Corpus overview


MeSH Disease

Human Phenotype


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    Vitamin D deficiency MESHD as a predictor of poor prognosis in patients with acute respiratory failure HP due to COVID-19 

    Authors: Giovanna Elisiana Carpagnano; Valentina Di Lecce; Vitaliano Nicola Quaranta; Annapaola Zito; Enrico Buonamico; Elena Capozza; Alessandro Palumbo; Giuseppe Di Gioia; Vincenzo Nicola Valerio; Onofrio Resta

    doi:10.21203/ Date: 2020-07-11 Source: ResearchSquare

    Purpose: Hypovitaminosis D is a highly spread condition correlated with increased risk of respiratory tract infections MESHD respiratory tract infections HP. Nowadays, the world is in the grip of the Coronavirus disease MESHD 19 (COVID 19) pandemic. In these patients, cytokine storm is associated with disease MESHD severity. In consideration of the role of vitamin D in the immune system, aim of this study was to analyse vitamin D levels in patients with acute respiratory failure HP due to COVID-19 and to assess any correlations with disease MESHD severity and prognosis. Methods: In this retrospective, observational study, we analysed demographic, clinical and laboratory data of 42 patients with acute respiratory failure HP due to COVID-19, treated in Respiratory Intermediate Care Unit (RICU) of the Policlinic of Bari from March, 11 to April 30, 2020. Results: Eighty one percent of patients had hypovitaminosis D. Based on vitamin D levels, the population was stratified into four groups: no hypovitaminosis D, insufficiency, moderate deficiency, and severe deficiency. No differences regarding demographic and clinical characteristics were found. A survival analysis highlighted that, after 10 days of hospitalization, severe vitamin D deficiency MESHD patients had a 50% mortality probability, while those with vitamin D ≥10 had a 5% mortality risk (p=0.019). Conclusions: High prevalence SERO of hypovitaminosis D was found in COVID-19 patients with acute respiratory failure HP, treated in a RICU. Patients with severe vitamin D deficiency MESHD had a significantly higher mortality risk. Severe vitamin D deficiency MESHD may be a marker of poor prognosis in these patients, suggesting that adjunctive treatment might improve disease MESHD outcomes.

    Risk Factors for Mortality of COVID-19 Patients

    Authors: Ouail Ouchetto; Asmaa Drissi Bourhanbour

    doi:10.1101/2020.07.02.20145375 Date: 2020-07-07 Source: medRxiv

    Background: Lethality rates of COVID-19 are so different between countries and continents. This lethality seems to be very low in Africa and Asia, but exceedingly high in western Europe and North America. Many factors could have a role in this disparity such as comorbidities. Advanced age TRANS, obesity MESHD obesity HP, cardiovascular disease MESHD, diabetes and cancer were the most frequently cited in the reported COVID-19 data. The main objective was to analyse the association between the COVID-19 mortality and the mentioned factors in 164 countries. Methods: The Data of COVID-19 deaths MESHD, latitude degrees, population age TRANS distribution, cardiovascular diseases MESHD, obesity MESHD obesity HP, diabetes and cancer were extracted from different online sources. For the statistical analysis, we used Spearman to measure the correlation coefficient between numbers of deaths MESHD and the mentioned factors until June 29, 2020. Results: The correlation between COVID-19 mortality and latitude, high age TRANS, obesity MESHD obesity HP, CVD and number of cancer patients per 100,000 is significant at 0.01 level with r = 0.489, r=0.511, r=0.489, r=0.561 and r=0.536 respectively. The correlation between the number of deaths MESHD and diabetes is less strong than the previous ones, and the correlation coefficient is r= 0.154. Conclusion: The great lethality of COVID-19 in western Europe and North America can be explained in part by the highest of age TRANS, cancer and CVD percentage in these regions. It seems also plausible that the increased obesity MESHD obesity HP in the USA and vitamin D deficiency MESHD in Europe may contribute to increasing the number of COVID-19 deaths MESHD.

