte counts and C-reactive protein, and more systemic symptoms. The cumulative incidence of day-28 mortality was 25.2% in the HIV-positive group versus 32.1% in the HIV-negative group (p=0.12); however, stratification for age TRANS revealed a higher mortality among HIV-positive people aged TRANS below 60 years. The effect of HIV-positive status was confirmed in adjusted analyses (adjusted hazard ratio [HR] 1.49, 95% confidence interval [CI] 0.99-2.25; p=0.06). Following additional adjustment for disease MESHD severity at presentation, mortality was higher in HIV-positive people (adjusted HR 1.63; 95% CI 1.07-2.48; p=0.02). In the HIV-positive group, mortality was more common among those who were slightly older and among people with obesity MESHD obesity HP and diabetes with complications MESHD. Interpretation. HIV-positive status may be associated with an increased risk of day-28 mortality following a COVID-19 related hospitalisation.

    Effects of COVID-19 on the Gut and the Liver - A Case Series of 711 Patients in New York City

    Authors: Sher Nazir Baig, MD; Fuad Abaleka, MD; Stephanie Herrera, MD; Mina Daniel, MD; Bisrat Nigusse, MD; Thu M Vu, MD; Tigist Gemechu, MD; George Abdelsayed, MD, FACG

    doi:10.21203/rs.3.rs-55080/v1 Date: 2020-08-06 Source: ResearchSquare

    Background As the COVID-19 epidemic is wreaking havoc with a staggering number of infections MESHD and fatalities worldwide, digestive symptoms are increasingly coming to the limelight. However, the data on the extent of gut and liver involvement has been variable and somewhat conflicting.Methods We identified 711 adults TRANS who had tested positive for COVID-19 at Richmond University Medical Center in New York between March 13 and May 13, 2020. We analyzed their clinical and laboratory data from electronic medical records.Results The average age TRANS of the patients was 60.5 years; 55% were men. 27.1% reported a gastrointestinal (GI) symptom and 56.9% had at least one abnormal liver enzyme. The most common was diarrhea MESHD diarrhea HP with a frequency of 17.3% followed by nausea MESHD nausea HP 16.2% and vomiting MESHD vomiting HP/ anorexia MESHD anorexia HP 13.7%. Abdominal pain MESHD Abdominal pain HP 5.6%, dysgeusia MESHD 3.2%, and GI bleeding 2.2% was the least common. Symptoms were mostly mild and lasted 3-5 days. The liver function was deranged in more than half of the patients. AST alone was elevated in 16.6%, both AST/ALT 15.7%, alkaline phosphatase 23%, and bilirubin 10%. Potential confounders were rare but included preexisting liver disease MESHD and hepatotoxic medications. Prothrombin time (PT) was mildly elevated in 13.4%. The lipase was elevated in 2.4% without upper abdominal pain MESHD abdominal pain HP. In 75%-90% of cases, liver test abnormalities were mild (1.5-3 x normal). Overall, 86.6% of patients were admitted primarily with respiratory failure HP and 28.5% died of their illness.Conclusions 27% of COVID-19 patients experienced a digestive disturbance and >55% showed a predominantly mild degree of liver dysfunction and cholestasis MESHD cholestasis HP.

    Impact of comorbidity burden on mortality in patients with COVID-19: a retrospective analysis of the Korean health insurance database

