Corpus overview


MeSH Disease

Human Phenotype


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    COVID-19: Role of the Interferons

    Authors: Claudio G. Gallo; Sirio Fiorino; Giovanni Posabella; Donato Antonacci; Antonio Tropeano; Emanuele Pausini; Carlotta Pausini; Tommaso Guarniero; Marco Zancanaro

    id:202008.0018/v1 Date: 2020-08-02 Source:

    COVID-19 disease MESHD, caused by the SARS-CoV2 virus, is a potentially fatal disease MESHD that represents a serious public health and economic problem worldwide. The SARS-CoV2 virus infects the lower respiratory tract and can cause pneumonia MESHD pneumonia HP in humans. ARDS is the leading cause of death MESHD in COVID-19 disease MESHD. One of the main characteristics of ARDS is the cytokine storm, an uncontrolled systemic inflammatory response resulting from the release of pro-inflammatory cytokines and chemokines and growth factors, by immune cells. The other important aspect of the disease MESHD is represented by the involvement of the vascular organ that undergoes endothelitis. Hyperinflammation and endothelitis contribute in various ways to trigger coagulation disorders with diffuse micro thrombotic and thromboembolic phenomena. Lastly, multiple organ failure MESHD may occur (MOF). Since so far there is no approved treatment, there is an urgent need to reposition known treatments, considered safe, to be included in trials. Naturally produced interferons represent the body's first line of defense against viruses. Pharmacological forms, obtained by means of genetic recombination techniques, have long been approved and used to treat numerous pathologies. Interferons are divided into three families, within which some subfamilies are distinguishable. Only IFN-II comprises a single isoform which has completely different aspects and functions. The IFN I and III, however, each comprise different subfamilies (17 subfamilies the IFN-I and 4 subfamilies the IFN-III), share many aspects, representing the body's first antiviral response, but play different roles. The use of IFNs has been studied in two severe hCoV (Human Coronavirus) diseases MESHD, closely related to COVID-19 disease MESHD, such as SARS and MERS. Numerous in vitro and in vivo studies have been conducted, often in combination with other antivirals. The results have been controversial. The positive results in vitro and in experimental animals were often not replicable in humans. The possible positioning of these molecules in the right window of therapeutic opportunity requires that the complex dialogue between IFN, inflammasome, cytokines, pro-inflammatory chemokines, growth factors and barrier function be shed light.

    COVID-19: Role of the Inflammasome

    Authors: Claudio G. Gallo; Sirio Fiorino; Giovanni Posabella; Donato Antonacci; Antonio Tropeano; Emanuele Pausini; Carlotta Pausini; Tommaso Guarniero; Marco Zancanaro

    id:202007.0246/v1 Date: 2020-07-12 Source:

    Covid-19 disease MESHD is caused by SARS Cov-2 virus. Despite its high transmissibility TRANS, the CFR (Case Fatality Rate) of COVID-19 seems to be lower than the SARS (9,5%) and MERS (34,4%) ones93 , but higher than the influenza one (0-1%)94,95 . The disease is asymptomatic MESHD asymptomatic TRANS or paucisymptomatic in most of the patients, although in few cases it can be characterized by serious complications. The main causes of hospitalization in intensive care are represented by ALI ( Acute Lung Injury MESHD), ARDS (Acute Respiratory Distress HP Syndrome MESHD), cardiovascular problems and coagulopathies (diffuse thrombosis MESHD, microthrombosis, embolisms MESHD, myocarditis MESHD myocarditis HP, arrhytmias, heart failure MESHD, stroke MESHD stroke HP)96-98, acute nephropathy99,100 and encephalopathies101. The virus presence in the vascular wall can cause endotheliitis, which triggers the process of diffuse coagulation that can lead to a worsening of the systemic inflammation MESHD. The exaggerated inflammatory response seems to be connected with the development of ARDS, MOF ( Multiple Organ Failure MESHD) and coagulopathies102-107.

