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 2671 - 2680 records in total 3444
    records per page

    How urgent do intravitreal anti-VEGF injections need to be to justify the risk of transmitting COVID-19? Proof-of-concept calculations to determine the Health Adjusted Life-Year (HALY) trade-off.

    Authors: Matt James Boyd; Daniel Andrew Richard Scott; David Michael Squirrell; Graham Ashley Wilson

    doi:10.1101/2020.04.27.20075085 Date: 2020-05-01 Source: medRxiv

    Background: Clinical ophthalmological guidelines encourage the assessment of potential benefits and harms when deciding whether to perform elective ophthalmology procedures during the COVID-19 pandemic, in order to minimize the risk of disease transmission TRANS. Method: We performed probability calculations to estimate COVID-19 infection status and likelihood of disease transmission TRANS among neovascular age TRANS-related macular degeneration HP macular degeneration MESHD patients and health care workers during anti-VEGF procedures, at various community prevalence SERO levels of COVID-19. We then applied the expected burden of COVID-19 illness and death expressed through health-adjusted life-years (HALYs) lost. We compared these results to the expected disease burden of severe visual impairment HP visual impairment MESHD if sight protecting anti-VEGF injections were not performed. Results: Our calculations estimate for a single treatment, where the background rate of COVID-19 in the community is 1000 active cases per million population, and full personal protective equipment (PPE) is available, that the benefits of treatment are greater than the expected harms to the patient and immediate health care team, provided the probability of severe visual impairment HP visual impairment MESHD without treatment is >0.001%. Without effective PPE, and with a COVID-19 prevalence SERO of 200,000 per million, an 8.5% chance of severe visual impairment HP visual impairment MESHD could still justify monthly injections for six months. Conclusion: In most cases analysed, the reduced disease burden from avoiding visual impairment HP visual impairment MESHD outweighs the expected HALYs lost from COVID-19 transmission TRANS. This finding is driven by the fact that HALYs lost when someone suffers severe visual impairment HP visual impairment MESHD for 5 years are equivalent to nearly 400 moderate cases of infectious disease MESHD lasting 2 weeks each.

    COVID-19-induced acute respiratory failure HP respiratory failure MESHD: an exacerbation of organ-specific autoimmunity HP?

    Authors: Daniel Gagiannis; Julie Steinestel; Carsten Hackenbroch; Michael Hannemann; Vincent G Umathum; Niklas Gebauer; Marcel Stahl; Hanno M Witte; Konrad Steinestel

    doi:10.1101/2020.04.27.20077180 Date: 2020-05-01 Source: medRxiv

    Background: Understanding the pathophysiology of respiratory failure HP respiratory failure MESHD (ARDS) in coronavirus disease MESHD 2019 (COVID-19) patients is of utmost importance for the development of therapeutic strategies and identification of risk factors. Since we observed clinical and histopathological similarities between COVID-19 and lung manifestations of connective tissue disease (CTD-ILD) in our clinical practice, aim of the present study is to analyze a possible role of autoimmunity HP in SARS-CoV-2-associated respiratory failure HP respiratory failure MESHD. Methods: In this prospective, single-center trial, we enrolled 22 consecutive patients with RT-PCR-confirmed SARS-CoV-2 infection MESHD hospitalized in March and April, 2020. We performed high-resolution computed tomography (HR-CT) and full laboratory testing including autoantibody (AAB) screening (anti-ANA, SS-B/La, Scl-70, Jo-1, CENP-B, PM-Scl). Transbronchial biopsies as well as post mortem tissue samples were obtained from 3 and 2 cases, respectively, and subsequent histopathologic analysis with special emphasis on characterization of interstitial lung disease MESHD was performed. Results: Twelve of 22 patients (54.5%) were male TRANS and median age TRANS was 69.0 (range: 28-88). 11 (50.0%) patients had to be undergo intensive care unit (ICU) treatment. Intubation with ventilation was required in 10/22 cases (46%). Median follow-up was 26 days. Clinical and serological parameters were comparable to previous reports. Radiological and histopathological findings were highly heterogeneous including patterns reminiscent of CTD-ILD. AAB titers [≥]1:100 were detected in 10/11 (91.9%) COVID-19 patients who required ICU treatment, but in 4/11 (36.4%) patients with mild clinical course (p=0.024). Patients with AABs tended to require invasive ventilation and showed significantly more severe complications (64.3% vs. 12.5%, p=0.031). Overall COVID-19-related mortality was 18.2% among hospitalized patients at our institution. Conclusion: Our findings point out serological, radiological and histomorphological similarities between COVID-19-associated ARDS and acute exacerbation of CTD-ILD. While the exact mechanism is still unknown, we postulate that SARS-CoV-2 infection MESHD might trigger or simulate a form of organ-specific autoimmunity HP in predisposed patients. The detection of autoantibodies might identify patients who profit from immunosuppressive therapy to prevent the development of respiratory failure HP respiratory failure MESHD.

