|drug895||Convalescent Plasma Wiki||0.46|
|drug893||Convalescent COVID 19 Plasma Wiki||0.26|
|drug900||Convalescent Plasma Transfusion Wiki||0.26|
|drug896||Convalescent Plasma (CP) Wiki||0.26|
|drug903||Convalescent Plasma of patients with COVID-19 Wiki||0.19|
|drug1566||Hydroxychloroquine, Doxycycline Wiki||0.19|
|drug1971||Masked Saline Placebo Wiki||0.19|
|drug1102||Drugs and supportive care Wiki||0.19|
|drug1425||Growth Mindset Wiki||0.19|
|drug1062||Digital cardiac Counseling Wiki||0.19|
|drug3386||Tele-medicine platform Wiki||0.19|
|drug2246||Non-invasive cardiac imaging Wiki||0.19|
|drug626||COVID visitation restrictions Wiki||0.19|
|drug631||COVID-19 Breastfeeding Support Wiki||0.19|
|drug1562||Hydroxychloroquine, Azithromycin Wiki||0.19|
|drug4035||placebo (hartmann plus albumine) Wiki||0.19|
|drug2997||SLEDD with a L-MOD Wiki||0.19|
|drug3416||Temporarily holding the RAAS inhibitor [intervention] Wiki||0.19|
|drug882||Control (albumin 5%) Wiki||0.19|
|drug315||Assessment of cardiovascular diseases and cardiovascular risk factors Wiki||0.19|
|drug891||Control swab Wiki||0.19|
|drug1565||Hydroxychloroquine, Clindamycin, Primaquine - low dose. Wiki||0.19|
|drug1167||Electrocardiogram, telemetry, echocardiogram, laboratory values Wiki||0.19|
|drug3198||Standard Donor Plasma Wiki||0.19|
|drug26||1: discontinuation of RAS blocker therapy Wiki||0.19|
|drug3326||Symptomatology, Treatment. daily Activities and Anxiety for Cardiovascular patients Survey (STRATA) Wiki||0.19|
|drug2802||Random Donor Plasma Wiki||0.19|
|drug1563||Hydroxychloroquine, Clindamycin Wiki||0.19|
|drug905||Convalescent Serum Wiki||0.19|
|drug901||Convalescent Plasma as Therapy for Covid-19 patients Wiki||0.19|
|drug660||COVID-19 exposure Wiki||0.19|
|drug3194||Standard COVID-19 therapies Wiki||0.19|
|drug1564||Hydroxychloroquine, Clindamycin, Primaquine - high dose. Wiki||0.19|
|drug2224||No interverntion Wiki||0.19|
|drug37||2: continuation of RAS blocker therapy Wiki||0.19|
|drug2760||RAAS inhibitor [continued standard of care] Wiki||0.19|
|drug2485||Phone-call screening and management by a medical student/general practitioner tandem Wiki||0.19|
|drug2685||Prototype swab Wiki||0.19|
|drug3196||Standard Care Therapy Wiki||0.19|
|drug1613||Icosapent ethyl Wiki||0.13|
|drug897||Convalescent Plasma (anti-SARS-CoV-2 plasma) Wiki||0.13|
|drug1312||Fiberoptic Endoscopic Evaluation of Swallowing Wiki||0.13|
|drug889||Control group Wiki||0.11|
|drug3297||Supportive Care Wiki||0.11|
|drug804||Clinical data Wiki||0.11|
|drug1683||Interferon Beta-1A Wiki||0.09|
|drug908||Convalescent plasma Wiki||0.04|
|drug3231||Standard of care Wiki||0.04|
|drug3221||Standard of Care Wiki||0.03|
|D015428||Myocardial Reperfusion Injury NIH||0.19|
|D015427||Reperfusion Injury NIH||0.19|
|D006333||Heart Failure NIH||0.18|
|D003327||Coronary Disease NIH||0.14|
|D013896||Thoracic Diseases NIH||0.13|
|D000787||Angina Pectoris NIH||0.13|
|D000073296||Noncommunicable Diseases NIH||0.13|
|D054143||Heart Failure, Systolic NIH||0.13|
|D006331||Heart Diseases NIH||0.11|
|D014029||Tobacco Use Disorder NIH||0.11|
|D003680||Deglutition Disorders NIH||0.09|
|D054058||Acute Coronary Syndrome NIH||0.08|
|D001523||Mental Disorders NIH||0.07|
|D000066553||Problem Behavior NIH||0.07|
|D003324||Coronary Artery Disease NIH||0.07|
|D008173||Lung Diseases, Obstructive NIH||0.05|
|D002908||Chronic Disease NIH||0.05|
|D009203||Myocardial Ischemia NIH||0.05|
|D008171||Lung Diseases, NIH||0.04|
|D014947||Wounds and Injuries NIH||0.03|
|D012141||Respiratory Tract Infections NIH||0.03|
|D016638||Critical Illness NIH||0.02|
|D011024||Pneumonia, Viral NIH||0.02|
|D003141||Communicable Diseases NIH||0.01|
|D018352||Coronavirus Infections NIH||0.01|
|HP:0001626||Abnormality of the cardiovascular system HPO||0.97|
|HP:0001681||Angina pectoris HPO||0.13|
|HP:0001635||Congestive heart failure HPO||0.12|
|HP:0001677||Coronary artery atherosclerosis HPO||0.08|
|HP:0000708||Behavioral abnormality HPO||0.07|
|HP:0006536||Pulmonary obstruction HPO||0.06|
|HP:0001658||Myocardial infarction HPO||0.05|
|HP:0002088||Abnormal lung morphology HPO||0.04|
|HP:0011947||Respiratory tract infection HPO||0.04|
There are 29 clinical trials
Cardiovascular events occurring after 2019-nCoV outbreak in Jinan were prospectively assessed by emergency physicians. We compared those events with events that occurred during the past 3 months and the same months of the last year.
This study aims to investigate the clinical characteristics, the incidence of myocardial injury, and the influence of myocardial injury on the prognosis in COVID-19 patients. There is no additional examination and treatment for this project.
