Corpus overview


MeSH Disease

Human Phenotype


    displaying 1 - 10 records in total 23
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    Pan-Echinocandin-Resistant Candida glabrata Bloodstream Infection MESHD Complicating COVID-19: A Fatal Case Report

    Authors: Brunella Posteraro; Riccardo Torelli; Antonietta Vella; Paolo Maria Leone; Giulia De Angelis; Elena De Carolis; Giulio Ventura; Maurizio Sanguinetti; Massimo Fantoni

    id:10.20944/preprints202008.0198.v1 Date: 2020-08-07 Source:

    Coinfections MESHD with bacteria or fungi may be a frequent complication of COVID-19, although coinfections MESHD with Candida species in COVID-19 patients remain rare. We report the 53-day clinical course of a complicated type-2 diabetes patient diagnosed with COVID-19, who developed bloodstream infections MESHD initially due to methicillin-resistant Staphylococcus aureus, secondly to multidrug-resistant Gram-negative bacteria, and lastly to a possibly fatal Candida glabrata. Development of FKS-associated pan-echinocandin resistance in the C. glabrata isolated from the patient after 13 days of caspofungin treatment aggravated the situation. The patient died of septic shock MESHD shock HP shortly before the prospect of receiving potentially effective antifungal therapy. This case emphasizes the importance of early diagnosis and monitoring for antimicrobial drug-resistant coinfections MESHD to reduce their unfavorable outcomes in COVID-19 patients.

    Duodenal Perforation Caused Septic Shock MESHD Shock HP: a Rare Case Combined With Coronavirus Disease MESHD 2019

    Authors: Huanhuan Guo; Jing Hu; Yunxiang Li; Wei Xiang; Quan Gan

    doi:10.21203/ Date: 2020-07-25 Source: ResearchSquare

    Background: Duodenal perforation is one of the rarer causes of acute abdomen MESHD in pregnancy, which is especially easy to be overlooked during the outbreak of 2019 novel coronavirus (2019-nCoV) after delivery.Case presentation: Here, we report a case of duodenal perforation-induced septic shock MESHD shock HP with coronavirus disease MESHD 2019 (COVID-19), and the patient underwent emergency MESHD laparotomy after reporting to the hospital management department under strict protection. Her recovery in postoperative period in Medical Intensive Care Unit (MICU) was uneventful and she was transferred to a designated hospital for treatment of COVID-19 5 days later.Conclusions: The establishment of emergency MESHD green channel for maternal health care, and timely and comprehensive multidisciplinary cooperation during the epidemic period, strengthen the standardized management of high-risk pregnancy, and better guarantee the safety of mothers and infants.

    COVID-19 in-hospital mortality and mode of death MESHD in a dynamic and non-restricted tertiary care model in Germany

    Authors: Siegbert Rieg; Maja von Cube; Johannes Kalbhenn; Stefan Utzolino; Katharina Pernice; Lena Bechet; Johanna Baur; Corinna N Lang; Dirk Wagner; Martin Wolkewitz; Winfried V Kern; Paul Biever

    doi:10.1101/2020.07.22.20160127 Date: 2020-07-24 Source: medRxiv

    Background Reported mortality of hospitalised COVID-19 patients varies substantially, particularly in critically ill patients. So far COVID-19 in-hospital mortality and modes of death MESHD under optimised care conditions have not been systematically studied. Methods This retrospective observational monocenter cohort study was performed after implementation of a non-restricted, dynamic tertiary care model at the University Medical Center Freiburg, an experienced ARDS and ECMO referral center. All hospitalised patients with PCR-confirmed SARS-CoV-2 infection MESHD were included. The primary endpoint was in-hospital mortality, secondary endpoints included major complications and modes of death MESHD. A multistate analysis and a Cox regression analysis for competing risk models were performed. Modes of death MESHD were determined by two independent reviewers. Results Between February 25, and May 8, 213 patients were included in the analysis. The median age TRANS was 65 years, 129 patients (61%) were male TRANS. 70 patients (33%) were admitted to the intensive care unit (ICU), of which 57 patients (81%) received mechanical ventilation and 23 patients (33%) extracorporeal membrane-oxygenation (ECMO) support. According to the multistate model the probability to die within 90 days after COVID-19 onset was 24% in the whole cohort. If the levels of care at time of study entry were accounted for, the probabilities to die were 16% if the patient was initially on a regular ward, 47% if in the ICU and 57% if mechanical ventilation was required at study entry. Age TRANS >=65 years and male TRANS sex were predictors for in-hospital death MESHD. Predominant complications - as judged by two independent reviewers - determining modes of death MESHD were multi-organ failure, septic shock MESHD shock HP and thromboembolic and hemorrhagic complications. Conclusion In a dynamic care model COVID-19-related in-hospital mortality remained substantial. In the absence of potent antiviral agents, strategies to alleviate or prevent the identified complications should be investigated. In this context, multistate analyses enable comparison of models-of-care and treatment strategies and allow estimation and allocation of health care resources.

