Id |
Subject |
Object |
Predicate |
Lexical cue |
T20 |
0-23 |
Sentence |
denotes |
2 PATIENTS AND METHODS |
T21 |
24-259 |
Sentence |
denotes |
We performed a retrospective chart review of patients with COVID‐19 and ARDS admitted to the medical and surgical ICU at the University Hospital of Cologne, a 1540‐bed teaching hospital between 7 March 2020 and 22 April 2020 (Table 1). |
T22 |
260-362 |
Sentence |
denotes |
TABLE 1 Patient characteristics of patients with COVID‐19 associated invasive pulmonary aspergillosis |
T23 |
363-438 |
Sentence |
denotes |
Characteristics Patient #1 Patient #2 Patient #3 Patient #4 Patient #5 |
T24 |
439-479 |
Sentence |
denotes |
Gender Female Male Male Male Female |
T25 |
480-507 |
Sentence |
denotes |
Age (y) 62 70 54 73 54 |
T26 |
508-563 |
Sentence |
denotes |
Medical history Lap. cholecystectomy for cholecystitis |
T27 |
564-585 |
Sentence |
denotes |
Arterial hypertension |
T28 |
586-621 |
Sentence |
denotes |
Obesity with sleep apnea (BMI 31.5) |
T29 |
622-642 |
Sentence |
denotes |
Hypercholesterolemia |
T30 |
643-676 |
Sentence |
denotes |
Ex‐smoker (30 PY; 5 y previously) |
T31 |
677-761 |
Sentence |
denotes |
Moderate COPD (GOLD 2) Vertebral disc prolapse left L4/5, flavectomy and nucleotomy |
T32 |
762-816 |
Sentence |
denotes |
Ex‐smoker (4 months previously) Arterial hypertension |
T33 |
817-834 |
Sentence |
denotes |
Diabetes mellitus |
T34 |
835-895 |
Sentence |
denotes |
Aneurysm coiling right A. vertebralis Arterial hypertension |
T35 |
896-913 |
Sentence |
denotes |
Bullous Emphysema |
T36 |
914-920 |
Sentence |
denotes |
Smoker |
T37 |
921-941 |
Sentence |
denotes |
Severe COPD (GOLD 3) |
T38 |
942-966 |
Sentence |
denotes |
Previous Hepatitis B No |
T39 |
967-1148 |
Sentence |
denotes |
Underlying immuno‐compromising condition (inhalational steroids for COPD) No (intravenous corticosteroid therapy 0.4 mg/kg/d, total of 13 d) (inhalational steroids for COPD) No |
T40 |
1149-1187 |
Sentence |
denotes |
ICU Ward MICU MICU SICU SICU MICU |
T41 |
1188-1192 |
Sentence |
denotes |
ARDS |
T42 |
1193-1322 |
Sentence |
denotes |
Horowitz‐Index, admission 12 Severe (53 mm Hg) Severe (93 mm Hg) Moderate (128 mm Hg) Severe (83 mm Hg) Moderate (167 mm Hg) |
T43 |
1323-1365 |
Sentence |
denotes |
Prone positioning Yes Yes Yes Yes Yes |
T44 |
1366-1393 |
Sentence |
denotes |
vvECMO Yes No No No No |
T45 |
1394-1438 |
Sentence |
denotes |
Acute renal failure Yes Yes Yes Yes Yes |
T46 |
1439-1476 |
Sentence |
denotes |
Dialysis No SLEDD SLEDD SLEDD No |
T47 |
1477-1489 |
Sentence |
denotes |
Microbiology |
T48 |
1490-1578 |
Sentence |
denotes |
Serum GM (>0.5) Negative Positive (0.7) Negative Negative 2× positive (2.7 and 1.3) |
T49 |
1579-1600 |
Sentence |
denotes |
Fungal culture BALF: |
T50 |
1601-1643 |
Sentence |
denotes |
Aspergillus fumigatus BALF: negative TA: |
T51 |
1644-1670 |
Sentence |
denotes |
Aspergillus fumigatus TA: |
T52 |
1671-1706 |
Sentence |
denotes |
Aspergillus fumigatus TA: negative |
T53 |
1707-1785 |
Sentence |
denotes |
Susceptibility testing Azole susceptible a Not applicable Azole susceptible |
T54 |
1786-1815 |
Sentence |
denotes |
Itraconazole MIC 0.380 (mg/L) |
T55 |
1816-1864 |
Sentence |
denotes |
Voriconazole MIC 0.094 (mg/L) Azole susceptible |
T56 |
1865-1894 |
Sentence |
denotes |
Itraconazole MIC 0.380 (mg/L) |
T57 |
1895-1940 |
Sentence |
denotes |