    Review and methodological analysis of trials currently testing treatment and prevention options for the novel coronavirus disease MESHD (COVID-19) globally.

    Authors: Paraskevi C. Fragkou; Drifa Belhadi; Nathan Peiffer-Smadja; Charalampos D. Moschopoulos; François-Xavier Lescure; Hannah Janocha; Emmanouil Karofylakis; Yazdan Yazdanpanah; France Mentré; Chrysanthi Skevaki; Cédric Laouénan; Sotirios Tsiodras

    doi:10.1101/2020.04.27.20080226 Date: 2020-05-01 Source: medRxiv

    Background: As novel coronavirus disease MESHD (COVID-19) cases continue to steeply rise globally within an unprecedented short period of time, solid evidence from large randomised controlled trials is still lacking. Currently, numerous trials testing potential treatment and preventative options are undertaken globally. Objectives: We summarised all currently registered clinical trials examining treatment and prevention options for COVID-19 pneumonia HP pneumonia MESHD. Additionally, we evaluated the quality of the retrieved interventional studies. Data sources: The, the Chinese Clinical Trial Registry and the European Union Clinical Trials Register were systematically searched. Study eligibility criteria: Registered clinical trials examining treatment and/or prevention options for COVID-19 were included. No language, country or study design restrictions were applied. Withdrawn, cancelled studies and trials not reporting therapeutic or preventative strategies for COVID-19 were excluded. Participants and interventions: No restrictions in terms of participants' age TRANS and medical background or type of intervention were enforced. Methods: The registries were searched using the term "coronavirus" or "COVID-19" from their inception until 26th March 2020. Additional manual search of the registries was also performed. Eligible studies were summarised and tabulated. Interventional trials were methodologically analysed, excluding expanded access studies and trials testing Traditional Chinese Medicine. Results: In total, 309 trials evaluating therapeutic management options, 23 studies assessing preventive strategies and 3 studies examining both were retrieved. Interventional treatment studies were mostly randomised (n=150, 76%) and open-label (n=73, 37%) with a median number of planned inclusions of 90 (IQR 40-200). Major categories of interventions that are currently being investigated are discussed. Conclusion: Numerous clinical trials have been registered since the onset of the COVID-19 pandemic. Summarised data on these trials will assist physicians and researchers to promote patient care and guide future research efforts for COVID-19 pandemic containment. However, up to the end of March, 2020, significant information concerning reported trials was lacking.

    A comparison of COVID-19 and imaging radiation risk in clinical patient populations

    Authors: Francesco Ria; Wanyi Fu; Hamid Chalian; Ehsan Abadi; Paul W. Segars; Rafael Fricks; Pegah Khoshpouri; Ehsan Samei

    doi:10.21203/ Date: 2020-04-30 Source: ResearchSquare

    Objective. The outbreak of coronavirus SARS-COV2 disease MESHD 2019 (COVID-19) necessitates fast and accurate diagnostic tools. RT-PCR has been identified as gold standard test with Chest-CT and Chest-Radiography showing promising results as well. However, several institutions are discouraging the use of radiological procedures for COVID-19 diagnosis, partly due to radiation risk. This study aimed to provide quantitative data towards an effective risk-to-benefit analysis for the justification of radiological studies in COVID-19 diagnosis to guide policy and decision makers.Methods. The analysis was performed in terms of mortality rate per age group TRANS. COVID-19 mortality was extracted from epidemiological data across 159,107 patients in Italy. For radiological risk, the study considered 659 Chest-CT performed in adult TRANS patients. Organ doses were estimated using a Monte Carlo method and then used to calculate the Risk Index that was converted into a related 5-year mortality rate (SEER, NCI). Results. COVID-19 mortality showed a rapid rise for ages TRANS >30 years old (min:0.30%; max:30.20%), whereas only 1 death MESHD was reported in the analyzed patient cohort for ages TRANS <20 years old. The rates decreased for radiation risk across age groups TRANS. The median mortality rate across all ages TRANS for Chest-CT and Chest-Radiography were 0.72% (min:0.46%; max:1.10%) and 0.03% (min:0.02%; max:0.04%), respectively.Conclusions. COVID-19, Chest-Radiography, and Chest-CT mortality rates showed different magnitudes and trends across age groups TRANS. In higher ages TRANS, COVID-19 risk far outweighs that of radiological exams. Based on risk comparison alone, Chest-Radiography and Chest-CT for COVID-19 care is justified for patients older than 30 and 50 years old, respectively.

