Corpus overview


MeSH Disease

Human Phenotype


    displaying 1 - 10 records in total 24
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    Persistent bacterial coinfection MESHD of a COVID-19 patient caused by a genetically adapted Pseudomonas aeruginosa chronic colonizer

    Authors: Zhao Cai; Yumei Liu; XiangKe Duan; Shuhong Han; Yuao Zhu; Yingdan Zhang; Chao Zhuo; Yang Liu; Liang Yang

    doi:10.1101/2020.08.05.238998 Date: 2020-08-06 Source: bioRxiv

    This study characterized a genetically adapted Pseudomonas aeruginosa small colony variant isolated from a COVID-19 patient who suffered persistent bacterial coinfection MESHD and eventually recovered from critical illness MESHD. Specification and modification of the isolates discovered at genomic and transcriptomic levels with aligned phenotypic observations indicated that these isolates formed excessive biofilm with elevated quorum sensing systems.

    Cardiac Troponin I Associated with Poor Prognosis and Death MESHD Risk in 726 Severe and Critical COVID-19 Patients: A Retrospective Cohort Study

    Authors: Huilong Chen; Xinjie Li; Tuohutaerbieke Marmar; Qiang Xu; Jing Tu; Tong Li; Jun Han; Dong Xu; Tao Shen

    doi:10.21203/ Date: 2020-07-28 Source: ResearchSquare

    Background: A few patients with coronavirus disease MESHD 2019 (COVID-19) may progress into irreparable outcomes. Early identification of patients with serious symptoms who may develop critical illness MESHD and even death MESHD is of considerable importance for personalizing treatment and balancing medical resources.Methods: In this retrospective study, demographic, clinical characteristics and laboratory tests from 726 patients with serious COVID-19 from Tongji Hospital (Wuhan, China) were analyzed. The standards for the serious type are guided by the Chinese management guideline for COVID-19. Patients were classified into critical group (174 cases) and severe group (552 cases) based on whether the composite endpoint was reached, and the former group was divided into the survivors (47 cases) and non-survivors (127 cases). Univariable and multivariable logistic regression and receiver operating characteristic (ROC) curve analysis were performed to investigate the risk factors associated with poor prognosis and mortality outcomes.Results: Male TRANS patients accounted for 62.1% and 51.6% in the critical group and severe group, with a median age TRANS of 68 and 65 years, respectively. Among critical cases there was a higher prevalence SERO of chronic obstructive lung disease MESHD obstructive lung disease HP (p = 0.029) and chest distress (p = 0.040) than in severe cases. In the multivariable analysis, the risk factors associated with poor prognosis in severe cases were advanced age TRANS (p = 0.002), high respiratory rate (RR) (p < 0.0001), high lactate dehydrogenase (LDH) level (p = 0.021), high hypersensitive cardiac troponin I (hs-cTnI) level (p < 0.0001), and low platelet counts (p = 0.005) at admission. In the adjusted models, higher mortality outcomes in critical patients were associated with high hs-cTnI level (p = 0.037). By plotting ROC curves of different indices, hs-cTnI and LDH were found to be predictive factors for poor prognosis in patients with severe COVID-19.Conclusions: For the risk assessment of serious COVID-19 patients on admission, advanced age TRANS, high level of RR, LDH, hs-cTnI, and low platelet counts, constitute important risk factors for poor prognosis in severe cases, and the hs-cTnI level can be helpful in predicting fatal outcomes in critically ill patients.

    Changes in lipid metabolism in patients with severe COVID-19

    Authors: Yi Li; Yan Zhang; Minhui Dai; Minxue Shen; Jianchu Zhang; Yanhui Cui; Ben Liu; Fengyu Lin; Lingli Chen; Duoduo Han; Yifei Fan; Yanjun Zeng; Wen Li; Sha Li; Xiang Chen; Pinhua Pan