Voriconazole MIC 0.094 (mg/L) Not applicable |
T58 |
1941-1958 |
Sentence |
denotes |
Fungal PCR BALF: |
T59 |
1959-1987 |
Sentence |
denotes |
Aspergillus fumigatus BALF: |
T60 |
1988-2016 |
Sentence |
denotes |
Aspergillus fumigatus BALF: |
T61 |
2017-2043 |
Sentence |
denotes |
Aspergillus fumigatus TA: |
T62 |
2044-2079 |
Sentence |
denotes |
Aspergillus fumigatus TA: negative |
T63 |
2080-2104 |
Sentence |
denotes |
TA/BALF GM (>0.5) BALF: |
T64 |
2105-2127 |
Sentence |
denotes |
Positive (>2.5) BALF: |
T65 |
2128-2150 |
Sentence |
denotes |
Positive (>2.5) BALF: |
T66 |
2151-2196 |
Sentence |
denotes |
Positive (>2.5) Not available Not available |
T67 |
2197-2214 |
Sentence |
denotes |
Definition of IPA |
T68 |
2215-2425 |
Sentence |
denotes |
EORTC/MSG Criteria 8 Not classifiable (no host criterion) Not classifiable (no host criterion) Not classifiable (no host criterion) Not classifiable (no host criterion) Not classifiable (no host criterion) |
T69 |
2426-2566 |
Sentence |
denotes |
(modified) AspICU algorithm 3 , 7 Putative Modified putative 3 (GM positivity) Putative Putative Modified putative 3 (GM positivity) |
T70 |
2567-2575 |
Sentence |
denotes |
Virology |
T71 |
2576-2626 |
Sentence |
denotes |
PCR TA: positive for hMPV and SARS‐CoV‐2 (E‐gene: |
T72 |
2627-2645 |
Sentence |
denotes |
C t 13.29; S‐gene: |
T73 |
2646-2702 |
Sentence |
denotes |
C t 12.61) TA: positive for hMPV and SARS‐CoV‐2(E‐gene: |
T74 |
2703-2723 |
Sentence |
denotes |
C t 34.29; ORF1 a/b: |
T75 |
2724-2771 |
Sentence |
denotes |
C t 31.47) TA positive for SARS‐CoV‐2 (E‐gene: |
T76 |
2772-2792 |
Sentence |
denotes |
C t 29.74; ORF1 a/b: |
T77 |
2793-2840 |
Sentence |
denotes |
C t 27.86) TA positive for SARS‐CoV‐2 (E‐gene: |
T78 |
2841-2861 |
Sentence |
denotes |
C t 21.47; ORF1 a/b: |
T79 |
2862-2927 |
Sentence |
denotes |
C t 20.12) TA positive for SARS‐CoV‐2 (C t values not available) |
T80 |
2928-3504 |
Sentence |
denotes |
CT imaging studies Combined bilateral ground‐glass opacities with crazy paving and peripheral nodular consolidations (Video S1, Figure 1A) Ground‐glass opacities with occasional nodules (Video S2, Figure 1B) Bilateral ground‐glass opacities, nodular infiltrates with cavities and air crescent sign (Video S3, Figure 1C) Ground‐glass opacities with occasional nodules, known bullous emphysema (Video S4, Figure 1D) Ground‐glass opacities, smaller areas with crazy paving pattern, central and peripheral consolidations, and smaller nodular infiltrates (Video S5, Figure 1E) |
T81 |
3505-3512 |
Sentence |
denotes |
Therapy |
T82 |
3513-3877 |
Sentence |
denotes |
Antifungal treatment Voriconazole iv (6/4 mg/kg BW twice daily) Isavuconazole iv (200 mg thrice daily for 2 d; 200 mg once daily from 3 d) Caspofungin (70/50 mg once daily) followed by voriconazole iv (6/4 mg/kg BW twice daily) Voriconazole iv (6/4 mg/kg BW twice daily) Caspofungin (70/50 mg once daily) followed by voriconazole iv (6/4 mg/kg BW twice daily) |
T83 |
3878-4140 |
Sentence |
denotes |
Antiviral therapy Supportive only Supportive only Hydroxychloroquine, darunavir and cobicistat at external hospital, in house changed to supportive only Supportive only Ribavirin, lopinavir/ritonavir at external hospital, in house changed to supportive only |
T84 |
4141-4180 |
Sentence |
denotes |
Outcome Died Died Alive Died Alive |
T85 |
4181-4935 |
Sentence |
denotes |
