Id |
Subject |
Object |
Predicate |
Lexical cue |
T298 |
0-8 |
Sentence |
denotes |
SARS-CoV |
T299 |
9-284 |
Sentence |
denotes |
Gastrointestinal (GI) involvement in SARS-CoV was common and occurred at different stages of the disease; rarely, patients reported only GI symptoms.68, 69, 70 The most common GI presentation was loss of appetite (up to 55%) and watery diarrhea (up to 76%)69 , 71 (Table 3 ). |
T300 |
285-436 |
Sentence |
denotes |
Patients also complained of nausea, vomiting (14-22.2%) and abdominal pain (3.5-12.6%).72 The association between symptoms and outcomes had been mixed. |
T301 |
437-981 |
Sentence |
denotes |
Leung et al found that patients with diarrhea had a higher likelihood of requiring ICU admission and ventilatory support.68 Others found that GI symptoms at presentation conferred a better prognosis.69 Others found no association between diarrhea and the development of ARDS or the requirement of ventilatory support.70 The mechanism of GI symptoms is unclear, but SARS-CoV particles have been detected in saliva (100%), feces (97%) and mucosal epithelial and lymphoid tissue of affected patients with associated depletion of lymphoid tissue.72 |
T302 |
982-1053 |
Sentence |
denotes |
Table 3 Hepatobiliary manifestation of SARS-CoV, MERS-CoV and COVID-19. |
T303 |
1054-1110 |
Sentence |
denotes |
SARS (only studies with large study population included) |
T304 |
1111-1564 |
Sentence |
denotes |
Study Duan et al (2003)N = 154, confirmed casesRetrospective study Ding et al (2004)N = 8 (4 confirmed cases, 4 control)Clinicopathologic study Chau et al (2004)N = 3, confirmedCase report Zhao et al (2004)N = 169, confirmed casesRetrospective study Yang et al (2005)N = 168, confirmed casesRetrospective study Zhan et al (2006)N = 12 (6 confirmed cases, 6 controls)Clinicopathologic study Yang et al (2010)N = 539 (520 confirmed cases)Prospective study |
T305 |
1565-1713 |
Sentence |
denotes |
Clinical Features Hepatic dysfunction Hepatic dysfunction Hepatic dysfunction Hepatic dysfunction Hepatic dysfunction Diabetes:• 35.9% within 3 days |
T306 |
1714-1736 |
Sentence |
denotes |
• 51.3% within 2 weeks |
T307 |
1737-1791 |
Sentence |
denotes |
Key findings on investigations • ↑ALT &/or AST (37.7%) |
T308 |
1792-1806 |
Sentence |
denotes |
• ↑ALT (70.7%) |
T309 |
1807-1829 |
Sentence |
denotes |
• ↑ALT and AST (22.4%) |
T310 |
1830-1878 |
Sentence |
denotes |
• ALT and AST normalized within 2 weeks in 75.9% |
T311 |
1879-1896 |
Sentence |
denotes |
• ↑T. bili (8.4%) |
T312 |
1897-1913 |
Sentence |
denotes |
• ↑Albumin (24%) |
T313 |
1914-1944 |
Sentence |
denotes |
• ↓ Prealbumin (28.6%) • ↑ ALT |
T314 |
1945-2003 |
Sentence |
denotes |
• + viral RT-PCR in liver, not sera • ↑ ALT (32.76-62.50%) |
T315 |
2004-2026 |
Sentence |
denotes |
• ↑ AST (13.04-40.00%) |
T316 |
2027-2053 |
Sentence |
denotes |
• ↓ Albumin (40.35-72.00%) |
T317 |
2054-2099 |
Sentence |
denotes |
• Total protein remained normal ↑ ALT:• Peak: |
T318 |
2100-2119 |
Sentence |
denotes |
111.32 ± 160.24 U/L |
T319 |
2120-2135 |
Sentence |
denotes |
• At admission: |
T320 |
2136-2142 |
Sentence |
denotes |
52.5%, |
T321 |
2143-2156 |
Sentence |
