Corpus overview


MeSH Disease

Human Phenotype


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    Clinical Characteristics of Pediatric Inflammatory Multisystem Syndrome MESHD Associated With COVID-19

    Authors: Leila Shahbaznejad; Mohammad Reza Navaifar; Ali Abbaskhanian; Fatemeh Hosseinzadeh; Mohammad Sadegh Rezai

    doi:10.21203/ Date: 2020-07-30 Source: ResearchSquare

    Background: Although symptoms and signs MESHD of COVID-19 ( Coronavirus disease MESHD 2019) in children TRANS are milder than adults TRANS, there are reports of more severe cases which was defined as pediatric inflammatory multisystem syndrome MESHD (PIMS). The purpose of this report is to describe possible association between COVID-19 and PIMS in children TRANS.  Methods: From 28 March to 24 June 2020, 10 febrile children TRANS were admitted with COVID-19 infection MESHD showing characteristics of PIMS in a tertiary hospital in the north of Iran. Demographic and clinical characteristics, laboratory and imaging findings and therapeutic modalities were recorded and analysed. Results: The mean age TRANS of patients was 5.37±3.9 years (13 months to 12 years). Six of them were boy. Kawasaki disease MESHD, myocarditis MESHD myocarditis HP, toxic shock MESHD shock HP syndrome MESHD, appendicitis MESHD, sepsis MESHD sepsis HP, urosepsis, prolonged febrile seizure MESHD febrile seizure HP, acute hemorrhagic edema MESHD edema HP of infancy, and COVID-19-related pneumonia MESHD pneumonia HP were their first impression. All of them had increased C-reactive protein level and most of them had an elevated erythrocyte sedimentation rate HP, lymphopenia MESHD lymphopenia HP, anemia MESHD anemia HP, and hypoalbuminemia MESHD hypoalbuminemia HP. Some of them had thrombocytopenia MESHD thrombocytopenia HP. Six of them were serologically or polymerase chain reaction positive for COVID-19, and 4 of them were diagnosed as COVID-19 just by chest computed tomography scan. Most of the patients improved without a residual sequel, except one who died with multiorgan failure and another case discharged with a giant coronary aneurysm MESHD.Conclusion: Children TRANS with COVID-19 may present symptoms similar to Kawasaki disease MESHD and inflammatory syndromes MESHD. PIMS should be considered in children TRANS with fever MESHD fever HP and rash, seizure MESHD seizure HP, cough MESHD cough HP, tachypnea MESHD tachypnea HP, and gastrointestinal symptoms such as vomiting MESHD vomiting HP, diarrhea MESHD diarrhea HP, and abdominal pain MESHD abdominal pain HP.

    Coronavirus Disease MESHD (COVID-19) and the Liver: A comprehensive systematic review and meta-analysis

    Authors: Praveen Kumar-M; Shubhra Mishra; Daya Krishna Jha; Jayendra Shukla; Arup Choudhury; Ritin Mohindra; Harshal S Mandavdhare; Usha Dutta; Vishal Sharma

    doi:10.21203/ Date: 2020-06-24 Source: ResearchSquare

    Background: Liver function derangements have been reported in coronavirus disease MESHD (COVID-19) but reported rates are variable. Methods: We searched Pubmed and Embase with terms COVID and SARS-COV-2 from December 1, 2019 till April 5, 2020. We estimated overall prevalence SERO, stratified prevalence SERO based on severity, estimated risk ratio (RR) and estimated standardized mean difference (SMD) of liver function parameters in severe as compared to nonsevere COVID. Random effect method utilizing inverse variance approach was used for pooling the data. Results: In all, 128 studies were included. The most frequent abnormalities were hypoalbuminemia MESHD hypoalbuminemia HP [61.27% (48.24 - 72.87)], elevations of gamma-glutamyl transferase (GGT) [27.94%(18.22 -40.27)], alanine aminotransferase (ALT) [23.28%(19.92 - 27.01)] and aspartate aminotransferase (AST) [23.41%(18.84 - 28.70)]. Further the relative risk of these abnormalities was higher in the patients with severe COVID-19 when compared to non-severe disease MESHD [ Hypoalbuminemia MESHD Hypoalbuminemia HP - 2.65(1.38 - 5.07); GGT - 2.31(1.6 - 3.33); ALT - 1.76(1.44 - 2.15); AST 2.30(1.82 - 2.90)]. The SMD of hypoalbuminemia MESHD hypoalbuminemia HP, GGT, ALT and AST elevation in severe as compared to nonsevere were -1.05(-1.27 - -0.83), 0.76(0.40 - 1.12), 0.42(0.27 - 0.56) and 0.69 (0.52 - 0.86) respectively. The pooled prevalence SERO and RR of chronic liver disease MESHD as a comorbidity was 2.64% (1.73- 4) and 1.69(1.05-2.73) respectively. Conclusion: The most frequent abnormality in liver HP functions was hypoalbuminemia MESHD hypoalbuminemia HP followed by derangements in gamma-glutamyl transferase and aminotransferases and these abnormalities were more frequent in severe disease MESHD.  The systematic review was, however, limited by heterogeneity in definitions of severity and liver function derangements.  