Description: The myocardial injury incidence of COVID-19 patientsMeasure: The myocardial injury incidence Time: 75 days
Description: The risk factors analysis for the death of COVID-19 patientsMeasure: The risk factors analysis for the death Time: 75 days
Description: The clinical characteristics description of COVID-19 patientsMeasure: Clinical characteristics Time: 75 days
Description: The clinical course description of COVID-19 patientsMeasure: Clinical course Time: 75 days
Description: The clinical characteristics and prognosis analysis in different cardiovascular comorbidity of COVID-19 patientsMeasure: Cardiovascular comorbidity Time: 75 days
Description: Analysis of causes of death in COVID-19 patientsMeasure: Analysis of causes of death Time: 75 days
It has been reported that nearly half of the patients who are hospitalized for Covid-19 pneumonia have on admission old age or comorbidities. In particular, hypertension was present in 30% of the cases, diabetes in 19%, coronary heart disease in 8% and chronic obstructive lung disease in 3% of the patients. Amazingly, in the two major studies published in the Lancet (Zhou F et al Lancet 2020) and in the New England Journal of Medicine (Guan W et al 2020), the weight of the subjects as well their body mass index (BMI) were omitted. However, obesity, alone or in association with diabetes, can be a major predisposition factor for Covid-19 infection. The primary end-point of our prospective, observational study is to assess the recovery rate in patients with diagnosis of Covid-19 pneumonia. Among the other secondary end-points, we intend to find the predictors of the time to clinical improvement or hospital discharge in patients affected by Covid-19 pneumonia.
Description: mean rate of recovery in patients with diagnosis of Covid-19 pneumonia, who present with complications at the time of hospital admission (such as diabetes, obesity, cardiovascular disease, hypertension or respiratory failure), with the mean recovery rate in patients without any of the above-mentioned complications.Measure: rate of recovery Time: 3 weeks
Description: comparison of the survival curves (times to improvement) in the two groups (patients with and without complications) and among patients presenting with different types of complicationsMeasure: time to improvement Time: 3 weeks
Description: the efficacy of different pharmaceutical treatment against Covid-19Measure: efficacy of treatments Time: 3 weeks
Description: liver, kidney or multiorgan failure, cardiac failureMeasure: organ failure Time: 3 weeks
CAPACITY (www.capacity-covid.eu) is a registry of patients with COVID-19 across Europe and has been established to answer questions on the role of cardiovascular disease in this pandemic. It is an extension of the Case Record Form (CRF) that was released by the ISARIC (International Severe Acute Respiratory and Emerging Infection Consortium) and WHO (World Health Organisation) in response to the emerging outbreak of COVID-19.
Management of known patients with cardiovascular disease (in particular the whole spectrum of atherosclerotic ischaemic coronary artery disease, essential hypertension under treatment, and also patients with chronic heart failure under medication) and with other associated chronic pathologies, with obvious effects on the management of the pandemic with modern / distance means (e-Health) of patients at high risk of mortality in contact with coronavirus. Given the Covid-19 Pandemic, all the above complex cardiovascular patients are under the obligation to stay in the house isolated and can no longer come to standard clinical and paraclinical monitoring and control visits. Therefore, a remote management solution (tele-medicine) of these patients must be found. The Investigators endeavour is to create an electronic platform to communicate with these patients and offer solutions for their cardiovascular health issues (including psychological and religious problems due to isolation). The Investigators intend to create this platform for communicating with a patient and stratify their complaints in risk levels. A given specialist will sort and classify their needs on a scale, based on specific algorithms (derived from the clinical European Cardiovascular Guidelines), and generate specific protocols varying from 911 like emergencies to cardiological advices or psychological sessions. These could include medication changing of doses, dietary advices or exercise restrictions. Moreover, in those patients suspected of COVID infection, special assistance should be provided per protocol.
Description: Development of an electronic (e-HEALTH) framework structure for management of patients with known cardiovascular disease in COVID19 pandemic social contextMeasure: Providing a special electronic platform (e-health) for remote managing cardiovascular outpatients Time: 6 months
Description: patients come into direct contact with the case coordinator, who provides ongoing assistance, including for connecting to devices that ensure real-time data transmission and directing to specialist teams that establish stage diagnosis and management / therapy behavior (including adjustment). doses, decisions to discontinue medication or to add medication);Measure: Number of patients included in this platform Time: 6 months
Description: Will be the number of sessions per patient multiplied with the number of patients includedMeasure: Number of consultations/sessions given Time: 6 months
The Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infects host-cells via ACE2-receptors, which leads to pneumonia (COVID-19) but also can lead to myocarditis (acute myocardial injury) and chronic damage to the cardiovascular system. Therefore, cardiovascular protection may be necessary when treating patients with COVID-19 infection. This may especially be necessary in patients with cardiovascular diseases, risk factors, and co-medication.
Description: mortality of any causeMeasure: All-cause mortality Time: During 1 year follow-up
Description: mortality of any causeMeasure: 30-day mortality Time: Within 30 days after inclusion
Description: Myocardial infarction, stroke, or CV deathMeasure: Major adverse cardiovascular events Time: During 1 year follow-up
Since December 2019, a novel coronavirus called SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) has caused an international outbreak of respiratory illness described as COVID-19. Individuals with a history of cardiovascular disease develop a more severe illness and have higher rates of death. Because of the potential interaction between RAS blockers and SARS-CoV-2 mechanism of infection, there are ongoing scientific discussions on whether they should be stopped or continued in patients with COVID-19. It is crucial to determine whether RAS blockers should be discontinued or not in patients with COVID-19.
Multicentric non-profit observational study, in patients with COVID-19 hospitalized in Italy, conducted through a pseudonymised survey.
