CORD-19-Sentences  

CORD-19:f8b26adcf8879212e0c3d9bd4067aeb8f8ec3824 JSONTXT 7 Projects

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Id Subject Object Predicate Lexical cue
TextSentencer_T1 0-119 Sentence denotes Rapid communication Influenza-associated pneumonia as reference to assess seriousness of coronavirus disease (COVID-19)
TextSentencer_T2 121-276 Sentence denotes Information on severity of coronavirus disease (COVID-19) (transmissibility, disease seriousness, impact) is crucial for preparation of healthcare sectors.
TextSentencer_T3 277-411 Sentence denotes We present a simple approach to assess disease seriousness, creating a reference cohort of pneumonia patients from sentinel hospitals.
TextSentencer_T4 412-495 Sentence denotes First comparisons exposed a higher rate of COVID-19 patients requiring ventilation.
TextSentencer_T5 496-603 Sentence denotes There were more case fatalities among COVID-19 patients without comorbidities than in the reference cohort.
TextSentencer_T6 604-694 Sentence denotes Hospitals should prepare for high utilisation of ventilation and intensive care resources.
TextSentencer_T7 695-835 Sentence denotes As severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spreads globally, crucial information on severity of the epidemic is needed.
TextSentencer_T8 836-1021 Sentence denotes According to the World Health Organization (WHO) guideline on Pandemic Influenza Severity Assessment, severity indicators would be transmissibility, disease seriousness and impact [1] .
TextSentencer_T9 1022-1183 Sentence denotes Transmissibility reflects the movement of the virus, which is influenced by the dynamics of the spread, the R 0 and the susceptibility of the exposed population.
TextSentencer_T10 1184-1354 Sentence denotes So far, several estimates on R 0 exist, ranging between 1.4 to 6.49, which indicate a higher transmissibility than seasonal influenza, and even higher than SARS-CoV [2] .
TextSentencer_T11 1355-1519 Sentence denotes Impact reflects the impact on the healthcare sector, such as capacity utilisation of general practitioners, hospitals and public health authorities, and on society.
TextSentencer_T12 1520-1638 Sentence denotes Given the current data, the impact in countries other than China is hard to assess, although potentially high [3, 4] .
TextSentencer_T13 1639-1758 Sentence denotes Disease seriousness reflects the extent of individual sickness including clinical symptoms, complications and outcomes.
TextSentencer_T14 1759-2046 Sentence denotes Recent publications from the area first affected in China (the city of Wuhan in the province of Hubei) offer valuable, although preliminary, data such as the proportion of hospitalised coronavirus disease (COVID-19) patients treated in intensive care units (ICU), ventilated or deceased.
TextSentencer_T15 2047-2131 Sentence denotes These are important parameters for the assessment of individual disease seriousness.
TextSentencer_T16 2132-2264 Sentence denotes However, a challenge is to apply these data to the situation in Europe, given the different population structures and comorbidities.
TextSentencer_T17 2265-2583 Sentence denotes We want to introduce the concept of using syndromic surveillance data to assess disease seriousness of COVID-19, directly relating the results from clinical studies and case series on COVID-19 pneumonia patients to the situation as it is observed in pneumonia patients at the beginning of seasonal influenza epidemics.
TextSentencer_T18 2584-2876 Sentence denotes With a simple approach, we give a preliminary assessment of individual seriousness of COVID-19 using well-described case series of hospitalised COVID-19 pneumonia patients from the cities of Wuhan, Beijing, Shenzhen and the provinces of Hubei and Zhejiang [5] [6] [7] [8] [9] [10] [11] [12] .
TextSentencer_T19 2877-3267 Sentence denotes We defined a reference group from a well-known setting: in 73 German sentinel hospitals, we extracted the data of all inpatients diagnosed with pneumonia (International Classification of Diseases, 10th revision codes J12-J18, primary diagnosis [13] ) that were admitted during three consecutive weeks, after the start and before the peak of the influenza epidemic in the years 2015 to 2019.
TextSentencer_T20 3268-3467 Sentence denotes We compared severity parameters that were described for COVID-19 patients (acute respiratory distress syndrome, ventilation, intensive care, case fatality) with those from the German sentinel system.
TextSentencer_T21 3468-3574 Sentence denotes Furthermore, we stratified parameters by potential risk groups such as age, sex and chronic comorbidities.
TextSentencer_T22 3575-3699 Sentence denotes We also compared outcomes and risk factors for critically ill patients (i.e. received intensive care and ventilation) [14] .
TextSentencer_T23 3700-3920 Sentence denotes As the Chinese population is younger, with a larger proportion of males compared with the German population, we applied weights and provided crude and adjusted proportions for the sentinel pneumonia patients (SPP) [15] .
TextSentencer_T24 3921-4084 Sentence denotes This approach, which can be used by other countries using syndromic surveillance, attempts to replicate the uncertainty of initial results for the new coronavirus.