    Why Does COVID-19 Disproportionately Affect the Elderly TRANS?

    Authors: Amber L. Mueller; Maeve S. McNamara; David A. Sinclair

    id:10.20944/preprints202004.0548.v1 Date: 2020-04-30 Source:

    The severity and outcome of coronavirus disease MESHD 2019 (COVID-19) largely depends on a patient’s age TRANS. Over 80% of hospitalizations are of those over 65 years of age TRANS with a 23-fold greater risk of death MESHD. In the clinic, COVID-19 patients most commonly present with fever HP fever MESHD, cough HP cough MESHD and dyspnea HP dyspnea MESHD. Particularly in those over 65, it can progress to pneumonia HP pneumonia MESHD, lung consolidation, cytokine release syndrome, endotheliitis, coagulopathy MESHD, multiple organ failure MESHD and death MESHD. Comorbidities such as cardiovascular disease MESHD, diabetes MESHD, obesity HP obesity MESHD and hypertension HP hypertension MESHD increase the chances of fatal disease, but they alone do not explain the variability in COVID-19 symptoms. Here, we present the molecular differences between the young, middle- aged TRANS and elderly TRANS that may determine whether COVID-19 is a mild or life-threatening illness. We also discuss several biological age TRANS clocks that could be used in conjunction with genetic tests to identify both the mechanisms of the disease and individuals most at risk. Finally, based on these mechanisms, we discuss treatments that could increase survival in the elderly TRANS, not simply by inhibiting the virus, but by restoring patients’ ability to clear the infection MESHD.

    A deeper look at COVID-19 CFR: health care impact and roots of discrepancy

    Authors: Amirhoshang Hoseinpour Dehkordi; Reza Nemati; Pouya Tavousi

    doi:10.1101/2020.04.22.20071498 Date: 2020-04-30 Source: medRxiv

    Intensive care capacity and proper testing play a paramount role in the COVID-19 Case Fatality Rate (CFR). Nevertheless, the real impact of such important measures has not been appreciated due to the lack of proper metrics. In this work, we have proposed a method for estimating a lower bound for the number of positive cases by using the reported data on the oldest age group TRANS and the regions' population distributions. The proposed estimation method improved the expected similarity between the age TRANS-distribution of positive cases and regions' population. Further, we have provided a quantitative measure for the impact of intensive care on the critical cases by comparing the CFR among those who did and did not receive intensive care. Our findings showed that the chance of living among non-ICU receivers is less than half of ICU receivers (~24% vs ~60%).

    Evaluation of "stratify and shield" as a policy option for ending the COVID-19 lockdown in the UK

    Authors: Paul M. McKeigue; Helen M Colhoun

    doi:10.1101/2020.04.25.20079913 Date: 2020-04-30 Source: medRxiv

    Although population-wide lockdowns have been successful in slowing the COVID-19 epidemic, there is a consensus among disease modellers that keeping the load on critical care services within manageable limits will require an adaptive social distancing strategy, alternating cycles of relaxation and re-imposition until a vaccine is available. An alternative strategy that has been tentatively proposed is to shield the elderly TRANS and others at high risk of severe disease, while allowing immunity to build up in those at low risk until the entire population is protected. We examine the performance SERO required from a classifier that uses information from medical records to assign risk status for a such a stratify-and-shield policy to be effective in limiting mortality when social distancing is relaxed. We show that under plausible assumptions about the level of immunity required for population-level immunity, the proportion shielded is constrained to be no more than 15% of the population. Under varying assumptions about the infection fatality ratio (from 0.1% to 0.4%) and the performance SERO of the classifier (3 to 4.5 bits of information for discrimination), we calculate the expected number of deaths in the unshielded group. We show that with likely values of the performance SERO of a classifier that uses information from age TRANS, sex and medical records, at least 80% of those who would die if unshielded would be allocated to the high-risk shielded group comprising 15% of the population. Although the proportion of deaths MESHD that would be prevented by effective shielding does not vary much with the infection fatality ratio, the absolute number of deaths in the unshielded varies from less than 10,000 if the infection fatality rate is 0.1% to more than 50,000 if the infection fatality rate is as high as 0.4%. For projecting the effect of an optimally applied stratify-and-shield policy, studies now under way should help to resolve key uncertainties: the extent to which infection confers immunity, the prevalence SERO of immunity, the infection fatality ratio, and the performance SERO of a classifier constructed using information from medical records. It is time to give serious consideration to a stratify-and-shield policy that could bring the COVID-19 epidemic to an end in a matter of months while restoring economic activity, avoiding overload of critical care services and limiting mortality.