    Prognostic factors in patients admitted to an urban teaching hospital with COVID-19 infection MESHD

    Authors: Donogh Maguire; Marylynne Woods; Conor Richards; Ross Dolan; Jesse Wilson Veitch; Wei MJ Sim; Olivia EH Kemmett; David C Milton; Sophie LW Randall; Ly D Bui; Nicola Goldmann; Allan Cameron; Barry Laird; Dinesh Talwar; Ian Godber; Alan Davidson; Donald C McMillan

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

    BackgroundSevere COVID-19 infection MESHD results in a systemic inflammatory response (SIRS). This SIRS response shares similarities to the changes observed during the peri-operative period that are recognised to be associated with the development of multiple organ failure MESHD. MethodsElectronic patient records for patients who were admitted to an urban teaching hospital during the initial 7-week period of the COVID-19 pandemic in Glasgow, U.K. (17th March 2020 - 1st May 2020) were examined for routine clinical, laboratory and clinical outcome data. Age TRANS, sex, BMI and documented evidence of COVID-19 infection MESHD at time of discharge or death MESHD certification were considered minimal criteria for inclusion.ResultsOf the 224 patients who fulfilled the criteria for inclusion, 52 (23%) had died at 30-days following admission. COVID-19 related respiratory failure HP (75%) and multiorgan failure (12%) were the commonest causes of death MESHD recorded. Age TRANS>70 years (p<0.001), past medical history of cognitive impairment HP (p<0.001), previous delirium MESHD delirium HP (p<0.001), clinical frailty MESHD score>3 (p<0.001), hypertension MESHD hypertension HP (p<0.05), heart failure MESHD (p<0.01), national early warning score (NEWS) >4 (p<0.01), positive CXR (p<0.01), and subsequent positive COVID-19 swab (p<0.001) were associated with 30-day mortality. CRP>80 mg/L (p<0.05), albumin <35g/L (p<0.05), peri-operative Glasgow Prognostic Score (poGPS) (p<0.05), lymphocytes <1.5 109/l (p<0.05), neutrophil lymphocyte ratio (p<0.001), haematocrit (<0.40 L/L ( male TRANS) / <0.37 L/L ( female TRANS)) (p<0.01), urea>7.5 mmol/L (p<0.001), creatinine >130 mmol/L (p<0.05) and elevated urea: albumin ratio (<0.001) were also associated with 30-day mortality.On analysis, age TRANS >70 years (O.R. 3.9, 95% C.I. 1.4 – 8.2, p<0.001), past medical history of heart failure MESHD (O.R. 3.3, 95% C.I. 1.2 – 19.3, p<0.05), NEWS >4 (O.R. 2.4, 95% C.I. 1.1 – 4.4, p<0.05), positive initial CXR (O.R. 0.4, 95% C.I. 0.2-0.9, p<0.05) and poGPS (O.R. 2.3, 95% C.I. 1.1 – 4.4, p<0.05) remained independently associated with 30-day mortality. Among those patients who tested PCR COVID-19 positive (n=122), age TRANS >70 years (O.R. 4.7, 95% C.I. 2.0 - 11.3, p<0.001), past medical history of heart failure MESHD (O.R. 4.4, 95% C.I. 1.2 – 20.5, p<0.05) and poGPS (O.R. 2.4, 95% C.I. 1.1- 5.1, p<0.05) remained independently associated with 30-days mortality.ConclusionAge > 70 years and severe systemic inflammation MESHD as measured by the peri-operative Glasgow Prognostic Score are independently associated with 30-day mortality among patients admitted to hospital with COVID-19 infection MESHD.

    Lessons Learned from the Early Stage of Convid-19 Pandemic: Clinical Analysis of 17 Related Deaths MESHD Associated with the 2019 Novel Coronavirus

