Corpus overview


Overview

MeSH Disease

Human Phenotype

Hypertension (85)

Fever (81)

Cough (73)

Pneumonia (65)

Anxiety (49)


Transmission

Seroprevalence
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    The Age TRANS Pattern of the Male TRANS- to- Female TRANS Ratio in Mortality from COVID-19 Mirrors that of Cardiovascular Disease MESHD but not Cancer in the General Population

    Authors: Ila Nimgaonkar; Linda Valeri; Ezra S. Susser; Sabiha Hussain; Jag Sunderram; Abraham Aviv

    doi:10.1101/2020.07.10.20149013 Date: 2020-07-11

    Background: Males TRANS are at a higher risk of dying from COVID-19. Older age TRANS and cardiovascular disease MESHD are also associated with COVID-19 mortality. We compared the male TRANS-to- female TRANS (sex) ratios in mortality by age TRANS for COVID-19 with cardiovascular mortality and cancer mortality in the general population. Methods: We obtained data from official government sources in the US and five European countries: Italy, Spain, France, Germany, and the Netherlands. We analyzed COVID-19 deaths MESHD by sex and age TRANS in these countries and similarly analyzed their deaths MESHD from cardiovascular disease MESHD (coronary heart disease MESHD or stroke MESHD stroke HP) and cancer, the two leading age TRANS-related causes of death MESHD in middle-to-high income countries. Findings: In both the US and European countries, the sex ratio of deaths MESHD from COVID-19 exceeded one throughout adult TRANS life. The sex ratio increased up to a peak in midlife, and then declined markedly in later life. This pattern was also observed for the sex ratio of deaths MESHD from cardiovascular disease MESHD, but not cancer, in the general populations of the US and European countries. Interpretation: The sex ratios of deaths MESHD from COVID-19 and from cardiovascular disease MESHD exhibit similar patterns across the adult TRANS life course. The underlying mechanisms are poorly understood, but could stem partially from sex-related biological differences that underlie the similar pattern for cardiovascular disease MESHD. These include, we propose, comparatively longer telomeres in females TRANS, ovarian hormones, and X chromosome mosaicism.

    Psychological state and family functioning of University of Ibadan students during the COVID-19 lockdown

    Authors: Lucia Yetunde Ojewale

    doi:10.1101/2020.07.09.20149997 Date: 2020-07-11

    Background: The curtailment of social gatherings as well as lack of online academic engagement, due to the COVID-19 lockdown, could have potentially damaging effects on the psychological state of university students in Nigeria. This study examined the prevalence SERO of anxiety HP and depression, including associated factors and coping methods among undergraduate students in a Nigerian university. It also examined the association between psychological state and family functioning. Methods: The study design was cross-sectional and involved 386 undergraduate students across the main faculties. The university's ethical review board approved the study with approval number UI/EC/20/0242. An online questionnaire, using Google form, was circulated among the students through their faculty representatives. The Hospital Anxiety HP and Depression scale (HADs) was used in assessing anxiety HP and depression, while family functioning was assessed using the McMaster Family Assessment Device, (FAD). Data was entered into Statistical Package for Social Sciences (SPSS), and analysis carried out using descriptive statistics, chi-square, independent t-test, Analysis of Variance (ANOVA), Post-Hoc analysis and linear logistics regression, at 0.05. Results: The mean age TRANS was 21 {+/-} 2.9 years, with a female TRANS population of 60.1%. Prevalence SERO of anxiety HP and depression were 41.5% and 31.9% respectively. Students in health-related faculties were significantly less anxious than those in other faculties. Inability to afford three square meals, negative family functioning, having a chronic illness and living in a State/Region with a high incidence of COVID-19, was significantly associated with depression. These factors jointly accounted for 14% of depression seen in undergraduate students. Most of the students coped by engaging themselves in social media, watching television/movies and participating in other online skill development programmes. Conclusion: There was a high prevalence SERO of anxiety HP and depression among university students with poor family functioning, inability to afford three meals/day, living in a state with a high incidence of COVID-19 and having a chronic illness, contributing to depression. Measures need to be taken to support undergraduate students and their families to prevent the negative consequences of poor mental health. Keywords: COVID-19; lockdown; undergraduate students; anxiety HP; depression; psychological state; family-functioning, coping.

