| Id |
Subject |
Object |
Predicate |
Lexical cue |
| T1 |
0-22 |
Sentence |
denotes |
The COVID‐19 Pandemic: |
| T2 |
23-74 |
Sentence |
denotes |
An Epidemiologic, Public Health, and Clinical Brief |
| T3 |
75-96 |
Sentence |
denotes |
The COVID‐19 Pandemic |
| T4 |
97-113 |
Sentence |
denotes |
Ward and Del Rio |
| T5 |
115-150 |
Sentence |
denotes |
Watch the interview with the author |
| T6 |
151-164 |
Sentence |
denotes |
Abbreviations |
| T7 |
165-201 |
Sentence |
denotes |
ACE2 angiotensin‐converting enzyme 2 |
| T8 |
202-248 |
Sentence |
denotes |
CDC Centers for Disease Control and Prevention |
| T9 |
249-282 |
Sentence |
denotes |
COVID‐19 coronavirus disease 2019 |
| T10 |
283-305 |
Sentence |
denotes |
CT computed tomography |
| T11 |
306-341 |
Sentence |
denotes |
FDA US Food and Drug Administration |
| T12 |
342-360 |
Sentence |
denotes |
IL‐6 interleukin‐6 |
| T13 |
361-415 |
Sentence |
denotes |
RT‐PCR reverse transcription polymerase chain reaction |
| T14 |
416-454 |
Sentence |
denotes |
SARS severe acute respiratory syndrome |
| T15 |
455-484 |
Sentence |
denotes |
WHO World Health Organization |
| T16 |
485-663 |
Sentence |
denotes |
On December 29, 2019, health authorities in China reported 27 cases of an unusual pneumonia, respiratory failure, and death linked to attendance at a live animal market in Wuhan. |
| T17 |
664-776 |
Sentence |
denotes |
1 , 2 On January 7, 2020, Chinese scientists confirmed a novel coronavirus, 2019‐nCoV, as the causative agent. |
| T18 |
777-1063 |
Sentence |
denotes |
3 Studies revealed >80% genetic homology of 2019‐nCoV with coronaviruses of bats, presumably the original host; pangolins, suggesting this animal sold at the market as an intermediate host; and another human coronavirus, SARS‐CoV, the cause of severe acute respiratory syndrome (SARS). |
| T19 |
1064-1150 |
Sentence |
denotes |
3 , 4 All evidence indicates that SARS‐CoV‐2 is of animal and not laboratory origin. |
| T20 |
1151-1289 |
Sentence |
denotes |
5 The World Health Organization (WHO) later named the novel virus SARS‐CoV‐2 and the related disease coronavirus disease 2019 (COVID‐19). |
| T21 |
1290-1382 |
Sentence |
denotes |
2 , 3 SARS‐CoV‐2 spread quickly through communities in China and other countries (Fig. 1). |
| T22 |
1383-1537 |
Sentence |
denotes |
On January 20, 2020, the first case was recognized in the United State when a 35‐year‐old man presented to an urgent care clinic in Snohomish, Washington. |
| T23 |
1538-1644 |
Sentence |
denotes |
6 , 7 On January 30, 2020, WHO declared the outbreak a Public Health Emergency of International Concern. |
| T24 |
1645-1699 |
Sentence |
denotes |
On March 11, 2020, WHO designated COVID‐19 a pandemic. |
| T25 |
1700-1856 |
Sentence |
denotes |
Almost all countries are implementing public health measures to prevent SARS‐CoV‐2 transmission and are marshaling clinical care for patients with COVID‐19. |
| T26 |
1857-2024 |
Sentence |
denotes |
This review highlights key features of SARS‐CoV‐2 infection, the epidemiology and clinical course of COVID‐19, and interventions to stop the growing COVID‐19 pandemic. |
| T27 |
2025-2068 |
Sentence |
denotes |
Fig 1 Chronology of the COVID‐19 pandemic. |
| T28 |
2070-2082 |
Sentence |
denotes |
Epidemiology |
| T29 |
2083-2178 |
Sentence |
denotes |
By March 11, 2020, 105 countries had reported 118,319 confirmed COVID‐19 cases and 4292 deaths. |
| T30 |
2179-2253 |
Sentence |
denotes |
2 Outside China, large epidemics emerged in South Korea, Iran, and Italy. |
| T31 |
2254-2340 |
Sentence |
denotes |