Abbreviations: ARDS, acute respiratory distress syndrome; BALF, bronchoalveolar lavage fluid; BW, body weight; COPD, chronic obstructive pulmonary disease; C t, threshold cycle; EORTC/MSG, European Organization for Research and Treatment of Cancer/Mycoses Study Group; GOLD, global initiative for chronic obstructive lung disease; hMPV, human metapneumovirus; IPA, invasive pulmonary aspergillosis; kg, kilogram; lap, laparoscopic; LVB, lumbar vertebral body; mg, milligram; MIC, minimal inhibitory concentration; MICU, medical ICU; ORF, open reading frame; PCR, polymerase chain reaction; PY, pack‐year history; SICU, surgical ICU; SLEDD, slow low‐efficient daily dialysis; TA, tracheal aspirate; vvECMO, veno‐venous extracorporeal membrane oxygenation. |
T86 |
4936-4986 |
Sentence |
denotes |
a Antifungal susceptibility testing by VIPcheck™. |
T87 |
4987-4988 |
Sentence |
denotes |
6 |
T88 |
4989-5136 |
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. |
T89 |
5137-5319 |
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. |
T90 |
5320-5450 |
Sentence |
denotes |
For patient #1 SARS‐CoV‐2 RT‐PCR Kit (altona Diagnostics) and for patients #2, #3 and #4 cobas® SARS‐CoV‐2 Test (Roche) were used. |
T91 |
5451-5500 |
Sentence |
denotes |
For patient #5, kit manufacturer remains unknown. |
T92 |
5501-5633 |
Sentence |
denotes |
Respective C t values are given in Table 1 where available. hMPV‐PCR was performed with NxTAG® Respiratory Pathogen Panel (Luminex). |
T93 |
5634-5726 |
Sentence |
denotes |
Aspergillus 28S rDNA‐Realtime PCR was performed as in‐house PCR test for screening purposes. |
T94 |
5727-5791 |
Sentence |
denotes |
Species identification was performed by artus® Aspergillus diff. |
T95 |
5792-5812 |
Sentence |
denotes |
RG PCR kit (Qiagen). |
T96 |
5813-5980 |
Sentence |
denotes |
For galactomannan testing from serum, bronchoalveolar lavage fluid (BALF) or tracheal aspirate (TA) Platelia Aspergillus antigen ELISA (Bio‐Rad Laboratories) was used. |
T97 |
5981-6085 |
Sentence |
denotes |
Antifungal susceptibility testing was performed using concentration gradient strips on RPMI agar plates. |
T98 |
6086-6248 |
Sentence |
denotes |
In brief, spore suspensions of the fungal isolates were adjusted to 106 CFU/mL and inoculated with MIC test strips for itraconazole and voriconazole (bioMérieux). |
T99 |
6249-6316 |
Sentence |
denotes |
MICs were determined visually after 48 hours of incubation at 35°C. |
T100 |
6317-6414 |
Sentence |
denotes |
VIPcheck™ (Mediaproducts BV) was performed in patient #1 for early detection of azole resistance. |
T101 |
6415-6416 |
Sentence |
denotes |
6 |
T102 |
6417-6678 |
Sentence |
denotes |
COVID‐19 associated IPA was classified according to the (modified) 3 AspICU algorithm 7 with the addition that positive galactomannan (≥1) from BALF or TA, or two consecutively but separately drawn positive serum samples (≥1) were accepted as entry criterion. |
T103 |
6679-6788 |
Sentence |
denotes |
8 Severe SARS‐CoV2 infection with ARDS was accepted as host criterion (acquired immunodeficiency) (Table 1). |
T104 |
6789-7047 |
Sentence |
denotes |
This study was carried out in accordance with the ethical principles reflected in the Declaration of Helsinki 9 and was approved by the ethic committee of the University Hospital of Cologne (Identifier of the University of Cologne Ethics Committee 20‐1157). |