Corpus overview


MeSH Disease

Human Phenotype


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    Outcomes of COVID-19 related hospitalisation among people with HIV in the ISARIC WHO Clinical Characterisation Protocol UK Protocol: prospective observational study

    Authors: Anna Maria Geretti; Alexander Stockdale; Sophie Kelly; Muge Cevik; Simon Collins; Laura Waters; Giovanni Villa; Annemarie B Docherty; Ewen M Harrison; Lance Turtle; Peter JM Openshaw; Kenneth Baillie; Caroline Sabin; Malcolm Gracie Semple

    doi:10.1101/2020.08.07.20170449 Date: 2020-08-11 Source: medRxiv

    Background. There is conflicting evidence about how HIV infection MESHD influences COVID-19. We compared the presentation characteristics and outcomes of people with and without HIV hospitalised with COVID-19 at 207 centres across the United Kingdom. Methods. We analysed data from people with laboratory confirmed or highly likely COVID-19 enrolled into the ISARIC CCP-UK study. The primary endpoint was day-28 mortality after presentation. We used Kaplan-Meier methods and Cox regression to describe the association with HIV status after adjustment for sex, ethnicity, age TRANS, indeterminate/probable hospital acquisition of COVID-19 (definite hospital acquisition excluded), presentation date, and presence/absence of ten comorbidities. We additionally adjusted for disease MESHD severity at presentation as defined by hypoxia MESHD/oxygen therapy. Findings. Among 47,539 patients, 115 (0.24%) had confirmed HIV-positive status and 103/115 (89.6%) had a record of antiretroviral therapy. At presentation, relative to the HIV-negative group, HIV-positive people were younger (median 55 versus 74 years; p<0.001), had a higher prevalence SERO of obesity MESHD obesity HP and moderate/severe liver disease MESHD, higher lymphocyte counts and C-reactive protein, and more systemic symptoms. The cumulative incidence of day-28 mortality was 25.2% in the HIV-positive group versus 32.1% in the HIV-negative group (p=0.12); however, stratification for age TRANS revealed a higher mortality among HIV-positive people aged TRANS below 60 years. The effect of HIV-positive status was confirmed in adjusted analyses (adjusted hazard ratio [HR] 1.49, 95% confidence interval [CI] 0.99-2.25; p=0.06). Following additional adjustment for disease MESHD severity at presentation, mortality was higher in HIV-positive people (adjusted HR 1.63; 95% CI 1.07-2.48; p=0.02). In the HIV-positive group, mortality was more common among those who were slightly older and among people with obesity MESHD obesity HP and diabetes with complications MESHD. Interpretation. HIV-positive status may be associated with an increased risk of day-28 mortality following a COVID-19 related hospitalisation.

    HIV infection MESHD and COVID-19 death MESHD: population-based cohort analysis of UK primary care data and linked national death MESHD registrations within the OpenSAFELY platform

    Authors: Krishnan Bhaskaran; Christopher T Rentsch; Brian MacKenna; Anna Schultz; Amir Mehrkar; Chris Bates; Rosalind M Eggo; Caroline E Morton; Seb Bacon; Peter Inglesby; Ian J Douglas; Alex J Walker; Helen I McDonald; Jonathan Cockburn; Elizabeth J Williamson; David Evans; Harriet J Forbes; Helen J Curtis; William Hulme; John Parry; Frank Hester; Sam Harper; Stephen JW Evans; Liam Smeeth; Ben Goldacre