By March 14, 2020, approximately one in four COVID‐19 cases and deaths were in Europe. |
| T32 |
2341-2408 |
Sentence |
denotes |
The US epidemic accelerated, with cases doubling every 6 to 7 days. |
| T33 |
2409-2532 |
Sentence |
denotes |
7 By March 29, 2020, more than 100,000 persons had COVID‐19 in the United States, the largest burden of COVID‐19 globally. |
| T34 |
2533-2680 |
Sentence |
denotes |
2 , 7 As of April 29, 2020, the COVID‐19 pandemic has grown to more than 3 million confirmed cases and more than 206,000 deaths in 179 countries. |
| T35 |
2681-2773 |
Sentence |
denotes |
The United States now has more than 1 million cases (33%) and more than 50,000 deaths (25%). |
| T36 |
2774-2886 |
Sentence |
denotes |
2 , 7 The potential is high for large COVID‐19 epidemics in Brazil, Russia, India, and many African countries. |
| T37 |
2887-3091 |
Sentence |
denotes |
SARS‐CoV‐2 is transmitted directly through inhalation or mucosal surface exposure to an infected person’s respiratory droplets or indirectly when touching the face after contact with contaminated objects. |
| T38 |
3092-3179 |
Sentence |
denotes |
2 , 4 , 7 SARS‐CoV‐2 can remain viable on environmental surfaces for up to 72 hours. |
| T39 |
3180-3329 |
Sentence |
denotes |
8 SARS‐CoV‐2 is highly infectious with an R0 of approximately 2.2 to 3.0, meaning each infected person will infect about two to three other persons. |
| T40 |
3330-3584 |
Sentence |
denotes |
7 Large COVID‐19 outbreaks have occurred in health care facilities, households, cruise ships, religious services (e.g., funerals), and other large gatherings 1 , 2 , 7 Individuals can transmit SARS‐CoV‐2 before, during, and after symptomatic disease. |
| T41 |
3585-3659 |
Sentence |
denotes |
As many as half of individuals with SARS‐CoV‐2 infection have no symptoms. |
| T42 |
3660-3661 |
Sentence |
denotes |
7 |
| T43 |
3663-3684 |
Sentence |
denotes |
Clinical Presentation |
| T44 |
3685-3926 |
Sentence |
denotes |
Similar to SARS‐CoV, SARS‐CoV‐2 binds to angiotensin‐converting enzyme 2 (ACE2) receptors for entry via endocytosis into alveolar epithelial cells, as well as other cells with ACE2 receptors in the heart, gastrointestinal tract, and kidneys. |
| T45 |
3927-4175 |
Sentence |
denotes |
2 , 4 COVID‐19 results from SARS‐CoV‐2 replication, causing early cell death (i.e., apoptosis) and provoking a storm of proinflammatory cytokines (e.g., interleukin‐6 [IL‐6]) disrupting alveolar walls with resulting fluid accumulation in alveoli. |
| T46 |
4176-4177 |
Sentence |
denotes |
4 |
| T47 |
4178-4287 |
Sentence |
denotes |
The incubation period from infection to onset of COVID‐19 disease is typically 5 to 7 days (range 1‐14 days). |
| T48 |
4288-4382 |
Sentence |
denotes |
1 , 2 , 7 The most common symptoms of COVID‐19 are fever and nonproductive cough (Table 1). |
| T49 |
4383-4540 |
Sentence |
denotes |
1 , 4 , 7 , 9 The Centers for Disease Control and Prevention (CDC) recently added anosmia and ageusia, the loss of smell and taste, as COVID‐19 symptoms. |
| T50 |
4541-4654 |
Sentence |
denotes |
7 Laboratory findings are remarkable for a normal leukocyte count, lymphopenia, and elevated C‐reactive protein. |
| T51 |
4655-4821 |
Sentence |
denotes |
1 , 6 , 8 Most hospitalized patients with COVID‐19 have a bilateral ground‐glass appearance on chest computed tomography (CT) scan consistent with viral pneumonia. |
| T52 |
4822-4907 |
Sentence |
denotes |
Table 1 Clinical Features of COVID‐19 in Wuhan and Multiple Other Locations in China |
| T53 |
4908-4966 |
Sentence |