Description: Using anamnestic data collected from the health record of the hospital or of the general practitioner, we will count the number of COVID-19 patients enrolled that were treated with ACE Inhibitors or ARB.Measure: Numbers of COVID-19 patients enrolled that use ACE inhibitors and/or Angiotensin Receptor Blockers (ARB) as antihypertensive agents Time: 3 months
Description: This study want to observe whether the assumption of antihypertensive ACE inhibitors or ARB increases the severity of the clinical manifestation of COVID19Measure: Numbers of COVID-19 patients enrolled with no symptoms, with moderate symptoms or with severe symptoms of pneumoni based on the WHO specification for ARDS that also used ACE inhibitors and/or Angiotensin Receptor Blockers (ARB) as antihypertensive agents Time: 3 months
Description: Collecting selected data from the health record and hospital charts of the patients we will assess whether among the recorded parameters there are any that can predict COVID19 prevalence and severityMeasure: Number and type of anthropometric and clinical parameters that associate with COVID19 and COVID-19 severity Time: 3 months
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the pathogen responsible for the novel coronavirus disease 2019 (COVID-19). The first reports of COVID-19 came from Wuhan, China in December of 2019. Since then, the disease has spread rapidly around the globe, accounting for thousands of deaths in multiple countries. On March 11th, 2020, the World Health Organization declared COVID-19 as a pandemic. Although COVID-19 manifests primarily as a respiratory illness, several cardiovascular implications have been reported related to its natural course and treatment. Its exact effect on the cardiovascular system though is currently unknown. Therefore, we propose a retrospective, observational, case-control study looking for cardiovascular manifestations of COVID-19, including laboratory evidence of myocardial injury, electrocardiographic changes, arrhythmias and echocardiographic abnormalities. Hospitalized patients admitted with fever, cough, sore throat, and/or dyspnea who were tested positive for SARS-CoV-2 will be included in our study and will be matched based on their age and gender with patients admitted with similar symptoms who tested negative for SARS-CoV-2. The electronic medical charts of the study subjects will be reviewed and relevant demographic, clinical, laboratory and imaging findings will be deidentified and recorded. Since our study will be a retrospective chart review study it carries minimal risk for the patients and the investigators. Cardiovascular disease associated with COVID-19 might be contributing to the high mortality rates and its recognition will allow for prevention, early diagnosis and appropriate treatment. This will be the first, large, case-control study assessing cardiovascular involvement of COVID-19 in a well-defined cohort of patients.
COVID-19 is associated with complications including ARDS and myocardial injury, which informs prognosis and patient outcome. The laboratory plans to perform immunophenotyping of peripheral T-cells in patients with COVID-19 and complications (ARDS, ITU admission, myocardial injury) and map this against clinical patient outcomes. The aim is to determine if there is a specific T-cell immunophenotype associated with COVID-19 and/or complications, which can be used to inform prognosis and potential therapies.
Description: T-cell immunophenotypeMeasure: T-cell immunophenotype Time: 12 months from enrollment
Description: death, survival to dischargeMeasure: Mortality Time: 12 months from enrolment
Description: Admission to the intensive careMeasure: ITU admission Time: 12 months from enrolment
Description: Defined by troponin rise to >99th centileMeasure: Myocardial injury Time: 12 months from enrolment
Following the announcement of the containment of the population due to the COVID-19 epidemic on March 17, 2020 in France, a notable decrease in the number of consultations in general practice was reported. Patients no longer contact their general practitioner, including those with regular follow-up for one or more chronic conditions. This observation raised worries since it could lead to delay or failure in detecting decompensations / complications of these chronic conditions by a lack of recourse to care. Thus, an urgent message from the National Health Department (Direction Générale de la Santé - DGS) was adressed on April 8, 2020 to the health professionals regarding the organization of care aside from COVID-19. The main recommendation was "that the personal physician or the corresponding specialist should contact the most fragile patients with chronic condition to ensure follow-up and detect any risk of decompensation ". Such fragile patients are in great numbers, up to more than 200 for an average general practitioner. Therefore, although this recommendation is regarded as "essential in view of the health needs of the population", it will prove quite difficult to follow without the help of a skilled external assistance that can be quickly mobilized. The COVIQUEST project is a cluster randomized trial in general practice designed to assess the optimizationg of the screening and management of patients with chronic condition at risk of decompensation through a collaboration between the general practitioner and a medical student. The trial will focus on patients wit cardiovascular conditions aged 70 or more and patients with mental health conditions. These conditions are both highly prevalent in general practice and both at risk of severe short-term complications. Practices will be randomly assigned to a group (A or B). In group A, students will start by contacting patients with cardiovascular conditions; in group B they will start by contacting patients patients with mentral health conditions. The students will call these patients on the phone and ask them specific questions about their health, their needs, and if they want their general practitioner to call them back. The student will then transmit this information to the general practitioner who will decide on the best care to offer the patient. The primary outcome is defined as the occurrence of hospitalization during a one-month period after the phone call. It will be collected by a second phone call from the medical student. This time, all patients will be contacted, i.e. both patients with mental illness and cardiovascular patients, whatever the group. Thus, patients allocated to the control groups (i.e. patients with mental illness from group A and cardiovascular patients from group B) will also benefit from the intervention at 1 month: again, students will ask patients about their health and whether they want their general practitioner to call them back. This approach has several advantages: 1. all patients will benefit from a phone call, in accordance with the recommendations of the DGS, 2. the involvement of students, competent in medical interviews and quickly mobilizable, will help general practitioners, on the front line of many missions, without any health risk linked to the contagiousness of COVID-19 for students, 3. randomizing the call order will allow to assess with a high level of evidence the impact of such an organization on hospitalizations, for two families of diseases with high prevalence. The trial will involve at least nine French regions. Considering that the general practitioner's patient base numbers an average of 110 patients with chronic cardiovascular disease or chronic mental illness, and that at least 25 general practitioners per region participate in the study, we can expect that 22,000 patients will benefit from the intervention of this study.