    doi:10.1101/2020.08.07.20169490 Date: 2020-08-07 Source: medRxiv

    Background: It is unclear whether HIV infection MESHD is associated with risk of COVID-19 death MESHD. We aimed to investigate this in a large-scale population-based study in England. Methods: Working on behalf of NHS England, we used the OpenSAFELY platform to analyse routinely collected electronic primary care data linked to national death MESHD registrations. People with a primary care record for HIV infection MESHD were compared to people without HIV. COVID-19 death MESHD was defined by ICD-10 codes U07.1 or U07.2 anywhere on the death MESHD certificate. Cox regression models were used to estimate the association between HIV infection MESHD and COVID-19 death MESHD, initially adjusted for age TRANS and sex, then adding adjustment for index of multiple deprivation and ethnicity, and finally for a broad range of comorbidities. Interaction terms were added to assess effect modification by age TRANS, sex, ethnicity, comorbidities and calendar time. Results: 17.3 million adults TRANS were included, of whom 27,480 (0.16%) had HIV recorded. People living with HIV were more likely to be male TRANS, of black ethnicity, and from a more deprived geographical area than the general population. There were 14,882 COVID-19 deaths MESHD during the study period, with 25 among people with HIV. People living with HIV had nearly three-fold higher risk of COVID-19 death MESHD than those without HIV after adjusting for age TRANS and sex (HR=2.90, 95% CI 1.96-4.30). The association was attenuated but risk remained substantially raised, after adjustment for deprivation and ethnicity (adjusted HR=2.52, 1.70-3.73) and further adjustment for comorbidities (HR=2.30, 1.55-3.41). There was some evidence that the association was larger among people of black ethnicity (HR = 3.80, 2.15-6.74, compared to 1.64, 0.92-2.90 in non-black individuals, p-interaction=0.045) Interpretation: HIV infection MESHD was associated with a markedly raised risk of COVID-19 death MESHD in a country with high levels of antiretroviral therapy coverage and viral suppression; the association was larger in people of black ethnicity.

    COVID-19 Vulnerability of Transgender Women With and Without HIV Infection MESHD in the Eastern and Southern U.S.

    Authors: Tonia Poteat; Sari Reisner; Marissa Miller; Andrea Wirtz

    doi:10.1101/2020.07.21.20159327 Date: 2020-07-24 Source: medRxiv

    Background: COVID-19 is a new global pandemic and people with HIV may be particularly vulnerable. Gender TRANS identity is not reported, therefore data are absent on the impact of COVID-19 on transgender people, including transgender people with HIV. Baseline data from the American Cohort to Study HIV Acquisition Among Transgender Women in High Risk Areas (LITE) Study provide an opportunity to examine pre-COVID vulnerability among transgender women. Setting: Atlanta, Baltimore, Boston, Miami, New York City, Washington, DC Methods: Baseline data from LITE were analysed for demographic, psychosocial, and material factors that may affect risk for COVID-related harms. Results: The 1020 participants had high rates of poverty, unemployment, food insecurity, homelessness, and sex work. Transgender women with HIV (n=273) were older, more likely to be Black, had lower educational attainment, and were more likely to experience material hardship. Mental and behavioural health symptoms were common and did not differ by HIV status. Barriers to healthcare included being mistreated mistreatment, uncomfortable providers, and past negative experiences; as well as material hardships, such as cost and transportation. However, most reported access to material and social support - demonstrating resilience. Conclusions: Transgender women with HIV may be particularly vulnerable to pandemic harms. Mitigating this harm would have positive effects for everyone, given the highly infectious nature of this coronavirus. Collecting gender TRANS identity in COVID-19 data is crucial to inform an effective public health response. Transgender-led organizations' response to this crisis serve as an important model for effective community-led interventions.