    Authors: Cheng Zhang; Dandan Hong; Wenyue Chen; Qun Guan; Qingling Ren

    doi:10.21203/ Date: 2020-06-19 Source: ResearchSquare

    Background Since the end of December 2019, a pneumonia MESHD pneumonia HP outbreak has occurred in Wuhan, Hubei Province, China. An epidemiological survey showed that the pneumovirus infection MESHD was closely related to the Huanan Seafood Wholesale Market in Wuhan, causing great panic among the general population. Through isolation of the pneumovirus strain and whole-genome sequencing, an infection MESHD model of the pneumovirus in human airway epithelial cells was established, and the pneumovirus was identified as the 2019 novel coronavirus (2019-nCoV), which belongs to the β-coronavirus genus. This study focused on the different characteristics of 2019-nCoV, which we learned at the early stage of Covid-19 pandemic will help us to save more lives during the outbreak. Methods The data of 17 deaths MESHD from 13 hospitals in Wuhan were obtained, and the initial symptoms, clinical features during the progression of the disease MESHD, and treatment processes were well analyzed. Results At the initial phase of the outbreak of 2019-nCoV, the lack of effective drugs for pneumonia MESHD pneumonia HP has led to lethal results in people who are often elderly TRANS with multiple underlying conditions. Males TRANS were affected more than females TRANS. Fever MESHD Fever HP, dry coughing MESHD coughing HP, shortness of breath were the primary presentations, but not all. Chest images showed typical features of viral pneumonia MESHD pneumonia HP. Respiratory support treatment were needed, although sometimes did not improve respiratory distress HP. All the patients died of multiple organ failure MESHD caused by respiratory failure HP. Many treatments of covid-19 were done in ICU and lasted for a long time, the occupation of public medical resources will put pressure on the present medical system.Conclusions COVID-19 is different from pneumonia MESHD pneumonia HP caused by previous coronaviruses, it is more infectious and hard to manage. The initial death MESHD population were mainly elderly TRANS patients with underlying diseases MESHD. Protecting the elderly TRANS is an effective method to reduce the number of deaths MESHD. In the absence of nucleic acid detection reagents, relying on identifying typical symptoms and making full use of CT can increase the diagnosis of suspicious people. The condition of patients may deteriorate rapidly which increased the complexity of treatment. The increasing number of patients will put great pressure on the existing medical system.

    Endothelial Shear Stress Enhancements: A Potential Solution for Critically Ill Covid-19 Patients

    Authors: Sayed Nour

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

    Rationale: Most critically ill Covid-19 patients succumb to multiple organ failure MESHD and / or cardiac arrest HP as a result of comorbid endothelial dysfunction disorders which had probably aggravated by conventional mechanical assist devices. Even worse, mechanical ventilators prevent the respiratory pump from performing its crucial function as a potential generator of endothelial shear stress (ESS) which controls microcirculation and hemodynamics since birth. The purpose of this work is to bring our experience with ESS enhancement and pulmonary vascular resistance (PVR) management as a potential therapeutic solution in acute respiratory distress HP syndrome MESHD (ARDS). We propose a noninvasive device composed of thoracic and infradiaphragmatic compartments that will be pulsated in an alternating frequency (20/40 bpm) with low-pressure pneumatic generator (0.1-0.5 bar). Oxygen supply, nasogastric ± endotracheal tubes are considered. Proof-of-concept: prototypes were tested in pediatric models of refractory cardiac arrest HP (≥20min), showed restoration of hemodynamics (BP≥100 mm Hg) and urine output, regardless of heartbeats, pharmacological supports and mechanical ventilation. Conclusions ESS enhancement represents a more effective treatment to increase tissue oxygenation and improve hemodynamic in ARDS. A cost-effective method which could be induced with a non-invasive pulsatile device adaptable to cardiopulmonary-circulatory biophysics to maintain a fully functional respiratory pump and avoid confrontation of the opposite hydraulic circuits.

    No detection of SARS-CoV-2 RNA on urethral swab in patients with positive naso-pharyngeal swab

    Authors: Lorenzo Spirito; Biagio Pinchera; Angela Patrì; Mario Delfino; Ciro Imbimbo; Paola Salvatore; Ivan Gentile; Gabriella Fabbrocini

    doi:10.21203/ Date: 2020-06-14 Source: ResearchSquare

    Background The recent SARS-CoV-2 infection MESHD is the cause of one of the most important pandemics that history has ever experienced. SARS-CoV-2 can lead to a MOF ( Multiple Organ Failure MESHD) that is critical for life of patients. Viral RNA is found in human tissues as lung, intestine, testicle, kidney, etc. and it is the reason to theorize different ways of transmission TRANS of the virus in addition to respiratory droplets. The aim of our study was to evaluate the presence of SARS-CoV-2 in urethral swabs.Methods We enrolled 10 patients with SARS-CoV-2 infection MESHD who attended the Infectious Diseases MESHD Unit of the A.O.U. Federico II of Naples, from March 2020 to April 2020. For each patient, one urethral swab was collected at the time of SARS-CoV-2 infection MESHD.Results All ten patients had a negative urethral swab for SARS-CoV-2 RNA when the rhino-oropharyngeal swab was found to be positive for SARS-CoV-2 RNA. Our data show for the first time that the virus would not affect the urinary tract and therefore would not be found in the urine and even less would it be transmissible through the urine. This result was independent of the stage of the disease MESHD, in fact, regardless of the severity of the clinical conditions, all patients had a negative urethral swab for SARS-CoV-2 RNA.Conclusion This observation, which needs to be further investigated with further studies and a larger sample, could be the cornerstone for understanding the role of SARS-CoV-2 in relation to the genitourinary system.

