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 31 - 40 records in total 2591
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    Multimorbidity patterns among COVID-19 deaths MESHD: considerations for a better medical practice

    Authors: Julian Alfredo Fernandez-Nino; Jhon A Guerra-Gomez; Alvaro Javier Idrovo-Velandia

    doi:10.1101/2020.07.28.20163816 Date: 2020-07-30 Source: medRxiv

    Medical care of individuals diagnosed with severe COVID-19 is complex, especially when patients are older adults TRANS with multimorbidity. The objective of this study was to describe patterns of multimorbidity among fatal cases of COVID-19. Data of Colombian confirmed deaths MESHD of COVID-19 until June 11, 2020, were included in this analysis (1488 deaths MESHD). Relationships between COVID-19, combinations of health conditions and age TRANS were explored using locally weighted polynomial regressions. Some multimorbidity patterns increase probability of death MESHD among older individuals, whereas other patterns are not age TRANS-related, or decreases the probability of death MESHD among older people. Consider multimorbidity in the medical management of COVID-19 patients is important to determine the more adequate medical interventions. In addition to the co-occurrence of COVID-19 with diseases MESHD of high prevalence SERO in the world, in Colombia there are cases more complex with COVID-19 co-occur with endemic and orphan tropical diseases MESHD. In these cases, although its occurrence may be low, clinical management requires adjusting to its complex clinical condition.

    Rationing and triage of scarce, lifesaving therapy in the context of the COVID-19 pandemic - a cross-sectional, social media-driven, scenario-based online query of societal attitudes

    Authors: Oliver J. Muensterer; Emilio A. Gianicolo; Norbert W. Paul

    doi:10.1101/2020.07.28.20163360 Date: 2020-07-30 Source: medRxiv

    Background: The recent COVID-19 pandemic made us aware that medical resources are limited. When demand for essential resources surpasses availability, difficult triaging decisions are necessary. While algorithms exist, almost nothing is known on societal attitudes regarding triage criteria. Methods: A cross-sectional survey was conducted via social media channels to query a broad sample of society. Participants were asked to make triage decisions in case-based vignettes, exploring a variety of factors. They also were asked to assess how sure they were about their decisions, and how such decisions should be reached. Results: The survey was completed in full by 1626 participants in April 2020. Median age TRANS was 39 years (range 12-80 years), 984 (61%) were female TRANS. Patient prognosis, responsibility towards others, the absence of behavior-induced co-morbidities, and younger age TRANS were rated the most important triage criteria, while participants found that insurance status, social status, and nationality should not play a substantial role. Ethics-committees and point systems were regarded potentially helpful for triage decision-making, while decisions based on order of presentation (first-come first-serve) or on a legal basis were viewed critically. Participants were least sure about their decision when dealing with age TRANS or behavior-induced co-morbidities. Overall, women were surer about their decisions than men, participants of Christian faith were also more secure about their decision than atheists-agnostics. Conclusions: This study uses social media to generate insight into public opinion and attitudes regarding triage criteria and modalities. These findings may be helpful for the development of future medical triage algorithms.

    Estimating missing deaths MESHD in Delhi's COVID-19 data

    Authors: Shoibal Chakravarty

    doi:10.1101/2020.07.29.20164392 Date: 2020-07-30 Source: medRxiv

    A sero- prevalence SERO survey in Delhi measured an infection MESHD rate of 23.48% and an implied infection MESHD fatality rate (IFR) of 0.06%. Modeling using age group TRANS based IFRs from France, Spain and Lombardia project an average IFR that is significantly higher than currently estimated. We show that at least 1500-2500 COVID-19 deaths MESHD in the 60+ age group TRANS are missing.

    Disparities in Case Frequency and Mortality of Coronavirus Disease MESHD 2019 (COVID-19) Among Various States in the United States

