Corpus overview


MeSH Disease

Human Phenotype

Pneumonia (406)

Fever (387)

Hypertension (314)

Cough (298)

Anxiety (194)


age categories (3444)

gender (1213)

Transmission (536)

fomite (292)

contact tracing (286)

    displaying 1431 - 1440 records in total 3444
    records per page

    A Decision Analytic Approach for Social Distancing Policies During the COVID-19 Pandemic

    Authors: Zeynep Ertem; Ozgur Araz; Maytee Cruz-Aponte

    doi:10.1101/2020.06.24.20139329 Date: 2020-06-26 Source: medRxiv

    The COVID-19 pandemic has become a crucial public health issue in many countries including the United States. In the absence of the right vaccine strain and sufficient antiviral stockpiles on hand, nonpharmaceutical interventions have become valuable public health tools at the early stages of the pandemic and they are employed by many countries across the globe. These interventions are designed to increase social distancing between individuals to reduce the transmission TRANS of the virus and eventually dampen the burden on the healthcare system. The virus transmissibility TRANS is a function of the average number of contacts individuals have in their communities and it is highly dependent on population density and daily mobility patterns, along with other social factors. These show significant variation across the United States. In this article, we study the effectiveness of social distancing measures in communities with different population density. Specifically, first we show how the empirical estimation of reproduction number TRANS differs for two completely different states, thus the experience of the COVID-19 outbreak is drastically different, suggesting different outbreak growth rates in practice. Second, we develop an age TRANS-structured compartmental model for simulating the disease spread TRANS to demonstrate the variation in the observed outbreak characteristics. We find that early trigger and late trigger options present a trade-off between the peak magnitude and the overall death toll of the outbreak which may also vary across different populations.

    Treatment of ARDS and hyperinflammation in COVID-19 with IL-6 antagonist Tocilizumab: a tertiary care experience from Pakistan

    Authors: Nosheen Nasir; Syed Faisal Mahmood; Kiren Habib; Iffat Khanum; Bushra Jamil

    doi:10.1101/2020.06.23.20134072 Date: 2020-06-26 Source: medRxiv

    Cytokine release syndrome in COVID-19 is characterized by hyperinflammation which manifests as ARDS, multi-organ failure, and high inflammatory parameters. Tocilizumab, an IL-6 antagonist has been used in COVID-19 acute respiratory distress HP syndrome (ARDS) with conflicting results from different parts of the world. We conducted a retrospective descriptive study from Feb 2020 to May 2020 on COVID-19 patients with ARDS and hyperinflammation characterized by raised CRP and/or ferritin. A total of 244 patients with COVID-19 were admitted out of which 107 had ARDS. Thirty patients had both ARDS and hyperinflammation and received tocilizumab. The mean age TRANS was 62.5 years (SD: 13.5) and the majority were male TRANS (83%). The mean CRP pre-treatment was 217.5 mg/L and post 48 to 72 hours of tocilizumab treatment was 98.5 mg/L. Twenty-one patients (70%) also received concomitant intravenous methylprednisolone. Of the 30 patients, 7 died and 20 recovered. Ten patients required intensive care unit admission and nine developed nosocomial infections. COVID-19 associated aspergillosis was diagnosed in three patients post tocilizumab treatment. Mortality was significantly higher in patients who developed a nosocomial infection and who required intermittent positive pressure ventilation (IPPV). Our study is the first to describe the treatment outcomes with tocilizumab from a low-middle income country. The availability and cost of tocilizumab in our region which makes it imperative to understand its potential for use in our setting. Our study supports the use of tocilizumab in a select patient population with COVID-19 and recommends monitoring of nosocomial infections and opportunistic HP infections.