    COVID-19 Control Strategies and Intervention Effects in Resource Limited Settings: A Modeling Study

    Authors: Kiran Raj Pandey; Anup Subedee; Bishesh Khanal; Bhagawan Koirala

    doi:10.1101/2020.04.26.20079673 Date: 2020-04-30 Source: medRxiv

    Introduction: Many countries with weaker health systems are struggling to put together a coherent strategy against the COVID-19 epidemic. We explored COVID-19 control strategies that could offer the greatest benefit in resource limited settings. Methods: Using an age TRANS-structured SEIR model, we explored the effects of COVID-19 control interventions--a lockdown, physical distancing measures, and active case finding (testing and isolation, contact tracing TRANS and quarantine)-- implemented individually and in combination to control a hypothetical COVID-19 epidemic in Kathmandu (population 2.6 million), Nepal. Results: A month-long lockdown that is currently in place in Nepal will delay peak demand for hospital beds by 36 days, as compared to a base scenario of no interventions (peak demand at 108 days (IQR 97-119); a 2 month long lockdown will delay it by 74 days, without any difference in annual mortality, or healthcare demand volume. Year-long physical distancing measures will reduce peak demand to 36% (IQR 23%-46%) and annual morality to 67% (IQR 48%-77%) of base scenario. Following a month long lockdown with ongoing physical distancing measures and an active case finding intervention that detects 5% of the daily infection burden could reduce projected morality and peak demand by more than 99%. Interpretation: Limited resources settings are best served by a combination of early and aggressive case finding with ongoing physical distancing measures to control the COVID-19 epidemic. A lockdown may be helpful until combination interventions can be put in place but is unlikely to reduce annual mortality or healthcare demand.

    Public perceptions of COVID-19 in Australia: perceived risk, knowledge, health-protective behaviours, and vaccine intentions

    Authors: Kate Faasse; Jill M Newby

    doi:10.1101/2020.04.25.20079996 Date: 2020-04-30 Source: medRxiv

    Widespread and sustained engagement with health-protective behaviours (i.e., hygiene and distancing) is critical to successfully managing the COVID-19 pandemic. Evidence from previous emerging infectious disease MESHD outbreaks points to the role of perceived risk, worry, media coverage, and knowledge in shaping engagement with health-protective behaviours as well as vaccination intentions. The current study examined these factors in 2,174 Australian residents. An online survey was completed between 2-9 March 2020, at an early stage of the COVID-19 outbreak in Australia. Results revealed that two thirds of respondents were at least moderately worried about a widespread COVID-19 outbreak in Australia (which subsequently occurred). Worry about the outbreak and closely following media coverage were consistent predictors of health-protective behaviours (both over the previous month, and intended behaviours in the case of a widespread outbreak) as well as vaccination intentions. Health-behaviour engagement over the previous month was lower in some demographic groups, including males TRANS and younger individuals (18-29 age group TRANS). These was a substantial mismatch between respondents' expected symptoms of infection MESHD and emerging evidence that a meaningful proportion of people who contract the novel coronavirus will experience asymptomatic TRANS infection MESHD (i.e., they will not experience symptoms associated with COVID-19). Only 0.3% of those in the current study believed that they personally would not experience any symptoms if they were infected. Uncertainty and misconceptions about COVID-19 were common, including one third of respondents who reported being unsure whether people are likely have natural or existing immunity. There was also uncertainty around whether specific home remedies (e.g., vitamins, saline rinses) would offer protection, whether the virus could spread via the airborne route, and whether the virus was human made and deliberately released. Such misconceptions are likely to cause concern for members of the public. These results point to areas of uncertainty that could be usefully targeted by public education campaigns, as well as psychological and demographic factors associated with engagement with health-protective behaviours. These findings offer potential pathways for interventions to encourage health-protective behaviours to reduce the spread of COVID-19.

    Potential Role of Cellular Senescence on Coronavirus Infections

    Authors: Prem Chapagain

    id:10.20944/preprints202004.0532.v1 Date: 2020-04-30 Source:

    The disproportionate incidences of COVID-19-related hospitalization and mortality for different age groups TRANS and various underlying health conditions is a result of a complex social predisposition to the exposure, resistance, and tolerance for the infection MESHD. Based on the observed data as well as the molecular mechanisms for viral entry and replication, cellular senescence related to aging, obesity HP obesity MESHD, hypertension HP hypertension MESHD, and diabetes MESHD appears to be strongly correlated with the SARS-CoV-2 infections MESHD resulting in higher COVID-19 related complications and mortality. Establishing such a correlation may allow us to better explain the pathobiology as well as the differential nature of the SARS-CoV-2 infections MESHD and consider targeted control and therapeutic strategies to combat the disease.

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MeSH Disease
Human Phenotype

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