    AIDS and COVID-19 are two diseases MESHD separated by a common lymphocytopenia

    Authors: Salvatore Sciacchitano; Simonetta Giovagnoli; Rachele Amodeo; Iolanda Santino; Maurizio Simmaco; Paolo Anibaldi; Deborah French; Rita Mancini; Claudia De Vitis; Michela D'Ascanio; Alberto Ricci; Alfredo Pennica; Antonio Aceti

    doi:10.21203/ Date: 2020-07-15 Source: ResearchSquare

    HIV and SARS-CoV-2 are responsible for two of the most dangerous and life-threatening infectious diseases MESHD of our times. To better analyze the difference in the immunological response elicited by the two infections MESHD, we compare the alterations in the lymphocyte subpopulations, measured by flow cytometry analysis (FCA) in both AIDS and COVID-19 patients, referred to our University Hospital. A total of 184 HIV infected patients were retrospectively examined and the results of FCA collected and compared to those obtained in 110 SARS-CoV-2 infected patients, examined during the actual outbreak. We observe a comparable reduction in B cells in both diseases MESHD and a more severe reduction in the total amount of T cells in COVID-19 as compared to AIDS patients. The analysis of the T cells subpopulations indicates that there is a comparable reduction in the CD4+ cells count. Conversely, a remarkable difference between them is observed in the CD8+ counts. In AIDS patients the CD8+ cells are slightly higher than normal, while in COVID-19 patients the CD8+ cell count is markedly reduced. As a result, the CD4+/CD8+ ratios, is very low in AIDS and higher than normal in COVID-19 patients. The NK cells are reduced in both diseases MESHD, but SARS-CoV-2 infection MESHD causes a more severe reduction compared to HIV infection MESHD. In conclusion, both HIV and SARS-CoV-2 viruses induce major changes in the lymphocytes count, with remarkable similarities and differences between them. The total absolute numbers of T cells and, in particular of the CD8+ subpopulation, are lower in COVID-19 patients compared to AIDS ones, while the CD4+ are reduced in both at similar levels. These results indicate that the host immune system reacts differently to the two infection MESHD, but they are responsible of a comparable dropping effect on the serum SERO levels of CD4+ T cell population. The meaning of the similarities and of the differences in terms of T cells activation and serum SERO depletion are discussed. The knowledge on how the immune system reacts to these two infections MESHD will be useful to better define their mechanism of action and to design specific preventive and therapeutic approaches.

    Report of a COVID-19 Case Combined with HIV Infection MESHD

    Authors: Aimei Liu; Jie Wei; Yuanlong Xu; Dayong Huang; Kangyan Lv; Zhihao Meng; Junli Huang; Liling Huang; Guowei Wu

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

    Background: Confirmed as a familial clustered case, a COVID-19 patient displaying established symptoms was simultaneously diagnosed with an HIV infection MESHD, and treated with several antiviral and compassionate drugs.Case presentation: The upper respiratory tract Nucleic Acid Testing (NAT) for the novel coronavirus continued to be positive for consecutive 49 days. During the course of treatment, it was observed that the other six cases in the family were non-HIV infected and displaying common Covid-19 symptoms, the familial cluster received parallel treatment along with the aforementioned patient, and the median time for the NAT to present as negative was 29 days. Conclusions: The results of this research indicate that the novel coronavirus attacks T lymphocyte subsets, andfurther studies with larger sample sizes are required to verify how the immune escape mechanism of the new coronavirus interacts with HIV infection MESHD.

    High Acceptance of HIV Self-testing Among PrEP Recipients before COVID-19 Era: A Cross-sectional Analysis from PrEP Demonstration Project of MSM in China

    Authors: Jing Zhang; Wei-ming Tang; Xia Jin; Hong-yi Wang; Zhen-xing Chu; Qing-hai Hu; Xiao-jie Huang; Yao-kai Chen; Hui Wang; Xiao-qing He; Yao Li; Lu-kun Zhang; Zhi-li Hu; Ran-tong Bao; Shang-cao Li; Hang Li; Hai-bo Ding; Yong-jun Jiang; Wen-qing Geng; Jun-jie Xu; Hong Shang