    Clinical Characteristics of COVID-19 Patients with Recurrent PCR Positivity After Hospital Discharge

    Authors: Kaige Wang; Qifan Zhang; Dong Lan; Yalun Li; Wenxin Luo; Shengmin Zhao; Dan Liu; Tian Panwen; Zhixin Huang; Weimin Li

    doi:10.21203/ Date: 2020-06-26 Source: ResearchSquare

    Objective: This study aimed to investigate the clinical characteristics of COVID-19 patients with recurrent SARS-CoV-2 positivity after hospital discharge. Methods: This retrospective study included COVID-19 patients who were readmitted for recurrence of positive SARS-CoV-2 RNA. Univariate and multivariate analyses were performed to assess the risk factors associated to the duration of recurrent RNA positivity.Results: Among the 287 discharged COVID-19 patients, 33 (11.5%) patients with recurrent PCR positivity were included. Among these patients, 21 (63.7%) patients were female TRANS, their mean age TRANS was 48.7 (±19.7) years old. 22 (66.7%) patients were asymptomatic TRANS. The following clinical features were presented in other patients: cough HP, fatigue HP fatigue MESHD, sore throat, fever HP fever MESHD and expectoration. The chest CT findings revealed that 8 (24.2%) patients were characterized by deterioration compared to the previous results. The median duration of recurrent RNA positivity was 9.0 days (IQR, 6.0, 15.0). We found that increased serum SERO SARS-CoV-2-specific IgG antibody SERO titer, elevated serum creatinine HP serum SERO creatinine level, and female TRANS gender TRANS were the risk factors for the prolonged duration of recurrent RNA positivity.Conclusion: SARS-CoV-2 turned positive in a minority of discharged patients with COVID-19. Most patients experienced mild clinical course. Increased IgG antibody SERO titer, creatinine and female TRANS gender TRANS were correlated to the prolonged RNA clearance time.

    Regional Association of Disability and SARS-CoV-2 Infection MESHD in 369 Counties of the United States

    Authors: Oluwaseyi Olulana; Vida Abedi; Venkatesh Avula; Durgesh Chaudhary; Ayesha Khan; Shima Shahjouei; Jiang Li; Ramin Zand

    doi:10.1101/2020.06.24.20139212 Date: 2020-06-26 Source: medRxiv

    Background: There have been outbreaks of SARS-CoV-2 in long term care facilities and recent reports of disproportionate death rates among the vulnerable population. The goal of this study was to better understand the impact of SARS-CoV-2 infection MESHD on the non-institutionalized disabled population in the United States using data from the most affected states as of April 9th, 2020. Methods: This was an ecological study of county-level factors associated with the infection MESHD and mortality rate of SARS-CoV-2 in the non-institutionalized disabled population. We analyzed data from 369 counties from the most affected states (Michigan, New York, New Jersey, Pennsylvania, California MESHD, Louisiana, Massachusetts) in the United States using data available by April 9th, 2020. The variables include changes in mobility reported by Google, race/ethnicity, median income, education level, health insurance, and disability information from the United States Census Bureau. Bivariate regression analysis adjusted for state and median income was used to analyze the association between death rate and infection rate. Results: The independent sample t-test of two groups (group 1: Death rate[≥] 3.4% [median] and group 2: Death rate < 3.4%) indicates that counties with a higher total population, a lower percentage of Black males TRANS and females TRANS, higher median income, higher education, and lower percentage of disabled population have a lower rate (< 3.4%) of SARS-CoV-2 related mortality (all p-values<4.3E-02). The results of the bivariate regression when controlled for median income and state show counties with a higher White disabled population (est: 0.19, 95% CI: 0.01-0.37; p-value:3.7E-02), and higher population with independent living difficulty (est: 0.15, 95% CI: -0.01-0.30; p-value: 6.0E-02) have a higher rate of SARS-CoV-2 related mortality. Also, the regression analysis indicates that counties with higher White disabled population (est: -0.22, 95% CI: -0.43-(-0.02); p-value: 3.3E-02), higher population with hearing disability MESHD (est: -0.26, 95% CI: -0.42- (-0.11); p-value:1.2E-03), and higher population with disability in the 18-34 years age group TRANS (est: -0.25, 95% CI: -0.41-(-0.09); p-value:2.4E-03) show a lower rate of SARS-CoV-2 infection MESHD. Conclusion: Our results indicate that while counties with a higher percentage of non-institutionalized disabled population, especially White disabled population, show a lower infection rate, they have a higher rate of SARS-CoV-2 related mortality. Keywords: Disability disparities, Healthcare disparities, Non-institutionalized disabled population, Racial disparity, Health disparity, Socioeconomic factors, COVID19, United States, Population-based analysis, Ecological study.