    Predictive Value of Neutrophil to Lymphocyte Ratio for Disease MESHD Deterioration and Serious Adverse Outcomes in Patients with COVID-19: A Prospective Cohort Study

    Authors: Zhi-Yong Zeng; Gong-Ping Chen; Jiang-Nan Wu

    doi:10.21203/ Date: 2020-07-23 Source: ResearchSquare

    Background: Early identification of patients who are at high risk of poor clinical outcomes is of great important in saving lives for patients with the novel corona virus disease MESHD 2019 (COVID-19) in context of limited medical resources. Objective: To evaluate value of the neutrophil to lymphocyte ratio (NLR), calculated at hospital admission and in isolation, for prediction of the subsequent presence of disease MESHD aggravation and serious clinical outcomes (e.g., shock MESHD shock HP, death MESHD).Methods: We designed a prospective cohort study of 352 hospitalized patients with COVID-19 between January 9 and February 26, 2020 in Yichang city, Hubei province. Patients with a NLR equal to and higher than the cutoff value derived from the receiver operating characteristic curve method were classified as the exposure group. The primary outcome was disease MESHD deterioration, defined as promotion of clinical classifications of the disease MESHD during hospitalization (e.g., moderate to severe/critical; severe to critical,). The secondary outcomes were shock MESHD shock HP and death MESHD occurred during the treatment.Results: During the follow up, 51 (14.5%) patients’ condition deteriorated, 15 patients (4.3%) complicated septic shock MESHD shock HP, and 15 patients (4.3%) died. NLR was higher in patients with deterioration than those without (median: 5.33 vs. 2.14, P <0.001), as well as between patients with and without serious clinical outcomes ( shock MESHD shock HP vs. no shock MESHD shock HP: 6.19 vs. 2.25, P <0.001; death MESHD vs. survival: 7.19 vs. 2.25, P <0.001). NLR measured at hospital admission had high value in predicting subsequent disease MESHD deterioration, shock MESHD shock HP and death MESHD (all the areas under the curve > 0.80). The sensitivity SERO of ≥ 2.6937 for the NLR in predicting subsequent disease MESHD deterioration, shock MESHD shock HP and death MESHD were 82.0% (95% confidence interval, 69.0 to 91.0), 93.3% (68.0 to 100), and 92.9% (66.0 to 100); and the corresponding negative predictive values SERO were 95.7% (93.0 to 99.2), 99.5% (98.6 to 100) and 99.5% (98.6 to 100), respectively. Conclusions: The NLR measured at admission and in isolation can be used to effectively predict subsequent presence of disease MESHD deterioration and serious clinical outcomes for patients with COVID-19.

    Clinical characteristics and risk factors for mortality in patients with coronavirus disease MESHD 2019 in intensive care unit: a single-center, retrospective, observational study in China

    Authors: Fangfang Sai; Xiaolei Liu; Lanyu Li; Yan Ye; Changqing Zhu; Ying Hang; Conghua Huang; Lei Tian; Xinhui Xu; Huan Huang