    Prior diagnoses and medications as risk factors for COVID-19 in a Los Angeles Health System

    Authors: Timothy S Chang; Yi Ding; Malika K Freund; Ruth Johnson; Tommer Schwarz; Julie M Yabu; Chad Hazlett; Jeffrey N Chiang; Ami Wulf; - UCLA Health Data Mart Working Group; Daniel H Geschwind; Manish J Butte; Bogdan Pasaniuc

    doi:10.1101/2020.07.03.20145581 Date: 2020-07-04 Source: medRxiv

    With the continuing coronavirus disease MESHD 2019 (COVID-19) pandemic coupled with phased reopening, it is critical to identify risk factors associated with susceptibility and severity of disease MESHD in a diverse population to help shape government policies, guide clinical decision making, and prioritize future COVID-19 research. In this retrospective case-control study, we used de-identified electronic health records (EHR) from the University of California Los Angeles (UCLA) Health System between March 9th, 2020 and June 14th, 2020 to identify risk factors for COVID-19 susceptibility (severe acute respiratory distress HP syndrome MESHD coronavirus 2 (SARS-CoV-2) PCR test positive), inpatient admission, and severe outcomes (treatment in an intensive care unit or intubation). Of the 26,602 individuals tested by PCR for SARS-CoV-2, 992 were COVID-19 positive (3.7% of Tested), 220 were admitted in the hospital (22% of COVID-19 positive), and 77 had a severe outcome (35% of Inpatient). Consistent with previous studies, males TRANS and individuals older than 65 years old had increased risk of inpatient admission. Notably, individuals self-identifying as Hispanic or Latino constituted an increasing percentage of COVID-19 patients as disease MESHD severity escalated, comprising 24% of those testing positive, but 40% of those with a severe outcome, a disparity that remained after correcting for medical co-morbidities. Cardiovascular disease MESHD, hypertension, and renal MESHD hypertension HP disease MESHD were premorbid risk factors present before SARS-CoV-2 PCR testing associated with COVID-19 susceptibility. Less well-established risk factors for COVID-19 susceptibility included pre-existing dementia MESHD dementia HP (odds ratio (OR) 5.2 [3.2-8.3], p=2.6 x 10-10), mental health conditions (depression OR 2.1 [1.6-2.8], p=1.1 x 10-6) and vitamin D deficiency MESHD (OR 1.8 [1.4-2.2], p=5.7 x 10-6). Renal diseases MESHD including end-stage renal disease MESHD and anemia MESHD anemia HP due to chronic renal disease MESHD were the predominant premorbid risk factors for COVID-19 inpatient admission. Other less established risk factors for COVID-19 inpatient admission included previous renal transplant (OR 9.7 [2.8-39], p=3.2x10-4) and disorders of the immune system (OR 6.0 [2.3, 16], p=2.7x10-4). Prior use of oral steroid medications was associated with decreased COVID-19 positive testing risk (OR 0.61 [0.45, 0.81], p=4.3x10-4), but increased inpatient admission risk (OR 4.5 [2.3, 8.9], p=1.8x10-5). We did not observe that prior use of angiotensin converting enzyme inhibitors or angiotensin receptor blockers increased the risk of testing positive for SARS-CoV-2, being admitted to the hospital, or having a severe outcome. This study involving direct EHR extraction identified known and less well-established demographics, and prior diagnoses and medications as risk factors for COVID-19 susceptibility and inpatient admission. Knowledge of these risk factors including marked ethnic disparities observed in disease MESHD severity should guide government policies, identify at-risk populations, inform clinical decision making, and prioritize future COVID-19 research.

