LitCovid-sentences  

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Id Subject Object Predicate Lexical cue
T3 0-256 Sentence denotes A novel coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has scourged the world since its outbreak in December 2019 at Wuhan, China resulting in the World Health Organization declaring it as a pandemic.
T4 257-447 Sentence denotes As of March 22, 2020, COVID-19 has affected over 292,000 people in at least 185 countries worldwide with most of the cases being reported from China, Europe and the United States of America.
T5 448-583 Sentence denotes The absolute number of deaths has already surpassed 12,750 globally and is expected to increase further as the disease spreads rapidly.
T6 584-657 Sentence denotes The disease has also infiltrated the Indian masses and is spreading fast.
T7 658-843 Sentence denotes India being a developing nation with more than 1.3 billion people, failure to contain the virus can lead to disastrous consequences with death toll perhaps surpassing all other nations.
T8 844-1012 Sentence denotes Although the overall mortality rate of COVID-19 is low (1.4–2.3%), patients with comorbidities are more likely to have severe disease and subsequent mortality [1], [2].
T9 1013-1225 Sentence denotes Most of the available studies have shown that diabetes mellitus (DM) as a distinctive comorbidity is associated with more severe disease, acute respiratory distress syndrome and increased mortality [1], [3], [4].
T10 1226-1364 Sentence denotes Amongst the 32 non-survivors from a group of 52 intensive care unit (ICU) patients, DM (22%) was a predominant underlying comorbidity [3].
T11 1365-1588 Sentence denotes Of the 1099 confirmed COVID-19 patients reported by Guan et al. from China, 173 had severe disease; patients with severe disease had a higher prevalence of DM (16.2%) as compared to those with non-severe disease (5.7%) [1].
T12 1589-1798 Sentence denotes Further, in the largest series reported by the Chinese Center for Disease Control and Prevention comprising of 72,314 cases of COVID-19, patients with DM had higher mortality (7.3% in DM vs. 2.3% overall) [2].
T13 1799-2052 Sentence denotes It can be assumed that patients with DM are more likely to be older than those without DM and advancing age has consistently been shown to be associated with poor prognosis in COVID-19, however, most of the aforementioned studies did not adjust for age.
T14 2053-2334 Sentence denotes Nevertheless, diabetes has been uniformly reported to be associated with poor prognosis in other viral infections, notably seasonal influenza, pandemic influenza A H1N1 (2009), Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS) [5], [6], [7], [8].
T15 2335-2452 Sentence denotes Multiple explanations can be put forward for this apparent association between pre-existing DM and COVID-19 severity.
T16 2453-2653 Sentence denotes Innate immunity, the first line of defense against SARS-CoV-2, is inevitably compromised in patients with uncontrolled DM thereby allowing unhindered proliferation of the pathogen within the host [9].
T17 2654-2749 Sentence denotes Even short-term hyperglycemia has been shown to transiently stun the innate immune system [10].
T18 2750-3102 Sentence denotes Moreover, DM is characterized by exaggerated pro-inflammatory cytokine response, notably interleukin (IL)-1, IL-6 and tumor-necrosis factor (TNF)-α, in the absence of appropriate immunostimulation; this may be further exaggerated in response to a stimulus as seen in patients with COVID-19 complicated by acute respiratory distress syndrome (ARDS) [9].
T19 3103-3210 Sentence denotes The role of angiotensin-converting enzyme 2 (ACE2) in the association between DM and COVID-19 is plausible.
T20 3211-3366 Sentence denotes ACE2 is a type 1 integral membrane glycoprotein that is constitutively expressed by the epithelial cells of the lungs, kidney, intestine and blood vessels.
T21 3367-3539 Sentence denotes In normal physiology, ACE2 breaks down angiotensin-II and to a lesser extent, angiotensin-I to smaller peptides, angiotensin (1–7) and angiotensin (1–9), respectively [11].
T22 3540-3752 Sentence denotes ACE2/Ang (1–7) system plays an important anti-inflammatory and anti-oxidant role protecting the lung against ARDS; indeed ACE2 has been shown to be protective against lethal avian influenza A H5N1 infection [12].
