Corpus overview


MeSH Disease

Infections (1083)

Disease (1015)

Death (699)

Coronavirus Infections (631)

Fever (322)

Human Phenotype

Pneumonia (325)

Fever (323)

Hypertension (254)

Cough (250)

Anxiety (129)


age categories (2567)

gender (921)

Transmission (398)

fomite (241)

asymptotic cases (205)

    displaying 11 - 20 records in total 2591
    records per page

    Household transmission TRANS of SARS-CoV-2: a systematic review and meta-analysis of secondary attack rate TRANS

    Authors: Zachary J. Madewell; Yang Yang; Ira M. Longini Jr.; M. Elizabeth Halloran; Natalie E. Dean

    doi:10.1101/2020.07.29.20164590 Date: 2020-08-01 Source: medRxiv

    Background: Severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) is spread by direct, indirect, or close contact TRANS with infected people via infected respiratory droplets or saliva. Crowded indoor environments with sustained close contact TRANS and conversations are a particularly high-risk setting. Methods: We performed a meta-analysis through July 29, 2020 of SARS-CoV-2 household secondary attack rate TRANS ( SAR TRANS), disaggregating by several covariates (contact type, symptom status, adult TRANS/ child TRANS contacts, contact sex, relationship to index case, index case sex, number of contacts in household TRANS, coronavirus). Findings: We identified 40 relevant published studies that report household secondary transmission TRANS. The estimated overall household SAR TRANS was 18.8% (95% confidence interval [CI]: 15.4%-22.2%), which is higher than previously observed SARs for SARS-CoV and MERS-CoV. We observed that household SARs were significantly higher from symptomatic index cases than asymptomatic TRANS index cases, to adult TRANS contacts than children TRANS contacts, to spouses than other family contacts, and in households TRANS with one contact than households TRANS with three or more contacts. Interpretation: To prevent the spread of SARS-CoV-2, people are being asked to stay at home worldwide. With suspected or confirmed infections TRANS infections MESHD referred to isolate at home, household transmission TRANS will continue to be a significant source of transmission TRANS.

    Improving COVID-19 critical care mortality over time in England: A national cohort study, March to June 2020

    Authors: John Dennis; Andrew McGovern; Sebastian Vollmer; Bilal A Mateen

    doi:10.1101/2020.07.30.20165134 Date: 2020-08-01 Source: medRxiv

    Objectives: To determine the trend in mortality risk over time in people with severe COVID-19 requiring critical care (high intensive unit [HDU] or intensive care unit [ICU]) management. Methods: We accessed national English data on all adult TRANS COVID-19 specific critical care admissions from the COVID-19 Hospitalisation in England Surveillance System (CHESS), up to the 29th June 2020 (n=14,958). The study period was 1st March until 30th May, meaning every patient had 30 days of potential follow-up available. The primary outcome was in-hospital 30-day all-cause mortality. Hazard ratios for mortality were estimated for those admitted each week using a Cox proportional hazards models, adjusting for age TRANS (non-linear restricted cubic spline), sex, ethnicity, comorbidities, and geographical region. Results: 30-day mortality peaked for people admitted to critical care in early April (peak 29.1% for HDU, 41.5% for ICU). There was subsequently a sustained decrease in mortality risk until the end of the study period. As a linear trend from the first week of April, adjusted mortality risk decreased by 11.2% (adjusted HR 0.89 [95% CI 0.87 - 0.91]) per week in HDU, and 9.0% (adjusted HR 0.91 [95% CI 0.88 - 0.94]) in ICU. Conclusions: There has been a substantial mortality improvement in people admitted to critical care with COVID-19 in England, with markedly lower mortality in people admitted in mid-April and May compared to earlier in the pandemic. This trend remains after adjustment for patient demographics and comorbidities suggesting this improvement is not due to changing patient characteristics. Possible causes include the introduction of effective treatments as part of clinical trials and a falling HP critical care burden.