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

    Background: Many Pre-exposure prophylaxis (PrEP) users have difficulty attending the quarterly facility-based HIV testing, which leads to the potential risk of drug resistance in the context of breakthrough infection MESHD with low drug compliance. We explored the acceptance of HIV self-testing (HIVST) service among PrEP recipients. Methods: MSM were recruited for the PrEP demonstration in four major cities in China from December 2018 to September 2019, provided with regimens of both daily and on-demand PrEP. Facility-based HIV testing was provided quarterly at clinic visits. Previous HIV testing history and acceptance of free HIVST kits to use between each quarterly clinic visit was collected. Correlates of levels of acceptance were analysed using multivariable ordinal logistic regression. Results: We recruited 1,222 MSM. among which 48.5% preferred daily PrEP and 51.5% preferred on-demand PrEP. There was 26.8% (321/1222) had never been to any facility-based HIV testing previously, and the self-reported major reason was that they had already routinely used HIVST. A quarter of the participants (74.5%, 910/1222) had used HIVST previously. There were 1184 MSM (96.9%) accepted to use HIVST between each quarterly clinic visits during PrEP usage, composing 947 ( 77.5%) very willing to, 237(19.4%)willing to, 29 (2.4%) unwilling to, and 9 (0.7%) very unwilling to. Participants preferred daily PrEP (vs. on-demand PrEP, aOR=1.8, 95% CI:1.3-2.4) and had less than 2 times of facility-based HIV testing in the past year (vs. ³2, aOR=1.4,95% CI:1.1-1.9) were more likely to have higher level of acceptance of HIVST.Conclusions: MSM had high acceptance of HIVST, especially among those preferred daily PrEP and with less facility-based HIV testing in the previous year. Offering HIVST services PrEP recipients is feasible and necessary. Above result is of great significance for promoting HIVST among PrEP users during COVID-19, improving awareness of their HIV infection MESHD status and ensuring compliance with medication. Future study should exam the impact of HIVST on HIV testing frequency among PrEP users.Trial registration: ChiCTR1800020374 on 27th Dec 2018.

    Clinical Characteristics and Comparative Analysis of Covid-19 Patients With or Without HIV Coinfection MESHD in Wuhan, China

    Authors: Rongrong Yang; Xien Gui; Yongxi Zhang; Yong Xiong; Shicheng Gao; Hengning Ke

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

    Background: COVID-19 is a public health emergency MESHD that is spreading worldwide and seriously affecting global economy. Information about the impact of HIV co- infection MESHD and anti-HIV drugs on the clinical characteristics and prognosis of COVID-19 patients remains limited.Methods: In this retrospective study, the maximum body temperatures, fever MESHD fever HP duration, chest computed tomography changes and viral shedding, lymphocyte counts changes and titer of SARS-CoV-2 antibody SERO were compared between COVID-19 patients with and without HIV infection MESHD in Zhongnan Hospital of Wuhan University from January 20th to February 14th, 2020. Results: Compared with 50 control COVID-19 patients, the two COVID-19/HIV co- infection MESHD patients had higher maximum body temperatures(40.2℃ and 40.3℃ vs 38.2℃), longer fever MESHD fever HP duration(11 days and 15 days vs 7 days), longer time of lung recovery(20 days and 24 days vs 14 days), shorter duration of viral shedding after the onset of symptoms TRANS(6 days and 4 days vs 10 days). Compared with three COVID-19 infection MESHD colleagues who had exposure history with the same COVID-19 patient, the third COVID-19/HIV co- infection MESHD patient had the same duration of viral shedding after exposure(29 days vs 29 days), lower titer of SARS-CoV-2 IgG(negative vs positive for all). Conclusion: For patients co-infected with HIV, the clinical manifestations of SARS-CoV-2 infection MESHD were diverse. The ability of those COVID-19/HIV co- infection MESHD patients with severe immunodeficiency HP to produce SARS-CoV-2 antibodies SERO were weakened. The small sample in this study implied that the effects of anti-HIV drugs in prevention and treatment of COVID-19 appears to be limited.

    Casual sex among MSM during the period of social isolation in the COVID-19 pandemic: Nationwide study in Brazil and Portugal.