Description: Hospitalization over a one month period. The primary outcome will be collected by a phone call from a medical student to the patient 1 month after randomization date. Hospitalizations (date, location, length, if available, and reason) will be collected. Because there will be many patients to be called for each practitioner, we expect these phone call to occur within a few days after day 28.Measure: Hospitalization(s) at 1 month Time: 1 month
Description: In the experimental group only: proportion of patients for whom the practitioner had to call back after the medical student had phoned (just after allocation of the practice to the experimental group) at 1 month.Measure: Phone-call from the general practitioner (in the experimental group only) Time: 1 month
Description: Mortality will be reported after checking with the city of the patient's home if there is no response to the phone callMeasure: Mortality at 1 month Time: 1 month
Description: Number of general practitioner consultations and teleconsultations (and time of general practitioner consultation, i.e. during the containment period or not) using data from the French Health National (SNDS) DatabaseMeasure: Use of primary care Time: 6 months
Description: Number of consultations with another medical specialist (and time of consultation, i.e. during the containment period or not) using data from the French Health National (SNDS) DatabaseMeasure: Use of secondary care Time: 6 months
Description: Number of prescriptions related to the chronic disease that were dispensed by the pharmacy using data from the French Health National (SNDS) DatabaseMeasure: Number of prescriptions related to the chronic disease dispensed by the pharmacy Time: 6 months
Description: Number of hospitalizations using data from the French Health National (SNDS) DatabaseMeasure: Number of hospitalization(s) Time: 6 months
Description: Time to hospitalization using data from the French Health National (SNDS) DatabaseMeasure: Time to hospitalization(s) Time: 6 months
Description: Hospitalization duration using data from the French Health National (SNDS) DatabaseMeasure: Hospitalization(s)' durations Time: 6 months
Description: Reason for hospitalization using data from the French Health National (SNDS) DatabaseMeasure: Reasons for hospitalization(s) Time: 6 months
Description: Number of deaths using data from the French Health National (SNDS) DatabaseMeasure: Mortality at 6 months Time: 6 months
Description: Only for patients in the COVIQuest_CV sub-trial: Cardiovascular events (MACE): nonfatal stroke, nonfatal myocardial infarction, cardiovascular death and hospitalization for heart failure using data from the French Health National (SNDS) DatabaseMeasure: Cardiovascular events (MACE) Time: 6 months
Description: Only for patients in the COVIQuest_MH sub-trial: Psychotropic drugs consumption using data from the French Health National (SNDS) DatabaseMeasure: Psychotropic drugs Time: 6 months
Patients presenting with the coronavirus-2019 disease (COVID-19) have a very high risk of cardiovascular adverse events, including death from cardiovascular causes. Unfortunately, there are no reliable statistics on the frequency and severity of these complications during the index hospitalization. Moreover, the long-term cardiovascular outcomes of these patients are entirely unknown. The investigators aim to perform a registry of patients who have undergone a diagnostic nasopharyngeal swab for SARS-CoV-2 and determine their long-term cardiovascular outcomes.
Description: Cardiovascular mortality is defined according to the Academic Research Consortium-2 and will be independently adjudicated by a Clinical Events Committee.Measure: Cardiovascular mortality Time: 1-year
Description: Acute myocardial infarction is defined according to the Academic Research Consortium-2.Measure: Acute myocardial infarction Time: 1-year
Description: Stroke is defined according to the Academic Research Consortium-2.Measure: Stroke Time: 1-year
Description: Documented hospital admission due to heart failureMeasure: Heart failure hospitalization Time: 1-year
Description: Documented by a chest computed tomographyMeasure: Pulmonary embolism Time: 1-year
Description: Documented hospital admission due to any cardiac arrhythmiaMeasure: Cardiac arrhythmias Time: 1-year
A dynamic analytical tool is being implemented to monitor the health, psychosocial and economic impacts of the COVID-19 pandemic as the crisis unfolds. A longitudinal survey is distributed via a network of hospitals, provincial/national organizations and web platforms. The survey information can be linked to provincial health administrative data and metrics derived from social media activity based on artificial intelligence methods. Targeted questions are included for critical populations such as healthcare workers and people with chronic illnesses.
Description: Cohen's Perceived Stress Scale (scores ranged from 0 to 40, higher scores indicating worse stress)Measure: Mental health - Stress Time: through study completion, estimated to 8 months
Description: Generalized Anxiety Disorder Scale (scores ranged from 0 to 21, higher scores indicating worse anxiety)Measure: Mental health - Anxiety Time: through study completion, estimated to 8 months
Description: Quick Inventory of Depressive Symptomatology-Self-report, short version (scores ranged from 0 to 27, higher scores indicating worse depression)Measure: Mental health - Depression Time: through study completion, estimated to 8 months
Description: Measure of Moral Distress - Healthcare Professionals (scores ranged from 0 to 432, higher scores indicating worse moral distress)Measure: Moral distress in healthcare workers Time: through study completion, estimated to 8 months
Description: Rushton Moral Resilience Scale (scores ranged from 1 to 4, higher scores indicating more resiliency)Measure: Moral resilience in healthcare workers Time: through study completion, estimated to 8 months
Description: Frequency of interacting with other people (daily, weekly, monthly, less often than monthly)Measure: Social life Time: through study completion, estimated to 8 months
Description: Fever, Cough, Difficulty breathing or shortness of breath, Tiredness, Aches and pains, Nasal congestion, Runny nose, Sore throat, Diarrhea (Mild Moderate, Severe, N/A)Measure: COVID-9 symptoms Time: through study completion, estimated to 8 months
Description: Mortality (Yes/No): https://datadictionary.ices.on.ca/Applications/DataDictionary/Default.aspxMeasure: Adverse health long-term outcome Time: 5 years before the outbreak and two years after
Description: Hospitalizations (total number): https://datadictionary.ices.on.ca/Applications/DataDictionary/Default.aspxMeasure: Health care utilization - Inpatient Time: 5 years before the outbreak and two years after
Description: Emergency Department visits (Total number): https://datadictionary.ices.on.ca/Applications/DataDictionary/Default.aspxMeasure: Health care utilization - ER Time: 5 years before the outbreak and two years after
Description: Outpatient visits: https://datadictionary.ices.on.ca/Applications/DataDictionary/Default.aspxMeasure: Health care utilization - Outpatient Time: 5 years before the outbreak and two years after
Description: Pittsburgh Sleep Quality Index (scores ranged from 0 to 21, higher scores indicating worse sleep disturbances)Measure: Sleep Time: through study completion, estimated to 8 months
Hospitalized patients with COVID-19 will be included in the study in centers around Poland. After the hospitalization, a short questionnaire will be completed, including pre-hospitalization diagnoses, pre-hospitalization medications, clinical status on admission, the course, complication and the duration of hospitalization. The questionnaire will be available in paper form and on-line.
