Corpus overview


MeSH Disease

Human Phenotype


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    Point-of-care ultrasound for COVID-19 pneumonia MESHD pneumonia HP patients in the ICU

    Authors: zouheir bitar; Mohammed Shamsah; Omar Bamasood; Ossama Maadrani; Huda Al foudri

    doi:10.21203/ Date: 2020-07-26 Source: ResearchSquare

    BackgroundPoint-of-care ultrasound (POCUS) has a major role in the management of patients with acute hypoxic respiratory and circulatory failure and guides hemodynamic management. There is scarce literature on POCUS assessment characteristics in COVID-19 pneumonia MESHD pneumonia HP with hypoxic respiratory failure HP.MethodsThe study is an observational, prospective, single‐center study conducted in the intensive care unit of Adan General Hospital from May 1st, 2020, to June 25, 2020. The study included adults TRANS suspected to have COVID-19 transferred to the intensive care unit (ICU) with fever MESHD fever HP or suspected respiratory infection MESHD. Patients were transferred to the ICU directly from the ED or general medical wards after reverse transcriptase-polymerase chain reaction (RT-PCR) testing. A certified intensivist in critical care ultrasound who was blinded to the RT-PCR results, if available at the time of examination, performed the lung ultrasound and echocardiology within 12 hours of the patient’s admission to the ICU. We calculated the E/e’, E/A ratio, left ventricular ejection fraction EF, IVC diameter, RV size and systolic function. We performed ultrasound in 12 chest areas.ResultsOf 92 patients with suspected COVID-19 pneumonia MESHD pneumonia HP, 77 (84%) cases were confirmed TRANS. The median age TRANS of the patients was 53 (82-36) years, and 71 (77%) were men.In the group of patients with confirmed COVID-19 pneumonia MESHD pneumonia HP, echocardiographic findings showed normal E/e’, deceleration time (DT), and transmittal E/A ratio in comparison to the non-COVID19 patients (P .001 for both). The IVC diameter was <2 cm with > 50% collapsibility in 62 (81%) patients with COVID-19 pneumonia MESHD pneumonia HP; a diameter of > 2 cm and < 50% collapsibility in all patients, with a P value of 0.001, was detected among those with non-COVID-19 pneumonia MESHD pneumonia HP. There were 3 cases of myocarditis MESHD myocarditis HP with poor EF (5.5%), severe RV dysfunction was seen in 9 cases (11.6%), and 3 cases showed RV thrombus.Chest US revealed four signs suggestive of COVID-19 pneumonia MESHD pneumonia HP in 77 patients (98.6%) ( sensitivity SERO 96.9%, CI 85%‐99.5%) when compared with RT-PCR results.ConclusionPOCUS plays an important role in bedside diagnosis, hemodynamic assessment and management of patients with acute hypoxic respiratory and circulatory failure in patients with COVID-19 pneumonia MESHD pneumonia HP.

    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.

    Life-threatening cardiogenic shock MESHD cardiogenic shock HP in a pediatric patient with SARS-CoV-2-associated myocarditis MESHD myocarditis HP treated with remdesivir: a case description and report of similar cases from the Literature

    Authors: Silvia Molinari; Lucia M.D. Colasanto; Maria L. Melzi; Alessandro Cattoni; Roberto Panceri; Michela Bombino; Giuseppe Lapadula; Andrea Biondi

    doi:10.21203/ Date: 2020-06-12 Source: ResearchSquare

    BackgroundChildren are relatively spared from Coronavirus disease MESHD 2019 (COVID-19), but some severe cases have been reported. Severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection MESHD in children TRANS may affect the cardiovascular system. We hereby report about a case of myocarditis MESHD myocarditis HP evolving to cardiogenic shock MESHD cardiogenic shock HP in a SARS-CoV-2 positive child TRANS.Case presentationAn otherwise healthy 12-year-old patient was admitted with fever MESHD fever HP, vomiting MESHD vomiting HP, diarrhoea and drowsiness HP, without any respiratory symptoms. He was diagnosed with COVID-19 on nasopharyngeal swab. He developed hypotension MESHD hypotension HP and cardiogenic shock MESHD cardiogenic shock HP. Bedside echocardiography revealed left ventricular impairment with an ejection fraction (LVEF) below 25%. Plasmatic markers of myocardial injury were remarkably raised, as well as inflammatory biomarkers, including procalcitonin (highest recorded value: 66 ng/mL) and interleukin-6 (8209 pg/mL). The child TRANS was transferred to Intensive Care Unit and he was treated with catecholamine support, mechanical ventilation and empiric anti-infectious therapy, including broad spectrum antibiotics and the antiviral agent remdesivir. All additional microbiological investigations yielded negative results. We observed a gradual improvement of LVEF within 5 days. A cardiac magnetic resonance confirmed the suspicion of myocarditis MESHD myocarditis HP. After 21 days of hospitalisation, the child TRANS was discharged without sequelae.ConclusionsOur hypothesis is that the child TRANS suffered from SARS-CoV-2-induced fulminant myocarditis MESHD myocarditis HP, probably in the setting of cytokine release syndrome MESHD (CRS). The peculiarity of this SARS-CoV-2 infection MESHD is the presence of cardiac failure in a previously healthy child TRANS without a respiratory illness. The positive outcome is in line with published Literature about the overall better prognosis of COVID-19 children TRANS compared to adults TRANS. Remdesivir, an investigational antiviral therapy, may have played a role on the clinical improvement of the child TRANS.

