Id |
Subject |
Object |
Predicate |
Lexical cue |
T16 |
0-12 |
Sentence |
denotes |
Introduction |
T17 |
13-126 |
Sentence |
denotes |
A mysterious illness causing pneumonia in December 2019 in Wuhan, China is now growing into a potential pandemic. |
T18 |
127-340 |
Sentence |
denotes |
These pneumonia cases were eventually characterized to be caused by a novel coronavirus (2019-nCoV) 1, of which Severe Acute Respiratory Syndrome (SARS) 2 and Middle East Respiratory Syndrome (MERS) 3 are members. |
T19 |
341-436 |
Sentence |
denotes |
SARS and MERS famously caused their own outbreak concerns when they were originally identified. |
T20 |
437-546 |
Sentence |
denotes |
SARS caused significant economic damage to Hong Kong and Southern China, before spreading to other countries. |
T21 |
547-665 |
Sentence |
denotes |
Ultimately, SARS infected up to 8,098 people and caused 774 deaths according to the World Health Organization (WHO) 4. |
T22 |
666-771 |
Sentence |
denotes |
The novel coronavirus, 2019-nCoV, is now quickly spreading across the world after originating in Wuhan 1. |
T23 |
772-974 |
Sentence |
denotes |
Human-to-human transmission of 2019-nCoV has been confirmed in familial case cluster reports 5, as additional cases continue to be identified in different cities in China and countries around the world. |
T24 |
975-1116 |
Sentence |
denotes |
Clinical symptoms of 2019-nCoV infection include fever, cough, and myalgia or fatigue with pneumonia demonstrated on chest CT scan imaging 6. |
T25 |
1117-1425 |
Sentence |
denotes |
Within China, the city of Wuhan along with several others has been shut down, with individuals not allowed to leave the city in an effort to contain the virus; such efforts are largely unprecedented in a city of this size ( https://www.nytimes.com/2020/01/22/world/asia/coronavirus-quarantines-history.html). |
T26 |
1426-1574 |
Sentence |
denotes |
For now, many travelers are being screened for fever (≥38°C) and reported recent history of travel to Wuhan in order to triage diagnostic testing 7. |
T27 |
1575-1692 |
Sentence |
denotes |
These efforts resemble not only what happened with SARS in 2002–2003, but also the Ebola virus outbreak in 2014–2015. |
T28 |
1693-1832 |
Sentence |
denotes |
During those outbreaks, special protocols were put in place to quarantine any infected individuals and identify patient contacts at risk 8. |
T29 |
1833-1989 |
Sentence |
denotes |
Healthcare workers were also at risk, and despite extensive personal protective equipment measures, clinical providers did get infected in both outbreaks 9. |
T30 |
1990-2196 |
Sentence |
denotes |
There were no specific, antiviral treatments for SARS or Ebola at the time of the outbreaks beyond supportive measures 10, 11, which is a similar situation that healthcare systems are facing with 2019-nCoV. |
T31 |
2197-2331 |
Sentence |
denotes |
The dire situations facing patients in outbreak scenarios demand quick responses by the healthcare community and the biotech industry. |
T32 |
2332-2541 |
Sentence |
denotes |
Unfortunately, many of the traditional options that guide drug development are inadequate for outbreaks; a process that takes years can’t help patients who are dying today, and economies that are being halted. |
T33 |
2542-2658 |
Sentence |
denotes |
In these situations, studies have often been conducted on compassionate use, and clinical trial approvals expedited. |
T34 |
2659-2778 |
Sentence |
denotes |
This was most recently seen in the 2014–2015 Ebola outbreak, where a variety of clinical trial candidates were studied. |
T35 |
2779-2894 |
Sentence |
denotes |
Many of these therapies failed, but ultimately a vaccine did emerge that was fully protective against the virus 12. |
T36 |
2895-3128 |
Sentence |
denotes |
It is important to note that, unlike the current situation with 2019-nCoV, Ebola had already been studied for years and this particular neutralizing vaccine made and tested in preclinical animal models years prior to the outbreak 13. |
T37 |
3129-3418 |
Sentence |
denotes |
For 2019-nCoV, beyond knowing the sequence of spike (S) protein of the coronavirus (GenBank: MN908947.3), there are no studies on how immunogenic this particular protein will be beyond surrogate comparisons to SARS and MERS, which limits the potential ability to quickly produce a vaccine. |
T38 |
3419-3707 |
Sentence |
denotes |
Moreover, while a vaccine would be greatly effective in helping to stop the spread of 2019-nCoV, an effective therapy is also needed for the patients infected with 2019-nCoV today, similar to the situation of Ebola patients needing effective therapies while vaccines were being developed. |
T39 |
3708-3989 |
Sentence |
denotes |
In this article, I will outline different potential treatment options that could be pursued as a therapy for 2019-nCoV virus, keeping the focus on agents that could be rapidly tested in patients today and broadly effective in spite of limited knowledge of the biology of 2019-nCoV. |
T40 |
3990-4122 |
Sentence |
denotes |
Simply stated, there is limited time for basic studies of 2019-nCoV in research labs, while patients need effective therapies today. |
T41 |
4123-4280 |
Sentence |
denotes |
I finally propose the best potential treatment option in my opinion, along with instructions on how to manufacture the therapy for testing in patients today. |