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

    Background: Dyslipidemia plays an important role in the pathogenesis and evolution of critical illness MESHD, but limited information exists regarding the lipid metabolism of severe coronavirus disease MESHD 2019 (COVID-19) patients. The aim of this study was to investigate role of dyslipidemia in patients with severe COVID-19Methods: We retrospectively reviewed 216 severe COVID-19 patients with clarified outcomes (discharged or deceased), admitted to the West Court of Union Hospital in Wuhan, China, between February 1 and March 31, 2020. The dynamic changes of lipid profiles and their relationships with disease MESHD severity and clinical outcomes were analyzed.Results: A total of 216 severe COVID-19 patients, including 24 non-survivors and 192 survivors, were included in the final analyses. The levels of high-density lipoprotein cholesterol (HDL-C) and apolipoprotein AI (Apo-AI) on admission were significantly lower in non-survivors compared to survivors. During hospitalization, low-density lipoprotein cholesterol (LDL-C), total cholesterol(TC), HDL-C and Apo-AI were shown an increasing trend in survivors, but maintained lower levels or shown downward trend in non-survivors. The serum SERO levels of HDL-C and Apo-AI were inversely correlated with C-reactive protein (CRP), length of hospital stay of survivors and disease MESHD severity. The receiver operating characteristic (ROC) curve analysis identified a CRP/ HDL-C ratio cut-off value of 62.54 as the predictor for in-hospital mortality (AUC=0.823, Sensitivity=83.3%, Specificity=70.8%). Logistic regression analysis demonstrated that hypertension MESHD hypertension HP, neutrophils-to-lymphocytes ratio(NLR), platelet count and high CRP/ HDL-C ratio (>62.54) were independent factors to predict in-hospital mortality.Conclusions: The results demonstrated that dyslipidemia was associated with the inflammatory response, disease MESHD severity and poor prognosis of COVID-19. High CRP/ HDL-C ratio may serve as an independently potential predictor for hospital mortality among patients with severe COVID-19.

    Clinical characteristics and outcome of critically ill COVID-19 patients with Acute Kidney Injury MESHD Acute Kidney Injury HP: A single centre cohort study

    Authors: Richard Lowe; Matteo Ferrari; Myra Nasim-Mohi; Alexander Jackson; Ryan Meacham; Kristin Veighey; Rebecca Cusack; Dominic Richardson; Michael Grocott; Denny Levett; Ahilanandan Dushianthan

    doi:10.21203/ Date: 2020-07-10 Source: ResearchSquare

    BackgroundAcute kidney injury (AKI) is a common manifestation among patients critically ill with SARS-CoV-2 infection MESHD (Coronavirus 2019) and is associated with significant morbidity and mortality. The pathophysiology of renal failure in this context is not fully understood, but likely to be multifactorial. The intensive care unit outcomes of patients following COVID-19 acute critical illness MESHD with associated AKI have not been fully explored. We conducted a cohort study to investigate the risk factors for acute kidney injury MESHD acute kidney injury HP in patients admitted to and intensive care unit with COVID-19, its incidence and associated outcomes.MethodsWe reviewed the medical records of all patients admitted to our adult intensive care unit suffering from SARS-CoV-2 infection from 3rd March 2020 until 10th May 2020. Acute kidney injury was defined using the Kidney Disease MESHD Improving Global Outcome (KDIGO) criteria. The outcome analysis was assessed up to date as 15th of June 2020.ResultsA total of 81 patients admitted during this period. All patients had acute hypoxic respiratory failure HP and needed either noninvasive or invasive mechanical ventilatory support. Thirty-six patients (44%) had evidence of AKI (Stage I-33%, Stage II-22%, Renal Replacement Therapy (RRT)-44%). All patients with AKI stage III had RRT. Age TRANS, diabetes mellitus MESHD diabetes mellitus HP, immunosuppression, lymphopenia MESHD lymphopenia HP, high D-Dimer levels, increased APACHE II and SOFA scores, mechanical ventilation and use of inotropic or vasopressor support were significantly associated with AKI. The peak AKI was at day 4 and mean duration of RRT was 9 days. The mortality was 25% for the AKI group compared to 7% in those without AKI. Among those received RRT and survived their illness, the renal function recovery is complete and back to baseline in 92% of patients. Conclusion Acute kidney injury and renal replacement therapy is common in critically ill patients presenting with COVID-19. It is associated with increased severity of illness on admission to ICU, increased mortality and prolonged ICU and hospital length of stay.