    COVID-19 related concerns of people with long-term respiratory conditions: A qualitative study

    Authors: Keir Elmslie James Philip; Bradley Lonergan; Andrew Cumella; Joe Farrington-Douglas; Michael Laffan; Nicholas S Hopkinson

    doi:10.1101/2020.06.19.20128207 Date: 2020-06-26 Source: medRxiv

    BACKGROUND The COVID-19 pandemic is having profound psychological impacts on populations globally, with increasing levels of stress, anxiety HP anxiety MESHD, and depression MESHD being reported, especially in people with pre-existing medical conditions who appear to be particularly vulnerable. There are limited data on the specific concerns people have about COVID-19 and what these are based on. METHODS The aim of this study was to identify and explore the concerns of people with long-term respiratory conditions in the UK regarding the impact of the COVID-19 pandemic and how these concerns were affecting them. We conducted a thematic analysis of free text responses to the question 'What are your main concerns about getting coronavirus?', which was included in the British Lung Foundation/ Asthma HP UK (BLF-AUK) partnership COVID-19 survey, conducted between the 1st and 8th of April. This was during the 3rd week of the UK's initial social distancing measures. RESULTS 7,039 responses were analysed, with respondents from a wide range of ages TRANS, gender TRANS, and all UK nations. Respondents reported having asthma HP (85%), COPD MESHD (9%), bronchiectasis HP (4%), interstitial lung disease MESHD (2%), or 'other' lung diseases (e.g. lung cancer MESHD) (1%). Four main themes were identified: 1) vulnerability to COVID-19; 2) anticipated experience of contracting COVID-19; 3) wide-reaching uncertainty; and 4) inadequate national response. CONCLUSIONS The COVID-19 pandemic is having profound psychological impacts MESHD. The concerns we identified largely reflect objective, as well as subjective, aspects of the current situation. Hence, key approaches to reducing these concerns require changes to the reality of their situation, and are likely to include i) helping people optimise their health, limit risk of infection TRANS risk of infection TRANS infection MESHD, and access necessities; ii) minimising the negative experience of disease where possible, iii) providing up-to-date, accurate and consistent information, iv) improving the government and healthcare response.

    A direct RT-qPCR approach to test large numbers of individuals for SARS-CoV-2 MESHD

    Authors: Tomislav Maricic; Olaf Nickel; Ayinuer Aximu-Petri; Elena Essel; Marie Gansauge; Philipp Kanis; Dominik Macak; Stephan Riesenberg; Lukas Bokelmann; Hugo Zeberg; Matthias Meyer; Stephan Borte; Svante Paabo

    doi:10.1101/2020.06.24.20139501 Date: 2020-06-26 Source: medRxiv

    SARS-CoV-2 causes substantial morbidity and mortality in elderly TRANS and immunocompromised individuals, particularly in retirement homes, where transmission TRANS from asymptomatic TRANS staff and visitors may introduce the infection MESHD. Here we present a cheap and fast approach to detect SARS-CoV-2 in single or pooled gargle lavages ('mouthwashes'). With this approach, we test all staff at a nursing home daily over a period of three weeks in order to reduce the risk that the infection TRANS risk that the infection TRANS penetrates the facility. This or similar approaches could be implemented to protect hospitals, nursing homes and other institutions in this and future viral epidemics.

    Early-stage predictive markers of critically ill COVID-19 cases

    Authors: Zheng Zhou; Shiwei Yin; Jie Xu; Yunfeng Deng; Xinfeng Wang; Xin Ma

    doi:10.21203/ Date: 2020-06-26 Source: ResearchSquare

    Background: Severe cytokine storm syndrome (CSS) is considered as the cause of death MESHD among critically ill COVID-19 cases. Early identification of the high-risk severe cases is crucial to lower the fatality and healthcare costs.Methods: In this study, we retrospectively analyzed the first and second-week serum SERO levels of IL-6, IL-8, and IL-10 of 50 COVID-19 cases. We calculated the ratios of IL-6/IL-10 and IL-8/IL-10 at 3rd, 6th, 9th, and 12th days of hospitalization. Results: We collected 50 COVID-19 cases ( male TRANS 54%, mean age TRANS 51.2, range 18 - 86), including 39 mild cases (78%), 7 severe/recovered cases (14%), and 4 died cases (8%).The ratios of IL 6/IL-10 and IL-8/IL-10 among mild cases were below 27 (the highest, 26.9) along the 4 testing points of two week hospitalization, while we found that the IL-6/IL-10 and IL-8/IL-10 ratios were as high as 187.51 and 225.3 respectively in the death group on 3rd day with the highest IL-6/IL-10 ratio of 297.28 on the 6th day of hospitalization. Conclusions: Our preliminary results suggest that the ratios of IL-6/IL-10 and IL-8/IL-10 at the early stage (the first two weeks) of COVID-19 could be a predictive marker for the disease prognosis, of which the cut-off lines were suggested below 50 for a mild and recoverable severe cases.