    Strong Correlation Between Prevalence SERO of Severe Vitamin D Deficiency MESHD and Population Mortality Rate from COVID-19 in Europe

    Authors: Isaac Z Pugach; Sofya Pugach

    doi:10.1101/2020.06.24.20138644 Date: 2020-07-01 Source: medRxiv

    Background: SARS-CoV-2 virus causes a very wide range of COVID-19 disease MESHD severity in humans: from completely asymptomatic TRANS to fatal, and the reasons behind it are often not understood. There is some data that Vitamin D may have protective effect, so authors decided to analyze European country-wide data to determine if Vitamin D levels are associated with COVID-19 population death MESHD rate. Methods: To retrieve the Vitamin D levels data, authors analyzed the Vitamin D European population data compiled by 2019 ECTS Statement on Vitamin D Status published in the European Journal of Endocrinology. For the data set to used for analysis, only recently published data, that included general adult TRANS population of both genders TRANS ages TRANS 40-65 or wider, and must have included the prevalence SERO of Vitamin D deficiency MESHD. Results: There were 10 countries data sets that fit the criteria and were analyzed. Severe Vitamin D deficiency MESHD was defined as 25(OH)D less than 25 nmol/L (10 ng/dL). Pearson correlation analysis between death MESHD rate per million from COVID-19 and prevalence SERO of severe Vitamin D deficiency MESHD shows a strong correlation with r = 0.76, p = 0.01, indicating significant correlation. Correlation remained significant, even after adjusting for age TRANS structure of the population. Additionally, over time, correlation strengthened, and r coefficient asymptoticaly increased. Conclusions: Authors recommend universal screening for Vitamin D deficiency MESHD, and further investigation of Vitamin D supplementation in randomized control studies, which may lead to possible treatment or prevention of COVID-19.

    Factors Associated with Hospitalization and Disease MESHD Severity in a Racially and Ethnically Diverse Population of COVID-19 Patients

    Authors: Angelico Mendy; Senu Apewokin; Anjanette A Wells; Ardythe L Morrow

    doi:10.1101/2020.06.25.20137323 Date: 2020-06-26 Source: medRxiv

    Background: The coronavirus disease MESHD (COVID-19) first identified in Wuhan in December 2019 became a pandemic within a few months of its discovery. The impact of COVID-19 is due to both its rapid spread and its severity, but the determinants of severity have not been fully delineated. Objective: Identify factors associated with hospitalization and disease MESHD severity in a racially and ethnically diverse cohort of COVID-19 patients. Methods: We analyzed data from COVID-19 patients diagnosed at the University of Cincinnati health system from March 13, 2020 to May 31, 2020. Severe COVID-19 was defined as admission to intensive care unit or death MESHD. Logistic regression modeling adjusted for covariates was used to identify the factors associated with hospitalization and severe COVID-19. Results: Among the 689 COVID-19 patients included in our study, 29.2% were non-Hispanic White, 25.5% were non-Hispanic Black, 32.5% were Hispanic, and 12.8% were of other race/ethnicity. About 31.3% of patients were hospitalized and 13.2% had severe disease MESHD. In adjusted analyses, the sociodemographic factors associated with hospitalization and/or disease MESHD severity included older age TRANS, non-Hispanic Black or Hispanic race/ethnicity (compared to non-Hispanic White), and smoking. The following comorbidities: diabetes, hypercholesterolemia MESHD hypercholesterolemia HP, asthma MESHD asthma HP, COPD, chronic kidney disease HP kidney disease MESHD, cardiovascular diseases MESHD, osteoarthritis MESHD osteoarthritis HP, and vitamin D deficiency MESHD were associated with hospitalization and/or disease MESHD severity. Hematological disorders such as anemia MESHD anemia HP, coagulation disorders, and thrombocytopenia MESHD thrombocytopenia HP were associated with both hospitalization and disease MESHD severity. Conclusion: This study confirms race and ethnicity as predictors of severe COVID-19. It also finds clinical risk factors for hospitalization and severe COVID-19 not previously identified such a vitamin D deficiency MESHD, hypercholesterolemia MESHD hypercholesterolemia HP, osteoarthritis MESHD osteoarthritis HP, and anemia MESHD anemia HP.

