LitCovid-sentences  

PMC:7068164 / 576-16443 JSONTXT 14 Projects

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Id Subject Object Predicate Lexical cue
T10 0-94 Sentence denotes A cluster of pneumonia of unknown origin was identified in Wuhan, China, in December 2019 [1].
T11 95-285 Sentence denotes On 12 January 2020, Chinese authorities shared the sequence of a novel coronavirus termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) isolated from some clustered cases [2].
T12 286-382 Sentence denotes Since then, the disease caused by SARS-CoV-2 has been named coronavirus disease 2019 (COVID-19).
T13 383-559 Sentence denotes As at 21 February 2020, the virus had spread rapidly mostly within China but also to 28 other countries, including in the World Health Organization (WHO) European Region [3-5].
T14 560-717 Sentence denotes Here we describe the epidemiology of the first cases of COVID-19 in this region, excluding cases reported in the United Kingdom (UK), as at 21 February 2020.
T15 718-877 Sentence denotes The study includes a comparison between cases detected among travellers from China and cases whose infection was acquired due to subsequent local transmission.
T16 879-918 Sentence denotes Surveillance in the WHO European Region
T17 919-1178 Sentence denotes On 27 January 2020, the European Centre for Disease Prevention and Control (ECDC) and the WHO Regional Office for Europe asked countries to complete a WHO standard COVID-19 case report form for all confirmed and probable cases according to WHO criteria [6-8].
T18 1179-1405 Sentence denotes The overall aim of surveillance at this time was to support the global strategy of containment of COVID-19 with rapid identification and follow-up of cases linked to affected countries in order to minimise onward transmission.
T19 1406-1622 Sentence denotes The surveillance objectives were to: describe the key epidemiological and clinical characteristics of COVID-19 cases detected in Europe; inform country preparedness; and improve further case detection and management.
T20 1623-1900 Sentence denotes Data collected included demographics, history of recent travel to affected areas, close contact with a probable or confirmed COVID-19 case, underlying conditions, signs and symptoms of disease at onset, type of specimens from which the virus was detected, and clinical outcome.
T21 1901-2278 Sentence denotes The WHO case definition was adopted for surveillance: a confirmed case was a person with laboratory confirmation of SARS-CoV-2 infection (ECDC recommended two separate SARS-CoV-2 RT-PCR tests), irrespective of clinical signs and symptoms, whereas a probable case was a suspect case for whom testing for SARS-CoV-2 was inconclusive or positive using a pan-coronavirus assay [8].
T22 2279-2634 Sentence denotes By 31 January 2020, 47 laboratories in 31 countries, including 38 laboratories in 24 European Union and European Economic Area (EU/EEA) countries, had diagnostic capability for SARS-CoV-2 available (close to 60% of countries in the WHO European Region), with cross-border shipment arrangements in place for many of those lacking domestic testing capacity.
T23 2635-2741 Sentence denotes The remaining six EU/EEA countries were expected to have diagnostic testing available by mid-February [9].
T24 2743-2793 Sentence denotes Epidemiology of first cases in the European Region
T25 2794-2935 Sentence denotes As at 09:00 on 21 February 2020, 47 confirmed cases of COVID-19 were reported in the WHO European Region and one of these cases had died [4].
T26 2936-3038 Sentence denotes Data on 38 of these cases (i.e. all except the nine reported in the UK) are included in this analysis.
T27 3039-3182 Sentence denotes The first three cases detected were reported in France on 24 January 2020 and had onset of symptoms on 17, 19 and 23 January respectively [10].
T28 3183-3237 Sentence denotes The first death was reported on 15 February in France.
T29 3238-3300 Sentence denotes As at 21 February, nine countries had reported cases (Figure):
T30 3301-3437 Sentence denotes Belgium (1), Finland (1), France (12), Germany (16), Italy (3), Russia (2), Spain (2), Sweden (1) and the UK (9 – not included further).
T31 3438-3594 Sentence denotes Figure Epidemic curve of reported COVID-19 cases by date of symptom onset, or date of notification, WHO European Region, as at 21 February 2020 (n = 38)a,b
T32 3595-3635 Sentence denotes COVID-19: coronavirus disease 2019; WHO:
T33 3636-3662 Sentence denotes World Health Organization.
T34 3663-3755 Sentence denotes a Four cases were reported by Germany with unknown date of onset and unknown symptomatology.
T35 3756-3811 Sentence denotes Belgium and France reported one asymptomatic case each.
T36 3812-3878 Sentence denotes These cases are displayed according to their date of notification.
T37 3879-3951 Sentence denotes b The figure does not include nine cases reported in the United Kingdom.