TextSentencer_T25 4085-4200 Sentence denotes Crude and adjusted values of mean and median age were lower in all COVID-19 case series compared with SPP (Table) .
TextSentencer_T26 4201-4306 Sentence denotes The proportion of females differed between the case series, ranging from 32% in Wuhan to 59% in Zhejiang.
TextSentencer_T27 4307-4428 Sentence denotes The adjusted SPP showed a range from 39% to 42% in the proportions of females throughout the 5 years under consideration.
TextSentencer_T28 4429-4521 Sentence denotes The overall proportion of comorbidities was much smaller in the COVID-19 case series (range:
TextSentencer_T29 4522-4622 Sentence denotes 20-51%) than in German patients, where the proportion ranged from 70% to 77%, depending on the year.
TextSentencer_T30 4623-4738 Sentence denotes Hypertension and diabetes were the most important chronic comorbidities both among COVID-19 patients and among SPP.
TextSentencer_T31 4739-4880 Sentence denotes However, there were fewer patients with chronic obstructive pulmonary disease (COPD) or renal disease among COVID-19 patients than among SPP.
TextSentencer_T32 4881-4972 Sentence denotes The proportion of ICU patients in the SPP was 20%, ranging from 18% in 2016 to 22% in 2019.
TextSentencer_T33 4973-5073 Sentence denotes This was the same scale as described in two case series from Wuhan in the province of Hubei [5, 6] .
TextSentencer_T34 5074-5249 Sentence denotes However, the case series from provinces outside of Hubei reported only 11%, 10% and 2% (one case) of ICU patients among COVID-19 cases, which is remarkably lower [9, 11, 12] .
TextSentencer_T35 5250-5416 Sentence denotes This may be attributed to the preliminary character of the outcome, as more than half of the cases were still hospitalised in these case series (Table and Figure 1 ).
TextSentencer_T36 5417-5572 Sentence denotes Among ICU patients, the proportion of males and the median age were strikingly similar between COVID-19 (61% and 66 years) and SPP (61% and 67 years) [6] .
TextSentencer_T37 5573-5638 Sentence denotes However, the proportions of chronic comorbidities were different:
TextSentencer_T38 5639-5798 Sentence denotes 28% of COVID-19 patients treated on the ICU did not have any reported comorbidity, whereas only 16% of German ICU patients were without comorbidities (Table) .
TextSentencer_T39 5799-5926 Sentence denotes Three case series from the province Hubei described a high rate of cases who needed ventilation (20%, 23% and 25%) [5, 6, 10] .
TextSentencer_T40 5927-6005 Sentence denotes German pneumonia patients had a two-to threefold lower ventilation rate of 9%.
TextSentencer_T41 6006-6158 Sentence denotes The two case series from Shenzhen and the province Zhejiang also reported much lower ventilation rates of, respectively, 11% and 2% [9, 11] (Figure 2 ).
TextSentencer_T42 6159-6226 Sentence denotes The median duration of ventilation was 9 days (interquartile range:
TextSentencer_T43 6227-6291 Sentence denotes 7-19, n = 13) for non-invasive and 17 days (interquartile range:
TextSentencer_T44 6292-6389 Sentence denotes 12-19, n = 4) for invasive ventilation in the COVID-19 case series described by Chen et al. [5] .
TextSentencer_T45 6390-6507 Sentence denotes In contrast, the median ventilation duration (invasive and non-invasive) in SPP was only 2 days (interquartile range:
TextSentencer_T46 6508-6522 Sentence denotes 1-4, n = 303).
TextSentencer_T47 6523-6718 Sentence denotes The high ventilation rates and the long duration of ventilation (data from one case series) can be attributed to a high rate of acute respiratory distress syndrome (ARDS) among COVID-19 patients.
TextSentencer_T48 6719-6814 Sentence denotes Again, the difference between Hubei (17-20% ARDS) and outside of Hubei (2-4% ARDS) is striking.
TextSentencer_T49 6815-6860 Sentence denotes However, ARDS was observed in only 1% of SPP.
TextSentencer_T50 6861-6987 Sentence denotes The observed case fatality ratios in the described case series from Hubei (including the city of Wuhan) ranged from 4% to 12%.
TextSentencer_T51 6988-7045 Sentence denotes Most case series outside Hubei did not report fatalities.
TextSentencer_T52 7046-7083 Sentence denotes One case series had 1% case fatality.
TextSentencer_T53 7084-7202 Sentence denotes However, more than two thirds of the cases reported from outside Hubei were still hospitalised at the reporting dates.
TextSentencer_T54 7203-7324 Sentence denotes The case fatality ratio among SPP was 6%, which is within the range of the reported COVID-19 case fatalities (Figure 3) .
TextSentencer_T55 7325-7447 Sentence denotes A study by Yang et al. described clinical courses and outcomes of 52 critically ill patients in a hospital in Wuhan [14] .
TextSentencer_T56 7448-7563 Sentence denotes Among 25 critically ill COVID-19 patients younger than 60 years, 12 died within 28 days after admission to the ICU.