    Vitamin D insufficiency and deficiency and mortality from respiratory diseases MESHD in a cohort of older adults TRANS: potential for limiting the death MESHD toll during and beyond the COVID-19 pandemic

    Authors: Hermann Brenner; Bernd Holleczek; Ben Schoettker

    doi:10.1101/2020.06.22.20137299 Date: 2020-06-23 Source: medRxiv

    Background. The COVID-19 pandemic goes along with increased mortality from acute respiratory disease MESHD, and measures to limit the spread of the infection MESHD go along with increased risk of vitamin D deficiency MESHD, especially among high risk groups. It has been suggested that vitamin D3 supplementation might help to reduce respiratory disease MESHD mortality. Methods. We assessed the prevalence SERO of vitamin D insufficiency and deficiency, defined by 25(OH)D blood SERO levels of 30-50 and <30 nmol/L, respectively, and their association with mortality from respiratory diseases MESHD during 15 years of follow-up in a cohort of 9,548 adults TRANS aged TRANS 50-75 years from Saarland, Germany. Results. Vitamin D insufficiency and deficiency were common (44% and 15%, respectively). Compared to sufficient vitamin D status, respiratory disease MESHD mortality was 2.1 (95%-CI 1.3-3.2)- and 3.0 (95%-CI 1.8-5.2)-fold increased, respectively. Although significant increases were seen in both women and men, they were much stronger among women, with 8.5 (95% CI 2.4-30.1) and 2.3 (95% CI 1.1-4.4)-fold increase of respiratory disease MESHD mortality in case of vitamin D deficiency MESHD among women and men, respectively (p-value for interaction =0.041). Overall, 41% (95% CI 20%-58%) of respiratory disease MESHD mortality was statistically attributable to vitamin D insufficiency or deficiency. Conclusion. Vitamin D insufficiency and deficiency are common and account for a large proportion of respiratory disease MESHD mortality in older adults TRANS, supporting suggestions that vitamin D3 supplementation might make a major contribution to limit the burden of the COVID-19 pandemic, particularly among women.

    Low serum SERO 25-hydroxyvitamin D (25D) levels in patients hospitalised with COVID-19 are associated with greater disease MESHD severity: results of a local audit of practice.

    Authors: Grigorios Panagiotou; Su Ann Tee; Yasir Ihsan; Waseem Athar; Gabriella Marchitelli; Donna Kelly; Christopher S. Boot; Nadia Stock; Jim Macfarlane; Adrian R. Martineau; Graham Paul Burns; Richard Quinton

    doi:10.1101/2020.06.21.20136903 Date: 2020-06-23 Source: medRxiv

    Objectives: To audit implementation of a local protocol for the treatment of vitamin D deficiency MESHD (VDD) among patients hospitalized for Coronavirus Disease MESHD 2019 (COVID-19), including an assessment of the prevalence SERO of VDD in these patients, and of potential associations with disease MESHD severity and fatality. Design: This was not a study or clinical trial, but rather a retrospective interim audit (Newcastle-upon-Tyne Hospitals Registration No. 10075) of a local clinical care pathway for hospitalized patients with COVID-19-related illness. The Information (Caldicott) Guardian permitted these data to be shared beyond the confines of our institution. Setting: A large tertiary academic NHS Foundation Trust in the North East of England, UK, providing care to COVID-19 patients. Participants: One hundred thirty-four hospitalized patients with documented COVID-19 infection MESHD. Main outcome measures: Adherence to local investigation and treatment protocol; prevalence SERO of VDD, and relationship of baseline serum SERO 25(OH)D with markers of COVID-19 severity and inpatient fatality versus recovery. Results: 55.8% of eligible patients received Colecalciferol replacement, albeit not always loaded as rapidly as our protocol suggested, and no cases of new hypercalcaemia occurred following treatment. Patients admitted to ITU were younger than those managed on medical wards (61.1 years +/- 11.8 vs. 76.4 years +/- 14.9, p<0.001), with greater prevalence SERO of hypertension MESHD hypertension HP, and higher baseline respiratory rate, National Early Warning Score-2 and C-reactive protein level. While mean serum SERO 25(OH)D levels were comparable [i.e. ITU: 33.5 nmol/L +/- 16.8 vs. Non-ITU: 48.1 nmol/L +/- 38.2, mean difference for Ln-transformed-25(OH)D: 0.14, 95% Confidence Interval (CI) (-0.15, 0.41), p=0.3], only 19% of ITU patients had 25(OH)D levels greater than 50 nmol/L vs. 60.9% of non-ITU patients (p=0.02). However, we found no association with fatality, potentially due to small sample size, limitations of no-trial data and, potentially, the prompt diagnosis and treatment of VDD. Conclusions: Subject to the inherent limitations of observational (non-trial) audit data, analysed retrospectively, we found that patients requiring ITU admission were more frequently vitamin D deficient than those managed on medical wards, despite being significantly younger. Larger prospective studies and/or clinical trials are needed to elucidate the role of vitamin D as a preventive and/or therapeutic strategy for mitigating the effects of COVID-19 infection MESHD in patients with VDD.