Description: Death, myocardial infarction, heart failure, myocarditis, acute renal failure, strokeMeasure: Adverse events Time: through study completion, an average of 2 weeks
Description: Number of participants with death, myocardial infarction, heart failure, myocarditis, acute renal failure, stroke analyzed separately for each of the endpointsMeasure: Number of participants with death, myocardial infarction, heart failure, myocarditis, acute renal failure, stroke Time: through study completion, an average of 2 weeks
Description: Ventilation during hospitalizationMeasure: Ventilation during hospitalization Time: through study completion, an average of 2 weeks
Description: Number of participants with death, myocardial infarction, heart failure, myocarditis, acute renal failure, stroke analyzed separately for each of the endpointsMeasure: Number of participants with death, myocardial infarction, heart failure, myocarditis, acute renal failure, stroke Time: prolonged follow up, through study completion, an average of one year
The coronavirus disease 2019 (COVID-19) global pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused considerable morbidity and mortality in over 170 countries. Increasing age and burden of cardiovascular comorbidities are associated with a worse prognosis among patients with COVID-19. In addition, serologic markers of more severe disease including coagulation abnormalities and thrombocytopenia, are not uncommon among patients hospitalized with severe COVID-19 infection and are more common in patients who died in-hospital. As the COVID-19 pandemic continues to grow, there is a pressing need to identify safe, effective, and widely available therapies that can be scaled and rapidly incorporated into clinical practice. Understanding the putative mechanism of increased mortality risk associated with abnormal coagulation function and cardiac injury is critical to guide studies of promising therapeutic interventions. Published and anecdotal reports indicate that endothelial dysfunction and thrombosis are common in critically ill patients with COVID-19, including reports of diffuse microvascular thrombosis in the lungs, heart, liver, and kidneys. Patients with cardiovascular disease (CVD) and CVD risk factors are known to have endothelial dysfunction and a heightened risk of thrombosis. A recent study of COVID-19 inpatients from Wuhan, China observed that an elevated D-dimer level greater than 1 ug/mL was associated with an 18 times higher risk of in-hospital death, underscoring the importance of increased coagulation activity as a potential modifiable risk marker that may drive end-organ injury. Given the established link between endothelial dysfunction and thrombosis in patients with cardiovascular disease, and the association between coagulopathy and adverse outcomes in patients with sepsis, the association between increased coagulation activity, end-organ injury, and mortality risk may represent a modifiable risk factor among COVID-19 patients with critical illness. Therefore, we propose to conduct a randomized, open-label trial of therapeutic anticoagulation in COVID-19 patients with an elevated D-dimer to evaluate the efficacy and safety.
Description: Aim 1 - Risk of death, cardiac arrest, symptomatic deep venous thrombosis, pulmonary embolism, arterial thromboembolism, myocardial infarction, or hemodynamic shock.Measure: Number of patients with the composite efficacy endpoint of death, cardiac arrest, symptomatic deep venous thrombosis, pulmonary embolism, arterial thromboembolism, myocardial infarction, or hemodynamic shock. Time: 12 weeks
Description: Aim 2 - Risk of major bleeding event according to the International Society on Thrombosis and Haemostasis (ISTH) definition.Measure: Number of patients with a major bleeding event according to the International Society on Thrombosis and Haemostasis (ISTH) definition. Time: 12 weeks
Background: Coronavirus disease (COVID-19) is a tremendous challenge the modern world has never seen before and is overwhelming the capacities of healthcare systems worldwide. Patients with cardiovascular diseases, heart failure in particular, and cardiovascular risk factors seem to be at a very high risk if affected by COVID-19 - and vice versa there are more and more reports of cardiac manifestations with the viral disease. Aim: The purpose of the study is to characterise the clinical course of adult inpatients with COVID-19 and concomitant cardiovascular affection in a worldwide, multicentre PCHF registry. Methods: Retrospective and prospective data analysis. Data on demographic, clinical, selected laboratory, electrocardiography and echocardiography parameters, treatment and outcome will be collected. The principal investigator provides dedicated electronic case report form. The primary outcome is in-hospital mortality. The secondary endpoints will be ICU length of stay, hospital length of stay, the need and duration of invasive mechanical ventilation, cardiovascular hospitalisation after 3 and 6 months from index hospitalisation, all-cause and cardiovascular mortality after 3 and 6 months from index hospitalisation.
Description: All-cause and cardiovascular mortality during index hospitalization.Measure: In-hospital mortality. Time: Hospitalization period, assessed up to 30 days
Description: The duration of hospitalization on the intensive care unit.Measure: The length of stay in the intensive care unit. Time: Hospitalization period in the ICU, assessed up to 30 days
Description: The total length of stay in the hospital.Measure: The duration of hospitalization. Time: Hospitalization period, assessed up to 30 days
Most patients undergoing a cardiovascular procedure need an ICU-bed during the hospitalization and therefore it is possible that for the unforeseen future, because of the Covid-19 crisis, many patients will stay on the waiting list for many months to come. There are some studies showing an increased mortality associated with an increased waiting time for the patients on the waiting list for an elective cardiac surgery. However, there is no data on the evolution of the morbidity, the quality of life and the symptomatology of the patients waiting for an elective operation. Also it is not clear whether the period of waiting for an elective cardiovascular operation would impact the morbidity or the mortality of the planned operation at later stage. Furthermore, there is a plethora of studies on risk factors associated with the perioperative morbidity and mortality in general. Therefore, the rationale of the current study is to evaluate whether Digital Cardiac Counseling (DCC) would improve outcomes of the patients waiting for an elective cardiac operation. At the DCC platform, there will be assessments of cardiovascular symptoms, Covid-19 prevention for cardiovascular patients, smoking cessation, anxiety relief, exercise stimulation, pulmonary rehabilitation and diet adjustments. This will be done by means of questionnaires and E-consults.
