LitCovid-sentences  

PMC:7261349 / 1732-10734 JSONTXT 12 Projects

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Id Subject Object Predicate Lexical cue
T14 0-10 Sentence denotes Highlights
T15 11-112 Sentence denotes The administration of heparin was associated with lower mortality in patients admitted with Covid-19.
T16 113-233 Sentence denotes Our findings support that there is a thrombotic component in the development of respiratory distress for these patients.
T17 234-352 Sentence denotes The positive effect of heparin seems consistent and its use, when indicated, could be considered in clinical settings.
T18 353-541 Sentence denotes Randomized controlled trials are necessary to complement observational studies, and assess the causal associations between heparin, in different therapeutic regimes, and clinical outcomes.
T19 542-716 Sentence denotes Heparin is easy to administer, its use in ambulatory patients, to prevent admissions, or reduce their duration, could also be considered by clinicians and future researchers.
T20 718-730 Sentence denotes Introduction
T21 731-825 Sentence denotes In December 2019 an out break of disease caused by the virus SARS-CoV-2 was declared in China.
T22 826-929 Sentence denotes This disease, later named Covid-19, spread throughout the world in the first few months of 2020 [1, 2].
T23 930-1112 Sentence denotes Around 80% of patients have mild symptoms, the rest can develop severe disease, mainly interstitial pneumonia and acute respiratory distress syndrome, and require hospital admission.
T24 1113-1164 Sentence denotes Intensive care may be necessary for 5% of patients.
T25 1165-1214 Sentence denotes Mortality is estimated to be less than 2% [3, 4].
T26 1215-1345 Sentence denotes The large number of simultaneous cases of Covid-19 has overloaded hospitals, making it very difficult to provide an adequate care.
T27 1346-1507 Sentence denotes The spread of Covid-19 is negatively affecting all areas of healthcare, and is also having an adverse impact on the entire society and the international economy.
T28 1508-1662 Sentence denotes Thrombotic events in different tissues, with consistent clinical laboratory and radiological findings, have been reported in patients with Covid-19 [5–7].
T29 1663-1761 Sentence denotes Perfusion abnormalities in lungs have been observed in patients who underwent dual-energy CTs [8].
T30 1762-1925 Sentence denotes There is also pathological evidence of the presence of platelet-fibrin thrombi in small arterial vessels in lung tissues of patients who have died of Covid-19 [9].
T31 1926-2060 Sentence denotes Based on these finding, doctors have used heparin to treat or prevent the coagulation disorder associated with the infection [5–7, 9].
T32 2061-2211 Sentence denotes This treatment can be associated with the clinical improvement of the patients, and decrease the duration of admissions and the mortality of Covid-19.
T33 2212-2307 Sentence denotes Heparin is safe, economical, and easy to use, it can be given both to admitted and outpatients.
T34 2308-2396 Sentence denotes However, the use of heparin in Covid-19 patients is still supported by limited evidence.
T35 2397-2527 Sentence denotes This study investigates the association of the use of heparin with mortality in a large number of patients admitted with Covid-19.
T36 2529-2536 Sentence denotes Methods
T37 2537-2727 Sentence denotes Anonymized clinical records up to the 24th of April 2020, of all patients (n = 2075) with Covid-19, admitted in 17 Spanish hospitals, of the healthcare provider HM Hospitales, were reviewed.
T38 2728-2835 Sentence denotes These hospitals are based in the provinces of Barcelona, Coruña, León, Madrid, Pontevedra, and Toledo [10].
T39 2836-2991 Sentence denotes Patients had been diagnosed with polymerase chain reaction test of respiratory samples for SARS-CoV-2, between the 1st of March and the 20th of April 2020.
T40 2992-3054 Sentence denotes Seven patients had been admitted before the 1st of March 2020.