    Authors: Soo Ick Cho; Susie Yoon; Ho-Jin Lee

    doi:10.21203/rs.3.rs-54298/v1 Date: 2020-08-05 Source: ResearchSquare

    We aimed to investigate the impact of comorbidity burden on mortality in patients with COVID-19. We analyzed the COVID-19 data from the nationwide health insurance claims of South Korea. Data on demographic characteristics, comorbidities, and mortality records of patients with COVID-19 were extracted from the database. The odds ratios of mortality according to comorbidities in patients with COVID-19 with and without adjustment for age TRANS and sex were calculated. The predictive value of the original Charlson comorbidity index (CCI) and the age TRANS-adjusted CCI (ACCI) for mortality in patients with COVID-19 were investigated using the receiver operating characteristic (ROC) curve analysis. Among 7,590 patients with COVID-19, 227 (3.0%) had died. After age TRANS and sex adjustment, hypertension MESHD hypertension HP, diabetes mellitus MESHD diabetes mellitus HP, congestive heart failure HP heart failure MESHD, dementia MESHD dementia HP, chronic pulmonary disease, liver MESHD, renal, and cancer were significant risk factors for mortality. The ROC curve analysis showed that ACCI threshold ≥4 yielded the best cut-off point for predicting mortality (area under the ROC 0.92; 95% CI, 0.91–0.94). Our study revealed multiple risk factors that were associated with mortality in patients with COVID-19. The high predictive power of the ACCI for mortality in our results could support the importance of old age TRANS and comorbidities in the severity of COVID-19.

    Respiratory viral infections MESHD by Non-influenza viruses are associated with more adverse clinical outcome in patients with underlying liver disease MESHD: a single centre laboratory based study.

    Authors: Ekta Gupta; Abhishek Padhi; Kavita Agarwal; Krithiga Ramachandran; Reshu Aggarwal; Samba Siva Rao Pasupuleti; Debajyoti Bhattacharyya; Rakhi Maiwall; Shiv Kumar Sarin

    doi:10.1101/2020.08.01.20166330 Date: 2020-08-04 Source: medRxiv

    Background Respiratory viral infections MESHD are an important cause of acute respiratory tract infections MESHD respiratory tract infections HP. They are caused by both Influenza and non influenza viruses. Respiratory viral infections MESHD are known to be associated with severe clinical outcome especially in the critically ill. A constant surveillance is needed for early etiological identification which can help in timely and appropriate management and will further help in prevention of indiscriminate use of antibiotics in patients with viral etiology. Methods In this retrospective study, clinical records of all adult TRANS liver disease MESHD patients with clinically confirmed ARI, whose request for respiratory viral testing were received in the virology laboratory during September 2016 - March 2019 were reviewed. Respiratory viruses were identified by real time PCR on FilmArray 2.0 instrument (BioFire Diagnostics, Utah, USA) using Respiratory panel as per the manufacturer's instructions. Results Of the 603 patients of liver disease MESHD with clinically confirmed influenza like illness, over all incidence of respiratory viral infection MESHD was 24.3% (n= 147). Infections MESHD by non-influenza viruses (87, 59.1%) were more than influenza group of viruses. Mortality was higher in non influenza group (43, 49.4%) as compared to influenza (24, 40%) [p=0.015] being maximum in Rhinovirus, 22 (32.8%). Two peaks were observed in both influenza and non influenza groups, first in the months of January and February and the other one in August and October. Conclusion With the emergence of SARS- CoV-2 it has now become imperative for a constant surveillance of the non influenza viruses for early etiological identification of the respiratory viral infection MESHD for proper and timely management in the critically ill.

    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.

    Understanding the patterns of repeated testing for COVID-19: Association with patient characteristics and outcomes

    Authors: Stephen Salerno; Zhangchen Zhao; Swaraaj Prabhu Sankar; Maxwell Salvatore; Tian Gu; Lars G. Fritsche; Seunggeun Lee; Lynda D Lisabeth; Thomas S Valley; Bhramar Mukherjee