denotes |
• First week: |
T322 |
2157-2162 |
Sentence |
denotes |
71.8% |
T323 |
2163-2177 |
Sentence |
denotes |
• Second week: |
T324 |
2178-2183 |
Sentence |
denotes |
85.7% |
T325 |
2184-2197 |
Sentence |
denotes |
• Third week: |
T326 |
2198-2203 |
Sentence |
denotes |
85.2% |
T327 |
2204-2231 |
Sentence |
denotes |
• ↓ Albumin ↑ blood glucose |
T328 |
2232-2286 |
Sentence |
denotes |
Histopathology N/A • Virus detected in liver, pancreas |
T329 |
2287-2336 |
Sentence |
denotes |
• Virus not detected in spleen. • Apoptosis (3/3) |
T330 |
2337-2373 |
Sentence |
denotes |
• Accumulated cells in mitosis (2/3) |
T331 |
2374-2398 |
Sentence |
denotes |
• Ballooning hepatocytes |
T332 |
2399-2450 |
Sentence |
denotes |
• Mild to moderate lobular lymphocytic infiltration |
T333 |
2451-2479 |
Sentence |
denotes |
• Ki-67 + nuclei (0.5-11.4%) |
T334 |
2480-2593 |
Sentence |
denotes |
• Virus detected in liver by RT-PCR, but not by EM N/A Nonspecific inflammation Spleen:• Severe white pulp damage |
T335 |
2594-2621 |
Sentence |
denotes |
• Altered cell distribution |
T336 |
2622-2677 |
Sentence |
denotes |
• Markedly reduced or absent CD3+, CD4+, and CD8+ cells |
T337 |
2678-2758 |
Sentence |
denotes |
• CD68+ macrophages most numerous ACE2 receptors found in pancreatic islet cells |
T338 |
2759-2859 |
Sentence |
denotes |
Key study findings and message • AST/ALT elevation rates associated with disease severity (P < 0.05) |
T339 |
2860-3171 |
Sentence |
denotes |
• Possibly beneficial to suppress cytokine storm in early stage Liver may also be target of infection besides lungs Liver damage likely by virus directly Total protein remained normal despite albuminemia • No association found between liver damage, and oxygen saturation or degree of fever or immune dysfunction |
T340 |
3172-3211 |
Sentence |
denotes |
• Liver damage likely by virus directly |
T341 |
3212-3301 |
Sentence |
denotes |
• Hepatotoxic drugs may contribute • Spleen damage most likely due to direct viral attack |
T342 |
3302-3337 |
Sentence |
denotes |
• Steroid medication may contribute |
T343 |
3338-3475 |
Sentence |
denotes |
• Indirect viral mechanism, perhaps vascular, causing spleen injury • Higher mortality in patients with hyperglycemia, ↑ AST (P < 0.0001) |
T344 |
3476-3532 |
Sentence |
denotes |
• Mortality not higher in patients with ↑ ALT (P = 0.35) |
T345 |
3533-3595 |
Sentence |
denotes |
• SARS-CoV may cause acute insulin dependent diabetes mellitus |
T346 |
3596-3650 |
Sentence |
denotes |
• 5% (2/39) still had diabetes 3 years after discharge |
T347 |
3651-3655 |
Sentence |
denotes |
MERS |
T348 |
3656-3836 |
Sentence |
denotes |
Study Saad et al (2014)N = 70, confirmed casesRetrospective Al-Hameed et al (2016)N = 8, confirmed casesProspective study Alsaad et al (2017)N = 1, confirmed casesClinicopathologic |
T349 |
3837-3936 |
Sentence |
denotes |
Clinical Features Hepatic dysfunction (31.4%) Hepatic dysfunction later during ICU stay (62.5%) N/A |
T350 |
3937-3979 |
Sentence |
denotes |
Key findings on investigations • ↓ Albumin |
T351 |
3980-3987 |
Sentence |
denotes |
• ↑ AST |
T352 |
3988-4010 |
Sentence |
denotes |
• ↑ T.bil • ↑ AST, ALT |