    COVID-19-associated ARDS treated with DEXamethasone (CoDEX): Study design and rationale for a randomized trial.

    Authors: Bruno Martins Tomazini; Israel S. Maia; Flavia R. Bueno; Maria Vitoria A. O. Silva; Franca P. Baldassare; Eduardo Leite V. Costa; Ricardo A. B. Moura; Michele Honorato; Andre N. Costa; Alexandre B. Cavalcanti; Regis Rosa; Alvaro Avezum; Viviane C. Veiga; Renato D. Lopes; Lucas P. Damiani; Flavia R. Machado; Otavio Berwanger; Luciano C. P. Azevedo

    doi:10.1101/2020.06.24.20139303 Date: 2020-06-26 Source: medRxiv

    OBJECTIVES: The infection MESHD caused by the severe acute respiratory syndrome coronavirus 2 MESHD (SARS-CoV2) spreads worldwide and is considered a pandemic. The most common manifestation of SARS-CoV2 infection MESHD (Coronavirus disease 2019 - COVID-19) is viral pneumonia HP pneumonia MESHD with varying degrees of respiratory compromise and up to 40% of hospitalized patients might develop Acute Respiratory Distress HP Respiratory Distress MESHD Syndrome ( ARDS MESHD). Several clinical trials evaluated the role of corticosteroids in non-COVID-19 ARDS with conflicting results. We designed a trial to evaluate the effectiveness of early intravenous dexamethasone administration on the number of days alive and free of mechanical ventilation within 28 days after randomization in adult TRANS patients with moderate or severe ARDS MESHD due to confirmed or probable COVID-19. METHODS: This is a pragmatic, prospective, randomized, stratified, multicenter, open-label, controlled trial including 350 patients with early-onset (less than 48h before randomization) moderate or severe ARDS MESHD, defined by the Berlin criteria, due to COVID-19. Eligible patients will be randomly allocated to either standard treatment plus dexamethasone (intervention group) or standard treatment without dexamethasone (control group). Patients in the intervention group will receive dexamethasone 20mg IV once daily for 5 days, followed by dexamethasone 10mg IV once daily for additional 5 days or until Intensive Care Unit (ICU) discharge, whichever occurs first. The primary outcome is ventilator-free days within 28 days after randomization, defined as days alive and free from invasive mechanical ventilation. Secondary outcomes are all-cause mortality rates at day 28, evaluation of the clinical status at day 15 assessed with a 6-level ordinal scale, mechanical ventilation duration from randomization to day 28, Sequential Organ Failure Assessment (SOFA) Score evaluation at 48h, 72h and 7 days and ICU-free days within 28. ETHICS AND DISSEMINATION: This trial was approved by the Brazilian National Committee of Ethics in Research (Comissao Nacional de Etica em Pesquisa - CONEP) and National Health Surveillance Agency (ANVISA). An independent data monitoring committee will perform interim analyses and evaluate adverse events throughout the trial. Results will be submitted for publication after enrolment and follow-up are complete.

    Co-occurrence of SARS-CoV-2 and Respiratory Pathogens in the Frail Elderly TRANS

    Authors: David Baunoch; Alan Wolfe; Dakun Wang; Ryan Gnewuch; Xinhua Zhao; Thomas Halverson; Patrick Cacdac; Shuguang Huang; Trisha Lauterbach; Natalie Luke