    Multisystem inflammatory syndrome MESHD with features of Atypical Kawasaki disease MESHD during COVID-19 pandemic: Report of a case from India

    Authors: Abdul Rauf; Ajay Vijayan; Shaji Thomas John; Raghuram A Krishnan; Abdul Latheef

    doi:10.21203/ Date: 2020-05-15 Source: ResearchSquare

    There is a global concern of increasing number of children TRANS presenting with inflammatory syndrome MESHD with clinical features simulating Kawasaki disease MESHD, during ongoing COVID-19 pandemic. We report a very similar case of 5-year-old boy from a COVID-19 hotspot area in Kerala state of India who presented in late April 2020 with acute febrile illness with abdominal pain MESHD abdominal pain HP and loose stools followed by shock MESHD shock HP. On examination, child TRANS had bulbar conjunctivitis MESHD conjunctivitis HP and extremity edema MESHD edema HP. Initial investigations showed high inflammatory parameters, elevated serum creatinine HP serum SERO creatinine and liver enzymes. Echocardiography showed moderate LV dysfunction and normal coronaries. Cardiac enzymes were also elevated, suggesting myocarditis MESHD myocarditis HP. He was treated with inotropic support, respiratory support with High Flow Nasal Cannula, IV Immunoglobulins, aspirin, steroids and diuretics. RT PCR for SARS-CoV-2 was negative twice. His clinical condition improved rapidly, was afebrile from day 2, inflammatory parameters decreased, left ventricular function improved and was discharged after 6 days of hospital stay.

    COVID-19 and Kawasaki Like Disease MESHD: The Known-Known, the Unknown-Known and the Unknown-Unknown

    Authors: Aurélie Morand; Diego Urbina; Alexandre Fabre

    id:10.20944/preprints202005.0160.v1 Date: 2020-05-09 Source:

    In the end of April nearly 100 cases of children TRANS aged TRANS between 6 month and 9 years with Kawasaki like disease MESHD were reported (mostly in Europe) probably linked to COVID-19. With the increasing awareness of this condition the number of cases reported is increasing worldwide. We aim to sum up the known data about this new entity based on published data (in a case report, a series of 8 cases and in newspapers and society statement) and using our knowledge of classical Kawasaki disease MESHD. It seems to be a post infectious disease MESHD with an onset between 2-4 weeks after the infection MESHD, probably in genetically predisposed children TRANS aged TRANS between 6 month to 17 years. A very rough estimation of incidence based on current data from Bergamo, Italy, and New York State and a lot assumption is between 0.016% (95% CI:0.013-0.02%) - 0.31% (95% CI: 0.2-0.47%) of infected children TRANS. Clinical signs overlaps with Kawasaki disease MESHD in some children TRANS, but another feature is prominent gastrointestinal manifestations. For the 9 detailed patients most had incomplete presentation for Kawasaki disease MESHD (with a mean 1.7 (+/-1.2) criteria per patient for the 5 non fever MESHD fever HP criterion) and only one had a classical form. In some cases, presentation is closer to toxic shock MESHD shock HP syndrome MESHD or isolated myocarditis MESHD myocarditis HP. Persistent fever MESHD fever HP seems to be constant and biological exploration are consistent with inflammation MESHD (elevated CRP, ferritin and D-Dimers). Management is described as supportive and children TRANS seem to improve rapidly, but can require cardiac or respiratory support. In date of 11 may 2020 there is 4 deaths MESHD confirmed linked to these new entities (1 in UK and 3 in New York). Paediatricians and general practitioners need to be aware of these possible evolution following COVID-19 infection MESHD. However it seems to be rare and children TRANS are probably still spared from most morbidities and mortality linked to COVID-19 infection MESHD .There are need of published detailed cohorts to better delineate these entities.

    SARS-CoV-2 infection MESHD and Cardiology: Beware of Myocarditis MESHD Myocarditis HP

    Authors: Marco Antonio Machado Schlindwein; Letícia Caroline Breis; Isabelle Pastor Bandeira; Rafael M. Ronsoni; Clizenaldo Torres; Marcus Vinicius Magno Gonçalves

    id:10.20944/preprints202004.0339.v1 Date: 2020-04-19 Source:

    The emergence of SARS-CoV-2 is a challenge in the actual medical scenario. Besides the classical lung and respiratory disease MESHD, patients infected with the virus can present with cardiac injury, and pathogenic mechanisms point to a direct infection MESHD of the heart.