    Authors: Rohit S. Loomba; Gaurav Aggarwal; Saurabh Aggarwal; Saul Flores; Enrique G. Villarreal; Juan S. Farias; Carl J. Lavie

    doi:10.1101/2020.07.28.20163931 Date: 2020-07-30 Source: medRxiv

    Objective: To utilize publicly reported, state-level data to identify factors associated with the frequency of cases, tests, and mortality in the US. Materials & Methods: Retrospective study using publicly reported data collected included the number of COVID-19 cases, tests, and mortality from March 14th through April 30th, 2020. Publicly available state-level data was collected which included: demographics comorbidities, state characteristics and environmental factors. Univariate and multivariate regression analyses were performed to identify the significantly associated factors with percent mortality, case and testing frequency. All analyses were state-level analyses and not patient-level analyses. Results: A total of 1,090,500 COVID-19 cases were reported during the study period. The calculated case and testing frequency were 3,332 and 19,193 per 1,000,000 patients. There were 63,642 deaths MESHD during this period which resulted in a mortality of 5.8%. Factors including to but not limited to population density (beta coefficient 7.5, p< 0.01), transportation volume (beta coefficient 0.1, p< 0.01), tourism index (beta coefficient -0.1, p=0.02) and older age TRANS (beta coefficient 0.2, p=0.01) are associated with case frequency and percent mortality. Conclusions: There were wide variations in testing and case frequencies of COVID-19 among different states in the US. States with higher population density had a higher case and testing rate. States with larger population of elderly TRANS and higher tourism had a higher mortality.

    Patient’s perspective regarding the elective surgical procedure during Covid 19 pandemic.

    Authors: Dr. Mayank Badkur; Dr Ashok Puranik; Dr Naveen Sharma; Dr. Suruthi Baskaran

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

    Introduction: The ongoing Covid-19 pandemic and the subsequent nationwide lockdown, has impacted all aspects of society including medical profession. In hospitals, the focus has mainly shifted to prevention and treatment of Covid-19 infection MESHD. Owing to this, all elective surgeries were postponed and only emergent surgeries were performed. This has affected the patients differently depending on the progression of disease MESHD and development of complications.Materials and Methods: A well-structured telephonic scripted questionnaire was administered to all patients who were given appointment for any elective surgery. Data was collected regarding the status of disease MESHD including complications and the patient’s perspective on method of treatment. Patients who developed complications or underwent emergency MESHD surgery or surgery elsewhere were excluded.Results: The male TRANS to female TRANS ratio was 2.3:1. Mean age TRANS of patients was 41.16 years. A total of 86 patients were included in the study. Almost all (98.8%) were aware that the lockdown and withholding of elective surgeries was to prevent spread of coronavirus infection MESHD. Among 34 patients with complications, 88.2% were willing to undergo surgical procedure and 73.5% were willing to visit hospital within a week or two. Among patients without complications, 71.2% were willing to continue treatment on wait and watch policy, for a period of 2 months or more (45.7%). 93.5% of patients avoided visit to hospital due to risk of infection TRANS risk of infection TRANS infection MESHD.Discussion: Patient’s attitude towards the choice of treatment (wait and watch Vs surgery) mainly depended on the progression of disease MESHD. It is critical, during these tough times of Covid-19 pandemic, that risks are weighed against benefits to decide the line of management for patients waiting for elective surgeries. 

    Corticosteroid Use in Severely Hypoxemic COVID-19 Patients: An Observational Cohort Analysis of Dosing Patterns and Outcomes in the Early Phase of the Pandemic

    Authors: Omar Rahman; Russel A Trigonis; Mitchell K Craft; Rachel M Kruer; Emily M Miller; Colin L Terry; Sarah A Persaud; Rajat Kapoor

    doi:10.1101/2020.07.29.20164277 Date: 2020-07-30 Source: medRxiv

    INTRODUCTION Hypoxemia HP in Severe Acute Respiratory Syndrome MESHD due to Novel Coronavirus of 2019 (SARS-CoV-2) is mediated by severe inflammation MESHD that may be mitigated by corticosteroids. We evaluated pattern and effects of corticosteroid use in these patients during an early surge of the pandemic. METHODS Observational study of 136 SARS-CoV-2 patients admitted to the Intensive care Unit between March 1 and April 27, 2020 at a tertiary care hospital in Indianapolis, USA. Statistical comparison between cohorts and dosing pattern analysis was done. Outcome measures included number of patients requiring intubation, duration of mechanical ventilation, length of ICU stay and inpatient mortality. RESULTS: Of 136 patients, 72 (53%) received corticosteroids. Groups demographics: Age TRANS (60.5 vs. 65; p .083), sex (47% male TRANS vs. 39% female TRANS; p .338) and comorbidities were similar. Corticosteroid group had increased severity of illness: PaO2/FiO2 (113 vs. 130; p .014) and SOFA (8 vs. 5.5; p < .001). Overall mortality (21% vs. 30%; p .234) or proportion of patients intubated (78 vs. 64%; p .078) was similar. Mortality was similar among mechanically ventilated (27% vs. 15%; p .151) however there were no deaths MESHD among patients who were not mechanically ventilated and received corticosteroids (0% vs. 57%; p