    Clinical features of middle- aged TRANS patients died of 2019 Novel Coronavirus–Infected Pneumonia MESHD Pneumonia HP

    Authors: Yangyang Huang; Guangwang Zeng; Guoxi Chen; Yuyang Cai; Hai Huang; Yaling Wang; Min Hou; Xiaopan Li; Chen Ji; Di Zhang; Xing Lan; Ling Yang

    doi:10.21203/ Date: 2020-05-11 Source: ResearchSquare

    Background Since December, 2019, the emerge of a Novel Coronavirus Disease MESHD 2019 (COVID-19) have caused global concern, the majority viewpoints are that the deaths MESHD are related to advanced ages TRANS, however, the emergence of younger deaths MESHD needs immediate attention.Methods Clinical characteristics, laboratory results, chest CT scans and treatment measures were retrospectively reviewed for six deceased patients under 60 years old with confirmed COVID-19 who were admitted to Wuhan Pulmonary Hospital in Wuhan, Hubei Province, China, from 6th January to 4th March, 2020.Results The age TRANS range of the patients was 50.17 ± 3.25 years (45–55 years), none of them had underlying diseases MESHD. All of patients presented with the symptoms of fever MESHD fever HP, respiratory system and digestive system. The level of albumin and lymphocyte counts decreased early in the stages of the disease MESHD, and then gradually increased. The neutrophil to lymphocyte ratio (NLR) increased (higher than normal range) in early stage and gradually decreased when the disease MESHD progressed. All the six patients showed ground-glass opacity (GGO) and bilateral patchy shadowing in early stage under the computed tomography (CT). All the patients died of severe pneumonia MESHD pneumonia HP and multiple organ failure MESHD.Conclusions The decreased level of serum SERO albumin occurred in the early stages of the disease MESHD, and delays in the first admission to hospital probably aggravate the disease MESHD development. The increase of the NLR in early stage of disease MESHD may be a risk of death MESHD for COVID-19. These findings may provide useful information for optimizing supportive care for COVID-19 pneumonia MESHD pneumonia HP.

    Viral Sepsis MESHD Sepsis HP, No Neglecting Complication Following Novel Corona Virus Disease MESHD (COVID-19)

    Authors: Di Liu; Qiang Wang; Huacai Zhang; Li Cui; Feng Shen; Yong Chen; Jiali Sun; Lebin Gan; Jianhui Sun; Jun Wang; Jing Zhang; Qingli Cai; Juan Du; Lei Li; Anqiang Zhang; Hong Huang; Jin Deng; Jianxin Jiang; Ling Zeng

    doi:10.21203/ Date: 2020-05-08 Source: ResearchSquare

    Background Until 24:00 of April 26th 2020, 2,918,268 laboratory- confirmed cases TRANS of Severe Acute Respiratory Syndrome MESHD Coronavirus 2 (SARS-CoV-2) infection MESHD have been reported worldwide, including 203,528 deaths MESHD. Bacterial infection MESHD is the main cause of sepsis MESHD sepsis HP, however, sepsis MESHD sepsis HP caused by virus is often ignored. Increased awareness, early recognition of viral sepsis MESHD sepsis HP, rapid administration of appropriate antiviral drugs, and urgent treatment can significantly reduce deaths MESHD of viral sepsis MESHD sepsis HP.Objectives Given the rapid global spread of novel Corona Virus Disease MESHD (COVID-19), coupled with the high rate of missed diagnosis of viral sepsis MESHD sepsis HP caused by SARS-CoV-2 infection MESHD, it is urgent to evaluate the multiple organ failure MESHD score and viral sepsis MESHD sepsis HP in COVID-19 patients, so as to determine the clinical characteristics of viral sepsis MESHD sepsis HP more accurately and reveal the risk factors related to mortality.Methods Here we provide a full description of three cases of viral sepsis MESHD sepsis HP and subsequent multiple organ dysfunction (MODS) caused by SARS-CoV-2 infection MESHD imported to Guiyang from Wuhan.Results Complete laboratory examination, imaging data and treatment methods for the patients are analyzed. Sepsis MESHD Sepsis HP-related Organ Failure Assessment score (SOFA score) and Multiple organ dysfunction scores (MOD score) were daily assessed, aim to elucidate the clinical feature of viral sepsis MESHD sepsis HP and MODS and to attract enough attention by clinicians.Conclusions Therefore, we strongly suggest to daily evaluate SOFA score and MOD score in severe and critically-ill COVID-19 patients, so as to early diagnose and prevention of sepsis MESHD sepsis HP and MODS.