    Association of Smoking Status with Outcomes in Hospitalized COVID-19 Patients

    Authors: Muhammad Adrish; Sridhar Chilimuri; Nikhitha Mantri; Haozhe Sun; Maleeha Zahid; Sudharsan Gongati; Ked Fortuzi; Abhishrut Pramod Jog; Pravish Purmessur; Ravish Singhal

    doi:10.21203/ Date: 2020-07-01 Source: ResearchSquare

    Introduction: Smoking causes inflammation MESHD of the lung epithelium by releasing cytokines and impairing muco-ciliary clearance. Some studies have linked smoking with severity of illness of COVID-19 whereas others have found no such association.Methods: This was a retrospective analysis of all adults TRANS hospitalized with COVID-19 from March 09 to May 18, 2020. Results: 1173 patients met the study criteria. 837 patients never smoked and 336 patients were either current smokers or past smoker and were grouped together in smokers group. Patients in smokers group were more likely to be male TRANS and had higher incidence of underlying COPD (19% vs. 6%, p<0.001), human immunodeficiency HP virus infection MESHD (11% vs. 5%,p<0.001), cancer (11% vs. 6%, p=0.005), congestive heart failure HP heart failure MESHD (15% vs. 8%, p<0.001), coronary artery disease MESHD (15% vs. 9%, p=0.027), chronic kidney disease HP kidney disease MESHD (11% vs. 8%, p=0.037), and end-stage renal disease MESHD (10% vs. 6%, p=0.009) compared to non-smokers. Smokers were more likely to develop critical illness MESHD requiring mechanical ventilation (47% vs. 37% p=0.005). Univariate Cox model for survival analysis by smoking status showed that smokers only current smokers had higher risk of death MESHD compared to never-smokers (HR 1.61, 95% confidence interval 1.22–2.12, p<0.001). In the multivariate approach Cox model for the survival, female TRANS sex, age TRANS, LDH and systemic steroid use were associated with overall survival.Conclusion: In our large single center retrospective database of patients hospitalized with COVID-19, smoking was associated with development of critical illness MESHD and higher likelihood of death MESHD

    Prognostic value of pro-inflammatory neutrophils and C-reactive protein in cancer patient with COVID-19: a multi-center, retrospective study

    Authors: Bo Zhang; Yuanhang Yu; Shawna Herbet; Yue Zhang; Jianhua Lu; Shihua Liu; Fang Xie; Liang Zhao; Xiao Lei; Wei Deng; Jianying Chen; Yunqiao Li

    doi:10.21203/ Date: 2020-06-22 Source: ResearchSquare

    Background: At present, the epidemic of the novel coronavirus disease MESHD 2019 (COVID-19) has quickly engulfed the world. Inflammatory cytokines are associated with the severity and outcomes of patients with COVID-19. However, the effects of pro-inflammatory factors in cancer patients with COVID-19 are unknown. Methods: A multi-center, retrospective, cross-sectional study, based on 5 designated tertiary hospitals for the treatment of COVID-19 in Hubei Province, China. 112 cancer patients with COVID-19, and 105 COVID-19 patients without cancer were enrolled in the study between January 1 st , 2020 and April 30 th , 2020. The risk assessment of pro-inflammatory factors for disease MESHD severity and clinical adverse outcomes was identified by univariable and multivariable logistic regression models. Results: Of the 112 cancer patients with COVID-19, 40 (35.7%) patients were in critical condition and 18 (16.1%) patients died unfortunately. Univariate and multivariate analysis demonstrated that hemoglobin count and pro-inflammatory neutrophil and C-reactive protein, can be used as independent factors affecting the severity of COVID-19; Meanwhile, pro-inflammatory neutrophils and C-reactive protein can be used as an independent influencing factor for adverse clinical outcome. Moreover, the dynamic changes of neutrophils and C-reactive protein were also presented, and compared with COVID-19 patients without cancer, cancer patients with COVID-19 showed higher neutrophil counts and C-reactive protein levels. Conclusions: In cancer patients with COVID-19, the significant increase in pro-inflammatory neutrophil and C-reactive protein indicated a more critical illness and adverse clinical outcome, and pro-inflammatory neutrophils and C-reactive protein played a more adverse effect compare with COVID-19 patients without cancer, which may be the cause of critical illness MESHD and adverse clinical outcomes of cancer patients with COVID-19.

