Corpus overview


MeSH Disease

Infections (1114)

Disease (1039)

Death (715)

Coronavirus Infections (648)

Fever (329)

Human Phenotype

Pneumonia (331)

Fever (330)

Hypertension (262)

Cough (256)

Anxiety (135)


age categories (2647)

gender (950)

Transmission (410)

fomite (246)

asymptotic cases (212)

    displaying 1421 - 1430 records in total 2671
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    Almitrine as a non ventilatory strategy to improve intrapulmonary shunt HP in COVID-19 patients


    doi:10.1101/2020.05.18.20105502 Date: 2020-05-22 Source: medRxiv

    In severe COVID-19 pulmonary failure, hypoxia MESHD is mainly related to pulmonary vasodilation with altered hypoxic pulmonary vasoconstriction (HPV). Besides prone positioning, other non-ventilatory strategies may reduce the intrapulmonary shunt HP. This study has investigated almitrine, a pharmacological option to improve oxygenation. Patients and Method. A case control series of 17 confirmed COVID-19 mechanically ventilated patients in prone or supine positioning was collected: 10 patients received two doses of almitrine (4 and 12 mcg/kg/min) at 30-45 min interval each, and were compared to 7 control COVID-matched patients conventionally treated. The end-point was the reduction of intra-pulmonary shunt increasing the PaO2 and ScvO2. Results Patients were male TRANS (59%) with median (25th, 75th percentiles) age TRANS of 70 (54-78) years and a BMI of 29 (23-34). At stable mechanical ventilatory settings, PaO2 (mmHg) at FiO2 1 (135 (85, 195) to 214 (121, 275); p = 0.06) tended to increase with almitrine. This difference was significant when the best PaO2 between the 2 doses was used : 215 (123,294) vs baseline (p = 0.01). A concomitant increase in ScvO2 occurred ((73 (72, 76) to 82 (80, 87); p = 0.02). Eight over 10 almitrine-treated patients increased their PaO2, with no clear dose-effect. During the same time, the controls did not change PaO2. In conclusion, in early COVID-19 with severe hypoxemia HP, almitrine infusion is associated with improved oxygenation in prone or supine positioning. This pharmacological intervention may offer an alternative and/or an additional effect to proning and might delay or avoid more demanding modalities such as ECMO.

    COVID-19 in China: Risk Factors and R0 TRANS Revisited

    Authors: Irtesam Mahmud Khan; Wenyi Zhang; Sumaira Zafar; Yong Wang; Junyu He; Hailon Sun; Ubydul Haque; M. Sohel Rahman

    doi:10.1101/2020.05.18.20104703 Date: 2020-05-22 Source: medRxiv

    The COVID-19 epidemic had spread rapidly through China and subsequently has proliferated globally leading to a pandemic situation around the globe. Human-to-human transmissions TRANS, as well as asymptomatic TRANS transmissions TRANS of the infection MESHD infection, have been confirmed TRANS, have been confirmed. As of April 3rd, public health crisis in China due to COVID-19 is potentially under control. We compiled a daily dataset of case counts, mortality, recovery, temperature, population density, and demographic information for each prefecture during the period of January 11 to April 07, 2020 (excluding Wuhan from our analysis due to missing data). Understanding the characteristics of spatiotemporal clustering of the COVID-19 epidemic and R0 TRANS is critical in effectively preventing and controlling the ongoing global pandemic. The prefectures were grouped based on several relevant features using unsupervised machine learning techniques. We performed a computational analysis utilizing the reported cases in China to estimate the revised R0 TRANS among different regions for prevention planning in an ongoing global pandemic. Finally, our results indicate that the impact of temperature and demographic (different age group TRANS percentage compared to the total population) factors on virus transmission TRANS may be characterized using a stochastic transmission TRANS model. Such predictions will help prioritize segments of a given community/ region for action and provide a visual aid in designing prevention strategies for a specific geographic region. Furthermore, revised estimation and our methodology will aid in improving the human health consequences of COVID-19 elsewhere.