    Why Does COVID-19 Disproportionately Affect the Elderly TRANS?

    Authors: Amber L. Mueller; Maeve S. McNamara; David A. Sinclair

    id:10.20944/preprints202004.0548.v1 Date: 2020-04-30 Source:

    The severity and outcome of coronavirus disease MESHD 2019 (COVID-19) largely depends on a patient’s age TRANS. Over 80% of hospitalizations are of those over 65 years of age TRANS with a 23-fold greater risk of death MESHD. In the clinic, COVID-19 patients most commonly present with fever MESHD fever HP, cough MESHD cough HP and dyspnea MESHD dyspnea HP. Particularly in those over 65, it can progress to pneumonia MESHD pneumonia HP, lung consolidation, cytokine release syndrome MESHD, endotheliitis, coagulopathy, multiple organ failure MESHD and death MESHD. Comorbidities such as cardiovascular disease MESHD, diabetes, obesity MESHD obesity HP and hypertension MESHD hypertension HP increase the chances of fatal disease MESHD, but they alone do not explain the variability in COVID-19 symptoms. Here, we present the molecular differences between the young, middle- aged TRANS and elderly TRANS that may determine whether COVID-19 is a mild or life-threatening illness. We also discuss several biological age TRANS clocks that could be used in conjunction with genetic tests to identify both the mechanisms of the disease MESHD and individuals most at risk. Finally, based on these mechanisms, we discuss treatments that could increase survival in the elderly TRANS, not simply by inhibiting the virus, but by restoring patients’ ability to clear the infection MESHD.

    Factors related to COVID-19 severity and mortality based on comparison between Henan and Zhejiang: an observational study

    Authors: Wangquan Ji; Ruonan Liang; Peiyu Zhu; Haiyan Yang; Shuaiyin Chen; Weiguo Zhang; Yuefei Jin; Guangcai Duan

    doi:10.21203/ Date: 2020-04-22 Source: ResearchSquare

    Background: Coronavirus Disease MESHD 2019 (COVID-19) has spread across China and the world, since outbreak at the end of 2019. Although COVID-19 is generally considered as self-limiting, some of cases develop in to fatal respiratory restress, multiple organ failure MESHD and even sudden death MESHD. According to the data released by the provincial health commissions, there are obvious regional differences in COVID-19 mortality. To explore possible factors of COVID-19 related severity and mortality in laboratory- confirmed cases TRANS from Henan and Zhejiang.Methods: We collected the public data released by the government. We analyzed and compared the possible factors, including initial symptoms, gender TRANS, age TRANS, place of residence, time interval from onset to diagnosis, epidemiological history and the grade of hospital for patient’s treatment in laboratory- confirmed cases TRANS. Student’s t-test, Chi-square (c2) test, Cochran-Mantel-Haenszel (CMH) test and Mann-Whitney U rank sum test were used complied with the applicable conditions. Statistical test was performed with a level of significance α=0.05.Results: Death MESHD cases in Henan were mainly from male TRANS, elderly TRANS infected persons and those who had a history of contact with patients and underlying basic diseases MESHD. Henan had the higher proportion of cases with fever MESHD fever HP and the lower proportion of asymptomatic infection MESHD asymptomatic TRANS, and had higher proportions of imported male TRANS cases with a contact history, and elderly TRANS cases living in rural areas, relative to Zhejiang. The time interval of confirmed cases TRANS in rural areas of Henan was 0.8 day longer than that in Zhejiang. Hospitals grade for patients’ treatment in Henan was lower than Zhejiang.Conclusions: Our findings suggest that initial symptoms, age TRANS, place of residence, gender TRANS, the time interval from onset to diagnosis and the grade of designated hospital for patient’s treatment are possible factors behind COVID-19 related severity or mortality. This study will provide useful information for public health authorities to develop disease MESHD prevention strategies.

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MeSH Disease
Human Phenotype

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