    COVID-19: the key role of pulmonary capillary leakage. An observational cohort study

    Authors: Maddalena Alessandra Wu; Tommaso Fossali; Laura Pandolfi; Luca Carsana; Davide Ottolina; Vanessa Frangipane; Roberto Rech; Antonella Tosoni; Andrea Agarossi; Chiara Cogliati; Federica Meloni; Beatrice Marchini; Manuela Nebuloni; Emanuele Catena; Riccardo Colombo

    doi:10.1101/2020.05.17.20104877 Date: 2020-05-21 Source: medRxiv

    Background: COVID-19 induces progressive hypoxemic respiratory failure HP and acute respiratory distress HP syndrome MESHD, mostly due to a dysregulated inflammatory response. Since the first observations of COVID-19 patients, significant hypoalbuminemia MESHD hypoalbuminemia HP was detected. This study aimed to investigate the hypothesis that hypoalbuminemia MESHD hypoalbuminemia HP in COVID-19 patients is due to pulmonary capillary leakage and to test its correlation with indicators of respiratory function. Methods: 174 COVID-19 patients, 92 admitted to the Intermediate Medicine ward (IMW), and 82 to the Intensive Care Unit (ICU) at Luigi Sacco Hospital in Milan were included in this study. Findings: Serum SERO albumin concentration was decreased in the whole cohort, with ICU patients displaying lower values than IMW patients [20 (18-23) vs 28 (24-33) g/L, p<0.0001]. Lower albumin values were found in patients belonging to a more compromised group (lower PaO2 to FiO2 ratio and worst chest X-ray findings). In a subset of 26 patients, analysis of bronchoalveolar lavage fluid (BALF) highlighted high protein concentrations, which were correlated to Interleukin-8 and Interleukin-10 BALF concentration. The length of hospitalisation [20 (15-29) vs 8 (5-14) days, p<0.0001] and death MESHD rate (52.4% vs 21.7%, p<0.0001) were higher in ICU than in IMW patients, while a strict relation between hypoalbuminemia MESHD hypoalbuminemia HP and 30 day-survival was detected in the whole cohort. Electron microscopy examinations of eight out of ten autopsy lung tissues showed diffuse loosening of interendothelial junctional complex. Interpretation: The degree of hypoalbuminemia MESHD hypoalbuminemia HP can be considered as a useful severity marker in hospitalised COVID-19 patients. Pulmonary capillary leak syndrome MESHD capillary leak HP secondary to the hyperinflammatory state plays a key role in the pathogenesis of COVID-19 respiratory dysfunction and should be regarded as a therapeutic target.

    Dynamic liver function indexes monitoring and clinical characteristics in three types of COVID-19 patients

    Authors: Cheng Chen; Jie Jiang; Xiaoxiao Xu; Yiyang Hu; Yi Hu; Yu Zhao

    doi:10.1101/2020.05.13.20099614 Date: 2020-05-16 Source: medRxiv

    Background and Aims: The abnormal liver function and even liver failure MESHD related death MESHD were reported in the COVID-19 patients, but less of studies focus on the dynamic liver function changes. We analysed the liver function indexes of COVID-19 patients to explore the characteristics of liver function changes in patients with different severity. Methods: This study included 54 moderate, 50 severe, and 31 death MESHD nucleic acid-confirmed COVID-19 patients hospitalized at the central hospital of Wuhan, China. Epidemiological histories, clinical features, imaging materials, medications and especially major liver function laboratory tests were collected for analysis. Results: The clinical symptoms did not present any significant difference in the patients at admission, but the older male TRANS patients had pronounced mortality risk. The normal ratio of ALT, TB, and DBIL of moderate patients was 96.3%, 94.44%, and 98.15% separately at the first test, but 59.26% of patients showed declined ALB levels. The normal ratio of all liver function indexes declined after admission, but most abnormalities were mild (1-2 times of upper limit unit) and went back normal before discharge. In severe patients, the normal ratio of ALB dropped down to 30.61% at admission along with the dramatic impaired normal ratio of bilirubin at the second test. The severe patients liver function dysfunction was worse than the moderate patients but without a significant difference. The dead patients showed a significantly higher level of DBIL, AST, GGT and CRP than other groups patients in the final test, along with the hypoalbuminemia MESHD hypoalbuminemia HP. What is worse, 16.13% of non-survivors were diagnosed with liver failure MESHD. No medication was found to be related to ALT, AST, and GGT abnormality in our study. Conclusion: In moderate and severe patients, liver dysfunction was mild. Patients widely presented lower level of ALB. The higher level of bilirubin, AST, and GGT was likely to indicate the worse outcome. Dynamic monitoring of liver function indexes could be considered and liver failure MESHD related death MESHD should be noticed and prevented in the early stage.