    doi:10.21203/ Date: 2020-07-20 Source: ResearchSquare

    Background: Coronavirus disease MESHD 2019 (COVID-19) is a potentially life-threatening contagious disease MESHD disease which has spread TRANS which has spread all over the world. Risk factors for the clinical outcomes of COVID-19 pneumonia MESHD pneumonia HP in intensive care unit (ICU) have not yet been well determined. Methods: In this retrospective, single-centered, observational study, we consecutively included 47 patients with confirmed COVID-19 who were admitted to the ICU of Leishenshan Hospital in Wuhan, China, from February 24 to April 5, 2020. Clinical characteristics and outcomes were collected and compared between survivors and non-survivors. Multivariable logistic regression was used to explore the risk factors associated with death MESHD in patients of COVID-19.Results: The study cohort included 47 adult TRANS patients with a median age TRANS of 70.55±12.52 years, and 30 (63.8%) patients were men. Totally 15 (31.9%) patients died. Compared with survivors, non-survivors were more likely to develop septic shock MESHD shock HP (6 [40%] patients vs 3 [9.4%] patients ), disseminated intravascular coagulation MESHD disseminated intravascular coagulation HP (3 [21.4%] vs 0), and had higher score of APACHE II (25.07±8.03 vs 15.56±5.95), CURB-65 (3[2-4] vs 2[1-3]), Sequential Organ Failure Assessment (SOFA) (7[5-9] vs 3[1-6]), higher level of D-dimer (5.74 [2.32-18] vs 2.05 [1.09-4.00] ) and neutrophil count (9.4[7.68-14.54] vs 5.32[3.85-9.34] ). SOFA score (OR 1.47, 1.01–2.13; p=0.0042) and lymphocyte count (OR 0.02, 0.00–0.86; p=0.042) on admission were independently risk factors for mortality. Patients with higher lymphocyte count (>0.63×109/L) and lower SOFA score ≤4 on admission had a significantly well prognosis than those with lower lymphocyte count (≤0.63×109/L) and higher SOFA score >4 in overall survival.Conclusions: Higher SOFA score and lower lymphocyte count on admission were associated with poor prognosis of patients with COVID-19 in ICU. Lymphocyte count may serve as a promising prognostic biomarker.

    Identification of Risk Factors for in-hospital Death MESHD of COVID - 19 Pneumonia MESHD Pneumonia HP

    Authors: Zhigang Wang; Zhiqiang Wang

    doi:10.21203/ Date: 2020-07-13 Source: ResearchSquare

    Objective: To examine the clinical characteristics and identify independent risk factors for in-hospital mortality of 2019 novel coronavirus (COVID-19) pneumonia MESHD pneumonia HP.Methods: A total of 156 patients diagnosed with COVID-19 pneumonia MESHD pneumonia HP at the central Hospital of Wuhan from January 29, 2020, to March 20, 2020 were enrolled in this single-centered retrospective study. Their epidemiological parameters, clinical presentations, underlying diseases MESHD, laboratory test results and disease MESHD outcomes were collected and analyzed. Results: The median age TRANS of enrolled patients was 66. Underlying diseases MESHD were identified in 101 patients, with hypertension MESHD hypertension HP being the most common one, followed by cardiovascular disease MESHD and diabetes. The most common symptoms identified upon admission were fever MESHD fever HP, cough MESHD cough HP, dyspnea MESHD dyspnea HP and fatigue MESHD fatigue HP. Compared to survival cases, patients who dead during hospitalization had higher plasma SERO levels of D-dimer, creatinine, creatine kinase, lactate dehydrogenase, lactate and lower percentage of lymphocytes (LYM [%]), platelet count and albumin levels. Most enrolled patients received anti-biotics and anti-viral treatment. In addition, 60 patients received corticosteroid and 51 received intravenous immunoglobulin infusion. 44 patients received noninvasive ventilation, 19 received invasive ventilation. Respiratory failure HP was the most frequently observed complication (106 [67.9%]), followed by sepsis MESHD sepsis HP (103 [66.0%]), acute respiratory distress HP syndrome MESHD (ARDS) (67 [42.9%]) and septic shock MESHD shock HP (50 [32.1%]). Multivariable regression suggested that advanced age TRANS (OR [odds ratio]= 1.059, 95% CI [confidence interval]: 1.011-1.110, P= 0.016) and elevated lactate level upon admission (OR= 2.411, 95% CI: 1.177-4.941, P= 0.016) were independent risk factors for in-hospital mortality for COVID-19 infection MESHD. Meanwhile, increased LYM (%) at admission (OR= 0.798, 95% CI: 0.728-0.876, P< 0.001) indicated a better prognosis. Conclusions: In this study, we discovered that age TRANS, LYM (%) and lactate level upon admission were independent factors that could influence in-hospital mortality rate.