    Performance SERO of Abbott Architect, Ortho Vitros, and Euroimmun Assays in Detecting Prior SARS-CoV-2 Infection MESHD

    Authors: Shiwani Mahajan; Carrie A Redlich; Adam V Wisnewski; Louis E Fazen; Lokinendi V Rao; Karthik Kuppusamy; Albert I Ko; Harlan M Krumholz

    doi:10.1101/2020.07.29.20164343 Date: 2020-07-30 Source: medRxiv

    Background: Several serological assays SERO have been developed to detect anti-SARS-CoV-2 IgG antibodies SERO, but evidence about their comparative performance SERO is limited. We sought to assess the sensitivity SERO of four anti-SARS-CoV-2 IgG enzyme-linked immunosorbent assays SERO ( ELISA SERO) in individuals with evidence of prior SARS-CoV-2 infection MESHD. Methods: We obtained sera from 36 individuals with PCR-confirmed SARS-CoV-2 infection MESHD between March and May 2020. We evaluated samples collected at around 21 days ({+/-}14 days) after their initial PCR test using 3 commercially available ELISA assays SERO, two anti-spike (Ortho-Clinical Diagnostics Vitros, and Euroimmun) and one anti-nucleocapsid (Abbott Architect), and a Yale-developed anti-spike ELISA SERO test. We determined the sensitivity SERO of the tests and compared their results. The Euroimmun and Yale ELISA SERO had an equivocal and indeterminate category, which were considered as both negative and positive. Results: Among the 36 individuals with SARS-CoV-2 infection MESHD, mean age TRANS was 43 ({+/-}13) years and 19 (53%) were female TRANS. The sensitivities SERO of the tests were not significantly different (Abbott Architect, Ortho Vitros, Euroimmmun, and Yale assays: 86% (95% confidence interval [CI], 71-95), 94% (95% CI, 81-99), 86% (95% CI, 71-95), and 94% (95% CI, 81-99), respectively; p-value=0.464). The sensitivities SERO of the Euroimmun and Yale ELISA SERO tests increased when the equivocal/indeterminate results were considered positive (97% [95% CI, 85-100] and 100% [95% CI, 90-100], respectively), but were not significantly different from other tests (p=0.082). The cross-correlation coefficient ranged from 0.85-0.98 between three anti-spike protein assays (Ortho Vitros, Euroimmun, Yale) and was 0.58-0.71 between the three anti-spike protein assays and the anti-nucleocapsid assay (Abbott). Conclusion: The sensitivities SERO of four anti-SARS-CoV-2 protein assays did not significantly differ, although the sample size was small. Sensitivity SERO also depended on the interpretation of equivocal and indeterminate results. The strongest correlations were present for the three anti-spike proteins assays. These findings suggest that individual test characteristics and the correlation between different tests should be considered when comparing or aggregating data across different populations studies for serologic surveillance of past SARS-CoV-2 infection MESHD.

    Incidence and outcomes of healthcare-associated COVID-19 infections MESHD: significance of delayed diagnosis and correlation with staff absence

    Authors: Kirstin Khonyongwa; Surabhi K Taori; Ana Soares; Nergish Desai; Malur Sudhanva; William Bernal; Silke Schelenz; Lisa A Curran

    doi:10.1101/2020.07.24.20148262 Date: 2020-07-30 Source: medRxiv

    Background: The sudden increase in COVID-19 admissions in hospitals during the SARS-CoV2 pandemic of 2020 has led to onward transmissions TRANS among vulnerable inpatients. Aims: This study was performed to evaluate the prevalence SERO and clinical outcomes of Healthcare-associated COVID-19 infections MESHD (HA-COVID-19) during the 2020 epidemic and study factors which may promote or correlate with its incidence and transmission TRANS in a London Teaching Hospital Trust. Methods: Electronic laboratory, patient and staff self-reported sickness records were interrogated for the period 1st March to 18th April 2020. HA-COVID-19 was defined as symptom onset TRANS >14d of admission. Test performance SERO of a single combined throat and nose swab (CTNS) for patient placement and the effect of delayed RNA positivity (DRP, defined as >48h delay) on patient outcomes was evaluated. The incidence of staff self-reported COVID-19 sickness absence, hospital bed occupancy, community incidence and DRP was compared HA-COVID-19. The incidence of other significant hospital-acquired bacterial infections MESHD (OHAI) was compared to previous years. Results: 58 HA-COVID-19 (7.1%) cases were identified. As compared to community-acquired cases, significant differences were observed in age TRANS (p=0.018), ethnicity (p<0.001) and comorbidity burden (p<0.001) but not in 30d mortality. CTNS negative predictive value SERO was 60.3%. DRP was associated with greater mortality (p=0.034) and 34.5% HA-COVID-19 cases could be traced TRANS to delayed diagnosis in CA-COVID-19. Incidence of HA-COVID-19 correlated positively with DRP (R=0.7108) and staff sickness absence (R=0.7815). OHAI rates were similar to previous 2 years. Conclusion: Early diagnosis and isolation of COVID-19 would help reduce transmission TRANS. A single CTNS has limited value in segregating patients into positive and negative pathways.

