Corpus overview


MeSH Disease

Human Phenotype


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    Possible Cross-Reactivity Between SARS-CoV-2 Proteins, CRM197 and Proteins in Pneumococcal Vaccines May Protect Against Symptomatic SARS-CoV-2 Disease MESHD and Death MESHD

    Authors: Robert Root-Bernstein

    id:10.20944/preprints202007.0141.v2 Date: 2020-08-04 Source:

    Various studies indicate that vaccination, especially with pneumococcal vaccines, protects against symptomatic cases of SARS-CoV-2 infection MESHD and death MESHD. This paper explores the possibility that pneumococcal vaccines in particular, but perhaps other vaccines as well, contain antigens that might be cross-reactive with SARS-CoV-2 antigens. Comparison of the glycosylation structures of SARS-CoV-2 with the polysaccharide structures of pneumococcal vaccines yielded no obvious similarities. However, while pneumococcal vaccines are primarily composed of capsular polysaccharides, some are conjugated to CRM197, a modified diphtheria MESHD toxin, and all contain about three percent protein contaminants, including the pneumococcal surface proteins PsaA, PspA and probably PspC. All of these proteins have very high degrees of similarity, using very stringent criteria, with several SARS-CoV-2 proteins including the spike protein, membrane protein and replicase 1a. CRM197 is also present in Hib and meningitis MESHD meningitis HP vaccines. Equivalent similarities were found at statistically significantly lower rates, or were completely absent, among the proteins in diphtheria MESHD, tetanus MESHD, pertussis, measles MESHD, mumps MESHD, rubella MESHD, and poliovirus vaccines. Notably, PspA and PspC are highly antigenic and new pneumococcal vaccines based on them are currently in human clinical trials so that their effectiveness against SARS-CoV-2 disease MESHD is easily testable.

    Neurological manifestations associated with COVID-19: a nationwide registry

    Authors: Elodie Meppiel; Nathan Peiffer-Smadja; Alexandra Maury; Imen Bekri; Cecile Delorme; Virginie Desestret; Lucas Gorza; Geoffroy Hautecloque-Raysz; Sophie Landre; Annie Lannuzel; Solene Moulin; Peggy Perrin; Paul Petitgas; Francois Sellal; Adrien Wang; Pierre Tattevin; Thomas de Broucker; - contributors to the NeuroCOVID registry