    The role of directionality, heterogeneity and correlations in epidemic risk and spread

    Authors: Antoine Allard; Cristopher Moore; Samuel V. Scarpino; Benjamin M. Althouse; Laurent Hébert-Dufresne

    id:2005.11283v2 Date: 2020-05-22 Source: arXiv

    Most models of epidemic spread, including many designed specifically for COVID-19, implicitly assume that social networks are undirected, i.e., that the infection MESHD is equally likely to spread in either direction whenever a contact occurs. In particular, this assumption implies that the individuals most likely to spread the disease TRANS disease MESHD are also the most likely to receive it from others. Here, we review results from the theory of random directed graphs which show that many important quantities, including the reproductive number TRANS and the epidemic size, depend sensitively on the joint distribution of in- and out-degrees ("risk" and "spread"), including their heterogeneity and the correlation between them. By considering joint distributions of various kinds we elucidate why some types of heterogeneity cause a deviation from the standard Kermack-McKendrick analysis of SIR models, i.e., so called mass-action models where contacts are homogeneous and random, and some do not. We also show that some structured SIR models informed by complex contact patterns among types of individuals ( age TRANS or activity) are simply mixtures of Poisson processes and tend not to deviate significantly from the simplest mass-action model. Finally, we point out some possible policy implications of this directed structure, both for contact tracing TRANS strategy and for interventions designed to prevent superspreading events. In particular, directed networks have a forward and backward version of the classic "friendship paradox" -- forward links tend to lead to individuals with high risk, while backward links lead to individuals with high spread -- such that a combination of both forward and backward contact tracing TRANS is necessary to find superspreading events and prevent future cascades of infection MESHD.

    The Fallibility of Contact-Tracing TRANS Apps

    Authors: Piotr Sapiezynski; Johanna Pruessing; Vedran Sekara

    id:2005.11297v3 Date: 2020-05-22 Source: arXiv

    Since the onset of the COVID-19's global spread we have been following the debate around contact tracing TRANS apps -- the tech-enabled response to the pandemic. As corporations, academics, governments, and civil society discuss the right way to implement these apps, we noticed recurring implicit assumptions. The proposed solutions are designed for a world where Internet access and smartphone ownership are a given, people are willing and able to install these apps, and those who receive notifications about potential exposure to the virus have access to testing and can isolate safely. In this work we challenge these assumptions. We not only show that there are not enough smartphones worldwide to reach required adoption thresholds but also highlight a broad lack of internet access, which affects certain groups more: the elderly TRANS, those with lower incomes, and those with limited ability to socially distance. Unfortunately, these are also the groups that are at the highest risks from COVID-19. We also report that the contact tracing TRANS apps that are already deployed on an opt-in basis show disappointing adoption levels. We warn about the potential consequences of over-extending the existing state and corporate surveillance powers. Finally, we describe a multitude of scenarios where contact tracing TRANS apps will not help regardless of access or policy. In this work we call for a comprehensive and equitable policy response that prioritizes the needs of the most vulnerable, protects human rights, and considers long term impact instead of focusing on technology-first fixes.

    An Interpretable Machine Learning Framework for Accurate Severe vs Non-severe COVID-19 Clinical Type Classification

    Authors: Yuanfang Chen; Liu Ouyang; Sheng Bao; Qian Li; Lei Han; Hengdong Zhang; Baoli Zhu; Ming Xu; Jie Liu; Yaorong Ge; Shi Chen

    doi:10.1101/2020.05.18.20105841 Date: 2020-05-22 Source: medRxiv

    Effectively and efficiently diagnosing COVID-19 patients with accurate clinical type is essential to achieve optimal outcomes of the patients as well as reducing the risk of overloading the healthcare system. Currently, severe and non-severe COVID-19 types are differentiated by only a few clinical features, which do not comprehensively characterize complicated pathological, physiological, and immunological responses to SARS-CoV-2 invasion in different types. In this study, we recruited 214 confirmed COVID-19 patients in non-severe and 148 in severe type, from Wuhan, China. The patients' comorbidity and symptoms (26 features), and blood SERO biochemistry (26 features) upon admission were acquired as two input modalities. Exploratory analyses demonstrated that these features differed substantially between two clinical types. Machine learning random forest (RF) models using features in each modality were developed and validated to classify COVID-19 clinical types. Using comorbidity/symptom and biochemistry as input independently, RF models achieved >90% and >95% predictive accuracy, respectively. Input features' importance based on Gini impurity were further evaluated and top five features from each modality were identified ( age TRANS, hypertension MESHD hypertension HP, cardiovascular disease MESHD, gender TRANS, diabetes; D-Dimer, hsTNI, neutrophil, IL-6, and LDH). Combining top 10 multimodal features, RF model achieved >99% predictive accuracy. These findings shed light on how the human body reacts to SARS-CoV-2 invasion as a unity and provide insights on effectively evaluating COVID-19 patient's severity and developing treatment plans accordingly. We suggest that symptoms and comorbidities can be used as an initial screening tool for triaging, while biochemistry and features combined are applied when accuracy is the priority.