    Multisystem Inflammatory Syndrome MESHD in Children TRANS: Survey of Early Hospital Evaluation and Management

    Authors: Matthew Dove; Preeti Jaggi; Michael Kelleman; Mayssa Abuali; Jocelyn Ang; Wassim Ballan; Sanmit Basu; Jay Campbell; Sathish Chikkabyrappa; Nadine Choueiter; Katherine Clouser; Daniel Corwin; Amy Edwards; Shira Gertz; Rod Ghassemzadeh; Rima Jarrah; Sophie Katz; Stacie Knutson; Joseph Kuebler; Jennifer Lighter; Christine Mikesell; Kanokporn Mongkolrattanothai; Ted Morton; Natasha Nakra; Rosemary Olivero; Christina Osborne; Sarah Parsons; Laurie Panesar; Rupal Patel; Jennifer Schuette; Deepa Thacker; Adrina Tremoulet; Navivot Vidwan; Matthew Oster

    doi:10.1101/2020.07.29.20164459 Date: 2020-08-01 Source: medRxiv

    Background: In the absence of evidence-based therapies for Multisystem Inflammatory Syndrome MESHD in Children TRANS (MIS-C), we aimed to describe the similarities and differences in the evaluation and treatment of MIS-C at hospitals in the United States. Methods: We conducted a cross-sectional survey from June 16 to July 16, 2020 of U.S. pediatric hospitals regarding protocols for patients with MIS-C. Elements included hospital characteristics, clinical definition of MIS-C, evaluation, treatment, and follow-up. We summarized key findings and compared results from centers that had treated >5 patients vs. those that had treated <5 patients. Results: Forty centers of varying size and experience with MIS-C participated. About half (21/40) of centers required only 1 day of fever MESHD fever HP for MIS-C to be considered. In the evaluation of patients, there was often a tiered approach. Intravenous immunoglobulin was the most widely used medication to treat MIS-C (98% of centers). Corticosteroids were listed in 93% of protocols for primarily the moderate or severe cases. Aspirin was commonly used including for mild cases, whereas heparin or low molecular weight heparin were used primarily in severe cases. In severe cases, anakinra and vasopressors were frequently recommended. Nearly all centers (39/40) recommended follow up with cardiology. There were similar findings between centers that had treated >5 patients vs. those that had treated <5 patients. A supplement containing hospital protocols is provided. Conclusion: There are many similarities yet some key differences between hospital protocols for MIS-C. These findings can help healthcare providers learn from others regarding options for managing MIS-C patients.

    Mathematical modeling of the transmission TRANS of SARS-CoV-2 '' Evaluating the impact of isolation in Sao Paulo State (Brazil) and lockdown in Spain associated with protective measures on the epidemic of covid-19

    Authors: Hyun Mo Yang; Luis Pedro Lombardi Jr.; Fabio Fernandes Morato Castro; Ariana Campos Yang

    doi:10.1101/2020.07.30.20165191 Date: 2020-08-01 Source: medRxiv

    Coronavirus disease MESHD 2019 (covid-19), with the fatality rate in elder (60 years old or more) being much higher than young (60 years old or less) patients, was declared a pandemic by the World Health Organization on March 11, 2020. Taking into account this age TRANS-dependent fatality rate, a mathematical model considering young and elder subpopulations was formulated based on the natural history of covid-19 to study the transmission TRANS of the SARS-CoV-2. This model can be applied to study the epidemiological scenario resulting from the adoption of isolation or lockdown in many countries to control the rapid propagation of covid-19. We chose as examples the isolation adopted in Sao Paulo State (Brazil) in the early phase but not at the beginning of the epidemic, and the lockdown implemented in Spain when the number of severe covid-19 cases was increasing rapidly. Based on the data collected from Sa o Paulo State and Spain, the model parameters were evaluated and we obtained higher estimation for the basic reproduction number TRANS R0 TRANS (9.24 for Sao Paulo State, and 8 for Spain) compared to the currently accepted estimation of R0 TRANS around 3. The model allowed to explain the flattening of the epidemic curves by isolation in Sao Paulo State and lockdown in Spain when associated with the protective measures (face mask and social distancing) adopted by the population. However, a simplified mathematical model providing lower estimation for R0 TRANS did not explain the flattening of the epidemic curves. The implementation of the isolation in Sa o Paulo State before the rapidly increasing phase of the epidemic enlarged the period of the first wave of the epidemic and delayed its peak, which are the desirable results of isolation to avoid the overloading in the health care system.