T38 3952-4259 Sentence denotes The place of infection (assessed at national level based on an incubation period presumed to be up to 14 days [11], travel history and contact with probable or confirmed cases as per the case definition) was reported for 35 cases (missing for three cases), of whom 14 were infected in China (Hubei province:
T39 4260-4338 Sentence denotes 10 cases; Shandong province: one case; province not reported for three cases).
T40 4339-4386 Sentence denotes The remaining 21 cases were infected in Europe.
T41 4387-4501 Sentence denotes Of these, 14 were linked to a cluster in Bavaria, Germany, and seven to a cluster in Haute-Savoie, France [12,13].
T42 4502-4652 Sentence denotes Cases from the Bavarian cluster were reported from Germany and Spain, whereas cases from the Haute-Savoie cluster were reported from France and Spain.
T43 4653-4829 Sentence denotes Cases linked to the Haute Savoie cluster were also detected in the UK, including the index case of this cluster, who was infected in Singapore before travelling to France [14].
T44 4830-4915 Sentence denotes The index cases for the cluster in Bavaria was reported to be infected in China [15].
T45 4916-4967 Sentence denotes The median age of the 38 cases was 42 years (range:
T46 4968-5005 Sentence denotes 2–81 years) and 25 were male (Table).
T47 5006-5246 Sentence denotes The proportion of male cases was higher among cases acquired in Europe (14 males of 21 cases) compared with those acquired in China (8 males of 14 cases) although the difference was not statistically significant (chi-squared test: p = 0.6).
T48 5247-5299 Sentence denotes There was no difference in median age by sex (males:
T49 5300-5318 Sentence denotes 45 years; females:
T50 5319-5434 Sentence denotes 38 years, k-sample median test, p = 1.0) or by whether infection was acquired in Europe or not (acquired in Europe:
T51 5435-5463 Sentence denotes 47 years; acquired in China:
T52 5464-5483 Sentence denotes 38 years, p = 0.2).
T53 5484-5589 Sentence denotes Table Characteristics of confirmed COVID-19 cases, WHO European Region, as at 21 February 2020 (n = 38)a
T54 5590-5711 Sentence denotes Characteristics Number of cases overall Number of cases infected in Europe Number of cases infected in China p valueb
T55 5712-5730 Sentence denotes Age range in years
T56 5731-5754 Sentence denotes     0–17 4 3 0 0.08
T57 5755-5775 Sentence denotes     18–49 24 13 9
T58 5776-5794 Sentence denotes     50–64 7 5 2
T59 5795-5812 Sentence denotes     ≥ 65 3 0 3
T60 5813-5816 Sentence denotes Sex
T61 5817-5841 Sentence denotes     Male 25 14 8 0.6
T62 5842-5862 Sentence denotes     Female 13 7 6
T63 5863-5875 Sentence denotes Hospitalised
T64 5876-5899 Sentence denotes     Yes 35 21 14 ND
T65 5900-5917 Sentence denotes     No 2 ND ND
T66 5918-5940 Sentence denotes     Unknown 1 ND ND
T67 5941-5988 Sentence denotes Symptomsc (31 cases with available information)
T68 5989-6020 Sentence denotes     Asymptomatic 2 ND ND ND
T69 6021-6042 Sentence denotes     Fever 20 ND ND
T70 6043-6064 Sentence denotes     Cough 14 ND ND
T71 6065-6088 Sentence denotes     Weakness 8 ND ND
T72 6089-6113 Sentence denotes     Headaches 6 ND ND
T73 6114-6140 Sentence denotes     Sore throat 2 ND ND
T74 6141-6167 Sentence denotes     Rhinorrhoea 2 ND ND
T75 6168-6202 Sentence denotes     Shortness of breath 2 ND ND
T76 6203-6271 Sentence denotes Mean days from onset to hospitalisation(29 cases) 3.7 4.6 2.5 ND
T77 6272-6355 Sentence denotes Mean days from onset to first positive laboratory test(16 cases) 5.1 6.5 5.2 ND
T78 6356-6425 Sentence denotes COVID-19: coronavirus disease 2019; ND: not determined or known; WHO:
T79 6426-6452 Sentence denotes World Health Organization.
T80 6453-6524 Sentence denotes a The Table does not include nine cases reported in the United Kingdom.
T81 6525-6637 Sentence denotes b Chi-squared test for difference in distributions between cases infected in Europe and those infected in China.
T82 6638-6687 Sentence denotes c A single case could have more than one symptom.
T83 6688-6738 Sentence denotes Only symptoms reported by two or more cases shown.
T84 6739-6947 Sentence denotes All but two cases were hospitalised (35 of 37 where information on hospitalisation was reported), although it is likely that most were hospitalised to isolate the person rather than because of severe disease.
