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MeSH Disease

Human Phenotype

Transmission

Seroprevalence
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    COVID-19 and Ischemic Stroke HP Stroke MESHD

    Authors: Amira Sidig; Khabab Abbasher; Hussien Abbasher; Radi Tofaha Alhusseini; Mohamed Elsayed; Mohammed Abbasher; Sufian Khalid M. N; Khalid Hajnoor; Mohammed Malekaldar; Mutaz F. Digna; Abbasher Hussien; Omer Eladil A. Hamid

    doi:10.21203/rs.3.rs-49338/v1 Date: 2020-07-26 Source: ResearchSquare

    Background: SARS-CoV-2 causes COVID-19 disease. It was identified in December 2019 and rapidly evolved into a pandemic. During the outbreak of COVID-19, researches demonstrated its effect on many systems, including the nervous system. In our clinic, we have reported an impact of SARS-CoV-2, causing the ischaemic stroke MESHD stroke HP.Case Report: A 62-year-old Sudanese male TRANS with some comorbidities brought to the A&E with fever HP fever MESHD, chest symptoms MESHD, and acute evolving left-sided hemiplegia HP hemiplegia MESHD power grade 0/5 MRCS with left upper motor neuron facial palsy HP facial palsy MESHD. Investigations: CT brain: right middle cerebral artery MCA infarction MESHD. CT- chest: bilateral ground-glass appearance. COVID-19 Test was positive. elevated D-dimer and C-reactive protein.Discussion: A retrospective study of data from the COVID-19 outbreak in China showed that the incidence of stroke HP stroke MESHD among hospitalized patients was approximately 5%. The fact that COVID-19 is an acute inflammatory condition associated with an increased incidence of fatty plaques formation, injury of the vascular wall, and hypercoagulability HP hypercoagulability MESHD, causing brain infarct MESHD can be a reasonable hypothesis.ConclusionPatients with COVID-19 are at increased risk of thrombo-embolization MESHD, leading to arterial and venous cerebrovascular accident MESHD. This case report enhances the importance of further studies to clarify the relationship between stroke HP stroke MESHD and COVID-19.

    Mechanical Thrombectomy of Large Vessel Occlusions MESHD in COVID-19 Related Stroke HP Stroke MESHD: Endovascular and Clinical Outcomes

    Authors: Anas S. Al-Smadi; Srishti Abrol; Ali Luqman; Parthasarathi Chamiraju; Hani Abujudeh

    doi:10.21203/rs.3.rs-49068/v1 Date: 2020-07-25 Source: ResearchSquare

    Background and PurposeStroke is a drastic complication and a poor prognostic marker of COVID-19 disease which emphasizes the importance of early identification and management of this complication. In this case series, we describe our experience of mechanical thrombectomy of large vessel occlusions (LVO) in patients with COVID-19.MethodsWe performed a retrospective study of a series of confirmed COVID-19 patients who underwent endovascular thrombectomy for acute cerebrovascular ischemic disease MESHD with large vessel occlusion. Patient demographics, presentations, lab values, angiographic and clinical outcomes were also reviewed.ResultsThree COVID-19 patients with large vessel occlusion who underwent endovascular thrombectomy were identified in our multi-center institution. Two patients had respiratory symptoms prior presentation and one patient presented initially with clinical deficits. Two patients had anterior circulation occlusion MESHD in the middle cerebral artery territory vs one had posterior circulation occlusion in the basilar artery. There was good angiographic outcome post thrombectomy in all patients, however poor clinical outcomes noted with no significant improvement in neurological manifestations in comparison with baseline at presentation.  All patients developed critically severe symptoms during hospitalization requiring intubation and one patient died of COVID-19 related respiratory failure HP respiratory failure MESHD.ConclusionIn this small case series, we noted worse clinical outcomes in COVID-19 related LVO stroke HP stroke MESHD despite effective thrombectomy, which may be related to the underlying COVID-19 disease and/or the nature of clot in these patients.