    doi:10.1101/2020.07.15.20154260 Date: 2020-07-16 Source: medRxiv

    Background: The clinical description of the neurological manifestations in COVID-19 patients is still underway. This study aims to provide an overview of the spectrum, characteristics and outcomes of neurological manifestations associated with SARS-CoV-2 infection MESHD. Methods: We conducted a nationwide, multicentric, retrospective study during the French COVID-19 epidemic in March-April 2020. All COVID-19 patients with de novo neurological manifestations were eligible. Results: We included 222 COVID-19 patients with neurological manifestations from 46 centers throughout the country. Median age TRANS was 65 years (IQR 53-72), and 136 patients (61.3%) were male TRANS. COVID-19 was severe or critical in almost half of the patients (102, 45.2%). The most common neurological diseases MESHD were COVID-19 associated encephalopathy HP (67/222, 30.2%), acute ischemic cerebrovascular syndrome MESHD (57/222, 25.7%), encephalitis MESHD encephalitis HP (21/222, 9.5%), and Guillain-Barre Syndrome MESHD (15/222, 6.8%). Neurological manifestations appeared after first COVID-19 symptoms with a median (IQR) delay of 6 (3-8) days in COVID-19 associated encephalopathy HP, 7 (5-10) days in encephalitis MESHD encephalitis HP, 12 (7-18) days in acute ischemic cerebrovascular syndrome MESHD and 18 (15-28) days in Guillain-Barre Syndrome MESHD. Brain imaging was performed in 192 patients (86.5%), including 157 MRI (70.7%). Brain MRI of encephalitis MESHD encephalitis HP patients showed heterogeneous acute non vascular lesion in 14/21 patients (66.7%) with associated small ischemic lesion or microhemorrhages in 4 patients. Among patients with acute ischemic cerebrovascular syndrome MESHD, 13/57 (22.8%) had multi territory ischemic strokes HP strokes MESHD, with large vessel thrombosis MESHD in 16/57 (28.1%). Cerebrospinal fluid was analyzed in 97 patients (43.7%), with pleocytosis in 18 patients (18.6%). A SARS-CoV-2 PCR was performed in 75 patients and was positive only in 2 encephalitis MESHD encephalitis HP patients. Among patients with encephalitis MESHD encephalitis HP, ten out of 21 (47.6%) fully recovered, 3 of whom received corticosteroids (CS). Less common neurological manifestations included isolated seizure MESHD seizure HP (8/222, 3.6%), critical illness MESHD neuropathy (8/222, 3.6%), transient alteration of consciousness (5/222, 2.3%), intracranial hemorrhage MESHD intracranial hemorrhage HP (5/222, 2.3%), acute benign lymphocytic meningitis MESHD meningitis HP (3/222, 1.4%), cranial neuropathy (3/222, 1.4%), single acute demyelinating lesion (2/222, 0.9%), Tapia syndrome MESHD (2/222, 0.9%), cerebral venous thrombosis HP venous thrombosis MESHD (1/222, 0.5%), sudden paraparesis MESHD paraparesis HP (1/222, 0.5%), generalized myoclonus MESHD myoclonus HP and cerebellar ataxia MESHD ataxia HP (1/222, 0.5%), bilateral fibular palsy (1/222, 0.5%) and isolated neurological symptoms ( headache MESHD headache HP, anosmia HP, dizziness MESHD, sensitive or auditive symptoms, hiccups MESHD, 15/222, 6.8%). The median (IQR) follow-up of the 222 patients was 24 (17-34) days with a high short-term mortality rate (28/222, 12.6%). Conclusion: Neurological manifestations associated with COVID-19 mainly included CAE, AICS, encephalitis MESHD encephalitis HP and GBS. Clinical spectrum and outcomes were broad and heterogeneous, suggesting different underlying pathogenic processes.

    COVID-19 Infected Woman with Tuberculous Meningitis MESHD Meningitis HP: A Case Report

    Authors: Mahshid Nadershahbaz; Reza Bidaki; Saeid Azimi; fatemeh saghafi

    doi:10.21203/ Date: 2020-06-29 Source: ResearchSquare

    Background: Several factors have been reported for COVID-19 disease MESHD. In addition, patients with COVID-19 are also susceptible to suffer from other problems. In this study, a case suffering from TB meningitis MESHD meningitis HP is reported to have developed COVID-19 disease MESHD, eventually showing symptoms of psychological disorders.Case presentation: A young Afghan woman was hospitalized with TB meningitis MESHD meningitis HP who did not respond to treatment. After a while, she was hospitalized again with diagnosis of COVID-19. The patient showed symptoms of postpartum depression MESHD and anxiety HP. She also had pseudoseizure attacks several times, so antidepressants and anti- anxiety HP medications were started for the patient In order to treat conversion disorder and panic disorders.Conclusion: Tuberculous meningitis MESHD meningitis HP, postpartum depression MESHD and other factors can increase the risk of COVID-19 infection MESHD leading to psychological disorders like conversion disorder in susceptible.

    nCoV-2019 infection MESHD induces neurological outcome and manifestation, linking its historical ancestor SARS-CoV & MERS-CoV: A systematic review and meta-analysis