    doi:10.1101/2020.07.26.20162453 Date: 2020-07-29 Source: medRxiv

    Importance The diagnostic tests for COVID-19 have a high false negative rate, but not everyone with an initial negative result is re-tested. Michigan Medicine, being one of the primary regional centers accepting COVID-19 cases, provided an ideal setting for studying COVID-19 repeated testing patterns during the first wave of the pandemic. Objective To identify the characteristics of patients who underwent repeated testing for COVID-19 and determine if repeated testing was associated with patient characteristics and with downstream outcomes among positive cases. Design This cross-sectional study described the pattern of testing for COVID-19 at Michigan Medicine. The main hypothesis under consideration is whether patient characteristics differed between those tested once and those who underwent multiple tests. We then restrict our attention to those that had at least one positive test and study repeated testing patterns in patients with severe COVID-19 related outcomes (testing positive, hospitalization and ICU care). Setting Demographic and clinical characteristics, test results, and health outcomes for 15,920 patients presenting to Michigan Medicine between March 10 and June 4, 2020 for a diagnostic test for COVID-19 were collected from their electronic medical records on June 24, 2020. Data on the number and types of tests administered to a given patient, as well as the sequences of patient-specific test results were derived from records of patient laboratory results. Participants Anyone tested between March 10 and June 4, 2020 at Michigan Medicine with a diagnostic test for COVID-19 in their Electronic Health Records were included in our analysis. Exposures Comparison of repeated testing across patient demographics, clinical characteristics, and patient outcomes Main Outcomes and Measures Whether patients underwent repeated diagnostic testing for SARS CoV-2 in Michigan Medicine Results Between March 10th and June 4th, 19,540 tests were ordered for 15,920 patients, with most patients only tested once (13596, 85.4%) and never testing positive (14753, 92.7%). There were 5 patients who got tested 10 or more times and there were substantial variations in test results within a patient. After fully adjusting for patient and neighborhood socioeconomic status (NSES) and demographic characteristics, patients with circulatory diseases MESHD (OR: 1.42; 95% CI: (1.18, 1.72)), any cancer (OR: 1.14; 95% CI: (1.01, 1.29)), Type 2 diabetes (OR: 1.22; 95% CI: (1.06, 1.39)), kidney diseases MESHD (OR: 1.95; 95% CI: (1.71, 2.23)), and liver diseases MESHD (OR: 1.30; 95% CI: (1.11, 1.50)) were found to have higher odds of undergoing repeated testing when compared to those without. Additionally, as compared to non-Hispanic whites, non-Hispanic blacks were found to have higher odds (OR: 1.21; 95% CI: (1.03, 1.43)) of receiving additional testing. Females TRANS were found to have lower odds (OR: 0.86; 95% CI: (0.76, 0.96)) of receiving additional testing than males TRANS. Neighborhood poverty level also affected whether to receive additional testing. For 1% increase in proportion of population with annual income below the federal poverty level, the odds ratio of receiving repeated testing is 1.01 (OR: 1.01; 95% CI: (1.00, 1.01)). Focusing on only those 1167 patients with at least one positive result in their full testing history, patient age TRANS in years (OR: 1.01; 95% CI: (1.00, 1.03)), prior history of kidney diseases MESHD (OR: 2.15; 95% CI: (1.36, 3.41)) remained significantly different between patients who underwent repeated testing and those who did not. After adjusting for both patient demographic factors and NSES, hospitalization (OR: 7.44; 95% CI: (4.92, 11.41)) and ICU-level care (OR: 6.97; 95% CI: (4.48, 10.98)) were significantly associated with repeated testing. Of these 1167 patients, 306 got repeated testing and 1118 tests were done on these 306 patients, of which 810 (72.5%) were done during inpatient stays, substantiating that most repeated tests for test positive patients were done during hospitalization or ICU care. Additionally, using repeated testing data we estimate the "real world" false negative rate of the RT-PCR diagnostic test was 23.8% (95% CI: (19.5%, 28.5%)). Conclusions and Relevance This study sought to quantify the pattern of repeated testing for COVID-19 at Michigan Medicine. While most patients were tested once and received a negative result, a meaningful subset of patients (2324, 14.6% of the population who got tested) underwent multiple rounds of testing (5,944 tests were done in total on these 2324 patients, with an average of 2.6 tests per person), with 10 or more tests for five patients. Both hospitalizations and ICU care differed significantly between patients who underwent repeated testing versus those only tested once as expected. These results shed light on testing patterns and have important implications for understanding the variation of repeated testing results within and between patients.