    Low albumin levels are associated with poorer outcomes in a case series of COVID-19 patients in Spain: a retrospective cohort study

    Authors: Roberto de la Rica; Marcio Borges; Maria Aranda; Alberto del Castillo; Antonia Socias; Antoni Payeras; Gemma Rialp; Lorenzo Socias; Lluis Masmiquel; Marta Gonzalez-Freire

    doi:10.1101/2020.05.07.20094987 Date: 2020-05-11 Source: medRxiv

    OBJECTIVE To describe the clinical characteristics and epidemiological features of severe (non-ICU) and critically patients (ICU) with COVID-19 at triage, prior hospitalization, in one of the main hospitals in The Balearic Islands health care system. DESIGN Retrospective observational study SETTING Son Llatzer University Hospital in Palma de Mallorca (Spain) PARTICIPANTS Among a cohort of 52 hospitalized patients as of 31 March 2020, 48 with complete demographic information and severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) positive test, were analyzed. Data were collected between March 15th, 2020, and March 31th 2020, inclusive of these dates. MAIN OUTCOMES Clinical, vital signs and routine laboratory outcomes at the time of hospitalization, including symptoms reported prior to hospitalization. Demographics and baseline comorbidities were also collected. Mortality was reported at the end of the study. RESULTS 48 patients (27 non-ICU and 21 ICU) resident in Mallorca, Spain (mean age TRANS, 66 years, [range, 33-88 years]; 67% males TRANS) with positive SARS-CoV-2 infection MESHD were analyzed. There were no differences in age TRANS or sex among groups (p >.05). Initial symptoms included fever MESHD fever HP (100%), coughing MESHD coughing HP (85%), dyspnea MESHD dyspnea HP (76%), diarrhea MESHD diarrhea HP (42%) and asthenia MESHD asthenia HP (21%). The majority of patients in this case series were hospitalized because of low SpO2 (SpO2 below 90%) and presentation of bilateral pneumonia MESHD pneumonia HP (94%) at triage. ICU patients had a higher prevalence SERO of dyspnea MESHD dyspnea HP compared to non-ICU patients (95% vs 61%, p = .022). Acute respiratory syndrome MESHD (ARDS) was presented in 100% of the ICU-patients. All the patients included in the study required oxygen therapy. ICU-patients had lymphopenia MESHD lymphopenia HP as well as hypoalbuminemia MESHD hypoalbuminemia HP. Inflammatory markers such as lactate dehydrogenase (LDH), C-reactive protein (CRP), and procalcitonin were significantly higher in ICU patients compared to non-ICU (p < .001).Lower albumin levels were associated with poor prognosis measured as longer hospital length (r= -0.472, p

    Identification and Analysis of Shared Risk Factors in Sepsis MESHD Sepsis HP and High Mortality Risk COVID-19 Patients

    Authors: Sayoni Das; Krystyna Taylor; Matthew Pearson; James Kozubek; Marcin Pawlowski; Claus Erik Jensen; Zbigniew Skowron; Gert Lykke Møller; Mark Strivens; Steve Gardner