    The Incidence of SARS-COV-2 Manifestations in the Central Nervous System: A Rapid Review and Meta-Analysis

    Authors: Verena Mayr; Glechner Anna; Gerald Gartlehner; Irma Klerings; Peter Lackner

    doi:10.21203/rs.3.rs-44795/v1 Date: 2020-07-17 Source: ResearchSquare

    Background: Coronavirus disease 2019 (COVID-19) is caused by SARS-CoV-2 and presents itself mainly as a respiratory tract infection HP respiratory tract infection MESHD. However, reports of associated central nervous system (CNS) manifestations are increasing.Methods: We conducted this rapid review to determine the frequency of CNS manifestations of COVID-19 (CNS symptoms, acute cerebrovascular disease MESHD, and infectious/inflammatory CNS diseases) and to summarize the current evidence for direct invasion of the CNS by SARS-CoV-2. An information specialist searched Ovid MEDLINE, the CDC: COVID-19 Research Articles Downloadable and WHO COVID-19 Databases, CENTRAL, and Epistemonikos.org on May 13, 2020. Two reviewers screened abstracts and potentially relevant full-text publications independently. The data extraction, assessment of risk of bias,and certainty of evidence using GRADE was done by one reviewer and double-checked by another. If possible and reasonable, a meta-analysis was carried out.Results: We identified 13 relevant studies (four cohort studies, nine case studies) with a total of 866 COVID-19 patients.In a Chinese cohort, dizziness MESHD (16.8%; 36 of 214) and headache HP headache MESHD (13.1%; 28 of 214) were the most common CNS symptoms reported. A meta-analysis of four cohort studies including 851 COVID-19 patients showed an incidence of 3.3% (95% CI: 2.2–4.9) for ischemic stroke HP ischemic stroke MESHD (follow-up: one to five weeks). In 13 of 15 encephalitis HP encephalitis MESHD case studies, PCR testing of the cerebrospinal fluid did not detect any virus components.Conclusion: CNS manifestations occur frequently in patients with COVID-19. It is important to integrate neurologists into the multiprofessional COVID-19 treatment team to detect neurological complications early and to treat them correctly. 

    Place and causes of acute cardiovascular mortality during the COVID19 pandemic: retrospective cohort study of 580,972 deaths in England and Wales, 2014 to 2020

    Authors: Jianhua Wu; Mamas Mamas; Mohamed Mohamed; Chun Shing Kwok; Chris Roebuck; Ben Humberstone; Tom Denwood; Tom Luescher; Mark De Belder; John Deanfield; Chris Gale

    doi:10.1101/2020.07.14.20153734 Date: 2020-07-16 Source: medRxiv

    Importance. The COVID-19 pandemic has resulted in a decline in admissions with cardiovascular (CV) emergencies. The fatal consequences of this are unknown. Objectives - To describe the place and causes of acute CV death MESHD during the COVID-19 pandemic. Design - Retrospective nationwide cohort. Setting - England and Wales. Participants - All adult TRANS ( age TRANS [≥]18 years) acute CV deaths MESHD (n=580,972) between 1st January 2014 and 2nd June 2020. Exposure - The COVID-19 pandemic (defined as from the onset of the first COVID-19 death MESHD in England on 2nd March 2020). Main outcomes - Place (hospital, care home, home) and acute CV events directly contributing to death as stated on the first part of the Medical Certificate of Cause of Death. Results - After 2nd March 2020, there were 22,820 acute CV deaths of which 5.7% related to COVID-19, and an excess acute CV mortality of 1752 (+8%) compared with the expected daily deaths in the same period. Deaths in the community accounted for nearly half of all deaths during this period. Care homes had the greatest increase in excess acute CV deaths MESHD (1065, +40%), followed by deaths at home (1728, +34%) and in hospital (57, +0%). The most frequent cause of acute CV death MESHD during this period was stroke HP stroke MESHD (8,290, 36.3%), followed by acute coronary syndrome MESHD ( ACS MESHD) (5,532, 24.2%), heart failure MESHD (5,280, 23.1%), pulmonary embolism HP pulmonary embolism MESHD (2,067, 9.1%) and cardiac arrest HP cardiac arrest MESHD (1,037, 4.5%). Deep vein thrombosis MESHD had the greatest increase in cause of excess acute CV death MESHD (18, +25%), followed pulmonary embolism HP pulmonary embolism MESHD (340, +19%) and stroke HP stroke MESHD (782, +10%). The greatest cause of excess CV death MESHD in care homes was stroke HP stroke MESHD (700, +48%), compared with cardiac arrest HP cardiac arrest MESHD (80, +56%) at home, and pulmonary embolism HP pulmonary embolism MESHD (126, +14%) and cardiogenic shock HP cardiogenic shock MESHD (41, +14%) in hospital. Conclusions and relevance - The COVID-19 pandemic has resulted in an inflation in acute CV deaths MESHD above that expected for the time of year, nearly half of which occurred in the community. The most common cause of acute CV death MESHD was stroke HP stroke MESHD followed by acute coronary syndrome MESHD and heart failure MESHD. This is key information to optimise messaging to the public and enable health resource planning.