Description: Major Adverse Cardiovascular Events defined as Cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, hospitalization for heart failure and/or fo earlier planned interventionMeasure: MACEs Time: Cumulative incidence (from inclusion) at 1 year postoperatively
Description: all-cause mortalityMeasure: Mortality Time: Before the scheduled date of the operation, at 30 days, in-hospital (at 30 days or during the same hospitalization for the planned procedure), at one-year postoperatively and cumulative from inclusion at 1-year postoperatively
Description: Mortality caused by cardiovascular diseaseMeasure: Cardiovascular-related mortality Time: Before the scheduled date of the operation, at one-year postoperatively and cumulative from inclusion at 1-year postoperatively
Description: Mortality caused by Covid-19 infection and/or related complicationsMeasure: Covid-19 related mortality Time: Before the scheduled date of the operation, at one-year postoperatively and cumulative from inclusion at 1-year postoperatively
Description: Measured using SF (Short Form) 36 Health SurveyMeasure: Health-related quality of life Time: during waiting time measured before the procedure, at 3 months, at 6 months and at 12 months
Description: New York Heart Association Functional ClassificationMeasure: NYHA Functional classification Time: during waiting time measured before the procedure, at 3 months, at 6 months and at 12 months
Description: Grading of angina pectorisMeasure: CCS (Canadian Cardiovascular Society grading of angina pectoris) Time: during waiting time measured before the procedure, at 3 months, at 6 months and at 12 months
Description: Major Adverse Cardiovascular Events defined as Cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, hospitalization for heart failure and/or fo earlier planned interventionMeasure: MACEs Time: during waiting time measured before the scheduled date of the operation, at 1-year postoperatively
Description: Respiratory failure, pneumonia, septicemia, renal failure, myocardial infarction, stroke, atrial fibrillation, pacemaker implantation, re-operation, delirium, wound infection, urinary tract infection and pressure ulcersMeasure: Perioperative complications Time: during waiting time measured before the scheduled date of the operation, at 30 days postoperatively and at 90 days postoperatively
Description: from surgery until discharge in daysMeasure: Hospital length of stay Time: from the admission to the hospital untill discharge from the hospital, assessed up to 12 months
Description: measured in hours from arrival in ICU until extubationMeasure: Time on mechanical ventilation Time: from the admission to the ICU untill discharge from the ICU, assessed up to 12 months
Description: whether patient is active smokingMeasure: Smoking status Time: during waiting time measured before the procedure, at 3 months, at 6 months and at 12 months
Description: Measured using HADS (Hospital Anxiety and Depression Scale) scoreMeasure: Anxiety and Depression Time: during waiting time measured before the procedure, at 3 months, at 6 months and at 12 months
Description: the percentage of patients taking part in postoperative cardiac rehabilitationMeasure: Participation in postoperative cardiac rehabilitation Time: postoperatively at 3 months, at 6 months and at 12 months
Description: Percentage BMI<20 or BMI>30Measure: Body-Mass Index (BMI) Time: during waiting time measured before the procedure, at 3 months, at 6 months and at 12 months
Description: Unplanned visits to emergency departmentMeasure: Number of participants with unplanned visits Time: during waiting time measured before the procedure, at 3 months, at 6 months and at 12 months
Description: Total costs of the whole treatment processMeasure: Healthcare costs Time: during waiting time measured before the procedure, at 3 months, at 6 months and at 12 months
The study will analyze the incidence, clinical outcomes and predictors of myocardial injury in a large patient population with COVID-19 treated in Mount Sinai Hospital (MSH) system. In addition, the study team will explore the association between high-sensitivity troponin I (TnI) levels and clinical characteristics, biomarkers, cardiac tests data and treatment approaches to uncover the potential mechanisms responsible for COVID-19 induced myocardial injury.
Description: Number of death during hospitalizationMeasure: Number of In-Hospital Death Time: During hospitalization, average 2-3 weeks
Description: Length of stay in the hospitalMeasure: Length of Stay Time: During hospitalization, average 2-3 weeks
Description: Successful treatment will be defined by two consecutive negative tests for COVID-19Measure: Number of Successful Treatment Time: During hospitalization, average 2-3 weeks
Considering that simvastatin, and probably statins in general, interfere with SARS-cov-2 cellular uptake and some inflammatory pathways activated by the virus, those patients on statin therapy should be less vulnerable to infection and their clinical course and prognosis should be better than that in individuals not on statin therapy.
Description: Assess the difference in the WHO SARS-cov-2 scale of severity (9 steps) achieved by Covid-19 infected patients, admitted in the hospital, with and without background statin therapy comparable in age and gender distributionMeasure: SARS-cov-2 scale of severity (9 steps) in Covid-19 infected patients with statin therapy Time: at the time of admission
Cardiac Troponin elevation is associated with adverse prognosis in COVID-19. The MIIC-MI study aims to investigate mechanisms of cardiac injury in COVID-19 using multi-modality imaging and immunophenotyping to better understand the link with adverse patient outcomes.
The novel coronavirus, severe acute respiratory syndrome coronavirus 2, that causes coronavirus disease 2019 (COVID -19), is highly contagious in the community and has resulted in a global pandemic. This infection has a special implication on the patient who complains from cardiac disease or acute cardiovascular condition and may result in cardiovascular complications such as myocardial infarction. For this end, we target to study this group of patient, who has a cardiac disease with COVID-19 in Qatar, in addition, the acute myocardial infarction with COVID-19 from the Gulf countries and collect all the related data to come with a comprehensive view about those patients.
Description: The outcome of this registry will be: entire information about the patients who admitted with COVID-19 accompany with a cardiovascular condition in Qatar. Additionally, a comparison will be conducted between the cardiac patient who admitted over the period February to December to December 2020 and the same category of patients over the same period of 2019 in Qatar to figure out the reason behind the dropping of the number of the patient. A multicenter data from the Gulf countries for Acute MI patients infected with COVID-19. A comparison between our patients (either in Qatar only or the entire Gulf) populations and the outcome of other international registries such as the NACMI (US registry)Measure: The impact of COVID-19 on cardiovascular patient Time: 2 month from starting date
A global study for a better understanding of the cardiovascular conditions that increase the risk of developing severe COVID-19, and a better characterization of cardiovascular complications in hospitalized patients with COVID-19.
Description: MACE is defined as the presence of any of the following CVD conditions: myocarditis, arrhythmia, heart failure [including Left ventricular ejection fraction], acute coronary event, as per the hospital admission and discharge records. Data will be collected at each site by local investigators and sent to the coordinating center. Only data outlined on the entry and outcome forms will be collected.Measure: Assessment of the patients for major adverse cardiovascular events (MACE) Time: Outcome will be assessed at discharge and 30-day follow-up visit from the hospital admission date.
Description: Data will be collected at each site by local investigators and sent to the coordinating center. Only data outlined on the entry and outcome forms will be collected.Measure: Assessment of the patients for Pulmonary outcomes including Pulmonary embolism, pneumonia, acute respiratory distress syndrome, need of intensive care - number of days in ICU or ICCU, need of ventilator] Time: at discharge and 30-day follow-up visits from the hospital admission date.
Description: Data will be collected at each site by local investigators and sent to the coordinating center. Only data outlined on the entry and outcome forms will be collected.Measure: Assessment of the patients for Neurological Outcomes including stroke and Transient Ischemic Attack (TIA) Time: at discharge and 30-day follow-up visits from the hospital admission date.
Description: Specific causes of death to be evaluated using CRF including sudden cardiac death, death due to Myocardial infarction, Death due to heart failure, death due to strokeMeasure: All cause deaths Time: any time during the hospital admission and at 30-day follow-up.