TextSentencer_T57 7564-7663 Sentence denotes Of 31 patients without chronic illnesses, 15 died, which is a comparable proportion of almost half.
TextSentencer_T58 7664-7799 Sentence denotes In the sentinel hospitals, we identified 462 pneumonia patients who were critically ill (i.e. received intensive care and ventilation).
TextSentencer_T59 7800-7872 Sentence denotes Of those patients, 92 were younger than 60 years, of whom 12 (13%) died.
TextSentencer_T60 7873-7987 Sentence denotes In addition, 18 of the critically ill pneumonia patients were without chronic preconditions and four of them died.
TextSentencer_T61 7988-8185 Sentence denotes Considering the 5 years from 2015 to 2019, the proportion of severe cases requiring intensive care and the case fatality ratios were strikingly similar among COVID-19 and German pneumonia patients.
TextSentencer_T62 8186-8343 Sentence denotes However, based on these data, COVID-19 may affect a younger cohort, which seems not fully explained by the different age structure of the Chinese population.
TextSentencer_T63 8344-8566 Sentence denotes As reported by the China Centre for Disease Control and Prevention, there seems to be a higher risk for severe disease in older ages and in patients with chronic Grey line: proportion of ICU in pneumonia sentinel patients.
TextSentencer_T64 8567-8617 Sentence denotes Data from five COVID-19 series [5, 6, 9, 11, 12] .
TextSentencer_T65 8618-8686 Sentence denotes Grey line: proportion of ventilation in pneumonia sentinel patients.
TextSentencer_T66 8687-8740 Sentence denotes Data from five COVID-19 series [5, 6, [9] [10] [11] .
TextSentencer_T67 8741-8757 Sentence denotes illnesses [16] .
TextSentencer_T68 8758-8960 Sentence denotes But severity in younger adults below 60 years and in patients without chronic preconditions appears to be higher in COVID-19 patients than in pneumonia patients usually seen during the influenza season.
TextSentencer_T69 8961-9135 Sentence denotes The rate of ARDS and of patients requiring ventilation was markedly higher among COVID-19 patients with much longer duration of ventilation, based in the data from one study.
TextSentencer_T70 9136-9266 Sentence denotes During the influenza pandemic 2009 however, specialised German hospitals reported similarly long ventilation duration times [17] .
TextSentencer_T71 9267-9488 Sentence denotes The case series from outside Hubei report much milder symptoms than those reported from Hubei, especially from Wuhan, which may be due to early admittance of contact persons and of suspected cases with only mild symptoms.
TextSentencer_T72 9489-9626 Sentence denotes In addition, the large impact on the health system in the initially affected province resulted in insufficient healthcare resources [3] .
TextSentencer_T73 9627-9725 Sentence denotes This may have inhibited adequate treatment as the strikingly higher case fatality indicates [18] .
TextSentencer_T74 9726-9840 Sentence denotes However, all COVID-19 case series were still open with more than half of the cases hospitalised at reporting date.
TextSentencer_T75 9841-9966 Sentence denotes It is known that COVID-19 cases can have a prolonged course with many fatalities occurring 3 weeks after symptom onset [19] .
TextSentencer_T76 9967-10061 Sentence denotes Case fatality rates from these COVID-19 case series can therefore only be seen as preliminary.
TextSentencer_T77 10062-10292 Sentence denotes Moreover, variations in health systems that could result in over-or underdiagnosis of chronic comorbidities such as COPD [20, 21] are unaccounted for and may contribute to some of the observed differences between COVID-19 and SPP.
TextSentencer_T78 10293-10444 Sentence denotes Our approach is flexible enough to create reference cohorts, which will allow estimation of COVID-19 severity using known characteristics and outcomes.
TextSentencer_T79 10445-10560 Sentence denotes As more data on European cases are published, the system can be applied to cases with a more comparable background.
TextSentencer_T80 10561-10744 Sentence denotes First comparisons expose the high rate of patients requiring ventilation over prolonged time periods, thus hospital resources may be in higher demand of ventilation supply than usual.
TextSentencer_T81 10745-10856 Sentence denotes In fact, Liu et al. suggests that early non-invasive mechanical ventilation can promote positive outcomes [9] .
TextSentencer_T82 10857-10972 Sentence denotes This can only be implemented if hospitals prepare for high utilisation of ventilation and intensive care resources.
TextSentencer_T83 10973-11215 Sentence denotes Although fatalities occur mostly among elderly people with chronic comorbidities, serious disease progressions do also occur among younger, healthy patients and more often than would be expected from the experience during influenza epidemics.
TextSentencer_T84 11216-11274 Sentence denotes This article was published as an e-Alert on 16 March 2020.
TextSentencer_T85 11275-11448 Sentence denotes Reported proportions of deceased and corresponding proportions of patients that were still hospitalised, seven COVID-19 case series, China, January-February 2020 (n = 1,087)