    Neurological manifestations associated with COVID-19: a nationwide registry

    Authors: Elodie Meppiel; Nathan Peiffer-Smadja; Alexandra Maury; Imen Bekri; Cecile Delorme; Virginie Desestret; Lucas Gorza; Geoffroy Hautecloque-Raysz; Sophie Landre; Annie Lannuzel; Solene Moulin; Peggy Perrin; Paul Petitgas; Francois Sellal; Adrien Wang; Pierre Tattevin; Thomas de Broucker; - contributors to the NeuroCOVID registry

    doi:10.1101/2020.07.15.20154260 Date: 2020-07-16 Source: medRxiv

    Background: The clinical description of the neurological manifestations in COVID-19 patients is still underway. This study aims to provide an overview of the spectrum, characteristics and outcomes of neurological manifestations associated with SARS-CoV-2 infection MESHD. Methods: We conducted a nationwide, multicentric, retrospective study during the French COVID-19 epidemic in March-April 2020. All COVID-19 patients with de novo neurological manifestations were eligible. Results: We included 222 COVID-19 patients with neurological manifestations from 46 centers throughout the country. Median age TRANS was 65 years (IQR 53-72), and 136 patients (61.3%) were male TRANS. COVID-19 was severe or critical in almost half of the patients (102, 45.2%). The most common neurological diseases MESHD were COVID-19 associated encephalopathy HP encephalopathy MESHD (67/222, 30.2%), acute ischemic cerebrovascular syndrome MESHD (57/222, 25.7%), encephalitis HP encephalitis MESHD (21/222, 9.5%), and Guillain-Barre Syndrome MESHD (15/222, 6.8%). Neurological manifestations appeared after first COVID-19 symptoms with a median (IQR) delay of 6 (3-8) days in COVID-19 associated encephalopathy HP encephalopathy MESHD, 7 (5-10) days in encephalitis HP encephalitis MESHD, 12 (7-18) days in acute ischemic cerebrovascular syndrome MESHD and 18 (15-28) days in Guillain-Barre Syndrome MESHD. Brain imaging was performed in 192 patients (86.5%), including 157 MRI (70.7%). Brain MRI of encephalitis HP encephalitis MESHD patients showed heterogeneous acute non vascular lesion in 14/21 patients (66.7%) with associated small ischemic lesion or microhemorrhages MESHD in 4 patients. Among patients with acute ischemic cerebrovascular syndrome MESHD, 13/57 (22.8%) had multi territory ischemic strokes HP ischemic strokes MESHD, with large vessel thrombosis MESHD in 16/57 (28.1%). Cerebrospinal fluid was analyzed in 97 patients (43.7%), with pleocytosis MESHD in 18 patients (18.6%). A SARS-CoV-2 PCR was performed in 75 patients and was positive only in 2 encephalitis HP encephalitis MESHD patients. Among patients with encephalitis HP encephalitis MESHD, ten out of 21 (47.6%) fully recovered, 3 of whom received corticosteroids (CS). Less common neurological manifestations included isolated seizure HP seizure MESHD (8/222, 3.6%), critical illness neuropathy MESHD (8/222, 3.6%), transient alteration of consciousness (5/222, 2.3%), intracranial hemorrhage HP intracranial hemorrhage MESHD (5/222, 2.3%), acute benign lymphocytic meningitis MESHD meningitis HP (3/222, 1.4%), cranial neuropathy MESHD (3/222, 1.4%), single acute demyelinating lesion MESHD (2/222, 0.9%), Tapia syndrome MESHD (2/222, 0.9%), cerebral venous thrombosis HP cerebral venous thrombosis MESHD (1/222, 0.5%), sudden paraparesis MESHD paraparesis HP (1/222, 0.5%), generalized myoclonus HP myoclonus MESHD and cerebellar ataxia MESHD ataxia HP (1/222, 0.5%), bilateral fibular palsy (1/222, 0.5%) and isolated neurological symptoms ( headache HP headache MESHD, anosmia HP anosmia MESHD, dizziness MESHD, sensitive or auditive symptoms MESHD, hiccups MESHD, 15/222, 6.8%). The median (IQR) follow-up of the 222 patients was 24 (17-34) days with a high short-term mortality rate (28/222, 12.6%). Conclusion: Neurological manifestations associated with COVID-19 mainly included CAE, AICS, encephalitis HP encephalitis MESHD and GBS MESHD. Clinical spectrum and outcomes were broad and heterogeneous, suggesting different underlying pathogenic processes.