denotes |
Clinical Features Wuhan, China Multiple Locations, China |
| T54 |
4967-5000 |
Sentence |
denotes |
Number of patients 10,999 3,062 |
| T55 |
5001-5009 |
Sentence |
denotes |
Symptoms |
| T56 |
5010-5025 |
Sentence |
denotes |
Fever 89% 80% |
| T57 |
5026-5041 |
Sentence |
denotes |
Cough 68% 63% |
| T58 |
5042-5065 |
Sentence |
denotes |
Expectoration 34% 42% |
| T59 |
5066-5083 |
Sentence |
denotes |
Dyspnea 19% 34% |
| T60 |
5084-5109 |
Sentence |
denotes |
Fatigue/Myalgia 38% 46% |
| T61 |
5110-5128 |
Sentence |
denotes |
Headache 14% 15% |
| T62 |
5129-5153 |
Sentence |
denotes |
Nausea/Vomiting 5% 10% |
| T63 |
5154-5171 |
Sentence |
denotes |
Diarrhea 4% 13% |
| T64 |
5172-5190 |
Sentence |
denotes |
Laboratory results |
| T65 |
5191-5227 |
Sentence |
denotes |
Leukocytes in normal range 94% 70% |
| T66 |
5228-5249 |
Sentence |
denotes |
Lymphopenia 83% 57% |
| T67 |
5250-5288 |
Sentence |
denotes |
Increased C‐reactive protein 61% 74% |
| T68 |
5289-5351 |
Sentence |
denotes |
Alanine aminotransferase above upper limit of normal 21% 29% |
| T69 |
5352-5359 |
Sentence |
denotes |
Imaging |
| T70 |
5360-5387 |
Sentence |
denotes |
Abnormal chest CT 86% 89% |
| T71 |
5388-5434 |
Sentence |
denotes |
Bilateral infiltrates (ground glass) 56% 76% |
| T72 |
5435-5479 |
Sentence |
denotes |
Acute respiratory distress syndrome 6% 20% |
| T73 |
5480-5499 |
Sentence |
denotes |
Mortality 1.4% 6% |
| T74 |
5500-5525 |
Sentence |
denotes |
Data are from Guna et al. |
| T75 |
5526-5576 |
Sentence |
denotes |
1 and Centers for Disease Control and Prevention. |
| T76 |
5577-5578 |
Sentence |
denotes |
7 |
| T77 |
5579-5726 |
Sentence |
denotes |
John Wiley & Sons, Ltd This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. |
| T78 |
5727-5909 |
Sentence |
denotes |
It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency. |
| T79 |
5910-6006 |
Sentence |
denotes |
Today, reverse transcription polymerase chain reaction (RT‐PCR) is the COVID‐19 diagnostic test. |
| T80 |
6007-6156 |
Sentence |
denotes |
2 , 7 RT‐PCR sensitivity is highest for testing bronchial alveolar lavage fluid (93%) and declines for sputum (72%) and nasal swab (63%) specimens. |
| T81 |
6157-6209 |
Sentence |
denotes |
10 COVID‐19 diagnosis might require repeat testing. |
| T82 |
6210-6294 |
Sentence |
denotes |
2 , 7 Serological tests to detect SARS‐CoV‐2 IgM and IgG antibodies are available. |
| T83 |
6295-6551 |
Sentence |
denotes |
However, because of test sensitivity and other quality concerns, the US Food and Drug Administration (FDA; https://www.fda.gov) advises current serological tests are best used for surveillance and research, and not as the sole basis for COVID‐19 diagnosis. |
| T84 |
6552-6588 |
Sentence |
denotes |
COVID‐19 is commonly a mild disease. |
| T85 |
6589-6772 |
Sentence |
denotes |
Of the first 72,314 COVID‐19 disease reported in China, 81% had no or mild pneumonia, 21% had severe dyspnea and radiological evidence of pulmonary disease, and 5% progressed to SARS. |
| T86 |
6773-6856 |
Sentence |
denotes |
1 Individuals can be ill for a week or longer before experiencing severe symptoms. |
| T87 |
6857-6968 |
Sentence |
denotes |
The risk for severe COVID‐19 disease is highest for men, older adults, and patients with certain comorbidities. |
| T88 |
6969-7063 |
Sentence |
denotes |
In the United States, 80% of reported COVID‐19–related deaths are among people aged ≥65 years. |
| T89 |
7064-7125 |
Sentence |
denotes |
7 , 9 , 11 Deaths are rare among persons <24 years of age. |
| T90 |
7126-7318 |
Sentence |