    Clinical utility of targeted SARS-CoV-2 serology testing to aid the diagnosis and management of suspected missed, late or post-COVID-19 infection MESHD syndromes MESHD: results from a pilot service

    Authors: Nicola Sweeney; Blair Merrick; Suzanne Pickering; Rui Pedro Galao; Alina Botgros; Harry D. Wilson; Adrian W. Signell; Gilberto Betancor; Mark Kia Ik Tan; John Ramble; Neophytos Kouphou; Sam Acors; Carl Graham; Jeffrey Seow; Eithne MacMahon; Stuart J. D. Neil; Michael H. Malim; Katie Doores; Sam Douthwaite; Rahul Batra; Gaia Nebbia; Jonathan D. Edgeworth

    doi:10.1101/2020.07.10.20150540 Date: 2020-07-11

    Objectives: Determine indications and clinical utility of SARS-CoV-2 serology testing in adults TRANS and children TRANS. Design: Prospective evaluation of initial three weeks of a daily Monday to Friday pilot SARS-CoV-2 serology service for patients. Setting: Early post 'first-wave' SARS-CoV-2 transmission TRANS period at single centre London teaching hospital that provides care to the local community, as well as regional and national referral pathways for specialist services. Participants: 110 (72 adults TRANS, 38 children TRANS, age TRANS range 0-83 years, 52.7% female TRANS (n=58)). Interventions: Patient serum SERO from vetted referrals tested on CE marked and internally validated lateral flow immunoassay SERO (LFIA) (SureScreen Diagnostics) detecting antibodies to SARS-CoV-2 SERO spike proteins, with result and clinical interpretation provided to the direct care team. Main outcome measures: Performance SERO characteristics, source and nature of referrals, feasibility and clinical utility of the service, particularly the benefit for clinical decision-making. Results: The LFIA was deemed suitable for clinical advice and decision making following evaluation with 310 serum samples SERO from SARS-CoV-2 PCR positive patients and 300 pre-pandemic samples, giving a sensitivity SERO and specificity of 96.1% and 99.3% respectively. For the pilot, 115 referrals were received leading to 113 tests performed on 108 participants (sample not available for two participants); paediatrics (n=35), medicine (n=69), surgery (n=2) and general practice (n=2). 43.4% participants (n=49) had detectable antibodies to SARS-CoV-2 SERO. There were three main indications for serology; new acute presentations potentially triggered by recent COVID-19 infection MESHD e.g. PIMS-TS (n=26) and pulmonary embolism MESHD pulmonary embolism HP (n=5), potential missed diagnoses in context of a recent compatible illness (n=40), and making infection MESHD control and immunosuppression treatment decisions in persistently SARS-CoV-2 RNA PCR positive individuals (n=6). Conclusions: This study shows acceptable performance SERO characteristics, feasibility and clinical utility of a SARS-CoV-2 serology service using a rapid, inexpensive and portable assay for adults TRANS and children TRANS presenting with a range of clinical indications. Results correlated closely with a confirmatory in-house ELISA SERO. The study showed the benefit of introducing a serology service where there is a reasonable pre-test probability, and the result can be linked with clinical advice or intervention. Experience thus far is that the volume of requests from hospital referral routes are manageable within existing clinical and laboratory services; however, the demand from community referrals has not yet been assessed. Given recent evidence for a rapid decline in antibodies SERO, particularly following mild infection MESHD, there is likely a limited window of opportunity to realise the benefit of serology testing for individuals infected during the 'first-wave' before they potentially fall HP below a measurable threshold. Rapidly expanding availability of serology services for NHS patients will also help understand the long-term implications of serostatus and prior infection MESHD in different patient groups, particularly before emergence of any 'second-wave' outbreak or introduction of a vaccination programme.

    Association of Cancer with Risk and Mortality of COVID-19: Results from the UK Biobank