    COVID-19: Role of the Inflammasome

    Authors: Claudio G. Gallo; Sirio Fiorino; Giovanni Posabella; Donato Antonacci; Antonio Tropeano; Emanuele Pausini; Carlotta Pausini; Tommaso Guarniero; Marco Zancanaro

    id:202007.0246/v1 Date: 2020-07-12 Source: Preprints.org

    Covid-19 disease is caused by SARS Cov-2 virus. Despite its high transmissibility TRANS, the CFR (Case Fatality Rate) of COVID-19 seems to be lower than the SARS (9,5%) and MERS (34,4%) ones93 , but higher than the influenza one (0-1%)94,95 . The disease is asymptomatic TRANS or paucisymptomatic in most of the patients, although in few cases it can be characterized by serious complications. The main causes of hospitalization in intensive care are represented by ALI MESHD (Acute Lung Injury), ARDS MESHD ( Acute Respiratory Distress Syndrome MESHD Respiratory Distress HP Syndrome), cardiovascular problems and coagulopathies MESHD (diffuse thrombosis MESHD, microthrombosis, embolisms MESHD, myocarditis HP myocarditis MESHD, arrhytmias, heart failure MESHD, stroke HP stroke MESHD)96-98, acute nephropathy99,100 and encephalopathies101 MESHD. The virus presence in the vascular wall can cause endotheliitis MESHD, which triggers the process of diffuse coagulation that can lead to a worsening of the systemic inflammation MESHD. The exaggerated inflammatory response seems to be connected with the development of ARDS MESHD, MOF (Multiple Organ Failure) and coagulopathies102-107.

    The 4C Initiative (Clinical Care for Cardiovascular disease MESHD in the COVID-19 pandemic): monitoring the indirect impact of the coronavirus pandemic on services for cardiovascular diseases MESHD in the UK

    Authors: - TC CVD-COVID-UK Consortium; Simon Ball; Amitava Banerjee; Colin Berry; Jonathan Boyle; Benjamin Bray; William Bradlow; Afzal Chaudhry; Rikki Crawley; John Danesh; Alastair Denniston; Florian Falter; Jonine Figueroa; Christopher Hall; Harry Hemingway; Emily Jefferson; Tom Johnson; Graham King; Ken Lee; Paul McKean; Suzanne Mason; Nicholas Mills; Ewen Pearson; Munir Pirmohamed; Michael TC Poon; Rouven Priedon; Anoop Shah; Reecha Sofat; Jonathan Sterne; Fiona Strachan; Cathie LM Sudlow; Zsolt Szarka; William Whiteley; Mike Wyatt