    Risk factors for the critical illness MESHD in SARS-CoV-2 infection MESHD: a multicenter retrospective cohort study

    Authors: Sijing Cheng; Dingfeng Wu; Jie Li; Yifeng Zou; Yunle Wan; Lihan Shen; Lixin Zhu; Mang Shi; Linlin Hou; Tao Xu; Na Jiao; Yichen Li; Yibo Huang; Zhipeng Tang; Mingwei Xu; Shusong Jiang; Maokun Li; Guangjun Yan; Ping Lan; Ruixin Zhu

    doi:10.21203/ Date: 2020-06-16 Source: ResearchSquare

    Background: Prior studies reported that 5~32% COVID-19 patients were critically ill, a situation that poses great challenge for the management of the patients and ICU resources. We aim to identify independent risk factors to serve as prediction markers for critical illness MESHD of SARS-CoV-2 infection MESHD. Methods : Fifty-two critical and 200 non-critical SARS-CoV-2 nucleic acid positive patients hospitalized in 15 hospitals outside Wuhan from January 19 to March 6, 2020 were enrolled in this study. Multivariable logistic regression and LASSO logistic regression were performed to identify independent risk factors for critical illness MESHD.Results: Age TRANS older than 60 years, dyspnea MESHD dyspnea HP, respiratory rate > 24 breaths per min, leukocytosis MESHD leukocytosis HP >9.5 X109/L, neutrophilia HP >6.3 X109/L, lymphopenia MESHD lymphopenia HP <1.1 X109/L, neutrophil-to-lymphocyte ratio >3.53, fibrinogen >4g/L, d-dimer >0.55 µg/mL, blood SERO urea nitrogen >7.1 mM, elevated aspartate transaminase, elevated alanine aminotransferase, total bilirubin >21 µM, and Sequential Organ Failure Assessment (SOFA) score ≥2 were identified as risk factors for critical illness MESHD. LASSO logistic regression identified the best combination of risk factors as SOFA score, age TRANS, dyspnea MESHD dyspnea HP, and leukocytosis MESHD leukocytosis HP. The Area Under the Receiver-Operator Curve values for the risk factors in predicting critical illness MESHD were 0.921 for SOFA score, 0.776 for age TRANS, 0.764 for dyspnea MESHD dyspnea HP, 0.658 for leukocytosis MESHD leukocytosis HP, and 0.960 for the combination of the four risk factors.Conclusions: Our findings advocate the use of risk factors SOFA score ≥2, age TRANS >60, dyspnea MESHD dyspnea HP and leukocytosis MESHD leukocytosis HP >9.5 X109/L on admission, alone or in combination, to determine the optimal management of the patients and health care resources.

    Impact of recent influenza A virus infection MESHD on clinical characteristics and outcomes in severe coronavirus disease MESHD 2019 adult TRANS inpatients

    Authors: Chang Gao; Xianjun Yang; Long Chen; Hongyang Xu; Jialin Liu; Shanshan Wang; Haitao Niu; Wenkui Yu; Jian-an Huang; Xiuqin Zhang; Bo Shen; Alpaslan Tasdogan; Jessalyn M. Ubellacker; Jiahao Chen; Ling Yang; Qingyuan Zhan; Qiang Guo

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

    Background: Coronavirus disease MESHD 2019 (COVID-19) is a current global pandemic. However, impact of recent influenza A virus infection MESHD on the clinical course and outcomes of severe COVID-19 adult TRANS inpatients needs to be further explored.Methods: In this retrospective cohort study, severe, laboratory confirmed COVID-19 adult TRANS patients from Wuhan Tongji Hospital were included. Data were obtained from electronic medical records and compared between patients with and without recent influenza A virus infection MESHD.Results: 200 patients were included, 51.5% with recent influenza A virus infection MESHD. Recent influenza A virus infection MESHD group presented with longer persistence of cough MESHD cough HP and sputum from illness onset (35.0 vs. 27.0 days, P = 0.018) and (33.0 vs. 26.0 days, P = 0.015), respectively. Median time of progression to critical illness MESHD from illness onset was shorter (day 11.5 vs. day 16.0, P = 0.034). Time to clinical improvement and length of hospital stay were longer in recent infection MESHD group (23.0 vs. 19.0 days, P = 0.044) and (22.0 vs. 18.0 days, P = 0.030), respectively.Conclusions: Patients with recent influenza A virus infection MESHD showed a delay in time to clinical improvement and increased length of hospital stay. There is a high clinical need to improve the detection of common respiratory pathogens to identify co- infection MESHD during the epidemic of COVID-19.