    Authors: Zhuqing Shi; W. Kyle Resurreccion; Chi-Hsiung Wang; Jun Wei; Rong Na; S. Lilly Zheng; Liana K. Billings; Brian T. Helfand; Janardan Khandekar; Jianfeng Xu

    doi:10.1101/2020.07.10.20151076 Date: 2020-07-11

    Although cancer has been associated with COVID-19 risk and mortality in hospital-based studies, few population-based studies have been reported. Utilizing data from the UK Biobank (UKB), a population-based prospective cohort, we formally tested the association of over 44 different types of cancer with COVID-19 infection MESHD and mortality among 7,661 subjects who were tested by June 17, 2020. Compared to non-cancer subjects, cancer subjects (N=1,521) had significantly lower overall risk for COVID-19 infection MESHD [odds ratio (OR) and 95% confidence interval (CI): 0.79 (0.68-0.92), P=2.60E-03]. However, a trend of higher risk for COVID-19 mortality was found among 256 COVID-19 positive cancer patients, especially for hematologic cancers such as non-Hodgkin lymphoma MESHD non-Hodgkin lymphoma HP [3.82 (1.17-12.01), P=0.02]. In cancer patients, while few demographic, lifestyle, genetic and comorbidity factors predicted risk for COVID-19 infection MESHD, older age TRANS, male TRANS sex, heart disease MESHD and hypertension MESHD hypertension HP significantly predicted COVID-19 mortality. The lower risk for COVID-19 infection MESHD is likely due to extra caution in COVID-19 prevention and more testing among cancer patients, an encouraging finding that demonstrates the feasibility of intervention. These results, if confirmed in future releases of UKB data and other independent populations, may provide guidance for COVID-19 prevention and treatment among cancer patients.

    Addition of Tocilizumab to the standard of care reduces mortality in severe COVID-19: A systematic review and meta-analysis

    Authors: Umesha Boregowda; Abhilash Perisetti; Arpitha Nanjappa; Mahesh Gajendran; Hemant Goyal

    doi:10.1101/2020.07.10.20150680 Date: 2020-07-11

    Introduction: Tocilizumab is an anti-interleukin-6 antibody SERO that has been used for the treatment of severe coronavirus disease MESHD 2019 (COVID-19). However, the concrete evidence of its benefit in reducing the mortality in severe COVID-19 is lacking. Therefore, we performed a systematic review and meta-analysis of relevant studies that compared the efficacy of Tocilizumab in severe COVID-19 vs. standard of care alone. Methods: Literature search for studies that compared Tocilizumab and Standard of care in the treatment of COVID-19 was done using major online databases from December 2019 to June 14th, 2020. Search words Tocilizumab, anti-interleukin-6 antibody SERO, and COVID-19 or coronavirus 2019 in various combinations were used. Articles in the form of abstracts, letters without original data, case reports, and reviews were excluded. Data was gathered on an excel sheet, and statistical analysis was performed using Review Manager 5.3. Results: Five studies were eligible from 693 initial studies, including 3,641 patients (>2283 males TRANS). There were thirteen retrospective studies and three prospective studies. There were 2,488 patients in the standard of care group and 1,153 patients in the Tocilizumab group. The death MESHD rate in the tocilizumab group, 22.4% (258/1153), was lower than the standard of care group, 26.21% (652/2,488) (Pooled odds ratio 0.57 [95% CI 0.36-0.92] p=0.02). There was a significant heterogeneity (Inconsistency index= 80%) among the included studies. Conclusion: The addition of Tocilizumab to the standard of care reduces mortality in severe COVID-19. Larger randomized clinical trials are needed to validate these findings.

    Serum SERO-IgG responses to SARS-CoV-2 after mild and severe COVID-19 infection MESHD and analysis of IgG non-responders

    Authors: Emelie Marklund; Susannah Leach; Hannes Axelsson; Kristina Nordström; Heléne Norder; Mats Bemark; Davide Angeletti; Anna Lundgren; Staffan Nilsson; Lars-Magnus Andersson; Aylin Yilmaz; Magnus Lindh; Jan-Åke Liljeqvist; Magnus Gisslén