    First Case of COVID-19 Complicated with Fulminant Myocarditis MESHD Myocarditis HP: A case Report and Insights

    Authors: Jia Hui Zeng; Ying-Xia Liu; Jing Yuan; Fu-Xiang Wang; Wei-Bo Wu; Jin-Xiu Li; Li-Fei Wang; Hong Gao; Yao Wang; Chang-Feng Dong; Yi-Jun Li; Xiao-Juan Xie; Cheng Feng; Lei Liu

    id:202003.0180/v2 Date: 2020-04-06 Source:

    Background: Coronavirus Disease MESHD 2019 (COVID-19) has been demonstrated to be the cause of pneumonia MESHD pneumonia HP. Nevertheless, it has not been reported as the cause of acute myocarditis MESHD myocarditis HP or fulminant myocarditis MESHD myocarditis HP. Case presentation: A 63-year-old male TRANS was admitted with pneumonia MESHD pneumonia HP and cardiac symptoms. He was genetically confirmed as having COVID-19 according to sputum testing on the day of admission. He also had elevated troponin I (Trop I) level (up to 11.37 g/L) and diffuse myocardial dyskinesia MESHD dyskinesia HP along with a decreased left ventricular ejection fraction (LVEF) on echocardiography. The highest level of interleukin-6 was 272.40 pg/ml. Bedside chest radiographs showed typical ground-glass changes indicative of viral pneumonia MESHD pneumonia HP. Laboratory test results for viruses that cause myocarditis MESHD myocarditis HP were all negative. The patient conformed to the diagnostic criteria of the Chinese expert consensus statement for fulminant myocarditis MESHD myocarditis HP. After receiving antiviral therapy and mechanical life support, Trop I was reduced to 0.10 g/L, and interleukin-6 was reduced to 7.63 pg/ml. Moreover, the LVEF of the patient gradually recovered to 68%. The patient died of aggravation of secondary infection MESHD on the 33rd day of hospitalization. Conclusion: COVID-19 patients may develop severe cardiac complications such as myocarditis MESHD myocarditis HP and heart failure MESHD. This is the first report of COVID-19 complicated with fulminant myocarditis MESHD myocarditis HP. The mechanism of cardiac pathology caused by COVID-19 needs further study.

    Discovery of potential drugs for COVID-19 based on the connectivity map

    Authors: Zhonglin Li; Tao Bai; Ling Yang; Xiaohua Hou

    doi:10.21203/rs.2.24684/v1 Date: 2020-02-25 Source: ResearchSquare

    Background: Corona virus infective disease MESHD 19 (COVID-19) is the disease MESHD caused by severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) and spreads very rapidly, which become a worldwide public healthy crisis. Until now, there is no effective antivirus drugs or vaccines specifically used for its treatment. So it is urgent to discover efficient therapeutic methods. The same as SARS-CoV, SARS-CoV-2 also invades organism by combining with Angiotensin-converting enzyme 2 (ACE2). Recently, there are reports about SARS-CoV-2 infected host not only through the respiratory tract, but also gastrointestinal tract. However, it is proved that ACE2 plays a key role in protecting subjects from lung injury MESHD and resisting the inflammation MESHD caused by intestinal epithelial damage. Interestingly, the expression of ACE2 protein is reduced after SARS-CoV infection MESHD. Methods: According to the dataset of genes co-expressed with ACE2 in the colonic epithelial cells, we established a protein-protein interaction (PPI) Network and selected hub genes from them. The cluster analysis was performed to find out the dense region of the PPI Network. Then, gene ontology (GO) and pathway enrichment analysis were performed to explore the main function of genes co-expressed with ACE2. Finally, we predicted the potential drugs for the treatment of COVID-19 based on the connectivity map (Cmap) . Results: We constructed a PPI network containing 125 hub genes of genes co-expressed with ACE2 in the colonic epithelial cells and obtained two modules through cluster analysis. The GO analysis and the KEGG pathway revealed these genes were aggregated in ribosome, exosomes, extracellular cellular components; structure constituent of ribosome, G-protein coupled receptor activity, MHC class I and II receptor activity biological processes; immune response, protein metabolism, signal transduction biological processes; and ribosome, graft-versus-host disease MESHD, viral myocarditis MESHD myocarditis HP pathways. The result from Cmap indicated ikarugamycin, molsidomine had highly correlated scores with the query files. Conclusion: We found out that ikarugamycin and molsidomine were the potential drugs for the treatment of COVID-19.

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MeSH Disease
Human Phenotype

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