T85 6948-7092 Sentence denotes The time from onset of symptoms to hospitalisation (and isolation) ranged between 0 and 10 days with a mean of 3.7 days (reported for 29 cases).
T86 7093-7222 Sentence denotes The mean number of days to hospitalisation was 2.5 days for cases imported from China, but 4.6 days for those infected in Europe.
T87 7223-7331 Sentence denotes This was mostly a result of delays in identifying the index cases of the two clusters in France and Germany.
T88 7332-7520 Sentence denotes In the German cluster, for example, the first three cases detected locally were hospitalised in a mean of 5.7 days, whereas the following six took only a mean of 2 days to be hospitalised.
T89 7521-7583 Sentence denotes Symptoms at the point of diagnosis were reported for 31 cases.
T90 7584-7650 Sentence denotes Two cases were asymptomatic and remained so until tested negative.
T91 7651-7770 Sentence denotes The asymptomatic cases were tested as part of screening following repatriation and during contact tracing respectively.
T92 7771-7857 Sentence denotes Of the remaining 29, 20 reported fever, 14 reported cough and eight reported weakness.
T93 7858-8018 Sentence denotes Additional symptoms reported included headaches (6 cases), sore throat (2), rhinorrhoea (2), shortness of breath (2), myalgia (1), diarrhoea (1) and nausea (1).
T94 8019-8073 Sentence denotes Fever was reported as the sole symptom for nine cases.
T95 8074-8319 Sentence denotes In 16 of 29 symptomatic cases, the symptoms at diagnosis were consistent with the case definition for acute respiratory infection [16], although it is possible that cases presented additional symptoms after diagnosis and these were not reported.
T96 8320-8495 Sentence denotes Data on pre-existing conditions were reported for seven cases; five had no pre-existing conditions while one was reported to be obese and one had pre-existing cardiac disease.
T97 8496-8578 Sentence denotes No data on clinical signs e.g. dyspnea etc. were reported for any of the 38 cases.
T98 8579-8735 Sentence denotes All hospitalised cases had a benign clinical evolution except four, two reported in Italy and two reported in France, all of whom developed viral pneumonia.
T99 8736-8873 Sentence denotes All three cases who were aged 65 years or over were admitted to intensive care and required respiratory support and one French case died.
T100 8874-8988 Sentence denotes The case who died was hospitalised for 21 days and required intensive care and mechanical ventilation for 19 days.
T101 8989-9079 Sentence denotes The duration of hospitalisation was reported for 16 cases with a median of 13 days (range:
T102 9080-9091 Sentence denotes 8–23 days).
T103 9092-9151 Sentence denotes As at 21 February 2020, four cases were still hospitalised.
T104 9153-9173 Sentence denotes Laboratory diagnosis
T105 9174-9401 Sentence denotes All cases were confirmed according to specific assays targeting at least two separate genes (envelope (E) gene as a screening test and RNA-dependent RNA polymerase (RdRp) gene or nucleoprotein (N) gene for confirmation) [8,17].
T106 9402-9455 Sentence denotes The specimen types tested were reported for 27 cases:
T107 9456-9679 Sentence denotes 15 had positive nasopharyngeal swabs, nine had positive throat swabs, three cases had positive sputum, two had a positive nasal swab, one case had a positive nasopharyngeal aspirate and one a positive endotracheal aspirate.
T108 9681-9691 Sentence denotes Discussion
T109 9692-9786 Sentence denotes As at 09:00 on 21 February, few COVID-19 cases had been detected in Europe compared with Asia.
T110 9787-9966 Sentence denotes However the situation is rapidly developing, with a large outbreak recently identified in northern Italy, with transmission in several municipalities and at least two deaths [18].
T111 9967-10090 Sentence denotes As at 5 March 2020, there are 4,250 cases including 113 deaths reported among 38 countries in the WHO European region [19].
T112 10091-10316 Sentence denotes In our analysis of early cases, we observed transmission in two broad contexts: sporadic cases among travellers from China (14 cases) and cases who acquired infection due to subsequent local transmission in Europe (21 cases).
T113 10317-10478 Sentence denotes Our analysis shows that the time from symptom onset to hospitalisation/case isolation was about 3 days longer for locally acquired cases than for imported cases.
T114 10479-10758 Sentence denotes People returning from affected areas are likely to have a low threshold to seek care and be tested when symptomatic, however delays in identifying the index cases of the two clusters in France and Germany meant that locally acquired cases took longer to be detected and isolated.