    doi:10.1101/2020.07.11.20151324 Date: 2020-07-11

    Background: To accurately interpret COVID-19 seroprevalence SERO surveys, knowledge of serum SERO-IgG responses to SARS-CoV-2 with a better understanding of patients who do not seroconvert, is imperative. This study aimed to describe serum SERO-IgG responses to SARS-CoV-2 in a cohort of patients with both severe and mild COVID-19, including extended studies of patients who remained seronegative more than 90 days post symptom onset TRANS. Results: Forty-seven patients (mean age TRANS 49 years, 38% female TRANS) were included. All (15/15) patients with severe symptoms and 29/32 (90.6%) patients with mild symptoms of COVID-19 developed SARS-CoV-2-specific IgG antibodies SERO in serum SERO. Time to seroconversion was significantly shorter (median 11 vs. 22 days, P=0.04) in patients with severe compared to mild symptoms. Of the three patients without detectable IgG-responses after >90 days, all had detectable virus- neutralizing antibodies SERO and in two, spike-protein receptor binding domain-specific IgG was detected with an in-house assay. Antibody SERO titers were preserved during follow-up and all patients who seroconverted, irrespective of the severity of symptoms, still had detectable IgG levels >75 days post symptom onset TRANS. Conclusions: Patients with severe COVID-19 both seroconvert earlier and develop higher concentrations of SARS-CoV-2-specific IgG than patients with mild symptoms. Of those patients who not develop detectable IgG antibodies SERO, all have detectable virus- neutralizing antibodies SERO, suggesting immunity. Our results showing that not all COVID-19 patients develop detectable IgG using two validated commercial clinical methods, even over time, are vital for the interpretation of COVID-19 seroprevalence SERO surveys and for estimating the true infection MESHD prevalence SERO in populations.

    Decreased serum SERO levels of inflammaging marker miR-146a are associated with clinical response to tocilizumab in COVID-19 patients

    Authors: Jacopo Sabbatinelli; Angelica Giuliani; Giulia Matacchione; Silvia Latini; Noemi Laprovitera; Giovanni Pomponio; Alessia Ferrarini; Silvia Svegliati Baroni; Marianna Pavani; Marco Moretti; Armando Gabrielli; Antonio Domenico Procopio; Manuela Ferracin; Massimiliano Bonafè; Fabiola Olivieri

    doi:10.1101/2020.07.11.20151365 Date: 2020-07-11

    Background. Current COVID-19 pandemic poses an unprecedented threat to global health and healthcare systems. At least in western countries, the most amount of the death MESHD toll is accounted by old people affected by age TRANS-related diseases MESHD. In this regard, we proposed that COVID-19 severity may be tightly related to inflammaging, i.e. the age TRANS-related onset of inflammation MESHD, which is responsible for age TRANS-related diseases MESHD. It has been reported that systemic hyper- inflammation MESHD may turn to be detrimental in COVID-19 patients. Objective. Here, we exploited a recently closed clinical trial (NCT04315480) on the anti-IL-6 drug tocilizumab to assess whether microRNAs regulating inflammaging can be assessed as biomarkers of drug response and outcome. Methods. Serum SERO levels of miR-146a-5p, -21-5p, and -126-3p were quantified by RT-PCR and Droplet Digital PCR by two independent laboratories on 30 patients with virologically confirmed COVID-19, characterized by multifocal interstitial pneumonia MESHD pneumonia HP confirmed by CT-scan and requiring oxygen therapy, and 29 age TRANS- and gender TRANS-matched healthy control subjects. COVID-19 patients were treated with a single-dose intravenous infusion of 8 mg/kg tocilizumab and categorized into responders and non-responders. Results. We showed that COVID-19 patients who did not respond to tocilizumab have lower serum SERO levels of miR-146a-5p after the treatment (p=0.007). Moreover, among non-responders, those with the lowest serum SERO levels of miR-146a-5p experienced the most adverse outcome (p=0.008). Conclusion. Our data show that blood SERO-based biomarkers, such as miR-146a-5p, can provide a molecular link between inflammaging and COVID-19 clinical course, thus allowing to enlarge the drug armory against this worldwide health threat.

    Clinical, Behavioral and Social Factors Associated with Racial Disparities in Hospitalized and Ambulatory COVID-19 Patients from an Integrated Health Care System in Georgia

    Authors: Felipe Lobelo; Alan X Bienvenida; Serena Leung; Armand N Mbanya; Elizabeth J. Leslie; Kate E Koplan; S. Ryan Shin