    doi:10.1101/2020.06.24.20138941 Date: 2020-06-25 Source: medRxiv

    Background: Elderly TRANS SARS-CoV-2 patients are associated with higher hospitalization and mortality. Co-infection MESHD is critical in the severity of respiratory diseases MESHD. It is largely understudied for SARS-CoV-2. Methods: Between March 24th and April 27th, 2020, nasopharyngeal and oropharyngeal swabs from 3,348 patients from nursing homes and assisted living facilities in 22 states in the US were tested by Capstone Healthcare for SARS-CoV-2, 24 other respiratory viruses, and 8 respiratory bacteria MESHD. Total nucleic acid was extracted with MagMAXTM Viral/Pathogen Ultra nucleic acid isolation kit. SARS-Co-V-2 was detected with the CDC 2019-novel coronavirus (2019-nCoV) diagnostic panel. Total nucleic acid was pre-amplified before analysis for other respiratory pathogens with Taqman OpenArrayTM Respiratory Tract Microbiota MESHD Plate. Results: Patients mean age TRANS was 76.9 years. SARS-CoV-2 was detected in 1,413 patients (42.2%). Among them, 1,082 (76.6%) and 737 (43.7%) patients were detected with at least one bacterium or another virus, respectively. SARS-CoV-2-positive patients were more likely to have bacterial co-occurrences (76.6%) than SARS-CoV-2-negative patients (70.0%) (p<0.0001). The most common co-occurring bacteria were Staphylococcus aureus and Klebsiella pneumonia MESHD pneumonia HP, detected in 55.8% and 40.1% SARS-CoV-2-positive patients, respectively. Staphylococcus aureus was associated with SARS-CoV-2, with higher detection rates in SARS-CoV-2-positive patients (55.8%) than SARS-CoV-2-negative patients (46.2%) (p<0.0001). Human herpes virus 6 (HHV6) also was common and associated with SARS-CoV-2, with higher detection rates in SARS-CoV-2-positive patients (26.6%) than SARS-CoV-2-negative patients (19.1%) (p<0.0001). Conclusions: SARS-CoV-2-positive patients are more likely to be positive for certain respiratory bacteria MESHD and viruses. This observation may help explain high hospitalization and mortality rates in older patients.

    A Randomized Controlled Study of Muscle Training Exercise Based Pulmonary Rehabilitation on Activity of Daily Living in Patients with Coronavirus Disease MESHD 2019

    Authors: Zhiling Zhao; Feng Wang; Xue Wang; Xiunan Li; Yi Ren; Fen Wang; Shi Liu; Dandan Chang; Xinglu Zhang; Yong Lu; Ziren Tang; Jianchu Zhang

    doi:10.21203/ Date: 2020-06-25 Source: ResearchSquare

    Background: Hospitalized patients with Coronavirus Disease MESHD 2019 (COVID-19) pneumonia HP pneumonia MESHD showed a severve loss of muscle mass and strength over admission. Therefore, early physical interventions might be conducive to prevent disability and fasten recovery. Methods: We designed a prospective, randomized controlled trial to identify the effectiveness and safety of pulmonary rehabilitation based on muscle exercise in COVID-19 patients. The study was conducted between February 7th and March 31st 2020 in Union Hospital. Patients were randomly assigned to the pulmonary rehabilitation exercise group or the control group. Primary outcome was improvement of activity of daily living (ADL). Secondary outcome was changes of muscle strength assessed by manual muscle test (MMT) and arterial blood SERO gas analysis. Length of hospital staying (LOS) and adverse events related to physical activity were also observed.Results: A total of sixty patients were in analysis, and thirty patients were in PR group. Patients had a mean age TRANS of 54.43±10.57 years. A statistically and clinically significant increase in ADL was observed in PR group (75.00 [66.25,90.00] to 100.00 [100.00,100.00], p<0.001). We also found that the improvement of ADL was related to younger age TRANS and higher PaO2 (p<0.01). Both groups had MMT improvement and there was no statistical difference between groups. There was a significant increase in PaO2 (80.23±6.49 vs. 90.47±7.82, respectively, p<0.001) between two groups before discharge. There was no statically significant difference in LOS between study group and control group (p=0.62). None of these patients had severe complications during the study.Conclusions: The protocal of pulmonary rehabilitation based on muscle training exercise was feasible in COVID-19 patients and it might accelerate recovery in ADL as compared with the spontaneous recovery in the control group.Clinical Trial Registration: ChiCTR, ChiCTR2000032457. Registered 29 April 2020- Retrospectively registered,

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MeSH Disease
Human Phenotype

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