    Authors: Ajay Prakash; Harvinder Singh; Phulen Sarma; Anusuya Bhattacharyya; Deba Prasad Dhibar; Neeraj Balaini; Ritu Shree; Manoj Goyal; Manish Modi; BIKASH MEDHI

    doi:10.21203/ Date: 2020-06-15 Source: ResearchSquare

    Importance: The first systematic review and meta-analysis to help clinician to identify early the sign and symptoms MESHD of neurological manifestation in COVID-19 positive patients which further help in early management of patients. Objective: Present systematic review and meta-analysis aimed to discuss the prevalence SERO of neurological involvement of the 2019-nCoV patients and assess the symptomatic trend of events as compared to the 2002 “SARS” and 2012 “MERS” pandemics.Methods: The articles were systematically screened through several search engine and databases. The articles published or in preprint were included in the study till 15th May 2020. The systematic review done as per the published literatures which included 31 cross sectional, observational studies and case reports which revealed neural sign and symptoms MESHD in SARS-COV-2 disease MESHD. For meta-analysis, we included 09 observational and cross sectional studies which included COVID-19 positive patients and assessed the predominance of various neurological sign and symptoms MESHD in COVID-19 patients relation to SARS-2002 and MERS-2012. Data were analyzed by using the “MedCalc Statistical Software version 19.2.6 and reported as pooled prevalence SERO. Heterogeneity was investigated (standard I2 test).  Results: We have collected and screened about a total 2615 articles, finally we have included 31 articles for the systematic review and 09 for meta-analysis as per the inclusion/exclusion criteria. The analysis was made as per the prevalence SERO rate of neurological symptoms during the COVID-19 positive patients. The cumulative neurological outcome of SARS-2002 and MERS-2012 was assessed to get the trends which is next tried to correlate the events with the current pandemic. During the analysis severity and outcome of neurological manifestations range from simple headache MESHD headache HP to vague non-focal complaints to severe neurologic impairment associated with seizure MESHD seizure HP or meningitis MESHD meningitis HP.Conclusion & Relevance: Central and peripheral nervous system (CNS/PNS) manifestations were seen during the SARS-2002, MERS-2012 and COVID-19. However, none of the publication found with the primary or secondary objective of finding the neurological manifestation in the COVID-19 patients and their mechanism which strengthen the importance to start more precise clinical trials.

    Assessment of Experiences of Preventive Measures Practice including Vaccination History and Health Education among Umrah Pilgrims in Saudi Arabia, 1440H-2019

    Authors: Mansour Tobaiqy; Sami S Almudarra; Manal M Shams; Samar A Amer; Mohamed F Alcattan; Ahmed H Alhasan

    doi:10.1101/2020.06.09.20126581 Date: 2020-06-11 Source: medRxiv

    Background Annually, approximately 10 million Umrah pilgrims travel TRANS to the Kingdom of Saudi Arabia for Umrah from more than 180 countries. This event presents major challenges for the Kingdom public health sector, which strives to decrease the burden of infectious diseases MESHD and to adequately control its spread. Aims of the study The aims of the study were to assess the experiences of preventive measures practice, including vaccination history and health education, among Umrah pilgrims in Saudi Arabia. Methods A cross sectional survey administered to a randomly selected group of pilgrims by the research team members from February to the end of April 2019 at the departure lounge at King Abdul Aziz International airport, Jeddah city. The questionnaire was comprised of questions on the following factors: sociodemographic information, level of education, history of vaccinations and chronic illnesses, whether the pilgrim has received any health education and orientation prior to coming Saudi Arabia or on their arrival, and their experiences with preventive medicine. Results Pilgrims (n=1012) of 48 nationalities completed the survey and were reported in this study. Chronic diseases MESHD (n=230) were reported among pilgrims, with hypertension MESHD hypertension HP being the most reported morbidity (n=124, 53.9%). The majority of pilgrims had taken immunization prior to travel TRANS to Saudi Arabia, and the most commonly reported immunizations were meningitis MESHD meningitis HP (n=567, 56%), influenza (n=460, 45.5%), and Hepatitis B MESHD Hepatitis HP virus vaccinations (n=324, 32%); however, 223(22%) had not received any vaccinations prior to travel TRANS, including meningitis MESHD meningitis HP vaccine, which is mandatory in Saudi Arabia. 305 pilgrims (30.1%) had reported never using face masks in crowded areas; however, 63.2% reported lack of availability of these masks. The majority of participants had received health education on preventive measures, including hygienic aspects (n=799, 78.9%) mostly in their home countries (n=450, 56.3%). A positive association was found between receiving health education and practicing of preventive measures, such as wearing masks in crowded areas (P= 0.04) and other health practice scores (P= 0.02). Conclusion Although the experiences of the preventive measures among pilgrims in terms of health education, vaccinations, and hygienic practices were overall positive, this study identified several issues with the following preventive measures: immunizations particularly meningitis MESHD meningitis HP vaccine and using face masks in crowded areas. Further studies are required to develop a health education module to promote comprehensive preventive measures for pilgrims. Keywords Umrah, pilgrims, personal preventive measures, COVID-19, Makkah, Saudi Arabia