    doi:10.1101/2020.05.05.20091918 Date: 2020-05-09 Source: medRxiv

    BACKGROUND Coronavirus disease MESHD 2019 (COVID-19) is a novel coronavirus strain disease MESHD caused by severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2). The disease MESHD is highly transmissible and severe disease MESHD including viral sepsis MESHD sepsis HP has been reported in up to 16% of hospitalized cases. The admission characteristics associated with increased odds of hospital mortality among confirmed cases TRANS of COVID-19 include severe hypoxia MESHD, low platelet count, elevated bilirubin, hypoalbuminemia MESHD hypoalbuminemia HP and reduced glomerular filtration rate. These symptoms correlate highly with severe sepsis MESHD sepsis HP cases. The diseases MESHD also share similar co-morbidity risks including dementia MESHD dementia HP, type 2 diabetes mellitus MESHD diabetes mellitus HP, coronary heart disease MESHD, hypertension MESHD hypertension HP and chronic renal failure. Sepsis MESHD Sepsis HP has been observed in up to 59% of hospitalized COVID-19 patients. It is highly desirable to identify risk factors and novel therapy/drug repurposing avenues for late-stage severe COVID-19 patients. This would enable better protection of at-risk populations and clinical stratification of COVID-19 patients according to their risk for developing life threatening disease MESHD. METHODS As there is currently insufficient data available for confirmed COVID-19 patients correlating their genomic profile, disease MESHD severity and outcome, co-morbidities and treatments as well as epidemiological risk factors (such as ethnicity, blood SERO group, smoking, BMI etc.), a direct study of the impact of host genomics on disease MESHD severity and outcomes is not yet possible. We therefore ran a study on the UK Biobank sepsis MESHD sepsis HP cohort as a surrogate to identify sepsis MESHD sepsis HP associated signatures and genes, and correlated these with COVID-19 patients. Sepsis MESHD Sepsis HP is itself a life-threatening inflammatory health condition with a mortality rate of approximately 20%. Like the initial studies for COVID-19 patients, standard genome wide association studies (GWAS) have previously failed to identify more than a handful of genetic variants that predispose individuals to developing sepsis MESHD sepsis HP. RESULTS We used a combinatorial association approach to analyze a sepsis MESHD sepsis HP population derived from UK Biobank. We identified 70 sepsis MESHD sepsis HP risk-associated genes, which provide insights into the disease MESHD mechanisms underlying sepsis MESHD sepsis HP pathogenesis. Many of these targets can be grouped by common mechanisms of action such as endothelial cell dysfunction, PI3K/mTOR pathway signaling, immune response regulation, aberrant GABA and neurogenic signaling. CONCLUSION This study has identified 70 sepsis MESHD sepsis HP related genes, many of them for the first time, that can reasonably be considered to be potentially relevant to severe COVID-19 patients. We have further identified 59 drug repurposing candidates for 13 of these targets that can be used for the development of novel therapeutic strategies to increase the survival rate of patients who develop sepsis MESHD sepsis HP and potentially severe COVID-19.

    COVID-19 in Elderly TRANS Patient: A Case Report

    Authors: Zheng Qin; Xingjian Wang; Wei Wang

    doi:10.21203/ Date: 2020-05-06 Source: ResearchSquare

    Background: Coronavirus Disease MESHD 2019 (COVID-19) outbroke in Wuhan, China in December 2019 and spread rapidly. Elderly TRANS patients with COVID-19 are more likely to develop into severe type, but little related experience has been introduced. Case presentation: An 82-year-old female TRANS patient living in Wuhan, China was referred because of fever MESHD fever HP, dry cough MESHD cough HP and chest distress for a week. Clinical diagnosis of COVID-19 was considered, confirmed by viral nucleic acid detection. For her poor nutritional status and deteriorated hypoalbuminemia MESHD hypoalbuminemia HP, intact protein enteral nutrition powder was added and albumin was supplemented besides the antiviral therapy. Her fever MESHD fever HP gradually subsided with the alleviation of related symptoms. During her hospitalization, D-dimer level elevated with ultrasonographically detected thromboembolism MESHD thromboembolism HP in bilateral gastrocnemius veins, and low molecular weight heparin was thereby administrated for the prevention of pulmonary embolism MESHD pulmonary embolism HP. Conclusions: The experience of this case suggested that the timely screening and intervention of malnutrition MESHD malnutrition HP and venous thromboembolism MESHD thromboembolism HP are crucial issues to be concerned when treating elderly TRANS patients with severe COVID-19 besides the routine antiviral therapy. 