    Unusual Presentation of Kawasaki Disease MESHD with Multisystem Inflammation MESHD and Antibodies SERO Against Severe Acute Respiratory Syndrome MESHD Coronavirus 2: A Case Report

    Authors: Haena Kim; Jung Yeon Shim; Jae-Hoon Ko; Aram Yang; Jae Won Shim; Deok Soo Kim; Hye Lim Jung; Ji Hee Kwak; In Suk Sol

    doi:10.21203/ Date: 2020-07-12 Source: ResearchSquare

    Background: Since mid-April 2020, cases of multisystem inflammatory syndrome MESHD in children TRANS (MIS-C) associated with coronavirus disease MESHD (COVID-19) that mimic Kawasaki disease MESHD (KD) have been reported in Europe and North America. However, no cases have been in East Asia, where KD is more prevalent.Case presentation: A previously healthy 11-year-old boy was admitted with a 4-day history of fever MESHD fever HP and abdominal pain MESHD abdominal pain HP. He had no contact history to any patient with COVID-19. Blood SERO acute inflammatory markers were highly elevated. He was treated with antibiotics for suspected bacterial enteritis MESHD, but he suddenly developed hypotension MESHD hypotension HP. Inotropics and intravenous immunoglobulin were administered to manage septic shock MESHD shock HP. On hospitalization day 6, he developed signs and symptoms MESHD of KD (conjunctival injection, strawberry tongue HP, cracked lip, and coronary artery dilatation HP) in addition to pleural/ pericardial effusion MESHD pericardial effusion HP and mesenteric lymphadenitis MESHD lymphadenitis HP. The results of microbiologic tests, including reverse-transcription polymerase chain reaction for severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2), were negative. Fluorescent immunoassay SERO and enzyme-linked immunosorbent assay SERO revealed abundant IgG antibodies SERO against SARS-CoV-2 in his serum SERO, but no IgM antibodies SERO. He was discharged successfully on day 13.Conclusion: MIS-C may occur in children TRANS with a previously asymptomatic TRANS COVID-19 infection MESHD. A high index of suspicion is required for this novel syndrome MESHD in unusual cases of KD or KD shock MESHD shock HP syndrome MESHD with multisystem inflammation MESHD, even when there is no clear history of contact or symptoms of COVID-19.

    Risk factors associated with failure of high-flow nasal cannula oxygen therapy in patients with severe COVID-19 in Wuhan, China

    Authors: Xiao-huan Ma; Fang Yin; Jie Zhang; Meng-yun Peng; Hong Guan; Ping Gong

    doi:10.21203/ Date: 2020-07-12 Source: ResearchSquare

    Methods: In this single-center, retrospective, observational study, we enrolled patients with confirmed severe COVID-19 admitted to Renmin Hospital of Wuhan university (Wuhan, China) from 1 February 2020 to 26 March 26 2020. Epidemiological, clinical, and laboratory data, and treatments and outcomes upon hospital admission, were obtained from electronic medical records. Sequential organ failure assessment (SOFA) scores were calculated.Results: Of 54 patients with severe COVID-19, HFNC was successful in 28 (51.9%) and unsuccessful in 26 (48.1%). HFNC failure was seen more commonly in patients aged TRANS ≥60 years and in men. In addition, compared with patients successfully treated with HFNC, patients with HFNC failure had the following characteristics: higher percentage of fatigue MESHD fatigue HP and anorexia MESHD anorexia HP as well as cardiovascular disease MESHD; increased time from onset to diagnosis and SOFA scores; elevated body temperature, respiratory rate, and heart rate; more complications including ARDS, septic shock MESHD shock HP, myocardial damage, and acute kidney injury MESHD acute kidney injury HP; increased neutrophil counts and prothrombin time; and decreased HP arterial partial pressure of oxygen/fraction of inspired oxygen (PaO2/FiO2) (all P < 0.05). However, binary logistic regression analysis showed that only male TRANS gender TRANS and PaO2/FiO2 were independent risk factors significantly associated with HFNC failure (both, P < 0.05). Conclusion: Patients with severe COVID-19 had a high HFNC treatment failure rate. Male TRANS gender TRANS and decreased PaO2/FiO2 were independent risk factors associated with HFNC failure in severe COVID-19 patients.