Non-commercial depersonalized multi-centered registry study on analysis of chronic non-infectious diseases dynamics after SARS-CoV-2 infection in adults.
Description: percentage of patients with non-infectious diseases relating to overall number of patients registered in studyMeasure: rate of non-infectious diseases Time: 12 month since a moment of request of medical help
Description: correlation between number of patients with COVID-19 of various severity and number of pre-existing conditions and their severity among these groupsMeasure: severity of COVID-19 depending on pre-existing diseases Time: 12 month since a moment of request of medical help
Description: Registration of disability or change of disability statusMeasure: disability registration / change of disability status Time: 12 month since a moment of request of medical help
Description: rate of deaths among registered participantsMeasure: rate of letal outcomes Time: 12 month since a moment of request of medical help
Description: correlation between number of deaths and pre-existing diseasesMeasure: rate of letal outcomes depending on pre-existing disease Time: 12 month since a moment of request of medical help
The proposed study seeks to determine the incidence of dysphagia and vocal fold mobility impairment (VFMI) in individuals undergoing cardiovascular surgical procedures. It also seeks to determine the impact of postoperative swallowing impairment on health-related outcomes.
Description: This scale is a validated measure used by trained blinded clinicians to assign ratings of safety to swallowing bolus trials. The development and use of an 8-point, equal-appearing interval scale (8 being best; 1 being worst) to describe penetration and aspiration events are described. Scores are determined primarily by the depth to which material passes in the airway and by whether or not material entering the airway is expelled.Measure: Penetration Aspiration Scale Time: Baseline (Prior to surgery)
Description: This scale is a validated measure used by trained blinded clinicians to assign ratings of safety to swallowing bolus trials. The development and use of an 8-point, equal-appearing interval scale (8 being best; 1 being worst) to describe penetration and aspiration events are described. Scores are determined primarily by the depth to which material passes in the airway and by whether or not material entering the airway is expelled.Measure: Penetration Aspiration Scale Time: Follow-up - Within 72 hours following extubation from surgery
Description: This scale is a validated measure used by trained blinded clinicians to assign ratings of efficiency to swallowing bolus trials. The Yale Pharyngeal Residue Severity Rating Scale was developed, standardized, and validated to provide reliable, anatomically defined, and image-based assessment of post-swallow pharyngeal residue severity as observed during fiberoptic endoscopic evaluation of swallowing (FEES). It is a five-point ordinal rating scale based on residue location (vallecula and pyriform sinus) and amount (none, trace, mild, moderate, and severe).Measure: Yale Residue Severity Rating Scale Time: Baseline (Prior to surgery)
Description: This scale is a validated measure used by trained blinded clinicians to assign ratings of efficiency to swallowing bolus trials. The Yale Pharyngeal Residue Severity Rating Scale was developed, standardized, and validated to provide reliable, anatomically defined, and image-based assessment of post-swallow pharyngeal residue severity as observed during fiberoptic endoscopic evaluation of swallowing (FEES). It is a five-point ordinal rating scale based on residue location (vallecula and pyriform sinus) and amount (none, trace, mild, moderate, and severe).Measure: Yale Residue Severity Rating Scale Time: Follow-up - Within 72 hours following extubation from surgery
Description: During a Fiberoptic Endoscopic Evaluation of Swallowing (FEES), the vocal folds will be visualized using a small camera passed through the open nasal passage. The patient will be asked to make a series of vocal tasks so that we can visualize their movement, any immobility will be notated.Measure: Vocal Fold Mobility Impairment Time: Baseline (Prior to surgery)
Description: During a Fiberoptic Endoscopic Evaluation of Swallowing (FEES), the vocal folds will be visualized using a small camera passed through the open nasal passage. The patient will be asked to make a series of vocal tasks so that we can visualize their movement, any immobility will be notated.Measure: Vocal Fold Mobility Impairment Time: Follow-up - Within 72 hours following extubation from surgery
MITIGATE is a prospective, open-label, parallel-group, randomized, pragmatic clinical trial. The MITIGATE Study has been designed to evaluate the real-world clinical effectiveness of pre-treatment with icosapent ethyl (IPE), also known as Vascepa®, compared to usual standard of care to prevent and reduce the sequelae of laboratory-confirmed viral upper respiratory infection (URI)-related (i.e., COVID-19, influenza, and other known viral respiratory pathogens) morbidity and mortality in a high-risk cohort of adults with established atherosclerotic cardiovascular disease (ASCVD).
Description: Confirmed viral URIs (i.e., including recurrent events) (i.e., COVID-19, influenza, and other known viral respiratory pathogens) based on laboratory testing (i.e., FDA or locally-approved testing modalities) with an oxygen saturation <94% on room air and/or requiring any form of supplemental oxygen.Measure: Percentage of patients with moderate or severe confirmed viral URIs Time: 0-12 months
Description: At any point in time based on a 7-point ordinal scale (i.e., 1 = death, 2 = mechanically ventilated/extracorporeal membrane oxygenation, 3 = high flow supplemental oxygen, 4 = low flow supplemental oxygen, 5 = hospitalized with no supplemental oxygen requirements, 6 = urgent care or emergency department visit not leading to hospitalization, and 7 = no relevant clinical encounters)Measure: Worst clinical status due to a confirmed viral URI Time: 0-12 months
Description: Death due to any cause, hospitalization for myocardial infarction, or hospitalization for ischemic strokeMeasure: Percentage of participants experiencing a major adverse cardiovascular event Time: 0-12 months
Description: Major adverse cardiovascular events, hospitalization for acute coronary syndrome, and coronary revascularization (i.e., percutaneous coronary intervention and/or coronary artery bypass graft)Measure: Percentage of participants experiencing an expanded major adverse cardiovascular event Time: 0-12 months
This cohort study will obtain electronic health record (EHR) de-identified data from 21 health systems affiliated with the Cancer Center Cessation Initiative (C3I) network or health systems with large numbers of COVID-19 patients to explore whether smoking status, cancer history, and other risk factors among patients diagnosed with COVID-19 are associated with mortality and/or COVID-19 disease severity/complications. Each site will provide de-identified data from their health system EHR on a monthly basis that includes all patients identified as having COVID-19 at some point in the interval from February 1, 2020, through December 31, 2020.