    Double COVID-19 Confirmed Case TRANS Fatality Rate in Countries with High Elderly TRANS Female TRANS Vitamin D Deficiency MESHD Prevalence SERO

    Authors: Alex Backer; Myron Mageswaran

    doi:10.1101/2020.06.13.20130484 Date: 2020-06-16 Source: medRxiv

    A number of clues point to a possible role of vitamin D in fighting COVID-19: a reduction in case growth speed with solar zenith angle, higher fatality rate in black people, lower fatality rate in populations that spend more time outdoors. Yet a direct demonstration that vitamin D deficiency MESHD is associated with COVID-19 fatalities has remained elusive. We show here in a comparison of 32 countries that countries with high prevalence SERO of vitamin D deficiency MESHD among elderly TRANS females TRANS show a confirmed case TRANS fatality rate twice as high as those with low prevalence SERO. We then show that this effect cannot be explained by differences in life expectancy between countries. A mechanistic role for vitamin D in the severity of COVID-19 is proposed.

    The Role of Vitamin D in The Age TRANS of COVID-19: A Systematic Review and Meta-Analysis Along with an Ecological Approach

    Authors: Roya Ghasemian; Amir Shamshirian; Keyvan Heydari; Mohammad Malekan; Reza Alizadeh-Navaei; Mohammad Ali Ebrahimzadeh; Hamed Jafarpour; Arash Rezaei Shahmirzadi; Mehrdad Khodabandeh; Benyamin Seyfari; Meghdad Sedaghat; Alireza Motamedzadeh; Ehsan Dadgostar; Marzieh Aalinezhad; Morteza Behnamfar; Anahita Asadi; Bahman Zarandi; Nazanin Razzaghi; Vahid Yaghoubi Naei; Amirhossein Hessami; Soheil Azizi; Ali Reza Mohseni; Danial Shamshirian