    Benefit-risk analysis of health benefits of routine childhood immunisation against the excess risk of SARS-CoV-2 infections MESHD during the Covid-19 pandemic in Africa

    Authors: Kaja Abbas; Simon R Procter; Kevin van Zandvoort; Andrew Clark; Sebastian Funk; - LSHTM CMMID Covid-19 Working Group; Tewodaj Mengistu; Dan Hogan; Emily Dansereau; Mark Jit; Stefan Flasche

    doi:10.1101/2020.05.19.20106278 Date: 2020-05-26 Source: medRxiv

    Background: National immunisation programmes globally are at risk of suspension due to the severe health system constraints and physical distancing measures in place to mitigate the ongoing COVID-19 pandemic. Our aim is to compare the health benefits of sustaining routine childhood immunisation in Africa against the risk of acquiring SARS-CoV-2 infections MESHD through visiting routine vaccination service delivery points. Methods: We used two scenarios to approximate the child TRANS deaths MESHD that may be caused by immunisation coverage reductions during COVID-19 outbreaks. First, we used previously reported country-specific child TRANS mortality impact estimates of childhood immunisation for diphtheria MESHD, tetanus MESHD, pertussis, hepatitis B MESHD hepatitis HP, Haemophilus influenzae type b, pneumococcal, rotavirus, measles MESHD, meningitis MESHD meningitis HP A, rubella MESHD, and yellow fever MESHD fever HP (DTP3, HepB3, Hib3, PCV3, RotaC, MCV1, MCV2, MenA, RCV, YFV) to approximate the future deaths MESHD averted before completing five years of age TRANS by routine childhood vaccination during a 6-month COVID-19 risk period without catch-up campaigns. Second, we analysed an alternative scenario that approximates the health benefits of sustaining routine childhood immunisation to only the child TRANS deaths MESHD averted from measles MESHD outbreaks during the COVID-19 risk period. The excess number of infections MESHD due to additional SARS-CoV-2 exposure during immunisation visits assumes that contact reducing interventions flatten the outbreak curve during the COVID-19 risk period, that 60% of the population will have been infected by the end of that period, that children TRANS can be infected by either vaccinators or during transport and that upon child TRANS infection MESHD the whole household would be infected. Country specific household age TRANS structure estimates and age TRANS dependent infection MESHD fatality rates are then applied to calculate the number of deaths MESHD attributable to the vaccination clinic visits. We present benefit-risk ratios for routine childhood immunisation alongside 95% uncertainty range estimates from probabilistic sensitivity SERO analysis. Findings: For every one excess COVID-19 death MESHD attributable to SARS-CoV-2 infections MESHD acquired during routine vaccination clinic visits, there could be 84 (14-267) deaths MESHD in children TRANS prevented by sustaining routine childhood immunisation in Africa. The benefit-risk ratio for the vaccinated children TRANS, siblings, parents TRANS or adult TRANS care-givers, and older adults TRANS in the households of vaccinated children TRANS are 85,000 (4,900 - 546,000), 75,000 (4,400 - 483,000), 769 (148 - 2,700), and 96 (14 - 307) respectively. In the alternative scenario that approximates the health benefits to only the child TRANS deaths MESHD averted from measles MESHD outbreaks, the benefit-risk ratio to the households of vaccinated children TRANS is 3 (0 - 10) under these highly conservative assumptions and if the risk to only the vaccinated children TRANS is considered, the benefit-risk ratio is 3,000 (182 - 21,000). Interpretation: Our analysis suggests that the health benefits of deaths MESHD prevented by sustaining routine childhood immunisation in Africa far outweighs the excess risk of COVID-19 deaths MESHD associated with vaccination clinic visits, especially for the vaccinated children TRANS. However, there are other factors that must be considered for strategic decision making to sustain routine childhood immunisation in African countries during the COVID-19 pandemic. These include logistical constraints of vaccine supply chain problems caused by the COVID-19 pandemic, reallocation of immunisation providers to other prioritised health services, healthcare staff shortages caused by SARS-CoV-2 infections MESHD among the staff, decreased demand for vaccination arising from community reluctance to visit vaccination clinics for fear of contracting SARS-CoV-2 infections MESHD, and infection MESHD infection risk TRANS infection risk TRANS risk to healthcare staff providing immunisation services as well as to their households and onward SARS-CoV-2 transmission TRANS into the wider community.