Description: Death resulting from COVID-19 illness in inpatients vs discharge from hospital (binary outcome)Measure: Mortality due to COVID-19 Time: February 1, 2020, through December 31, 2020
Description: COVID-19 severity as measured by intubation for respiratory support (i.e., patient required intubation during hospitalization) - binary variableMeasure: COVID-19 Severity Time: February 1, 2020, through December 31, 2020
The design included 152 patients with confirmed heart failure (HF) evaluated in two different periods of time: a baseline before the outbreak, and other during the outbreak of which 76 patients were randomized in each group. A care and follow-up guide was used as an instrument through a face-to-face survey (baseline group) and telemedicine (group outbreak). The primary outcome was the comparison of functional class modification observed in patients
Description: NYHA class modification in the last four weeks. Basal and follow-up measures: Basal on June 2020. Follow up: every three months and a year (June 2021). NYHA Scale: Minimum: 1 to maximum :4Measure: NYHA class deterioration Time: 1 year
Description: physiological parameter to worsening of shortness of breath perception, in last four weeks. Basal and follow-up measures: Basal on June 2020. Follow up: every three months and a year (June 2021).Dichotomic scale presence or absenceMeasure: Dyspnea deterioration Time: 1 year
Description: Physiological parameter to worsening of dyspnea that suddenly occurs to decubitus, in last four weeks. Basal and follow-up measures: Basal on June 2020. Follow up: every three months and a year (June 2021). Dichotomic scale presence or absence.Measure: Paroxysmal nocturnal dyspnea deterioration Time: 1 year
Description: Physiological parameter to worsening of quantification of swollen ankles in both pelvic limbs, in last four weeks. Basal and follow-up measures: Basal on June 2020. Follow up: every three months and a year (June 2021). Dichotomic scale presence or absenceMeasure: Edema Time: 1 year
Description: a perceived limitation on walking more 500 meters, in last four weeks. Basal and follow-up measures: Basal on June 2020. Follow up: every three months and a year (June 2021). Dichotomic scale presence or absence.Measure: Daily activities In the last four weeks? Please, mention if you a perceived limitation on : Walking deterioration Time: 1 year
Coronavirus disease (COVID-19) related pneumonia significantly impact patients with underlying cardiovascular (CV) conditions. Animal studies suggest that drugs commonly used to treated CV diseases may increase the ability of COVID-19 to infect cells. The RAAS-COVID-19 trial aims to assess whether temporarily holding these CV drugs in patients who are admitted with COVID-19, versus continuing them, in patients admitted with COVID-19 can impact short term outcomes.
Description: The primary end point is a global rank score which is applied to all participants. The global rank sum is based on the following endpoints (and corresponding score): Death (7); Transfer to ICU for Invasive ventilation (6); Transfer to ICU for other indication (5); Non-fatal MACE (Any of the following - MI, Stroke, Acute HF, new onset Afib) (4); Length of stay > 4 days (3); Development of acute kidney injury (>40% decline in eGFR or doubling of serum Cr) (2); Urgent intravenous treatment for high blood pressure/hypertensive crisis (2); >30% Increase in baseline high sensitivity troponin (1); >30% increase in baseline BNP (1); Increase in baseline CRP to 48 hours >30%(1); Lymphocyte count drop >30% (1). The primary endpoint will be assessed from baseline to day 7 (or day of discharge if occurs before day 7). Participants will receive a weighted score depending on the events experienced. The global rank sum score will then be averaged and compared between treatment arms.Measure: Global rank score Time: Baseline - day 7
Patients are part of a family network. When any person in a family becomes critically unwell and requires the assistance of an Intensive Care Unit (ICU), this has an impact on all members of that family. COVID-19 changed visiting for all patients in hospitals across Scotland. It is not known what effect these restrictions will have on patients' recovery, nor do we understand the impact it may have on their relatives or staff caring for them. This study will look at the implications of the visiting restrictions as a consequence of the COVID-19 pandemic upon patients without COVID-19 who are in the cardiothoracic ICU. It will also explore the impact of these restrictions on them, their relatives and staff. This study will be carried out within a single specialised intensive care unit in Scotland using mixed methods. The first arm of this study will use retrospective data that is routinely collected in normal clinical practice. The investigators will compare patient outcomes prior to COVID-19 with outcomes following the implementation of COVID-19 visiting restrictions. The aim is to establish if the restrictions on visiting has an impact on the duration of delirium. Delirium is an acute mental confusion and is associated with longer hospital stays and worse outcomes in this patient group. The second arm of this study involves semi-structured interviews with patients, relatives and staff that will allow deeper exploration of the issues around current visiting policy. The interviews will last approximately 1 hour and will address these issues. They will then be transcribed word for word and analysed using grounded theory, meaning the theories will develop from the data as it is analysed.
Description: Number of days patient found to have delirium using the Confusion Assessment Method for the ICU (CAM-ICU)Measure: Duration of delirium Time: From the date of admission to the Intensive Care Unit (ICU) until discharge from the ICU or death, whichever came first, up to 12 months.
Description: CAM-ICUMeasure: Incidence of delirium Time: From the date of admission to the Intensive Care Unit (ICU) until discharge from the ICU or death, whichever came first, up to 12 months.
Description: DaysMeasure: Length of critical care stay Time: From the date of admission to the ICU until discharge from the ICU or death, whichever came first, up to 12 months.
Description: DaysMeasure: Length of hospital stay Time: From the date of admission to the hospital until discharge from the hospital or death, whichever came first, up to 12 months.
Description: DaysMeasure: Length of time ventilated Time: From the date of admission to the ICU until discharge from the ICU or death, whichever came first, up to 12 months.
Description: Semi structured interviewsMeasure: Exploring the experiences of patients, relatives and staff of the visitation restrictions during the COVID-19 pandemic Time: 18 months
Data processed on September 26, 2020.
An HTML report was created for each of the unique drugs, MeSH, and HPO terms associated with COVID-19 clinical trials. Each report contains a list of either the drug, the MeSH terms, or the HPO terms. All of the terms in a category are displayed on the left-hand side of the report to enable easy navigation, and the reports contain a list of correlated drugs, MeSH, and HPO terms. Further, all reports contain the details of the clinical trials in which the term is referenced. Every clinical trial report shows the mapped HPO and MeSH terms, which are also hyperlinked. Related HPO terms, with their associated genes, protein mutations, and SNPs are also referenced in the report.Drug Reports MeSH Reports HPO Reports