    Red blood SERO cell distribution width (RDW) in Hospitalized COVID-19 Patients

    Authors: Preethi Ramachandran; Mahesh Gajendran; Abhilash Perisetti; Karim Osama Elkholy; Abhishek Chakraborti; Giuseppe Lippi; Hemant Goyal

    doi:10.1101/2020.06.29.20143081 Date: 2020-07-03 Source: medRxiv

    Introduction: Coronavirus disease MESHD-2019 (COVID-19), caused by severe acute respiratory syndrome MESHD coronavirus-2 (SARS-CoV-2), is causing dramatic morbidity and mortality worldwide. The Red Blood SERO Cell Distribution Width (RDW) has been strongly associated with increased morbidity and mortality in multiple diseases MESHD. Objective: To assess if elevated RDW is associated with unfavorable outcomes in hospitalized COVID-19. Methods: We retrospectively studied clinical outcomes of hospitalized COVID-19 patients for their RDW values. In-hospital mortality was defined as primary outcome, while septic shock MESHD shock HP, need for mechanical ventilation, and length of stay (LOS) were secondary outcomes. Results- A total of 294 COVID-19 patients were finally studied. Overall prevalence SERO of increased RDW was 49.7% (146/294). RDW was associated with increased risk of in-hospital mortality (aOR, 4.5; 95%CI, 1.4-14.3) and septic shock MESHD shock HP (aOR, 4.6; 95%CI, 1.4-15.1) after adjusting for anemia MESHD anemia HP, ferritin, and lactate. The association remained unchanged even after adjusting for other clinical confounders such as age TRANS, sex, body mass index, coronary artery disease MESHD, hypertension MESHD hypertension HP, diabetes mellitus MESHD diabetes mellitus HP, and chronic obstructive pulmonary disease MESHD chronic obstructive pulmonary disease HP. No association was found instead with mechanical ventilation and median LOS. Conclusion: Elevated RDW in hospitalized COVID-19 patients is associated with a significantly increased risk of mortality and septic shock MESHD shock HP.

    Cancer inpatient with COVID-19: a report from the Brazilian National Cancer Institute

    Authors: Andreia C de Melo; Luiz Claudio S Thuler; Jesse L da Silva; Lucas Z de Albuquerque; Ana Carla Pecego; Luciana O.R. Rodrigues; Magda S da Conceicao; Marianne M Garrido; Gelcio L Mendes; Ana Cristina M Pereira; Marcelo A Soares; Joao P.B. Viola; - INCA COVID-19 Task Force

    doi:10.1101/2020.06.27.20141499 Date: 2020-06-29 Source: medRxiv

    Brazil has been recording a frightening exponential curve of confirmed cases TRANS of SARS-CoV-2 infection MESHD. Cancer patients with COVID-19 are likely to have a greater risk of complications and death MESHD. A retrospective search in the electronic medical records of cancer inpatients admitted to the Brazilian National Cancer Institute from April 30, 2020 to May 26, 2020 granted identification of 181 patients with COVID-19 confirmed by RT-PCR method. The mean age TRANS was 55.3 years (SD 21.1). The most prevalent solid tumors were breast (40 [22.1%]), gastrointestinal (24 [13.3%]), and gynecological (22 [12.2%]). Among hematological malignancies, lymphoma MESHD lymphoma HP (20 [11%]) and leukemia MESHD leukemia HP (10 [5.5%]) predominated. The most common complications were respiratory failure HP (70 [38.7%]), septic shock MESHD shock HP (40 [22.1%]) and acute kidney injury MESHD acute kidney injury HP (33 [18.2%]). A total of 60 (33.1%) patients died due to COVID-19 complications. By multivariate analysis, cases with admission due to symptoms of COVID-19 (p = 0.027) and with two or more metastatic sites (p <0.001) showed a higher risk of COVID-19-specific death MESHD. This is the first study in a cohort of Brazilian cancer patients with COVID-19. The rates of complications and COVID-19-specific death MESHD were significantly high. Our data prompts urgent and effective public policies for this group of especially vulnerable patients.

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MeSH Disease
Human Phenotype

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