    Authors: Alvaro Francisco Lopes de Sousa; Layze Braz Oliveira; Guilherme Schneider; Artur Acelino Francisco Luz Queiroz; Herica Emilia Felix de Carvalho; Telma Maria Evangelista de Araujo; Emerson Lucas Silva Camargo; Sandra Brignol; Isabel Amelia Costa Mendes; Willi McFarland; Inês Fronteira

    doi:10.1101/2020.06.07.20113142 Date: 2020-06-09 Source: medRxiv

    Background: The social isolation to which Brazilians and Portuguese are subjected has been affecting their mental and sexual health, decreasing social support and increasing sexual risk behavior and exposure to the SARSCoV-2 virus. In this study we aim to investigate the practice of casual sex and the factors that are associated with this event in the context of the COVID-19 pandemic. Methods: An online survey carried out throughout Brazil and Portugal in April 2020, during the period of social isolation, with a sample of 2361 MSM. The collection took place in meeting apps and Facebook. Findings: There was a high frequency of casual sex (53%) and the use of strategies, without technical or scientific basis, to prevent infection MESHD by SARSCoV-2, such as the use of Truvada (12.7%). Among the factors that increased the chance of engaging in casual sex, we highlight: having sex simultaneously with two or more people (aOR = 2.1; 95%CI 1.4 - 3.4); Having sex with a regular and casual partner (aOR = 1.6; 95% CI 0.9-2.8), and only with casual (aOR = 2.5; 95%CI 1.8 - 3.5), using Facebook (aOR = 4.6; 95%CI 3.0-7.2), and cruising, swing houses, saunas or cruising points to get partners (aOR = 5.4; 95%CI 3.2 -8.9), being HIV positive (ORa = 11.7; 95%CI 4.7-29.2), or of unknown serological status (aOR = 1.4; 95%CI 0.7-2.3). In both countries, the longer the period of social isolation, the greater the chance of engaging in casual sex. Interpretation: Despite the great differences between the two countries, in both of them we registered a significant frequency of practicing casual sex, accompanied by dubious strategies to minimize the risk of acquiring SARSCov-2. This indicates that MSM participating in the research, to some degree, continue to be exposed to risky sexual practices for HIV infection MESHD and other STIs, but also for COVID-19. Funding: Conselho Nacional de Pesquisa-CNPq, Brazil.

    Antiretroviral Drug Activity and Potential for Pre-Exposure Prophylaxis Against COVID-19 and HIV Infection MESHD

    Authors: Dennis C. Copertino Jr.; Bruno Lima; Rodrigo Duarte; Timothy Wilkin; Roy Gulick; Miguel de Mulder Rougvie; Douglas Nixon

    doi:10.26434/chemrxiv.12250199.v1 Date: 2020-05-07 Source: ChemRxiv

    COVID-19 is the disease MESHD caused by SARS-CoV-2, and has led to over 250,000 deaths MESHD by May 2020. Urgent studies to identify new antiviral drugs, repurpose existing drugs, or identify those drugs that can specifically target the overactive immune response are ongoing around the world. Antiretroviral drugs (ARVs) have been tested in past human coronavirus infections MESHD, and also against SARS-CoV-2, but a recent clinical trial of lopinavir and ritonavir failed to show any clinical benefit in COVID-19 disease MESHD. However, anecdotal reports suggest either reduced infection MESHD or a course of milder COVID-19 disease MESHD in people living with HIV (PLWH) on ARVs. We hypothesized ARVs other than lopinavir and ritonavir might be responsible for such effects. Here, we used chemoinformatic analyses to predict which ARVs would bind and potentially inhibit the SARS-CoV-2 main protease or RNA-dependent RNA polymerase enzymes, and identified a number of ARVs which bind to SARS-CoV-2 enzymes in silico. Our study identified HIV nucleoside/nucleotide analogue reverse transcriptase inhibitors (abacavir, emtricitabine, lamivudine, tenofovir, zidovudine), HIV protease inhibitors (ASC09, atazanavir, indinavir, lopinavir, nelfinavir, ritonavir, saquinavir, tipranavir) and an HIV pharmacokinetic booster (cobicistat), as drug candidates with effective in silico binding to one or both viral enzymes. Tenofovir and emtricitabine are FDA-approved as HIV pre-exposure prophylaxis (PrEP) and have an extensive safety profile of use in populations without HIV. Existing or new combinations of antiretroviral drugs could potentially prevent or ameliorate the course of COVID-19, if shown to inhibit SARS-CoV-2 in vitro and/or in clinical trials. Further studies are needed to establish the activity of ARVs for treatment or prevention of SARS-CoV-2 infection MESHD.