denotes |
1 , 7 , 11 In the United States, most hospitalized patients with COVID‐19 have comorbid conditions, including obesity, hypertension, diabetes, and cardiovascular disease 7 , 11 (Table 2). |
| T91 |
7319-7544 |
Sentence |
denotes |
Although listed by the CDC as a comorbid condition associated with severe COVID‐19, chronic liver disease, including cirrhosis, has not been a common comorbidity associated with hospitalization in the United States (Table 2). |
| T92 |
7545-7686 |
Sentence |
denotes |
The high prevalence of comorbid conditions can explain, in part, African Americans’ increased risk for hospitalization with COVID‐19 disease. |
| T93 |
7687-7777 |
Sentence |
denotes |
5 Variable comorbidity prevalence contributes to differences in national COVID mortality. |
| T94 |
7778-7985 |
Sentence |
denotes |
Globally, crude fatality rates for COVID‐19 range from 0.2% in Singapore, to 2.0% to 3.0% in South Korea and Germany, to 4.3% for the United States, and to 10% to 13% in Spain, Italy, and the United Kingdom. |
| T95 |
7986-7992 |
Sentence |
denotes |
2 , 5 |
| T96 |
7993-8066 |
Sentence |
denotes |
Table 2 Comorbidities Among Persons With COVID‐19 Disease, United States |
| T97 |
8067-8107 |
Sentence |
denotes |
Condition United States* New York City |
| T98 |
8108-8168 |
Sentence |
denotes |
Not Hospitalized Hospitalized Intensive Care Hospitalized |
| T99 |
8169-8200 |
Sentence |
denotes |
Patients 5143 1037 457 5700 |
| T100 |
8201-8242 |
Sentence |
denotes |
One or more condition 27% 71% 78% 88% |
| T101 |
8243-8258 |
Sentence |
denotes |
Obesity 42% |
| T102 |
8259-8279 |
Sentence |
denotes |
Hypertension 57% |
| T103 |
8280-8316 |
Sentence |
denotes |
Diabetes mellitus 6% 24% 32% 34% |
| T104 |
8317-8358 |
Sentence |
denotes |
Cardiovascular disease 5% 23% 29% 18% |
| T105 |
8359-8399 |
Sentence |
denotes |
Chronic renal disease 1% 9% 12% 0.6% |
| T106 |
8400-8437 |
Sentence |
denotes |
Chronic liver disease 1% 1% 2% 9% |
| T107 |
8438-8471 |
Sentence |
denotes |
Immunocompromised 3% 6% 9% 2% |
| T108 |
8472-8489 |
Sentence |
denotes |
Mortality 21% |
| T109 |
8490-8503 |
Sentence |
denotes |
Total 21% |
| T110 |
8504-8525 |
Sentence |
denotes |
1 Comorbidity 88% |
| T111 |
8526-8590 |
Sentence |
denotes |
* Based on data from the CDC for all 50 states and territories. |
| T112 |
8591-8628 |
Sentence |
denotes |
Otherwise, data are Richardson et al. |
| T113 |
8629-8631 |
Sentence |
denotes |
11 |
| T114 |
8632-8779 |
Sentence |
denotes |
John Wiley & Sons, Ltd This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. |
| T115 |
8780-8962 |
Sentence |
denotes |
It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency. |
| T116 |
8963-9196 |
Sentence |
denotes |
The search for effective therapies and a vaccine is occurring at a remarkable pace, with at least 29 studies of therapeutic agents and 5 studies of candidate vaccines registered on ClinicalTrials.org (https://www.clinicaltrials.gov). |
| T117 |
9197-9351 |
Sentence |
denotes |
On May 1, 2020, the FDA granted Emergency Use Authorization of remdesivir, a broad‐spectrum antiviral nucleotide prodrug for treatment of severe COVID‐19. |
| T118 |
9352-9445 |
Sentence |
denotes |
Studies of monoclonal antibodies against IL‐6 and hyperimmune immunoglobulin are in progress. |
| T119 |
9446-9599 |
Sentence |
denotes |
Following reports of serious cardiac arrythmias, the FDA cautioned clinicians of prescribing hydroxychloroquine or chloroquine for treatment of COVID‐19. |
| T120 |
9600-9708 |
Sentence |
denotes |