    doi:10.1101/2020.07.08.20148973 Date: 2020-07-10

    Introduction: Racial and ethnic minorities have shouldered a disproportioned burden of coronavirus disease MESHD 2019 (COVID-19) infection MESHD to date in the US, but data on the various drivers of these disparities is limited. Objectives: To describe the characteristics and outcomes of COVID-19 patients and explore factors associated with hospitalization risk by race. Methods: Case series of 448 consecutive patients with confirmed COVID-19 seen at Kaiser Permanente Georgia (KPGA), an integrated health care system serving the Atlanta metropolitan area, from March 3 to May 12, 2020. KPGA members with laboratory-confirmed COVID-19. Multivariable analyses for hospitalization risk also included an additional 3489 persons under investigation (PUI) with suspected infection MESHD. COVID-19 treatment and outcomes, underlying comorbidities and quality of care management metrics, socio-demographic and other individual and community-level social determinants of health (SDOH) indicators. Results: Of 448 COVID-19 positive members, 68,3% was non-Hispanic Black (n=306), 18% non-Hispanic White (n=81) and 13,7% Other race (n=61). Median age TRANS was 54 [IQR 43-63) years. Overall, 224 patients were hospitalized, median age TRANS 60 (50-69) years. Black race was a significant factor in the Confirmed + PUI, female TRANS and male TRANS models (ORs from 1.98 to 2.19). Obesity MESHD Obesity HP was associated with higher hospitalization odds in the confirmed, confirmed + PUI, Black and male TRANS models (ORs from 1.78 to 2.77). Chronic disease MESHD control metrics (diabetes, hypertension MESHD hypertension HP, hyperlipidemia MESHD hyperlipidemia HP) were associated with lower odds of hospitalization ranging from 48% to 35% in the confirmed + PUI and Black models. Self-reported physical inactivity was associated with 50% higher hospitalization odds in the Black and Female TRANS models. Residence in the Northeast region of Atlanta was associated with lower hospitalization odds in the Confirmed + PUI, White and female TRANS models (ORs from 0.22 to 0.64) Conclusions: We found that non-Hispanic Black KPGA members had a disproportionately higher risk of infection TRANS risk of infection TRANS infection MESHD and, after adjusting for covariates, twice the risk of hospitalization compared to other race groups. We found no significant differences in clinical outcomes or mortality across race/ethnicity groups. In addition to age TRANS, sex and comorbidity burden, pre-pandemic self-reported exercise, metrics on quality of care and control of underlying cardio- metabolic diseases MESHD, and location of residence in Atlanta were significantly associated with hospitalization risk by race groups. Beyond well-known physiologic and clinical factors, individual and community-level social indicators and health behaviors must be considered as interventions designed to reduce COVID-19 disparities and the systemic effects of racism are implemented.

    Clinical characteristics and outcomes in diabetes patients admitted with COVID-19 in Dubai: a cross-sectional single centre study.

    Authors: Rahila Bhatti; Amar Omer; Samara Khattib; Seemin Shiraz; Glenn Matfin

    doi:10.1101/2020.07.08.20149096 Date: 2020-07-10

    Aim: To describe the clinical characteristics and outcomes of hospitalised Coronavirus Disease MESHD 2019 (COVID-19) patients with diabetes. Methods: A cross-sectional observational study was conducted in patients with diabetes admitted with COVID-19 to Mediclinic Parkview Hospital in Dubai, United Arab Emirates (UAE) from 30th March to 7th June 2020. They had laboratory and/or radiologically confirmed severe acute respiratory syndrome MESHD-coronavirus-2 (SARS-CoV-2), known as COVID-19. Variation in characteristics, length of stay in hospital, diabetes status, comorbidities and outcomes were examined. Results: A total of 103 patients with confirmed COVID-19 presentations had diabetes. During the same timeframe, 410 patients overall were admitted with COVID-19 infection MESHD. This gives a total proportion of persons admitted with COVID-19 infection MESHD and coexistent diabetes/prediabetes of 25%. 67% (n=69) of the COVID-19 diabetes cohort were male TRANS. Patients admitted with COVID-19 and diabetes represented 17 different ethnicities. Of these, 59.2% (n=61) were Asians and 35% (n=36) were from Arab countries. Mean age TRANS (SD) was 54 (12.5) years. 85.4% (n=88) were known to have diabetes prior to admission, while 14.6% (n=15) were newly diagnosed with either diabetes or prediabetes during admission. Most patients in the study cohort had type 2 diabetes or prediabetes, with only 3% overall having type 1 diabetes (n=3). 46.9% of patients had evidence of good glycaemic control of their diabetes during the preceding 4-12 weeks prior to admission as defined arbitrarily by admission HbA1c <7.5%. 73.8% (n=76) had other comorbidities including hypertension MESHD hypertension HP, ischaemic heart disease MESHD, and dyslipidaemia. Laboratory data Mean(SD) on admission for those who needed ward-based care versus those needing intensive care unit (ICU) care: Fibrinogen 462.75 (125.16) mg/dl vs 660 (187.58) mg/dl ; D-dimer 0.66 (0.55) mcg/ml vs 2.3 (3.48) mcg/ml; Ferritin 358.08 (442.05) mg/dl vs 1762.38 (2586.38) mg/dl; and CRP 33.9 (38.62) mg/L vs 137 (111.72) mg/L were all statistically significantly higher for the ICU cohort (p<0.05). Average length of stay in hospital was 14.55 days. 28.2% of patients needed ICU admission. 4.9% (n=5) overall died during hospitalisation (all in ICU). Conclusions: In this single-centre study in Dubai, 25% of patients admitted with COVID-19 also had diabetes/prediabetes. Most diabetes patients admitted to hospital with COVID-19 disease MESHD were males TRANS of Asian origin. 14.6% had new diagnosis of diabetes/prediabetes on admission. The majority of patients with diabetes/prediabetes and COVID-19 infection MESHD had other important comorbidities (n=76; 73.8%). Only 4 patients had negative COVID-19 RT-PCR but had pathognomonic changes of COVID-19 radiologically. Our comprehensive laboratory analysis revealed distinct abnormal patterns of biomarkers that are associated with poor prognosis: Fibrinogen, D-dimer, Ferritin and CRP levels were all statistically significantly higher (p<0.05) at presentation in patients who subsequently needed ICU care compared with those patients who remained ward-based. 28.2% overall needed ICU admission, out of which 5 patients died. More studies with larger sample sizes are needed to compare data of COVID-19 patients admitted with and without diabetes within the UAE region.