T41 3055-3339 Sentence denotes Data on age, gender, temperature and saturation of oxygen at the time of admission, together with treatments at any time during admission with heparin, hydroxychloroquine, azithromycin, steroids, tocilizumab, a combination of lopinavir with ritonavir, and oseltamivir, were collected.
T42 3340-3542 Sentence denotes The limited evidence on which these treatments were based, and the rapidly evolving clinical protocols, resulted in these drugs being given in many different specific preparations, doses, and frequency.
T43 3543-3671 Sentence denotes No information on dosage, duration of treatment, route of administration, or specific preparations of these drugs was collected.
T44 3672-3713 Sentence denotes Finally, data on mortality were recorded.
T45 3714-3797 Sentence denotes The age of patients treated and not treated with heparin was compared with t tests.
T46 3798-3913 Sentence denotes The proportion of men and women for those treated and not treated with heparin was compared with chi squared tests.
T47 3914-4068 Sentence denotes The association between the treatment with heparin and mortality was examined with a logistic regression model that was first adjusted for age and gender.
T48 4069-4206 Sentence denotes Second, two markers of severity, temperature > 37 °C and saturation of oxygen < 90% on admission, were introduced into the model as well.
T49 4207-4372 Sentence denotes Finally, treatments with hydroxychloroquine, azithromycin, steroids, tocilizumab, a combination of lopinavir with ritonavir, or oseltamivir, were added to the model.
T50 4373-4607 Sentence denotes Sensitivity analyses were made to compare estimates based on using missing data of severity markers as categories with, (1) estimates based on complete data dropping variables with missing observations, and (2) complete case analysis.
T51 4608-4648 Sentence denotes Stata 14 was used for the analysis [11].
T52 4649-4707 Sentence denotes The ethics committee of HM Hospitales approved this study.
T53 4708-4764 Sentence denotes Data were anonymized before the authors could access it.
T54 4766-4773 Sentence denotes Results
T55 4774-4885 Sentence denotes Among the 2075 patients whose records were reviewed, 1256 were men, 819 were women, and the mean age was 67.57.
T56 4886-5088 Sentence denotes At the time of collecting the data, 301 patients had died, 1447 had been discharged home from the hospitals, 201 were still admitted, and 126 had been transferred to hospitals not included in the study.
T57 5089-5133 Sentence denotes Median follow up time was 8 (IQR 5–12) days.
T58 5134-5192 Sentence denotes Among the 1734 patients who received heparin 242 had died.
T59 5193-5391 Sentence denotes The patients treated with heparin were older than the ones who did not received it (p < 0.001) and the proportion of men and women who received heparin did not have significant difference (Table 1).
T60 5392-5449 Sentence denotes Table 1 Description of the patients included in the study
T61 5450-5484 Sentence denotes N Age M(SD) Female n(%) Death n(%)
T62 5485-5542 Sentence denotes Total cohort 2075 67.57 (15.52) 819 (39.47%) 301 (14.51%)
T63 5543-5608 Sentence denotes Oxygen saturation < 90% Yes 70 73.18 (13.7) 20 (28.57) 28 (53.85)
T64 5609-5651 Sentence denotes No 221 67.00 (16.14) 95 (42.99) 24 (46.15)
T65 5652-5715 Sentence denotes Temperature > 37° C Yes 159 61.20 (17.27) 47 (29.56) 24 (10.86)
T66 5716-5761 Sentence denotes No 1422 68.53 (15.65) 577 (40.58) 197 (89.14)
T67 5762-5816 Sentence denotes Heparin Yes 1734 68.77 (15.09) 686 (39.56) 242 (13.96)
T68 5817-5859 Sentence denotes No 285 61.76 (17.67) 96 (33.68) 44 (15.44)
T69 5860-5925 Sentence denotes Hydroxychloroquine Yes 1857 67.11 (15.51) 705 (37.96) 237 (12.76)
T70 5926-5968 Sentence denotes No 162 73.47 (16.22) 77 (47.53) 49 (30.25)