    High SARS-CoV-2 seroprevalence SERO in Health Care Workers but relatively low numbers of deaths MESHD in urban Malawi

    Authors: Marah Grace Chibwana; Khuzwayo Chidiwa Jere; Jonathan Mandolo; Vincent Katunga-Phiri; Dumizulu Tembo; Ndaona Mitole; Samantha Musasa; Simon Sichone; Agness Lakudzala; Lusako Sibale; Prisca Matambo; Innocent Kadwala; Rachel Louise Byrne; Alice Mbewe; Ben Morton; Chimota Phiri; Jane Mallewa; Henry C Mwandumba; Emily R Adams; Stephen B Gordon; Kondwani Charles Jambo

    doi:10.1101/2020.07.30.20164970 Date: 2020-08-01 Source: medRxiv

    Background In low-income countries, like Malawi, important public health measures including social distancing or a lockdown, have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) infection MESHD, there are no reliable estimates of the true burden of infection MESHD and death MESHD. We, therefore, conducted a SARS-CoV-2 serosurvey amongst health care workers (HCW) in Blantyre city to estimate the cumulative incidence of SARS-CoV-2 infection MESHD in urban Malawi. Methods Five hundred otherwise asymptomatic TRANS HCWs were recruited from Blantyre City (Malawi) from 22nd May 2020 to 19th June 2020 and serum samples SERO were collected all participants. A commercial ELISA SERO was used to measure SARS-CoV-2 IgG antibodies SERO in serum SERO. We run local negative samples (2018 - 2019) to verify the specificity of the assay. To estimate the seroprevalence SERO of SARS CoV-2 antibodies SERO, we adjusted the proportion of positive results based on local specificity of the assay. Results Eighty-four participants tested positive for SARS-CoV-2 antibodies SERO. The HCW with a positive SARS-CoV-2 antibody SERO result came from different parts of the city. The adjusted seroprevalence SERO of SARS-CoV-2 antibodies SERO was 12.3% [CI 9.0-15.7]. Using age TRANS-stratified infection MESHD fatality estimates reported from elsewhere, we found that at the observed adjusted seroprevalence SERO, the number of predicted deaths MESHD was 8 times the number of reported deaths MESHD. Conclusion The high seroprevalence SERO of SARS-CoV-2 antibodies SERO among HCW and the discrepancy in the predicted versus reported deaths MESHD, suggests that there was early exposure but slow progression of COVID-19 epidemic in urban Malawi. This highlights the urgent need for development of locally parameterised mathematical models to more accurately predict the trajectory of the epidemic in sub-Saharan Africa for better evidence-based policy decisions and public health response planning.

    High rate of major drug-drug interactions of lopinavir-ritonavir for COVID-19 treatment

    Authors: Juan Macias; Ana Pinilla; Francisco A Lao-Dominguez; Anais Corma; Enrique Contreras-Macias; Alejandro Gonzalez-Serna; Antonio Gutierrez-Pizarraya; Marta Fernandez-Fuertes; Ramon Morillo-Verdugo; Marta Trigo; Luis M Real; Juan A Pineda

    doi:10.1101/2020.07.30.20165027 Date: 2020-08-01 Source: medRxiv

    The impact of drug-drug interactions (DDI) between ritonavir-boosted lopinavir (LPV-r) to treat patients with coronavirus disease MESHD 2019 (COVID-19) and commonly used drugs in clinical practice is not well-known. Thus, we evaluated the rate and severity of DDI between LPV-r for COVID-19 treatment and concomitant medications. This was a cross-sectional study including all individuals diagnosed of SARS-CoV-2 infection MESHD treated with LPV-r and attended at a single center in Southern Spain (March 1st to April 30th, 2020). The frequency [95% confidence interval (95% CI)] of potential and major DDI were calculated. Overall, 469 patients were diagnosed of COVID-19, 125 (27%) of them were prescribed LPV-r. LPV-r had potential DDI with concomitant medications in 97 (78%, 95% CI: 69%-85%) patients, and in 33 (26%, 95% CI: 19%-35%) individuals showed major DDI. Twelve (36%) patients with major DDI and 14 (15%) individuals without major DDI died (p=0.010). After adjustment, only the Charlson index was independently associated with death MESHD [adjusted OR (95% CI) for Charlson index [≥]5: 85 (10-731), p <0.001]. LPV-r was discontinued due to side effects in 31 (25%) patients. Management by the Infectious Diseases MESHD Unit was associated with a lower likelihood of major DDI [adjusted odds ratio (95% CI): 0.14 (0.04-0.53), p=0.003). In conclusion, a high frequency of DDI between LPV-r for treating COVID-19 and concomitant medications was found, including major DDI. Patients with major DDI showed worse outcomes, but this association was explained by the older age TRANS and comorbidities. Patients managed by the Infectious Diseases MESHD Unit had lower risk of major DDI.