    doi:10.1101/2020.07.10.20151118 Date: 2020-07-11 Source: medRxiv

    Background: The coronavirus (COVID-19) pandemic affects cardiovascular diseases MESHD ( CVDs MESHD) directly through infection MESHD and indirectly through health service reorganisation and public health policy. Real-time data are needed to quantify direct and indirect effects. We aimed to monitor hospital activity for presentation, diagnosis and treatment of CVDs MESHD during the pandemic to inform on indirect effects. Methods: We analysed aggregate data on presentations, diagnoses and treatments or procedures for selected CVDs MESHD (acute coronary syndromes, heart failure MESHD, stroke HP stroke MESHD and transient ischaemic attack MESHD, venous thromboembolism MESHD thromboembolism HP, peripheral arterial disease MESHD and aortic aneurysm HP aortic aneurysm MESHD) in UK hospitals before and during the COVID-19 epidemic. We produced an online visualisation tool to enable near real-time monitoring of trends. Findings: Nine hospitals across England and Scotland contributed hospital activity data from 28 Oct 2019 (pre-COVID-19) to 10 May 2020 (pre-easing of lockdown), and for the same weeks during 2018-2019. Across all hospitals, total admissions and emergency department (ED) attendances decreased after lockdown (23 March 2020) by 57.9% (57.1-58.6%) and 52.9% (52.2-53.5%) respectively compared with the previous year. Activity for cardiac, cerebrovascular and other vascular conditions started to decline 1-2 weeks before lockdown, and fell HP by 31-88% after lockdown, with the greatest reductions observed for coronary artery bypass grafts, carotid endarterectomy, aortic aneurysm HP aortic aneurysm MESHD repair and peripheral arterial disease MESHD procedures. Compared with before the first UK COVID-19 (31 January 2020), activity declined across diseases and specialties between the first case and lockdown (total ED attendances RR 0.94, 0.93-0.95; total hospital admissions RR 0.96, 0.95-0.97) and after lockdown (attendances RR 0.63, 0.62-0.64; admissions RR 0.59, 0.57-0.60). There was limited recovery towards usual levels of some activities from mid-April 2020. Interpretation: Substantial reductions in total and cardiovascular activities are likely to contribute to a major burden of indirect effects of the pandemic, suggesting they should be monitored and mitigated urgently.

    The Age TRANS Pattern of the Male TRANS- to- Female TRANS Ratio in Mortality from COVID-19 Mirrors that of Cardiovascular Disease MESHD but not Cancer in the General Population

    Authors: Ila Nimgaonkar; Linda Valeri; Ezra S. Susser; Sabiha Hussain; Jag Sunderram; Abraham Aviv

    doi:10.1101/2020.07.10.20149013 Date: 2020-07-11 Source: medRxiv

    Background: Males TRANS are at a higher risk of dying from COVID-19. Older age TRANS and cardiovascular disease MESHD are also associated with COVID-19 mortality. We compared the male TRANS-to- female TRANS (sex) ratios in mortality by age TRANS for COVID-19 with cardiovascular mortality and cancer MESHD mortality in the general population. Methods: We obtained data from official government sources in the US and five European countries: Italy, Spain, France, Germany, and the Netherlands. We analyzed COVID-19 deaths by sex and age TRANS in these countries and similarly analyzed their deaths from cardiovascular disease MESHD ( coronary heart disease MESHD or stroke HP stroke MESHD) and cancer MESHD, the two leading age TRANS-related causes of death in middle-to-high income countries. Findings: In both the US and European countries, the sex ratio of deaths from COVID-19 exceeded one throughout adult TRANS life. The sex ratio increased up to a peak in midlife, and then declined markedly in later life. This pattern was also observed for the sex ratio of deaths from cardiovascular disease MESHD, but not cancer MESHD, in the general populations of the US and European countries. Interpretation: The sex ratios of deaths from COVID-19 and from cardiovascular disease MESHD exhibit similar patterns across the adult TRANS life course. The underlying mechanisms are poorly understood, but could stem partially from sex-related biological differences that underlie the similar pattern for cardiovascular disease MESHD. These include, we propose, comparatively longer telomeres in females TRANS, ovarian hormones, and X chromosome mosaicism.

    Neurological Manifestations and Complications of Coronavirus Disease MESHD 2019 (COVID-19): A Systematic Review and Meta-Analysis 