A safe and effective vaccine, if successfully developed, probably will not be available for 12 to 18 months. |
| T121 |
9710-9720 |
Sentence |
denotes |
Prevention |
| T122 |
9721-9984 |
Sentence |
denotes |
In the absence of a vaccine, prevention is composed of a combination of nonpharmacological interventions for suppression of transmission to R0 <1 and mitigation of the number of patients with COVID‐19 who require intensive care and mechanical respiratory support. |
| T123 |
9985-10218 |
Sentence |
denotes |
12 Interventions include improved personal hygiene promotions, symptomatic screening and laboratory testing for case detection, contact tracing, household quarantine of those with transmission risks, and social distancing (Table 3). |
| T124 |
10219-10400 |
Sentence |
denotes |
The United States and most other countries have implemented extensive travel restrictions, workplace and school closures, and cancellation of sporting and other large public events. |
| T125 |
10401-10542 |
Sentence |
denotes |
China, South Korea, and Taiwan successfully curbed large COVID‐19 epidemics with prompt scale‐up of testing, contact tracing, and quarantine. |
| T126 |
10543-10689 |
Sentence |
denotes |
2 , 4 , 7 In the United States, although testing rates are low, models suggest prevention measures are reducing transmission and future deaths. |
| T127 |
10690-10909 |
Sentence |
denotes |
13 The US government recently recommended increased COVID‐19 surveillance, testing, and contact tracing with modified social distancing measures to sustain SARS‐CoV‐2 prevention while opening up education and commerce. |
| T128 |
10910-10912 |
Sentence |
denotes |
14 |
| T129 |
10913-11031 |
Sentence |
denotes |
Table 3 Prevention Measures to Reduce Risks for COVID‐19, Priority Populations for Testing, and Information Resources |
| T130 |
11032-11103 |
Sentence |
denotes |
Prevention measures to reduce risks for COVID‐19 Practice good hygiene |
| T131 |
11104-11183 |
Sentence |
denotes |
○ Wash hands often for >20 seconds with soap and water or 60% alcohol sanitizer |
| T132 |
11184-11242 |
Sentence |
denotes |
○ Avoid touching eyes, nose, and mouth with unwashed hands |
| T133 |
11243-11297 |
Sentence |
denotes |
○ Sneeze or cough into a tissue or inside of the elbow |
| T134 |
11298-11508 |
Sentence |
denotes |
○ Disinfect surfaces and used items frequently with soap and water and Environmental Protection Agency–registered household disinfectants or bleach solution (4 teaspoons [20 mL] bleach per quart [or 1 L] water) |
| T135 |
11509-11535 |
Sentence |
denotes |
Limit close social contact |
| T136 |
11536-11607 |
Sentence |
denotes |
○ Learn signs and symptoms of COVID‐19, and follow local disease trends |
| T137 |
11608-11738 |
Sentence |
denotes |
○ Stay home as much as possible, particularly persons who are ill, older (>65 years) adults, and those at risk for severe COVID‐19 |
| T138 |
11739-11789 |
Sentence |
denotes |
○ Persons who are ill, call a health care provider |
| T139 |
11790-11857 |
Sentence |
denotes |
○ Consider 2‐week supply of medications, food, and other essentials |
| T140 |
11858-11947 |
Sentence |
denotes |
○ When out in public, keep social distance of at least 6 feet and wear a cloth face cover |
| T141 |
11948-11981 |
Sentence |
denotes |
○ Avoid gatherings of >10 persons |
| T142 |
11982-12015 |
Sentence |
denotes |
○ Work or attend school from home |
| T143 |
12016-12042 |
Sentence |
denotes |
○ Avoid unnecessary travel |
| T144 |
12043-12109 |
Sentence |
denotes |
○ Avoid visits to nursing homes or long‐term retirement facilities |