    Visualizing and Assessing US County-Level COVID19 Vulnerability

    Authors: Gina Cahill; Carleigh Kutac; Nicholas L Rider

    doi:10.1101/2020.07.30.20164608 Date: 2020-08-01 Source: medRxiv

    Objective: Like most of the world, the United States public health and economy are impacted by the COVID19 pandemic. However, discrete pandemic effects may not be fully realized on the macro-scale. With this perspective, our goal is to visualize spread of the pandemic and measure county-level features which may portend vulnerability. Materials and Methods: We accessed the New York Times GitHub repository COVID19 data and 2018 US Census data for all US Counties. The disparate datasets were merged and filtered to allow for visualization and assessments about case fatality rate (CFR%) and associated demographic, ethnic and economic features. Results: Our results suggest that county-level COVID19 fatality rates are related to advanced population age TRANS (p <0.001) and less diversity as evidenced by higher proportion of Caucasians in High CFR% counties (p < 0.001). Also, lower CFR% counties had a greater proportion of the population reporting has having 2 or more races (p <0.001). We noted no significant differences between High and Low CFR% counties with respect to mean income or poverty rate. Conclusions: Unique COVID19 impacts are realized at the county level. Use of public datasets, data science skills and information visualization can yield helpful insights to drive understanding about community-level vulnerability.

    Sustained Cellular Immune Dysregulation HP in Individuals Recovering from SARS-CoV-2 Infection MESHD

    Authors: Jacob K Files; Sushma Boppana; Mildred D Perez; Sanghita Sarkar; Kelsey E Lowman; Kai Qin; Sarah Sterrett; Eric Carlin; Anju Bansal; Steffanie Sabbaj; Dustin M Long; Olaf Kutsch; James Kobie; Paul A Goepfert; Nathan Erdmann

    doi:10.1101/2020.07.30.20165175 Date: 2020-08-01 Source: medRxiv

    SARS-CoV-2 causes a wide spectrum of clinical manifestations and significant mortality. Studies investigating underlying immune characteristics are needed to understand disease MESHD pathogenesis and inform vaccine design. In this study, we examined immune cell subsets in hospitalized and non-hospitalized individuals. In hospitalized patients, many adaptive and innate immune cells were decreased in frequency compared to healthy and convalescent individuals, with the exception of B lymphocytes which increased. Our findings show increased frequencies of T-cell activation markers (CD69, Ox40, HLA-DR and CD154) in hospitalized patients, with other T-cell activation/exhaustion markers (CD25, PD-L1 and TIGIT) remaining elevated in hospitalized and non-hospitalized individuals. B cells had a similar pattern of activation/exhaustion, with increased frequency of CD69 and CD95 during hospitalization, followed by an increase in PD1 frequencies in non-hospitalized individuals. Interestingly, many of these changes were found to increase over time in non-hospitalized longitudinal samples, suggesting a prolonged period of immune dysregulation HP following SARS-CoV-2 infection MESHD. Changes in T-cell activation/exhaustion in non-hospitalized patients were found to positively correlate with age TRANS. Severely infected individuals had increased expression of activation and exhaustion markers. These data suggest a prolonged period of immune dysregulation HP following SARS-CoV-2 infection MESHD highlighting the need for additional studies investigating immune dysregulation HP in convalescent individuals.