T23 3753-3934 Sentence denotes ACE2 expression is reduced in patients with DM possibly due to glycosylation; this might explain the increased predisposition to severe lung injury and ARDS with COVID-19 [4], [11].
T24 3935-4026 Sentence denotes Strange it might sound, even overexpression of ACE2 would be counterproductive in COVID-19.
T25 4027-4107 Sentence denotes SARS-CoV-2 utilizes ACE2 as a receptor for entry into the host pneumocytes [13].
T26 4108-4245 Sentence denotes Herein comes the confounding role of ACE inhibitors (ACEi) and angiotensin-receptor blockers (ARBs), drugs that are so widely used in DM.
T27 4246-4424 Sentence denotes The expression of ACE2 is markedly increased in patients with DM (and hypertension) on ACEi or ARBs as an adaptive response to counteract the elevated levels of Ang-II and Ang-I.
T28 4425-4587 Sentence denotes Thus, use of ACE2-stimulating drugs would facilitate the entry of SARS-CoV-2 into pneumocytes and consequently might result in more severe and fatal disease [14].
T29 4588-4723 Sentence denotes Amongst others, pioglitazone and liraglutide have also been shown to be associated with ACE2 upregulation in animal studies [14], [15].
T30 4724-4806 Sentence denotes Unfortunately, none of the studies have taken into account the baseline treatment.
T31 4807-4990 Sentence denotes Furthermore, a recently concluded study showed that severe and critically ill patients with COVID-19 had a higher prevalence of hypokalemia that resulted from renal potassium wasting.
T32 4991-5199 Sentence denotes This can be explained by downregulation of ACE2 following viral intrusion resulting in decreased degradation of angiotensin-II, increased aldosterone secretion and subsequent increased urinary potassium loss.
T33 5200-5317 Sentence denotes Infact early normalization of serum potassium has been proposed to be a predictor of good prognosis in COVID-19 [16].
T34 5318-5480 Sentence denotes Thus, ACE2 overexpression, while facilitating entry of SARS-CoV-2, is unable to protect against lung injury as the enzyme gets degraded by the virus (see Fig. 1).
T35 5481-5560 Sentence denotes Fig. 1 Schematic diagram depicting interplay between SARS-CoV-2 and pneumocyte.
T36 5561-5663 Sentence denotes SARS-CoV-2 gains entry into the pneumocyte using angiotensin-converting enzyme 2 (ACE2) as a receptor.
T37 5664-5791 Sentence denotes ACE2 is upregulated with the prior use of angiotensin-converting enzyme inhibitors (ACEi)/angiotensin-receptor blockers (ARBs).
T38 5792-5878 Sentence denotes Following entry into the pneumocyte, the virus replicates and ACE2 gets downregulated.
T39 5879-6036 Sentence denotes As a result, there is reduced degradation of angiotensin-II which in turn leads to increased secretion of aldosterone and subsequent renal potassium wasting.
T40 6037-6166 Sentence denotes Whatever may be the underlying etiology, people with DM are definitely at an increased risk of severe and fatal COVID-19 disease.
T41 6167-6299 Sentence denotes The prevalence of DM in India is 7.3% [17], thereby predisposing a large section of the community to COVID-19 and its complications.
T42 6300-6426 Sentence denotes Hence it is advisable that community-dwelling residents having underlying DM take extra precautions not to contract the virus.
T43 6427-6507 Sentence denotes Social distancing, strict hand and respiratory hygiene are the need of the hour.
T44 6508-6621 Sentence denotes People with DM should ensure good glucose control as improvement in glycemia does boost host immune response [9].
T45 6622-6787 Sentence denotes Although not recommended due to lack of robust data, use of ACEi/ARBs/thiazolidinediones/liraglutide merits reconsideration in patients with DM during this outbreak.
T46 6789-6822 Sentence denotes Declaration of competing interest
T47 6823-6993 Sentence denotes The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.