    Complex Immuno-metabolic Profiling Reveals Activation of Cellular Immunity and Biliary Lesion in Patients with Severe COVID-19

    Authors: Adam Klocperk; Marketa Bloomfield; Zuzana Parackova; Irena Zentsova; Petra Vrabcova; Jan Balko; Grigorij Meseznikov; Luis Fernando Casas Mendez; Alzbeta Grandcourtova; Jan Sipek; Martin Tulach; Josef Zamecnik; Tomas Vymazal; Anna Sediva

    id:10.20944/preprints202007.0596.v1 Date: 2020-07-24 Source: Preprints.org

    The aim of this study was to assess the key laboratory features displayed by coronavirus disease MESHD 2019 (COVID-19) inpatients which associated with mild, moderate, severe and fatal course of the disease MESHD and, through longitudinal follow-up, to understand the dynamics of COVID-19 pathophysiology. All SARS-CoV-2 positive patients admitted to the University Hospital in Motol between March and June 2020 were included in this study. Severe course of COVID-19 was associated with elevation of proinflammatory markers, efflux of immature granulocytes into peripheral blood SERO, activation of CD8 T cells, which infiltrate lungs, and transient liver disease MESHD. In particular, the elevation of serum SERO gamma-glutamyl transferase (GGT) and histological signs of cholestasis MESHD cholestasis HP were highly specific for patients with severe disease MESHD. In contrast, patients with fatal course of COVID-19 failed to upregulate markers of inflammation MESHD, showed dyscoordination of immune response and progressed towards acute kidney failure. COVID-19 is a disease MESHD with multi-organ affinity characterized by activation of innate and cellular adaptive immunity. Biliary lesion with elevation of GGT and organ-infiltration of IL-6 producing cells are defining characteristic for patients with fulminant disease MESHD.

    Dynamic changes of liver function parameters in patients with coronavirus disease MESHD 2019: A multicenter, retrospective study

    Authors: Qing-Lei Zeng; Zu-Jiang Yu; Fanpu Ji; Guang-Ming Li; Guo-Fan Zhang; Jiang-Hai Xu; Wan-Bao Lin; Guo-Qiang Zhang; Guo-Tao Li; Guang-Lin Cui; Fu-Sheng Wang

    doi:10.21203/rs.3.rs-48131/v1 Date: 2020-07-23 Source: ResearchSquare

    Background: Liver injuries in patients with coronavirus disease MESHD 2019 (COVID-19) have been reported, however, the clinical role played by severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) is obscure.  Methods: In this multicenter, retrospective study, the parameters of liver function tests in COVID-19 inpatients were compared between various timepoints referred to SARS-CoV-2 shedding, and 3 to 7 days before first detection of viral shedding was regarded as reference baseline.Results: Totally, 70 COVID-19 inpatients were enrolled. Twenty-two (31.4%) cases had self-medications history after illness. At baseline, 10 (14.3%), 7 (10%), 9 (12.9%), 2 (2.9%), 15 (21.4%), and 4 (5.7%) patients already had abnormal rates of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), alkaline phosphatase (ALP), albumin, and total bilirubin (TBIL), respectively. ALT and AST abnormal rates and levels did not show any significantly dynamic change during the full period of viral shedding (all P > 0.05). GGT abnormal rate (P = 0.008) and level (P = 0.033) significantly increased on day 10 of viral shedding. Meanwhile, no simultaneously significant increases of ALP abnormal rates and levels were observed. TBIL abnormal rates and levels significantly increased on day 1 and 5 of viral shedding (all P < 0.05). Albumin abnormal decrease rates increased and levels decreased consistently from baseline to SARS-CoV-2 clearance day (all P < 0.05). Thirteen (18.6%) patients had chronic liver diseases MESHD, two of them died. The ALT and AST abnormal rates and levels did not increase in patients with chronic liver diseases MESHD during SARS-CoV-2 shedding.Conclusions: The SARS-CoV-2 does not directly lead to elevations of ALT and AST, but may result in elevations of GGT and TBIL, the albumin decreased extraordinarily even SARS-CoV-2 shedding discontinued.