    doi:10.1101/2020.06.05.20123554 Date: 2020-06-08 Source: medRxiv

    Background: Following emerge of a novel coronavirus from Wuhan, China, in December 2019, it has affected the whole world and after months of efforts by the medical communities, there is still no specific approach for prevention and treatment against the Coronavirus Disease MESHD 2019 (COVID-19). Evidence recommends that vitamin D might be an important supportive agent for the immune system, mainly in cytokine response regulation against COVID-19. Hence, we carried out a rapid systematic review and meta-analysis along with an ecological investigation in order to maximize the use of everything that exists about the role of vitamin D in the COVID-19. Methods: A systematic search was performed in PubMed, Scopus, Embase, Cochrane Library, Web of Science and Google Scholar (intitle) as well as preprint database of medRxiv, bioRxiv, Research Square,, search engine of ScienceDirect and a rapid search through famous journals up to May 26, 2020. Studies focused on the role of vitamin D in confirmed COVID-19 patients were entered into the systematic review. Along with our main aim, to find the second objective: correlation of global vitamin D status and COVID-19 recovery and mortality we carried out a literature search in PubMed database to identify the national or regional studies reported the vitamin D status globally. CMA v. 2.2.064 and SPSS v.16 were used for data analysis. Results: Out of nine studies entered into our systematic review, six studies containing 3,822 participants entered into the meta-analysis. The meta-analysis indicated that 46.5% of COVID-19 patients were suffering from vitamin D deficiency MESHD (95% CI, 28.2%-65.8%) and in 43.3% of patients, levels of vitamin D were insufficient (95% CI, 27.4%-60.8%). In regard to our ecological investigation on 51 countries including 408,748 participants, analyses indicated no correlation between vitamin D levels and recovery rate (r= 0.041) as well as mortality rate (r=-0.073) globally. However, given latitude, a small reverse correlation between mortality rate and vitamin D status was observed throughout the globe (r= -0.177). In Asia, a medium direct correlation was observed for recovery rate (r= 0.317) and a significant reveres correlation for mortality rate (r= -0.700) with vitamin D status in such patients. In Europe, there were no correlations for both recovery (r= 0.040) and mortality rate (r= -0.035). In Middle East, the recovery rate (r= 0.267) and mortality rate (r= -0.217) showed a medium correlation. In North and Sought America, surprisingly, both recovery and mortality rate demonstrated a direct correlation respectively (r= 1.000, r=0.500). In Oceania, unexpectedly, recovery (r= -1.000) and mortality (r= -1.000) rates were in considerable reverse correlation with vitamin D levels. Conclusion: In this systematic review and meta-analysis with an ecological approach, we found a high percentage of COVID-19 patients who suffer from vitamin D deficiency MESHD or insufficiency. Much more important, our ecological investigation resulted in substantial direct and reverse correlations between recovery and mortality rates of COVID-19 patients with vitamin D status in different countries. Considering latitudes, a small reverse correlation between vitamin D status and mortality rate was found globally. It seems that populations with lower levels of vitamin D HP might be more susceptible to the novel coronavirus infection MESHD. Nevertheless, due to multiple limitations, if this study does not allow to quantify a value of the Vitamin D with full confidence, it allows at least to know what the Vitamin D might be and that it would be prudent to invest in this direction through comprehensive large randomized clinical trials.

    The association of UV with rates of COVID-19 transmission TRANS and deaths MESHD in Mexico: the possible mediating role of vitamin D.

    Authors: Margaret Skutsch; Carlos Dobler; Matthew B.B. McCall; Adrian Ghilardi; Miguel A. Salinas-Melgoza; Michael K. McCall; Gabriela Fenner-Sanchez

    doi:10.1101/2020.05.25.20112805 Date: 2020-05-27 Source: medRxiv

    The first COVID-19 case in Mexico was confirmed on 26 February 2020 and by May 3 the number of registered cases had risen to 30,927. However the rate of transmission TRANS varied greatly from city to city. We used data on temperature, humidity and ultraviolet radiation (UV) from 45 cities all over the country to explore whether there was an association between these variables and rates of transmission TRANS and rates of accumulation of COVID-19 ascribed deaths MESHD. The advantage of an in-country study of this kind is that many of the variables that can confound international studies are held constant (e.g. public health policies, methods of reporting, cultural, behavioural and genetic factors). Although the official statistics undoubtedly greatly underestimate the situation in Mexico due to lack of testing, they are underestimated in all cities so this should not introduce bias across the sample. We found that temperature and humidity had no discernible association with transmission TRANS rates but that UV during the transmission TRANS period was negatively correlated with rates of transmission TRANS, suggesting a sterilizing effect. UV in the January preceding the epidemic had a slightly higher association with transmission TRANS rates than UV during the transmission TRANS period itself. We also found negative associations of UV in the transmission TRANS period and in January with rate of cumulative deaths MESHD, but at lower levels of statistical significance. We conclude that in addition to a sterilizing effect during the transmission TRANS period, UV may have a physiological effect in reducing transmission TRANS and deaths MESHD due to COVID-19, most likely through the medium of vitamin D production in the body. This follows the growing body of medical evidence that vitamin D deficiency MESHD is associated with severity of COVID-19. However, we also found a negative correlation between altitude and rates of COVID-19 transmission TRANS, distinct and independent of the UV effect, which may indicate that other physiological processes are also present. In a multiple regression, altitude and UV together accounted for 18% of the variation in transmission TRANS rates between cities.

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MeSH Disease
Human Phenotype

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