    Using Supervised Machine Learning and Empirical Bayesian Kriging to reveal Correlates and Patterns of COVID-19 Disease MESHD outbreak in sub-Saharan Africa: Exploratory Data Analysis

    Authors: Amobi Andrew Onovo; Akinyemi Atobatele; Abiye Kalaiwo; Christopher Obanubi; Ezekiel James; Pamela Gado; Gertrude Odezugo; Doreen Magaji; Dolapo Ogundehin; Michele Russell

    doi:10.1101/2020.04.27.20082057 Date: 2020-05-02 Source: medRxiv

    Introduction: Coronavirus disease MESHD 2019 (COVID-19) is an emerging infectious disease MESHD that was first reported in Wuhan, China, and has subsequently spread worldwide. Knowledge of coronavirus-related risk factors can help countries build more systematic and successful responses to COVID-19 disease MESHD outbreak. Here we used Supervised Machine Learning and Empirical Bayesian Kriging (EBK) techniques to reveal correlates and patterns of COVID-19 Disease MESHD outbreak in sub-Saharan Africa (SSA). Methods: We analyzed time series aggregate data compiled by Johns Hopkins University on the outbreak of COVID-19 disease MESHD across SSA. COVID-19 data was merged with additional data on socio-demographic and health indicator survey data for 39 of SSA 48 countries that reported confirmed cases TRANS and deaths MESHD from coronavirus between February 28, 2020 through March 26, 2020. We used supervised machine learning algorithm, Lasso for variable selection and statistical inference. EBK was used to also create a raster estimating the spatial distribution of COVID-19 disease MESHD outbreak. Results: The lasso Cross-fit partialing out predictive model ascertained seven variables significantly associated with the risk of coronavirus infection MESHD (i.e. new HIV infections MESHD among pediatric, adolescent, and middle- aged TRANS adult TRANS PLHIV, time (days), pneumococcal conjugate-based vaccine, incidence of malaria MESHD and diarrhea MESHD diarrhea HP treatment). Our study indicates, the doubling time in new coronavirus cases was 3 days. The steady three-day decrease in coronavirus outbreak rate of change (ROC) from 37% on March 23, 2020 to 23% on March 26, 2020 indicates the positive impact of countries' steps to stymie the outbreak. The interpolated maps show that coronavirus is rising every day and appears to be severely confined in South Africa. In the West African region (i.e. Burkina Faso, Ghana, Senegal, CotedIviore, Cameroon, and Nigeria), we predict that new cases and deaths MESHD from the virus are most likely to increase. Interpretation: Integrated and efficiently delivered interventions to reduce HIV, pneumonia MESHD pneumonia HP, malaria MESHD and diarrhea MESHD diarrhea HP, are essential to accelerating global health efforts. Scaling up screening and increasing COVID-19 testing capacity across SSA countries can help provide better understanding on how the pandemic is progressing and possibly ensure a sustained decline in the ROC of coronavirus outbreak. Funding: Authors were wholly responsible for the costs of data collation and analysis.

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MeSH Disease
Human Phenotype

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