    COVID-19 impact on consecutive neurological patients admitted to the emergency MESHD department

    Authors: Andrea Pilotto; Alberto Benussi; Ilenia Libri; Stefano Masciocchi; Loris Poli; Enrico Premi; Antonella Alberici; Enrico Baldelli; Sonia Bonacina; Laura Brambilla; Matteo Benini; Salvatore Caratozzolo; Matteo Cortinovis; Angelo Costa; Stefano Cotti Piccinelli; Elisabetta Cottini; Viviana Cristillo; Ilenia Delrio; Massimiliano Filosto; Massimo Gamba; Stefano Gazzina; Nicola Gilberti; Stefano Gipponi; Marcello Giunta; Alberto Imarisio; Paolo Liberini; Martina Locatelli; Francesca Schiano Di Cola; Renata Rao; Barbara Risi; Luca Rozzini; Andrea Scalvini; Veronica Vergani; Irene Volonghi; Nicola Zoppi; Barbara Borroni; Mauro Magoni; Matilde Leonardi; Gainluigi Zanusso; Sergio Ferrari; Sara Mariotto; Alessandro Pezzini; Roberto Gasparotti; Ciro Paolillo; Alessandro Padovani

    doi:10.1101/2020.05.23.20110650 Date: 2020-05-26 Source: medRxiv

    Abstract Objective: Aim of this study was to analyse the impact of COVID-19 on clinical and laboratory findings and outcome of neurological patients consecutively admitted to the emergency MESHD department (ED) of a tertiary hub center. Methods: All adult TRANS patients consecutively admitted to the ED for neurological manifestations from February 20 th through April 30 th 2020 at Spedali Civili of Brescia entered the study. Demographic, clinical, and laboratory data were extracted from medical records and compared between patients with and without COVID-19. Results: Out of 505 consecutively patients evaluated at ED with neurological symptoms, 147 (29.1%) tested positive for SARS-CoV-2. These patients displayed at triage higher values of CRP, AST, ALT, and fibrinogen but not lymphopenia MESHD lymphopenia HP (p<0.05). They were older (73.1 + 12.4 vs 65.1 + 18.9 years, p=0.001) had higher frequency of stroke MESHD stroke HP (34.7% vs 29.3%), encephalitis MESHD encephalitis HP/ meningitis MESHD meningitis HP (9.5% vs 1.9%) and delirium MESHD delirium HP (16.3% vs 5.0%). Compared to patients without COVID, they were more frequently hospitalized (91.2% vs 69.3%, p<0.0001) and showed higher mortality rates (29.7% vs 1.8%, p<0.0.001) and discharge disability, independently from age TRANS. Conclusions: COVID-19 impacts on clinical presentation of neurological disorders, with higher frequency of stroke MESHD stroke HP, encephalitis MESHD encephalitis HP and delirium MESHD delirium HP, and was strongly associated with increased hospitalisation, mortality and disability.

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MeSH Disease
Human Phenotype

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