T71 5969-6028 Sentence denotes Azithromycin Yes 1223 68.33 (15.03) 456 (37.29) 146 (11.94)
T72 6029-6073 Sentence denotes No 796 66.54 (16.51) 326 (40.95) 140 (17.59)
T73 6074-6128 Sentence denotes Steroids Yes 960 69.88 (16.76) 330 (34.38) 200 (20.83)
T74 6129-6172 Sentence denotes No 1059 65.58 (16.76) 452 (42.68) 86 (8.12)
T75 6173-6228 Sentence denotes Tocilizumab Yes 421 66.1 (13.11) 117 (27.79) 89 (21.14)
T76 6229-6274 Sentence denotes No 1598 68.00 (16.24) 665 (41.61) 197 (12.33)
T77 6275-6343 Sentence denotes Lopinavir + Ritonavir Yes 1230 63.94 (14.28) 421 (34.23) 160 (13.01)
T78 6344-6388 Sentence denotes No 789 73.37 (15.99) 361 (45.75) 126 (15.97)
T79 6389-6444 Sentence denotes Oseltamivir Yes 132 67.78 (13.79) 51 (38.64) 26 (19.70)
T80 6445-6490 Sentence denotes No 1887 67.61 (15.78) 731 (38.74) 260 (13.78)
T81 6491-6627 Sentence denotes Heparin was associated with lower mortality when the model was adjusted for age and gender, with OR (95% CI) 0.55 (0.37–0.82) p = 0.003.
T82 6628-6872 Sentence denotes This association remain significant when saturation of oxygen < 90%, and temperature > 37 °C were added to de model with OR 0.54 (0.36–0.82) p = 0.003, and also when all the other drugs were included as covariates OR 0.42 (0.26–0.66) p < 0.001.
T83 6874-6884 Sentence denotes Discussion
T84 6885-6986 Sentence denotes The administration of heparin was associated with lower mortality in patients admitted with Covid-19.
T85 6987-7028 Sentence denotes This study has strengths and limitations.
T86 7029-7154 Sentence denotes Patients were not randomized and the difference in outcome may be explained by factors other than the treatment with heparin.
T87 7155-7306 Sentence denotes In an effort to control for the severity of disease, or the effects of other drugs, the models were adjusted for clinical markers and other treatments.
T88 7307-7496 Sentence denotes The observation of a large number of unselected patients in 17 hospitals, and the analyses run with some variations to test the consistency of the results, are also strengths of this study.
T89 7497-7575 Sentence denotes However, residual confounding is always present in all observational research.
T90 7576-7766 Sentence denotes For all models the sensitivity analyses described in the methods were used to assess the impact of missing data on the two severity markers, and results were consistent with those presented.
T91 7767-7993 Sentence denotes While the nature of the hypoperfusion of lungs in Covid-19 patients is still not fully understood, our findings support that there is a thrombotic component in the development of respiratory distress for these patients [6, 8].
T92 7994-8235 Sentence denotes The association between heparin and survival is consistent with the findings of an observational study where among the 99 patients who received heparin, and had a sepsis-induced coagulopathy index > 4, mortality was significantly lower [12].
T93 8236-8389 Sentence denotes A recent observational study conducted in a hospital has also reported lower mortality among the 786 Covid-19 patients who received anticoagulation [13].
T94 8390-8519 Sentence denotes To the best of our knowledge, there is no interventional evidence on the management of the coagulopathy associated with Covid-19.
T95 8520-8638 Sentence denotes The positive effect of heparin seems consistent and its use, when indicated, could be considered in clinical settings.
T96 8639-8827 Sentence denotes Randomized controlled trials are necessary to complement observational studies, and assess the causal associations between heparin, in different therapeutic regimes, and clinical outcomes.
T97 8828-9002 Sentence denotes Heparin is easy to administer, its use in ambulatory patients, to prevent admissions, or reduce their duration, could also be considered by clinicians and future researchers.