Id |
Subject |
Object |
Predicate |
Lexical cue |
T20 |
0-12 |
Sentence |
denotes |
Introduction |
T21 |
13-134 |
Sentence |
denotes |
In December 2019, authorities in Wuhan, China reported a cluster of pneumonia cases caused by an unknown etiologic agent. |
T22 |
135-331 |
Sentence |
denotes |
The pathogen was soon identified and sequenced as a novel coronavirus related to the agent of severe acute respiratory syndrome (SARS) and was subsequently termed SARS Coronavirus-19 (SARS-CoV-2). |
T23 |
332-459 |
Sentence |
denotes |
The infection spread in the subsequent 3 months on all continents and was declared a pandemic by the World Health Organization. |
T24 |
460-626 |
Sentence |
denotes |
As of April 2, 2020, 961,818 documented cases were reported worldwide, and 49,165 patients had died (https://www.who.int/emergencies/diseases/novel-coronavirus-2019). |
T25 |
627-721 |
Sentence |
denotes |
This novel coronavirus has a tropism for the lung, causing community-acquired pneumonia (CAP). |
T26 |
722-865 |
Sentence |
denotes |
Some patients with pneumonia suddenly deteriorate into severe respiratory failure (SRF) and require intubation and mechanical ventilation (MV). |
T27 |
866-950 |
Sentence |
denotes |
The risk of death of these patients is high, reaching even 60% (Arabi et al., 2020). |
T28 |
951-1023 |
Sentence |
denotes |
Proper management mandates better understanding of disease pathogenesis. |
T29 |
1024-1178 |
Sentence |
denotes |
The majority of physicians use sepsis as a prototype of critical illness for the understanding of severe coronavirus disease 2019 (COVID-19) pathogenesis. |
T30 |
1179-1295 |
Sentence |
denotes |
This is mostly because severe COVID-19 is associated with hyper-cytokinemia (Guan et al., 2020, Huang et al., 2020). |
T31 |
1296-1391 |
Sentence |
denotes |
Lethal sepsis is commonly arising from bacterial CAP, often leading to SRF and the need for MV. |
T32 |
1392-1678 |
Sentence |
denotes |
The peculiar clinical course of CAP caused by SARS-CoV-2, including the sudden deterioration of the clinical condition 7–8 days after the first symptoms, generates the hypothesis that this illness is driven by a unique pattern of immune dysfunction that is likely different from sepsis. |
T33 |
1679-1846 |
Sentence |
denotes |
The features of lymphopenia with hepatic dysfunction and increase of D-dimers (Qin et al., 2020) in these patients with severe disease further support this hypothesis. |
T34 |
1847-2256 |
Sentence |
denotes |
Immune responses of critically ill patients with sepsis can be classified into three patterns: macrophage-activation syndrome (MAS) (Kyriazopoulou et al., 2017), sepsis-induced immunoparalysis characterized by low expression of the human leukocyte antigen D related (HLA-DR) on CD14 monocytes (Lukaszewicz et al., 2009), and an intermediate functional state of the immune system lacking obvious dysregulation. |
T35 |
2257-2355 |
Sentence |
denotes |
We investigated whether this classification might apply to patients with SRF caused by SARS-CoV-2. |
T36 |
2356-2662 |
Sentence |
denotes |
Results revealed that approximately one fourth of patients with SRF have MAS and that most patients suffer from immune dysregulation dominated by low expression of HLA-DR on CD14 monocytes, which is triggered by monocyte hyperactivation, excessive release of interleukin-6 (IL-6), and profound lymphopenia. |
T37 |
2663-2792 |
Sentence |
denotes |
This pattern is distinct from the immunoparalysis state reported in either bacterial sepsis or SRF caused by 2009 H1N1 influenza. |