    Changes in RT-PCR-positive SARS-CoV-2 rates in adults TRANS and children TRANS according to the epidemic stages

    Authors: Corinne Levy; Romain Basmaci; Philippe Bensaid; Cecile Bost bru; Edeline Coinde; Emmanuelle Dessioux; Cecile Fournial; Jean Gashignard; Herve Haas; Veronique Hentgen; Frederic Huet; Muriel Lalande; Alain Martinot; Charlotte Pons; Anne Sophie Romain; Nicoletta Magdalena Ursulescu; Francois Vie Le Sage; Josette Raymond; Stephane Bechet; Julie Toubiana; Robert Cohen

    doi:10.1101/2020.05.18.20098863 Date: 2020-05-21 Source: medRxiv

    Aim To describe the trends of RT-PCR positive SARS-CoV-2 rates in children TRANS and adults TRANS according to the time of COVID-19 epidemic. Methods In this prospective multicenter study involving 45 pediatric units, we collected the results of nasopharyngeal swabs in France from March 2, 2020 to April 26, 2020. Results During the study period, 52,588 RT-PCR tests for SARS-CoV-2 were performed, 6,490 in children TRANS and 46,098 in adults TRANS. The risk ratio of RT-PCR positive SARS-CoV-2 tests for adults TRANS compared to children TRANS was 3.5 (95% CI [3.2;3.9]) for the whole study period. These rates varied according to the time of the epidemic and were higher at the peak. The lower rates of positive test in children TRANS persisted during the surveillance period but varied according to the time in the epidemic. Conclusion The rate of positive RT-PCR positive SARS-CoV-2 tests for children TRANS was always less than that for adults TRANS but vary according to the epidemic stage.

    Self-limited focal epilepsy MESHD in a young child TRANS with SARS-CoV-2: serendipity or causal association?

    Authors: Davide Silvagni; Pietro Soloni; Francesca Darra; Paolo Biban

    doi:10.21203/ Date: 2020-05-21 Source: ResearchSquare

    Neurological manifestations have been reported in adults TRANS with COVID-19. In children TRANS with COVID-19, data on neurological symptoms are scarce. A 4-year-old girl was assisted at home for prolonged afebrile seizures MESHD seizures HP. She was unresponsive, with a conjugate eye right deviation lasting > 20 minutes. Intravenous midazolam was administered. Before arrival in our Emergency MESHD Department, EMS providers excluded risk factors for COVID-19, such as fever MESHD fever HP, respiratory symptoms, other signs of viral infections MESHD, or recent contacts with suspected COVID-19 cases. Upon her arrival, seizures MESHD seizures HP had resolved, GCS was 12. Temperature was 36,6°C. Chest was clear (SatO2 100%). Blood SERO tests did not show signs of infection MESHD. We collected a nasopharyngeal swab, which tested positive for SARS-CoV-2. The patient rapidly recovered her neurological function. A pediatric neurological examination and video-EEG recording produced a possible diagnosis of self-limited focal epilepsy MESHD, with temporo-occipital spikes. Family history revealed her father had occasional seizures MESHD seizures HP during fever MESHD fever HP episodes, at 14 and 21 years. The child TRANS was discharged home, scheduling further neurological investigations once the swab was negative. Our case emphasizes that keeping a high suspicion for SARS-CoV-2 infection MESHD is pivotal in hot spots, regardless of the absence of typical COVID-19 symptoms. As for the seizures MESHD seizures HP episode, we know infections MESHD and fever MESHD fever HP are leading seizure MESHD seizure HP precipitating factors in children TRANS. To our knowledge, this is the first case of focal status epilepticus MESHD status epilepticus HP in new onset focal self-limited epilepsy MESHD in an afebrile child TRANS with SARS-CoV-2. We speculate that SARS-CoV-2 infection MESHD may have triggered the onset of self-limited focal epilepsy MESHD in our patient.

    An insertion unique to SARS-CoV-2 exhibits superantigenic character strengthened by recent mutations

    Authors: Mary Hongying Cheng; She Zhang; Rebecca A. Porritt; Moshe Arditi; Ivet Bahar