| T145 |
12110-12150 |
Sentence |
denotes |
Protect patients and health care workers |
| T146 |
12151-12251 |
Sentence |
denotes |
○ Reduce facility risks: screen for COVID‐19 symptoms on entry; reduce visits; practice telemedicine |
| T147 |
12252-12302 |
Sentence |
denotes |
○ Isolate symptomatic patients as soon as possible |
| T148 |
12303-12380 |
Sentence |
denotes |
○ Protect health care personnel with recommended infection‐control procedures |
| T149 |
12381-12465 |
Sentence |
denotes |
Recommended testing in consultation with health care provider Hospitalized patients |
| T150 |
12466-12499 |
Sentence |
denotes |
Persons with symptoms of COVID‐19 |
| T151 |
12500-12530 |
Sentence |
denotes |
○ Health care facility workers |
| T152 |
12531-12570 |
Sentence |
denotes |
○ Patients in long‐term care facilities |
| T153 |
12571-12598 |
Sentence |
denotes |
○ Patients >65 years of age |
| T154 |
12599-12650 |
Sentence |
denotes |
○ Patients with underlying conditions with symptoms |
| T155 |
12651-12669 |
Sentence |
denotes |
○ First responders |
| T156 |
12670-12726 |
Sentence |
denotes |
Critical infrastructure workers and others with symptoms |
| T157 |
12727-12776 |
Sentence |
denotes |
Health care facility workers and first responders |
| T158 |
12777-12857 |
Sentence |
denotes |
Persons mildly ill in communities with high numbers of COVID‐19 hospitalizations |
| T159 |
12858-12982 |
Sentence |
denotes |
Good information resources Centers for Disease Control and Prevention: https://www.cdc.gov/coronavirus/2019-ncov/index.html |
| T160 |
12983-13073 |
Sentence |
denotes |
World Health Organization: https://www.who.int/emergencies/diseases/novel-coronavirus-2019 |
| T161 |
13074-13178 |
Sentence |
denotes |
Infectious Disease Society of America: https://www.idsociety.org/public-health/COVID-19-Resource-Center/ |
| T162 |
13179-13285 |
Sentence |
denotes |
American Association for the Study of Liver Diseases: https://www.aasld.org/about-aasld/covid-19-resources |
| T163 |
13286-13374 |
Sentence |
denotes |
European Association for the Study of the Liver: https://easl.eu/covid-19-and-the-liver/ |
| T164 |
13375-13474 |
Sentence |
denotes |
European Centre for Disease Control and Prevention: https://www.ecdc.europa.eu/en/covid-19-pandemic |
| T165 |
13475-13555 |
Sentence |
denotes |
The Society for Healthcare Epidemiology of America: https://www.shea-online.org/ |
| T166 |
13556-13703 |
Sentence |
denotes |
John Wiley & Sons, Ltd This article is being made freely available through PubMed Central as part of the COVID-19 public health emergency response. |
| T167 |
13704-13886 |
Sentence |
denotes |
It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency. |
| T168 |
13888-13895 |
Sentence |
denotes |
Summary |
| T169 |
13896-14019 |
Sentence |
denotes |
SARS‐CoV‐2 is a new human pathogen, readily spread via respiratory droplets and the cause of the growing COVID‐19 pandemic. |
| T170 |
14020-14128 |
Sentence |
denotes |
Men, older adults (>65 years old), and persons with comorbidities are at risk for severe COVID‐19 and death. |
| T171 |
14129-14327 |
Sentence |
denotes |
Countries have successfully suppressed transmission and mitigated needs for intensive care with robust case/contact detection (testing), isolation of infected/exposed persons, and social distancing. |
| T172 |
14328-14501 |
Sentence |
denotes |
To stop the COVID‐19 pandemic, the challenge is for all countries to scale up and sustain prevention measures while awaiting the arrival of effective vaccines and therapies. |