    Authors: Ahmed Yassin; Mohammed Nawaiseh; Ala' Shaban; Khalid Alsherbini; Khalid El-Salem; Ola Soudah; Mohammad Abu-Rub

    doi:10.21203/rs.3.rs-39952/v1 Date: 2020-07-02 Source: ResearchSquare

    Background: The spectrum of neurological involvement in COVID-19 is not thoroughly understood. To the best of our knowledge, no systematic review with meta-analysis and a sub-group comparison between severe and non-severe cases has been published. The aim of this study is to assess the frequency of neurological manifestations and complications, identify the neurodiagnostic findings, and compare these aspects between severe and non-severe COVID-19 cases.Methods: A systematic search of PubMed, Scopus, EBSCO, Web of Science, and Google Scholar databases was conducted for studies published between the 1st of January 2020 and 22nd of April 2020. In addition, we scanned the bibliography of included studies to identify other potentially eligible studies. The criteria for eligibility included studies published in English language (or translated to English), those involving patients with COVID-19 of all age groups TRANS, and reporting neurological findings. Data were extracted from eligible studies. Meta-analyses were conducted using comprehensive meta-analysis software. Random-effects model was used to calculate the pooled percentages and means with their 95% confidence intervals (CIs). Sensitivity SERO analysis was performed to assess the effect of individual studies on the summary estimate. A subgroup analysis was conducted according to severity. The main outcomes of the study were to identify the frequency and nature of neurological manifestations and complications, and the neuro-diagnostic findings in COVID-19 patients.Results: 44 articles were included with a pooled sample size of 13480 patients. The mean age TRANS was 50.3 years and 53% were males TRANS. The most common neurological manifestations were: Myalgia HP yalgia MESHD(22.2%, 95% CI, 17.2% to 28.1%), t aste impairment MESHD(19.6%, 95% CI, 3.8% to 60.1%), smell impairment (18.3%, 95% CI, 15.4% to 76.2%), headache HP eadache MESHD(12.1%, 95% CI, 9.1% to 15.8%), d izziness MESHD(11.3%, 95% CI, 8.5% to 15.0%), and encephalopathy HP ncephalopathy MESHD(9.4%, 95% CI, 2.8% to 26.6%). Nearly 2.5% (95% CI, 1% to 6.1%) of patients had a cute cerebrovascular diseases MESHD(C VD) MESHD. Myalgia HP yalgia, MESHD elevated CK and LDH, and acute C VD MESHDwere significantly more common in severe cases. Moreover, 20 case reports were assessed qualitatively, and their data presented separately.Conclusions: Neurological involvement is common in COVID-19 patients. Early recognition and vigilance of such involvement might impact their overall outcomes.

    Excess of Cardiovascular Deaths MESHD During the COVID-19 Pandemic in Brazilian Capital Cities

    Authors: Luisa Campos Caldeira Brant; Bruno Ramos Nascimento; Renato Teixeira; Marcelo Antonio Queiroga Lopes; Deborah Carvalho Malta; Glaucia Maria Moraes Oliveira; Antonio Luiz Pinho Ribeiro

    doi:10.1101/2020.06.24.20139295 Date: 2020-06-26 Source: medRxiv

    Introduction: During the COVID-19 pandemic, excess mortality has been reported, while hospitalizations for acute cardiovascular events reduced. Brazil is the second country with more deaths due to COVID-19. We aimed to evaluate excess cardiovascular mortality during COVID-19 pandemic in 6 Brazilian capital cities. Methods: Using the Civil Registry public database, we evaluated total and cardiovascular excess deaths MESHD, further stratified in ACS, stroke HP stroke MESHD and unspecified cardiovascular deaths MESHD in the 6 Brazilian cities with greater number of COVID-19 deaths (Sao Paulo, Rio de Janeiro, Fortaleza, Recife, Belem, Manaus). We compared data from epidemiological weeks 12 to 22 of 2020, with the same period in 2019. We also compared the number of hospital and home deaths during the period. Results: There were 69,328 deaths MESHD and 17,877 COVID-19 deaths in the studied period and cities for 2020. Cardiovascular mortality increased in most cities, with greater magnitude in the Northern capitals. However, while there was a reduction in ACS and stroke HP stroke MESHD in the most developed cities, the Northern capitals showed an increase of these events. For unspecified cardiovascular deaths MESHD, there was a marked increase in all cities, which strongly correlated to the rise in home deaths (r=0.86, p=0.01). Conclusion: The excess cardiovascular mortality was greater in the less developed cities, possibly associated with healthcare collapse. ACS and stroke HP stroke MESHD deaths decreased in the most developed cities, in parallel with an increase in unspecified cardiovascular and home deaths, presumably as a result of misdiagnosis. Conversely, ACS and stroke HP stroke MESHD deaths increased in cities with a healthcare collapse.

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