Id |
Subject |
Object |
Predicate |
Lexical cue |
T19 |
0-7 |
Sentence |
denotes |
2 Case |
T20 |
8-88 |
Sentence |
denotes |
Here we report a 70-year-old male who was diagnosed with COVID-19 in March 2020. |
T21 |
89-455 |
Sentence |
denotes |
Underlying diseases included chronic obstructive pulmonary disease (COPD) GOLD grade 2, obstructive sleep apnea syndrome, insulin-dependent type 2 diabetes with end-organ damage [retinopathy, nephropathy (CKD 3b according to the KDIGO classification at first presentation), polyneuropathy], arterial hypertension, coronary heart disease and obesity (body mass index: |
T22 |
456-466 |
Sentence |
denotes |
38 kg/m2). |
T23 |
467-561 |
Sentence |
denotes |
Past medical history included proximal deep vein thrombosis four months prior to presentation. |
T24 |
562-825 |
Sentence |
denotes |
His medication consisted of a long-acting beta agonist/long-acting muscarinic antagonist combination, inhaled glucocorticoid (400 μg budesonide per day), valsartan, spironolactone, ivabradine, atorvastatin, metformin, liraglutide, insulin glargine and enoxaparin. |
T25 |
826-936 |
Sentence |
denotes |
The patient presented with productive cough, dyspnea and intermittent fever (>38.5 °C) for one week (Fig. 1 ). |
T26 |
937-990 |
Sentence |
denotes |
Arterial pO2 was 67 mmHg while breathing ambient air. |
T27 |
991-1134 |
Sentence |
denotes |
White blood cell count was within the normal limits and C-reactive protein (CRP) was slightly elevated (33 mg/dl; upper limit of norm 5 mg/dl). |
T28 |
1135-1171 |
Sentence |
denotes |
D-dimer was within the normal range. |
T29 |
1172-1253 |
Sentence |
denotes |
Chest X-ray revealed bilateral basal coarse reticular opacities (Fig. 2 a and b). |
T30 |
1254-1348 |
Sentence |
denotes |
Real-time polymerase chain reaction (PCR) from oropharyngeal swab was positive for SARS-CoV-2. |
T31 |
1349-1478 |
Sentence |
denotes |
However, the patient refused to be hospitalized due to personal reasons and was discharged home with oral doxycycline 200 mg q.d. |
T32 |
1479-1643 |
Sentence |
denotes |
One week later, the patient returned to the emergency department because of clinical deterioration and hypoxemia (arterial pO2 46 mmHg while breathing ambient air). |
T33 |
1644-1766 |
Sentence |
denotes |
Chest CT-scan was performed and showed multiple bilateral ground-glass opacities with a crazy paving appearance (Fig. 2c). |
T34 |
1767-1825 |
Sentence |
denotes |
In addition, a reversed halo sign was described (Fig. 2d). |
T35 |
1826-2015 |
Sentence |
denotes |
White blood-cell count was slightly elevated (11.65 × 10^9 per L), neutrophils were elevated (9.7 × 10^9 per L), CRP level was 144 mg/dl, interleukin-6 was 396 pg/ml and ferritin 465 ng/ml. |
T36 |
2016-2095 |
Sentence |
denotes |
Creatinine levels increased from 1.85 mg/dl (first presentation) to 3.26 mg/dl. |
T37 |
2096-2137 |
Sentence |
denotes |
Lymphocytes were within the normal range. |
T38 |
2138-2313 |
Sentence |
denotes |
The patient was admitted to ICU with moderate ARDS (oxygenation index 154) and received meropenem 1 g b.i.d., azithromycin 500mg once q.d., and hydroxychloroquine 200mg b.i.d. |
T39 |
2314-2359 |
Sentence |
denotes |
He was intubated and mechanically ventilated. |
T40 |
2360-2530 |
Sentence |
denotes |
Chest X-ray revealed a progression of the bilateral infiltrates on day 2 after ICU admission concordant with significant pulmonary deterioration (oxygenation index <100). |
T41 |
2531-2622 |
Sentence |
denotes |
On day 3 of ICU stay (day 14 after onset of symptoms) endotracheal aspiration was obtained. |
T42 |
2623-2743 |
Sentence |
denotes |
Culture grew Aspergillus fumigatus (voriconazole minimal inhibitory concentration 0.125 mg/L), without bacterial growth. |
T43 |
2744-2979 |
Sentence |
denotes |
Aspergillus lateral-flow device (LFD) [3], detecting an Aspergillus specific antigen secreted during active growth of Aspergillus and not during colonization, was performed from the endotracheal aspirate and revealed a positive result. |
T44 |
2980-3074 |
Sentence |
denotes |
Due to low sample volume, galactomannan could not be performed from this respiratory specimen. |
T45 |
3075-3152 |
Sentence |
denotes |
Serum fungal biomarkers (galactomannan and 1,3-ß-D-glucan) remained negative. |
T46 |
3153-3538 |
Sentence |
denotes |
Based on progression of pulmonary infiltrates, recovery of Aspergillus fumigatus in endotracheal aspirate, positive LFD in endotracheal aspirate and the clinical deterioration the patient was diagnosed with putative invasive pulmonary aspergillosis according to Blot et al. [4] and intravenous voriconazole (6 mg/kg b.i.d followed by 4 mg/kg b.i.d.) was initiated on day 4 of ICU stay. |
T47 |
3539-3689 |
Sentence |
denotes |
Despite treatment of ICU and addition of voriconazole, the patient deceases 3 days after initiation of antifungal treatment due to multiorgan failure. |
T48 |
3690-3716 |
Sentence |
denotes |
Autopsy was not performed. |
T49 |
3717-3792 |
Sentence |
denotes |
Fig. 1 Timeline representing the course of COVID-19 in the reported patient |
T50 |
3793-4074 |
Sentence |
denotes |
Abbreviations: q.d. = once daily; b.i.d. = twice daily, i.v. = intravenous; LFD = lateral-flow device; ER = emergency room; ARDS = acute respiratory distress syndrome; ICU = intensive care unit; SARS-CoV-2 = Severe acute respiratory syndrome coronavirus 2, CT = computed tomography |
T51 |
4075-4097 |
Sentence |
denotes |
* Voriconazole dosage: |
T52 |
4098-4160 |
Sentence |
denotes |
6 mg/kg twice daily on day 1, followed by 4 mg/kg twice daily. |
T53 |
4161-4235 |
Sentence |
denotes |
Chest imagings displayed here are also displayed in more detail in Fig. 2. |
T54 |
4236-4330 |
Sentence |
denotes |
Fig. 2 Fig. 2a and b representing findings on chest X-ray performed on day 6 of symptom onset. |
T55 |
4331-4439 |
Sentence |
denotes |
The lateral chest view revealed bilateral dorsal and basal coarse reticular opacities, no pleural effusions. |
T56 |
4440-4509 |
Sentence |
denotes |
Fig. 2c and d representing chest CT scans on day 12 of symptom onset. |
T57 |
4510-4794 |
Sentence |
denotes |
Axial CT image of the chest demonstrate extensive-ground glass opacities with bilateral and multi-lobar distribution (2c) and a combination of consolidation and surrounding ground-glass opacities basal in the posterior left lower lung (“reversed halo sign” - shown by the arrow) (2d). |