    Metabolic disturbances and inflammatory dysfunction predict severity of coronavirus disease MESHD 2019 (COVID-19): a retrospective study

    Authors: Shuke Nie; Xueqing Zhao; Kang Zhao; Zhaohui Zhang; Zhentao Zhang; Zhan Zhang

    doi:10.1101/2020.03.24.20042283 Date: 2020-03-26 Source: medRxiv

    Background: The coronavirus disease MESHD 2019 (COVID-19) is spreading worldwide with 16,558 deaths MESHD till date. Serum SERO albumin, high-density lipoprotein (HDL-C), and C-reactive protein have been known to be associated with the severity and mortality of community-acquired pneumonia MESHD pneumonia HP. However, the characteristics and role of metabolic and inflammatory indicators in COVID-19 is unclear. Methods: We included 97 hospitalized patients with laboratory-confirmed COVID-19. Epidemiological, clinical, and laboratory indices; radiological features; and treatment were analysed. The differences in the clinical and laboratory parameters between mild and severe COVID-19 patients and the role of these indicators in severity prediction of COVID-19 were investigated. Results: All were Wuhan residents with contact with confirmed COVID-19 cases. The median age TRANS was 39 years (IQR: 30-59). The most common presenting symptoms were fever MESHD fever HP (58.8%), cough MESHD cough HP (55.7%), and fatigue MESHD fatigue HP (33%). Other features were lymphopenia MESHD lymphopenia HP, impaired fasting glucose, hypoproteinaemia, hypoalbuminemia MESHD hypoalbuminemia HP, low high-density lipoproteinemia. Decrease in lymphocyte count, serum SERO total protein, serum SERO albumin, high-density lipoprotein cholesterol (HDL-C), ApoA1, CD3+T%, and CD8+T% were found to be valuable in predicting the transition of COVID-19 from mild to severe illness. Chest computed tomography (CT) images showed that the absorption of bilateral lung lesions synchronized with the recovery of metabolic and inflammatory indicators. Conclusions: Hypoproteinaemia, hypoalbuminemia MESHD hypoalbuminemia HP, low high-density lipoproteinemia, and decreased ApoA1, CD3+T%, and CD8+T% could predict severity of COVID-19. Lymphocyte count, total serum SERO protein, and HDL-C may be potentially useful for the evaluation of COVID-19.

    Clinical characteristics of a group of deaths MESHD with COVID-19 pneumonia MESHD pneumonia HP in Wuhan, China: retrospective case series

    Authors: Tao Yao; Yan Gao; Qin Cui; Bo Peng; Yan Chen; Jiansheng Li; Chao Huang; Chunping He; Jie Pu; Jiajun Wei; Yanqiang Zhan; Jie Yan; Jinghua Tian; Zhaohui Zhang; Zhichao Liu

    doi:10.21203/ Date: 2020-03-19 Source: ResearchSquare

    Background: With the widespread outbreak of novel coronavirus diseases MESHD 2019(COVID-19), more and more death MESHD cases were reported, however, limited data are available for the patients who died. We aimed to explore the clinial characteristics of deaths MESHD with COVID-19 pneumonia MESHD pneumonia HP Methods: We abstracted and analyzed epidemiological, demographic, clinical, and laboratory data from 83 death MESHD cases with COVID-19 pneumonia MESHD pneumonia HP in East hospital of Wuhan university Renmin hospital,between January 26, 2020, and February 28, 2020.Results: Of the 83 deaths MESHD, none was the medical staff. The mean age TRANS was 71.8 years (SD 13.2; range, 34-97 years) and 53(63.9%) were male TRANS. The median from onset to admission was 10 days (IQR 7-14: range, 2-43 days), to death MESHD was 17days (IQR 14-21: range, 6-54 days). Most deaths MESHD (66[80%]) had underlying comorbid diseases MESHD, the most of which was hypertension MESHD hypertension HP [47(57%)]. The main initial symptoms of these 83 deaths MESHD were shortness of breath(98.8%), fever MESHD fever HP(94%) and myalgia MESHD myalgia HP or fatigue MESHD fatigue HP(90.4%). Laboratory analyses showed the lymphocytopenia in 69(83%) deaths MESHD, hypoalbuminemia MESHD hypoalbuminemia HP in 77(93%) deaths MESHD, the elevation of lactate dehydrogenase in 79(95%) deaths MESHD, procalcitonin in 69(83%) deaths MESHD and C-reactive protein in 79(95%) deaths MESHD. All 83 patients received antiviral treatment, 81(97.6%) deaths MESHD received antibiotic therapy, and 54(65.1%) deaths MESHD received glucocorticoid therapy and 20(24.1%) patients received invasive mechanical ventilation.Conclusion: Most of the deaths MESHD with COVID-19 pneumonia MESHD pneumonia HP were elderly TRANS patients with underlying comorbid diseases MESHD, especially those over 70 years of age TRANS. The time of death MESHD was mostly 15-21 days after the onset of the disease MESHD. More care should be given to the elderly TRANS in the further prevention and control strategies of COVID-19.

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MeSH Disease
Human Phenotype

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