    Construction and Validation of a Machine Learning-based Nomogram: A TOOL to Predict the Risk of Getting Severe Corona Virus Disease MESHD 2019 (COVID-19)

    Authors: Xinyi Zheng; Zhixian Yao; Zhong Zheng; Ke Wu; Junhua Zheng

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

    Background Identifying patients who may develop severe coronavirus disease MESHD 2019 (COVID-19) will facilitate personalized treatment and optimize the distribution of medical resources.Methods In this study, 590 COVID-19 patients during hospitalization were enrolled (Training set: n = 285; Internal validation set: n = 127; Prospective set: n = 178). After filtered by 2 machine learning methods in the training set, 5 out of 31 clinical features were selected into model building to predict the risk of developing severe COVID-19 disease MESHD. Multivariate logistic regression was applied to build the prediction nomogram and validated in 2 different sets. Receiver operating characteristic (ROC) analysis and decision curve analysis (DCA) were used to evaluate its performance SERO.Results From 31 potential predictors in the training set, 5 independent predictive factors were identified and included in the risk score: C-reactive protein (CRP), Lactate dehydrogenase (LDH), Age TRANS, Charlson/Deyo comorbidity score (CDCS) and Erythrocyte sedimentation rate (ESR). Subsequently, we generated the nomogram based on the above features for predicting severe COVID-19. In the training cohort, the Area under curves (AUCs) were 0.822 (95% CI 0.765–0.875) and the internal validation cohort was 0.762 (95% CI 0.768–0.844). Further, we validated it in a prospective cohort with the AUCs of 0.705 (95% CI 0.627–0.778). The internally bootstrapped calibration curve showed favorable consistency between prediction by nomogram and actual situation. And DCA analysis also conferred high clinical net benefit.Conclusion In this study, our predicting model based on 5 clinical characteristics of COVID-19 patients will enable clinicians to predict the potential risk of developing critical illness MESHD and thus optimize medical management.

    Development a Nomogram to Predict Prognosis in Severe and Critically Ill Patients with COVID-19

    Authors: Weiping Tan; Ying Zhu; Hui Yi; Yingyu Lin; Yumei Liu; Zhentian Wu; Xiang Si; Mimi Tang; Chunlin Hu; Yongjun Liu; Yi Yang; Zhenguang Chen; Dayue Liu; Yangli Liu; Yubiao Guo; Ke Jiang; Li Wan; Yukun Kuang; Yifeng Luo

    doi:10.21203/ Date: 2020-06-08 Source: ResearchSquare

    Background: The number of deaths MESHD caused by COVID-19 are on the rising worldwide. This study focused on severe and critically ill COVID-19, aim to explore independent risk factors associated with disease MESHD severity and to build a nomogram to predict patients’ prognosis.Methods: Patients with laboratory-confirmed COVID-19 admitted to the Union Hospital, Tongji Medical College and Hankou Hospital of Wuhan, China, from February 8th to April 6th, 2020. LASSO Regression and Multivariate Analysis were applied to screen independent factors. COX Nomogram was built to predict the 7-day, 14-day and 1-month survival probability.Results: A total of 115 severe [73 (63.5%)] and critically ill [42 (36.5%)] patients were included in this study, containing 93 (80.9%) survivors and 22 (19.1%) non-survivors. For disease MESHD severity, D-dimer [OR 6.33 (95%CI, 1.27-45.57], eosinophil percentage [OR 8.02 (95%CI, 1.82-45.04)], total bilirubin [OR 12.38 (95%CI, 1.24-223.65)] and lung involvement score [OR 1.22 (95%CI, 1.08-1.40)] were the independent factors associated with critical illness MESHD. Troponin [HR 9.02 (95%CI, 3.02, 26.97)] and total bilirubin [HR 3.16 (95%CI, 1.13, 8.85)] were the independent predictors for patients’ prognosis. Troponin≥26.2 ng/L and total bilirubin>20 μmol/L were associated with poor prognosis. The nomogram based on the independent risk factors had a C-index of 0.92 (95%CI, 0.87, 0.98) for predicting survival probability. The survival nomogram validated in the critically ill patients had a C-index of 0.83 (95%CI: 0.75, 0.94).Conclusions: In conclusion, in severe and critically ill patients with COVID-19, D-dimer, eosinophil percentage, total bilirubin and lung involvement score were the independent risk factors associated with disease MESHD severity. The proposed survival nomogram accurately predicted prognosis. The survival analysis may suggest that early incidence of multiple organ dysfunction may be an important predictor of poor prognosis.

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MeSH Disease
Human Phenotype

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