    Quantification of the association between predisposing health conditions, demographic, and behavioural factors with hospitalisation, intensive care unit admission, and death MESHD from COVID-19: a systematic review and meta-analysis

    Authors: Nathalie Veronica Fernandez Villalobos; Joerdis Jennifer Ott; Carolina Judith Klett-Tammen; Annabelle Bockey; Patrizio Vanella; Gerard Krause; Berit Lange

    doi:10.1101/2020.07.30.20165050 Date: 2020-08-01 Source: medRxiv

    Background Comprehensive evidence synthesis on the associations between comorbidities and behavioural factors with hospitalisation, Intensive Care Unit (ICU) admission, and death MESHD due to COVID-19 is lacking leading to inconsistent national and international recommendations on who should be targeted for non-pharmaceutical interventions and vaccination strategies. Methods We performed a systematic review and meta-analysis on studies and publicly available data to quantify the association between predisposing health conditions, demographics, and behavioural factors with hospitalisation, ICU admission, and death MESHD from COVID-19. We provided ranges of reported and calculated effect estimates and pooled relative risks derived from a meta-analysis and meta-regression. Results 75 studies were included into qualitative and 74 into quantitative synthesis, with study populations ranging from 19 - 44,672 COVID-19 cases. The risk of dying from COVID-19 was significantly associated with cerebrovascular [pooled RR 2.7 (95% CI 1.7-4.1)] and cardiovascular [RR 3.2 (CI 2.3-4.5)] diseases MESHD, hypertension MESHD hypertension HP [RR 2.6 (CI 2.0-3.4)], and renal disease MESHD [RR 2.5 (CI 1.8-3.4)]. Health care workers had lower risk for death MESHD and severe outcomes of disease MESHD (RR 0.1 (CI 0.1-0.3). Our meta-regression showed a decrease of the effect of some comorbidities on severity of disease MESHD with higher median age TRANS of study populations. Associations between comorbidities and hospitalisation and ICU admission were less strong than for death MESHD. Conclusions We obtained robust estimates on the magnitude of risk for COVID-19 hospitalisation, ICU admission, and death MESHD associated with comorbidities, demographic, and behavioural risk factors. We identified and confirmed population groups that are vulnerable and that require targeted prevention approaches.

    Rapid real-time tracking of non-pharmaceutical interventions and their association SARS-CoV-2 positivity: The COVID-19 Pandemic Pulse Study

    Authors: Steven J. Clipman; Amy P. Wesolowski; Dustin G. Gibson; Smisha Agarwal; Anastasia S. Lambrou; Gregory D. Kirk; Alain B. Labrique; Shruti H. Mehta; Sunil S. Solomon

    doi:10.1101/2020.07.29.20164665 Date: 2020-08-01 Source: medRxiv

    Background: Current mitigation strategies for severe acute respiratory syndrome MESHD coronavirus 2 (SARS-CoV-2) rely on population-wide adoption of non-pharmaceutical interventions (NPIs). Collecting demographically and geographically resolved data on NPIs and their association with SARS-CoV-2 infection MESHD history can provide critical information related to reopening geographies. Methods: We sampled 1,030 individuals in Maryland from June 17 - June 28, 2020 to capture socio-demographically and geographically resolved information about NPI adoption, access to SARS-CoV-2 testing, and examine associations with self-reported SARS-CoV-2 positivity. Results: Median age TRANS of the sample was 43 years and 45% were men; Whites and Blacks/African Americans represented 60% and 23%, respectively. Overall, 96% of the sample reported traveling TRANS outside their home for non-employment related services: most commonly cited reasons were essential services (92%) and visiting friends TRANS/family (66%). Use of public transport was reported by 18% of respondents. 68% reported always social distancing indoors and 53% always wearing masks indoors; indoor social distancing was significantly less common among younger vs. older individuals, and race/ethnicity and income were significantly associated with mask use (p<0.05 for all). 55 participants (5.3%) self-reported ever testing positive for SARS-CoV-2 with strong dose-response relationships between movement frequency and SARS-CoV-2 positivity that were significantly attenuated by social distancing. In multivariable analysis, history of SARS-CoV-2 infection MESHD was negatively associated with the practice of social distancing (adjusted Odd Ratio [aOR]: 0.10; 95% Confidence Interval: 0.03 - 0.33); the only travel TRANS associated with higher likelihood of SARS-CoV-2 infection MESHD was use of public transport (aOR for 7 or more times vs. never: 4.29) and visiting a place of worship (aOR for 3 or more times vs. never: 16.0) after adjusting for social distancing. Conclusions: Using a rapid cost-efficient approach, we highlight the role of movement and social distancing on SARS-CoV-2 transmission risk TRANS. Continued monitoring of NPI uptake, access to testing, and the subsequent impact on SARS-CoV-2 transmission TRANS will be critical for pandemic control and decisions about reopening geographies.

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MeSH Disease
Human Phenotype

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