T115 10759-11031 Sentence denotes Once the exposure is determined and contacts identified and quarantined (171 contacts in France and 200 in Germany for the clusters in Haute-Savoie and Bavaria, respectively), further cases are likely to be rapidly detected and isolated when they develop symptoms [15,20].
T116 11032-11215 Sentence denotes In the German cluster, for example, the first three cases detected locally were hospitalised in a mean of 5.7 days, whereas the following six were hospitalised after a mean of 2 days.
T117 11216-11466 Sentence denotes Locally acquired cases require significant resources for contact tracing and quarantine, and countries should be prepared to allocate considerable public health resources during the containment phase, should local clusters emerge in their population.
T118 11467-11767 Sentence denotes In addition, prompt sharing of information on cases and contacts through international notification systems such as the International Health Regulations (IHR) mechanism and the European Commission’s European Early Warning and Response System is essential to contain international spread of infection.
T119 11768-11827 Sentence denotes All of the imported cases had a history of travel to China.
T120 11828-12056 Sentence denotes This was consistent with the epidemiological situation in Asia, and supported the recommendation for testing of suspected cases with travel history to China and potentially other areas of presumed ongoing community transmission.
T121 12057-12287 Sentence denotes The situation has evolved rapidly since then, however, and the number of countries reporting COVID-19 transmission increased rapidly, notably with a large outbreak in northern Italy with 3,089 cases reported as at 5 March [18,19].
T122 12288-12655 Sentence denotes Testing of suspected cases based on geographical risk of importation needs to be complemented with additional approaches to ensure early detection of local circulation of COVID-19, including through testing of severe acute respiratory infections in hospitals irrespectively of travel history as recommended in the WHO case definition updated on 27 February 2020 [21].
T123 12656-12756 Sentence denotes The clinical presentation observed in the cases in Europe is that of an acute respiratory infection.
T124 12757-12905 Sentence denotes However, of the 31 cases with information on symptoms, 20 cases presented with fever and nine cases presented only with fever and no other symptoms.
T125 12906-13099 Sentence denotes These findings, which are consistent with other published case series, have prompted ECDC to include fever among several clinical signs or symptoms indicative for the suspected case definition.
T126 13100-13139 Sentence denotes Three cases were aged 65 years or over.
T127 13140-13216 Sentence denotes All required admission to intensive care and were tourists (imported cases).
T128 13217-13492 Sentence denotes These findings could reflect the average older age of the tourist population compared with the local contacts exposed to infection in Europe and do not allow us to draw any conclusion on the proportion of severe cases that we could expect in the general population of Europe.
T129 13493-13731 Sentence denotes Despite this, the finding of older individuals being at higher risk of a severe clinical course is consistent with the evidence from Chinese case series published so far although the majority of infections in China have been mild [22,23].
T130 13732-13840 Sentence denotes This preliminary analysis is based on the first reported cases of COVID-19 cases in the WHO European Region.
T131 13841-13976 Sentence denotes Given the small sample size, and limited completeness for some variables, all the results presented should be interpreted with caution.
T132 13977-14259 Sentence denotes With increasing numbers of cases in Europe, data from surveillance and investigations in the region can build on the evidence from countries in Asia experiencing more widespread transmission particularly on disease spectrum and the proportion of infections with severe outcome [22].
T133 14260-14387 Sentence denotes Understanding the infection-severity is critical to help plan for the impact on the healthcare system and the wider population.
T134 14388-14477 Sentence denotes Serological studies are vital to understand the proportion of cases who are asymptomatic.
T135 14478-14605 Sentence denotes Hospital-based surveillance could help estimate the incidence of severe cases and identify risk factors for severity and death.
T136 14606-14742 Sentence denotes Established hospital surveillance systems that are in place for influenza and other diseases in Europe may be expanded for this purpose.
T137 14743-14954 Sentence denotes In addition, a number of countries in Europe are adapting and, in some cases, already using existing sentinel primary care based surveillance systems for influenza to detect community transmission of SARS-CoV-2.
T138 14955-15210 Sentence denotes This approach will be used globally to help identify evidence of widespread community transmission and, should the virus spread and containment no longer be deemed feasible, to monitor intensity of disease transmission, trends and its geographical spread.
T139 15211-15477 Sentence denotes Additional research is needed to complement surveillance data to build knowledge on the infectious period, modes of transmission, basic and effective reproduction numbers, and effectiveness of prevention and case management options also in settings outside of China.
T140 15478-15714 Sentence denotes Such special studies are being conducted globally, including a cohort study on citizens repatriated from China to Europe, with the aim to extrapolate disease incidence and risk factors for infection in areas with community transmission.
T141 15715-15867 Sentence denotes Countries together with ECDC and WHO, should use all opportunities to address these questions in a coordinated fashion at the European and global level.