LitCovid-sentences  

PMC:7152526 / 9949-16949 JSONTXT 13 Projects

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Id Subject Object Predicate Lexical cue
T90 0-10 Sentence denotes DISCUSSION
T91 11-797 Sentence denotes The study of the therapeutic benefits of plasma transfusion of a cured person from infectious diseases began in the 20th century.2 As new antibiotics, antiviral agents, and vaccines are developed, administration of convalescent plasma is not a common treatment, but it can be still an important treatment in the absence of specific treatment of new infectious diseases.3 Over the decades, convalescent plasma has proved its effectiveness as a potential treatment in patients with MERS-CoV,4 H1N15 and H5N1 avian flu,5 and SARS-CoV.6 A systemic review and meta-analysis to evaluate the clinical effects of convalescent plasma shows a statistically significant reduction of mortality.1 In this context, convalescent plasma can be a promising treatment option for severe COVID-19 patients.
T92 798-1033 Sentence denotes As can be seen in the two cases, both received lopinavir/ritonavir and hydroxychloroquine but showed persistent fever, rapidly aggravated hypoxemia and progressive bilateral infiltrations in accordance with the criteria of severe ARDS.
T93 1034-1180 Sentence denotes After convalescent plasma infusion, the patients showed improved oxygenation and chest X-rays with decreased inflammatory markers and viral loads.
T94 1181-1283 Sentence denotes Intravenous methylprednisolone was started just before the convalescent plasma infusion in both cases.
T95 1284-1357 Sentence denotes We did not use corticosteroids from the beginning as a routine treatment.
T96 1358-1659 Sentence denotes Current guidelines recommend that systemic corticosteroids should not be given routinely for the treatment of COVID-19 due to the lack of evidence of its clinical efficacy on mortality reduction.78 However, we decided to start corticosteroids when the patients' condition rapidly deteriorated to ARDS.
T97 1660-1779 Sentence denotes Methylprednisolone was administered one day and two days before the plasma infusion in case 1 and case 2, respectively.
T98 1780-1941 Sentence denotes Serial laboratory and oxygenation parameters showed rapid improvement right after the corticosteroid administration even before the convalescent plasma infusion.
T99 1942-2642 Sentence denotes ARDS is partly caused by cytokine storm and host immune responses.7 Autopsy of patients dying from COVID-19 shows diffuse alveolar damage with exudate and inflammation very similar to those seen in SARS and MERS-CoV infections.9 Theoretically, systemic corticosteroids may have a role to dampen excessive lung damage due to inflammatory responses.10 The recent article about risk factors associated with ARDS and death among COVID-19 patients showed that treatment with methylprednisolone might be beneficial to reduce the risk of death for patients developing ARDS.11 However, corticosteroids are also thought to inhibit proper immune responses and viral clearance and delay antibody production.1213
T100 2643-2756 Sentence denotes Convalescent plasma infusion might play a role in the coexistence of benefits and concerns of corticosteroid use.
T101 2757-3054 Sentence denotes Antibodies contained in the convalescent plasma will suppress viruses.14 In an animal study, passively transferred antibodies can provide total protection as well as the maintenance of high levels of antibody titer until the host's immune responses could be increased to clear the viral infection.
T102 3055-3233 Sentence denotes Besides, in vivo studies showed that the effects of neutralizing antibodies were not only limited to viral clearance, but also included acceleration of infected cell clearance.15
T103 3234-3406 Sentence denotes In our cases, the viral load estimated by Ct values showed an increasing trend just before plasma infusion but began to decrease right after the use of convalescent plasma.
T104 3407-3642 Sentence denotes Although improvement of inflammatory marker and oxygenation could be contributed to the combined use of corticosteroid, decreased viral load of SARS-CoV-2 might mean the effectiveness of convalescent plasma in the treatment of COVID-2.
T105 3643-3767 Sentence denotes Convalescent plasma was administered after 22 days from the onset of symptoms in Case 1, and 7 days in Case 2, respectively.
T106 3768-3981 Sentence denotes Because these are not in the early phase of the disease, it is difficult to determine clearly that the decrease in the viral load shown in both cases is due to convalescent plasma or natural pathology of COVID-19.
T107 3982-4439 Sentence denotes Other studies about viral kinetics of COVID-19 show naturally reducing viral titers after 7–10 days from onset in most patients.1617 However, Liu and colleagues reported that severe patients requiring intensive care unit admission due to COVID-19 had high viral load for a longer period than in mild patients.16 Both our cases presented severe ARDS and the viral loads were in increasing trend at the time of plasma infusion regardless of the date of onset.
T108 4440-4567 Sentence denotes In Case 2, the patient showed lymphopenia from day 1, and it persisted even after clinical improvement with corticosteroid use.
T109 4568-4750 Sentence denotes When the convalescent plasma was administered on day 6, lymphocyte count immediately rose to normal level (from 0.52 × 103/µL to 1.21 × 103/µL) and then remained in the normal range.
T110 4751-5248 Sentence denotes Patients with severe COVID-19 pneumonia and ARDS also presented with lymphopenia in other studies.11 Some authors hypothesized that continuous and gradual increases in lymphocyte count might be required for immunity against SARS-CoV-2 infection.11 In SARS patients, lymphopenia existed at the onset of illness and persisted until the recovery period.1819 These findings were consistent with the recovery of lymphocyte count with clinical improvement of Case 2 after the use of convalescent plasma.
T111 5249-5327 Sentence denotes We could not assess neutralizing antibody titers from the convalescent plasma.
T112 5328-5601 Sentence denotes Plasma with high neutralizing antibody titers is likely to be available from the patients in the convalescent phase recovered from severe infection.20 To use plasma for treatment, a neutralization test is suggested as the optimal assay for assessing proper donor or plasma.
T113 5602-5921 Sentence denotes However, some studies showed that ELISA IgG correlates well with neutralization titers in MERS cases so that it might be a suitable screening test for plasma donation.2021 In our cases, donors presented bilateral pneumonia in the course of COVID-19 and both showed positive results in the ELISA IgG test for SARS-CoV-2.
T114 5922-5985 Sentence denotes There are still limitations for the use of convalescent plasma.
T115 5986-6122 Sentence denotes Scientific evidence is insufficient due to the lack of large-scale clinical trials that may be representative of the target populations.
T116 6123-6206 Sentence denotes Second, the number of antibodies administered to each patient was not standardized.
T117 6207-6415 Sentence denotes Finally, convalescent plasma usually proceeds with other treatments, such as antiviral agents and steroids, which can affect the relationship between convalescent plasma and antibody, confounding the results.
T118 6416-6632 Sentence denotes Despite the limitations, our cases suggest that convalescent plasma from patients who have recovered from COVID-19 infection might be an additional option to treat patients without causing any severe adverse effects.
T119 6633-6863 Sentence denotes Also, when used with systemic corticosteroids, we might expect the possibility of reducing excessive inflammatory response by corticosteroids as well as promoting the reduction of viral loads by convalescent plasma simultaneously.
T120 6864-7000 Sentence denotes Further well-designed studies are needed to demonstrate the efficacy and safety of convalescent plasma transfusion in COVID-19 patients.