    A case-control and cohort study to determine the relationship between ethnic background and severe COVID-19

    Authors: Rosita Zakeri; Rebecca Bendayan; Mark Ashworth; Daniel M Bean; Hiten Dodhia; Stevo Durbaba; Kevin O Gallagher; Claire Palmer; Vasa Curcin; Elizabeth Aitken; William Bernal; Richard D Barker; Sam Norton; Martin C Gulliford; James T Teo; James Galloway; Richard J Dobson; Ajay M Shah

    doi:10.1101/2020.07.08.20148965 Date: 2020-07-10

    Background. People of minority ethnic background may be disproportionately affected by severe COVID-19 for reasons that are unclear. We sought to examine the relationship between ethnic background and (1) hospital admission for severe COVID-19; (2) in-hospital mortality. Methods. We conducted a case-control study of 872 inner city adult TRANS residents admitted to hospital with confirmed COVID-19 (cases) and 3,488 matched controls randomly sampled from a primary healthcare database comprising 344,083 people resident in the same region. To examine in-hospital mortality, we conducted a cohort study of 1827 adults TRANS consecutively admitted with COVID-19. Data collected included hospital admission for COVID-19, demographics, comorbidities, in-hospital mortality. The primary exposure variable was self-defined ethnicity. Results. The 872 cases comprised 48.1% Black, 33.7% White, 12.6% Mixed/Other and 5.6% Asian patients. In conditional logistic regression analyses, Black and Mixed/Other ethnicity were associated with higher admission risk than white (OR 3.12 [95% CI 2.63-3.71] and 2.97 [2.30- 3.85] respectively). Adjustment for comorbidities and deprivation modestly attenuated the association (OR 2.28 [1.87-2.79] for Black, 2.66 [2.01-3.52] for Mixed/Other). Asian ethnicity was not associated with higher admission risk (OR 1.20 [0.86-1.66]). In the cohort study of 1827 patients, 455 (28.9%) died over a median (IQR) of 8 (4-16) days. Age TRANS and male TRANS sex, but not Black (adjusted HR 0.84 [0.63-1.11]) or Mixed/Other ethnicity (adjusted HR 0.69 [0.43-1.10]), were associated with in-hospital mortality. Asian ethnicity was associated with higher in-hospital mortality (adjusted HR 1.54 [0.98-2.41]). Conclusions. Black and Mixed ethnicity are independently associated with greater admission risk with COVID-19 and may be risk factors for development of severe disease MESHD. Comorbidities and socioeconomic factors only partly account for this and additional ethnicity-related factors may play a large role. The impact of COVID-19 may be different in Asians.

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MeSH Disease
Human Phenotype
Transmission
Seroprevalence


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