    The Pattern of Liver Dysfunction in Patients with COVID-19: A Retrospective Study

    Authors: Chunyan wang; Yihui Rong; Lei Wei; Huanwei Zheng; Jing Xu; Xiaoxia Niu; Dong Ji

    doi:10.21203/rs.3.rs-42863/v1 Date: 2020-07-14 Source: ResearchSquare

    Background. Information about liver dysfunction in patients with COVID-19 is scarce. We aimed to explored the pattern and risk factors of liver dysfunction in patients with COVID-19.Methods. In this retrospective study, we included all consecutive confirmed patients with COVID-19 in Fuyang Second People’s Hospital between January 20 and February 25, 2020 and collected clinical characteristics until discharge. The pattern and risk factors of liver dysfunction, viral shedding and outcome were analyzed.Results. Totally, 146 patients were analyzed. The median age TRANS was 44.9 years and 54.1% were men, 43.8% patients presented liver dysfunction (22.6% on admission, 21.2% during hospitalization). The percentage of elevated ALT (15.1% on admission and 24.7% during hospitalization) were significantly higher than ALP (2.1% on admission and 3.4% during hospitalization) (P < 0.001). Four clinical types were identified, type 1 (persistent normal liver function, 56.2%), type 2 (normal liver function on admission developed to liver dysfunction during hospitalization, 21.2%), type 3 (liver dysfunction on admission restored to normal on discharge, 13.0%) and type 4 (persistent liver dysfunction, 9.6%). The median duration of viral shedding was 12.0 (type 1), 15.0 (type 2), 14.0 (type 3) and 18.0 (type 4) days (P < 0.001). Prolonged viral shedding and severity were potential risk factors associated with liver dysfunction. Conclusions. The incidence of liver dysfunction in patients with COVID-19 is common but not severe, which mainly due to SARS-CoV-2-mediated immune injury on hepatocyte rather than cholangiocyte, DILI and underlying chronic liver disease MESHD should not be neglect. 

    Risk Factors Prediction, Clinical Outcomes, and Mortality of COVID-19 Patients

    Authors: Roohallah Alizadehsani; Zahra Alizadeh sani; Mohaddeseh Behjati; Zahra Roshanzamir; Sadiq Hussain; Niloofar Abedini; Fereshteh Hasanzadeh; Abbas Khosravi; Afshin Shoeibi; Mohamad Roshanzamir; Pardis Moradnejad; Saeid Nahavandi; Fahime Khozeimeh; Assef Zare; Maryam Panahiazar; U. Rajendra Acharya; Sheikh Mohammed Shariful Islam

    doi:10.1101/2020.07.07.20148569 Date: 2020-07-09 Source: medRxiv

    Background: Preventing communicable diseases MESHD requires understanding the spread, epidemiology, clinical features, progression, and prognosis of the disease MESHD. Early identification of risk factors and clinical outcomes might help to identify critically ill patients, provide proper treatment and prevent mortality. Methods: We conducted a prospective study in patients with flu-like symptoms referred to the imaging department of a tertiary hospital in IRAN between 3 March 2020 and 8 April 2020. Patients with COVID-19 were followed up to check their health condition after two months. The categorical data between groups were analyzed by Fisher exact test and continuous data by Wilcoxon Rank-Sum Test. Findings: 319 patients (mean age TRANS 45.48 years, 177 women) were enrolled. Fever MESHD Fever HP, dyspnea MESHD dyspnea HP, weakness, shivering HP, C-reactive protein (CRP), fatigue MESHD fatigue HP, dry cough MESHD cough HP, anorexia MESHD anorexia HP, anosmia HP, ageusia MESHD, dizziness MESHD, sweating and age TRANS were the most important symptoms of COVID-19 infection MESHD. Traveling TRANS in past three months, asthma MESHD asthma HP, taking corticosteroids, liver disease MESHD, rheumatological disease MESHD, cough MESHD cough HP with sputum, eczema MESHD eczema HP, conjunctivitis MESHD conjunctivitis HP, tobacco use, and chest pain MESHD chest pain HP did not have any relationship with COVID-19. Interpretation: Finding clinical symptoms for early diagnosis of COVID-19 is a critical part of prevention. These symptoms can help in the assessment of disease progression MESHD. To the best of our knowledge, some of the effective features on the mortality due to COVID-19 are investigated for the first time in this research. Funding: None

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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