    Long-term Existence of SARS-CoV-2 in COVID-19 Patients: Host Immunity, Viral Virulence, and Transmissibility TRANS

    Authors: Meilin Jin; Xingyu Wang; Haini Jiang; Lijuan Hua; Weiwei Yu; dan ding; ke wang; Xiaopan Li; Kun Huang; Zhong zou; Shuyun Xu

    id:10.20944/preprints202007.0719.v1 Date: 2020-07-30 Source:

    COVID-19 patients can recover with a median SARS-CoV-2 clearance of 20 days post initial symptoms (PIS). However, we observed some COVID-19 patients with existing SARS-CoV-2 for more than 50 days PIS. This study aimed to investigate the cause of viral clearance delay and the infectivity in these patients. Demographic data and clinical characteristics of 22 long-term COVID-19 patients were collected. SARS-CoV-2 nucleic acid, peripheral lymphocyte count, and functionality were assessed. SARS-CoV-2-specific and neutralization antibodies SERO were detected, followed by virus isolation and genome sequencing. The median age TRANS of the studied cohort was 59.83±12.94 years. All patients were clinically cured after long-term SARS-CoV-2 infection MESHD ranging from 53 to 112 days PIS. Peripheral lymphocytes counts were normal. Interferon gamma (IFN-ƴ)-generated CD4+ and CD8+ cells were normal as 24.68±9.60% and 66.41±14.87%. However, the number of IFN-ƴ-generated NK cells diminished (58.03±11.78%). All patients presented detectable IgG, which positively correlated with mild neutralizing activity (ID50=157.2, P=0.05). SARS-CoV-2 was not isolated, and a cytopathic effect was lacking. Only three synonymous variants were identified in spike protein coding regions. In conclusion, decreased IFN-γ production by NK cells and low neutralizing antibodies SERO might favor SARS-CoV-2 long-term existence. Further, low viral load and weak viral pathogenicity was observed in COVID-19 patients with long-term SARS-CoV-2 infection MESHD.

    Circulating Mitochondrial DNA is an Early Indicator of Severe Illness and Mortality from COVID-19

    Authors: Davide Scozzi; Marlene Cano; Lina MA; Dequan Zhou; Ji Hong Zhu; Charles Goss; Adriana Rauseo; Zhiyi Liu; Valentina Peritore; Monica Rocco; Alberto Ricci; Rachele Amodeo; Laura Aimati; Mohsen Ibrahim; Ramsey Hachem; Daniel Kreisel; Philip A Mudd; Hrishikesh S Kulkarni; Andrew E Gelman

    doi:10.1101/2020.07.30.227553 Date: 2020-07-30 Source: bioRxiv

    Mitochondrial DNA (MT-DNA) are intrinsically inflammatory nucleic acids released by damaged solid organs. Whether the appearance of cell-free MT-DNA is linked to poor COVID-19 outcomes remains undetermined. Here, we quantified circulating MT-DNA in prospectively collected, cell-free plasma SERO samples from 97 subjects with COVID-19 at the time of hospital presentation. Circulating MT-DNA were sharply elevated in patients who eventually died, required ICU admission or intubation. Multivariate regression analysis revealed that high circulating MT-DNA levels is an independent risk factor for all of these outcomes after adjusting for age TRANS, sex and comorbidities. Additionally, we found that circulating MT-DNA has a similar or superior area-under-the curve when compared to clinically established measures of systemic inflammation MESHD, as well as emerging markers currently of interest as investigational targets for COVID-19 therapy. These results show that high circulating MT-DNA levels is a potential indicator for poor COVID-19 outcomes.

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MeSH Disease
Human Phenotype

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