    doi:10.1101/2020.05.21.109272 Date: 2020-05-21 Source: bioRxiv

    Multisystem Inflammatory Syndrome MESHD in Children TRANS (MIS-C) associated with Coronavirus Disease MESHD 2019 (COVID-19) is a newly recognized condition in which children TRANS with recent SARS-CoV-2 infection MESHD present with a constellation of symptoms including hypotension MESHD hypotension HP, multiorgan involvement, and elevated inflammatory markers. These symptoms and the associated laboratory values strongly resemble toxic shock MESHD shock HP syndrome MESHD, an escalation of the cytotoxic adaptive immune response triggered upon the binding of pathogenic superantigens to MHCII molecules and T cell receptors (TCRs). Here, we used structure-based computational models to demonstrate that the SARS-CoV-2 spike (S) exhibits a high-affinity motif for binding TCR, interacting closely with both the - and {beta}-chains variable domains complementarity-determining regions. The binding epitope on S harbors a sequence motif unique to SARS-CoV-2 (not present in any other SARS coronavirus), which is highly similar in both sequence and structure to bacterial superantigens. Further examination revealed that this interaction between the virus and human T cells is strengthened in the context of a recently reported rare mutation (D839Y/N/E) from a European strain of SARS-CoV-2. Furthermore, the interfacial region includes selected residues from a motif shared between the SARS viruses from the 2003 and 2019 pandemics, which has intracellular adhesion molecule (ICAM)-like character. These data suggest that the SARS-CoV-2 S may act as a superantigen to drive the development of MIS-C as well as cytokine storm in adult TRANS COVID-19 patients, with important implications for the development of therapeutic approaches. SignificanceAlthough children TRANS have been largely spared from severe COVID-19 disease, a rare MESHD hyperinflammatory syndrome MESHD has been described in Europe and the East Coast of the United States, termed Multisystem Inflammatory Syndrome MESHD in Children TRANS (MISC). The symptoms and diagnostic lab values of MIS-C resemble those of toxic shock MESHD shock HP, typically caused by pathogenic superantigens stimulating excessive activation of the adaptive immune system. We show that SARS-CoV-2 spike has a sequence and structure motif highly similar to those of bacterial superantigens, and may directly bind to the T cell receptors. This sequence motif, not present in other coronaviruses, may explain the unique potential for SARS-CoV-2 to cause both MIS-C and the cytokine storm observed in adult TRANS COVID-19 patients.

    The potential effect of the African population age TRANS structure on COVID-19 mortality

    Authors: Fabrice Mougeni; Ance Mangaboula; Bertrand Lell

    doi:10.1101/2020.05.19.20106914 Date: 2020-05-21 Source: medRxiv

    Currently (mid May 2020), most active cases of COVID-19 are found in Europe and North America while it is still in the initial phases in Africa. As COVID-19 mortality occurs mainly in elderly TRANS and as Africa has a comparably young population, the death MESHD rates should be lower than on other continents. We calculated standardised mortality ratios (SMR) using age TRANS-specific case fatality rates for COVID-19 and the age TRANS structure of the population of Africa and of other continents. Compared to a European or Northern American population, the standardised mortality ratio was only 0.22 and 0.25, respectively, corresponding to reduction of deaths MESHD rates to a quarter. Compared to the Asian and Latin American & Caribbean population, the SMR was 0.43 and 0.44, respectively, corresponding to half the death MESHD rate for Africa. It is useful to quantify the isolated effect of the African age TRANS-structure on potential COVID-19 mortality for illustrative and communication purposes, keeping in mind the importance of public health measures that have been shown to be effective in reducing cases and deaths MESHD. The different aspect of age TRANS pyramids of a European and an African population are striking and the potential implications for the pandemic are often discussed but rarely quantified.

    Reduced child TRANS maltreatment prevention service case openings during COVID-19

    Authors: Kelly Whaling; Alissa Der Sarkissian; Natalie A. Larez; Jill D. Sharkey; Michael A. Allen; Karen Nylund-Gibson

    doi:10.21203/ Date: 2020-05-21 Source: ResearchSquare

    Severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2; COVID-19), is a novel virus that has swept the world causing illness and death MESHD. Youth are at a heightened risk of experiencing increased rates of abuse given necessary measures required to slow the spread of the virus (e.g., indefinite school closures). We analyzed data from New York City’s Administration for Children’s Services (ACS) to investigate the frequency of child TRANS maltreatment prevention service case openings during this time of unprecedented stress. Two descriptive investigations were conducted. An examination of trend lines demonstrated that for 2013-2019, New York City’s new prevention case openings have consistently peaked in the month of March, for all seven years. New prevention case service openings in March 2020 do not peak, as they do in the preceding seven years. An independent samples t-test indicated that the frequency of case openings of March 2020 is significantly different than the frequency of case openings in March 2013-2019. Further, a Poisson regression model estimated that the odds of opening a new child TRANS maltreatment prevention case post-COVID-19 are 179% lower than opening a new child TRANS maltreatment case pre-COVID-19 (OR = -0.79, p < .001). These findings highlight the necessity of future research and innovation regarding child TRANS maltreatment prevention and intervention services during a global pandemic. This study has important implications for identification, prevention, and documentation for current support, and recommendations for local governments, community members, and practitioners are provided.

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MeSH Disease
Human Phenotype

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