T353 |
4011-4024 |
Sentence |
denotes |
• ↑ T.bil N/A |
T354 |
4025-4124 |
Sentence |
denotes |
Histopathology N/A N/A Liver:• Mild portal inflammation, chronic, with CD4+ and CD8+ T lymphocytes. |
T355 |
4125-4166 |
Sentence |
denotes |
Necroinflammatory foci in hepatic lobules |
T356 |
4167-4246 |
Sentence |
denotes |
• Reactive parenchyma with mild hydropic degeneration, more in perivenular area |
T357 |
4247-4280 |
Sentence |
denotes |
• Rare multinucleated hepatocytes |
T358 |
4281-4318 |
Sentence |
denotes |
• Mild disarray of the hepatic plates |
T359 |
4319-4446 |
Sentence |
denotes |
• Minimal macrovesicular perivenular steatotic change, sinusoidal congestion, hemorrhage and focal perivenular hepatocytes loss |
T360 |
4447-4657 |
Sentence |
denotes |
Key study findings and message Albumin <35 g/L at diagnosis predictor of severe infection (P = 0.026) 41% developed multiorgan failure Portal and lobular hepatitis, viral particles not identified in liver on EM |
T361 |
4658-4666 |
Sentence |
denotes |
COVID-19 |
T362 |
4667-4904 |
Sentence |
denotes |
Study Fan et al (2020)N = 148, confirmed casesRetrospective study Chai et al (2020)N = 4 (healthy)Clinicopathologic Huang et al (2020)N = 41, confirmed casesRetrospective study Wang et al (2020)N = 138, confirmed casesRetrospective study |
T363 |
4905-5044 |
Sentence |
denotes |
Clinical features Hepatic dysfunction at admission (50.7%) Preexisting chronic liver disease (2%) Pre-existing chronic liver disease (2.9%) |
T364 |
5045-5180 |
Sentence |
denotes |
Key findings on investigations ↓ CD4+ and CD8+ T cells in patients with hepatic dysfunction N/A ↑ AST (37%)(62% ICU, 25% non-ICU) ↑ LDH |
T365 |
5181-5272 |
Sentence |
denotes |
Histopathology N/A ACE2 expression in cholangiocytes (59.7%) and hepatocytes (2.6%) N/A N/A |
T366 |
5273-5413 |
Sentence |
denotes |
Key study findings and message • Patients with hepatic dysfunction more likely to have moderate-high fever, more in males (P = 0.035, 0.005) |
T367 |
5414-5584 |
Sentence |
denotes |
• Abnormal liver function after admission associated with prolonged stay (P = 0.02) • Hepatic dysfunction more likely due to cholangiocyte damage by virus, not hepatocyte |
T368 |
5585-5777 |
Sentence |
denotes |
• Drug induced damage, SIRS may also play a role Cytokine storm possible associated with disease severity AST, ALT, T.bil, LDH higher in ICU patients (P < 0.001, P = 0.007,P = 0.02, P < 0.001) |
T369 |
5778-6042 |
Sentence |
denotes |
ALT, alanine aminotransferase; AST, aspartate aminotransferase; LDH, lactate dehydrogenase; MERS-CoV, middle east respiratory syndrome coronavirus; RT-PCR, reverse transcriptase polymerase chain reaction; SARS-COV, severe acute respiratory syndrome coronavirus; T. |
T370 |
6043-6065 |
Sentence |
denotes |
Bili, total bilirubin. |
T371 |
6066-6376 |
Sentence |
denotes |
A significant mode of spread in community outbreaks was fecal-oral transmission.70 , 73 , 74 Patients with diarrhea also had a higher rate of positive serological and nasopharyngeal secretion tests.75 The virus remained stable in stool up to 2-4 days, and may even be detectable as late as 4 weeks.70 , 73 , 76 |