Id |
Subject |
Object |
Predicate |
Lexical cue |
T107 |
0-10 |
Sentence |
denotes |
Discussion |
T108 |
11-106 |
Sentence |
denotes |
Ocular involvement with Coronavirus family has been shown in various publications [10, 13, 14]. |
T109 |
107-314 |
Sentence |
denotes |
On January 22, 2020, when a visiting doctor in Wuhan developed conjunctivitis, and later yielded positive for SARS-CoV-2, call for research on ocular transmission and involvement of SARS-CoV-2 was made [14]. |
T110 |
315-490 |
Sentence |
denotes |
In a prospective study by Xia et al. [10], tear and conjunctival secretions of 30 COVID-19 patients were collected, and the presence of the virus was evaluated by RT-PCR [10]. |
T111 |
491-731 |
Sentence |
denotes |
Virus was detected in only one patient’s conjunctival scrapes who had conjunctivitis at the time of specimen collection; therefore, it was proposed that the virus only existed in the tear and conjunctiva of the patients with conjunctivitis. |
T112 |
732-1032 |
Sentence |
denotes |
On the other hand, in the same study, it was stated that the sample volume of tear and conjunctival secretion might be insufficient for RT-PCR detection, and therefore, the possibility of viral particles’ presence in tears and conjunctiva should not be ignored in patients without conjunctivitis.[10] |
T113 |
1033-1182 |
Sentence |
denotes |
In the present study, we reported the ocular findings and symptoms of COVID-19 patients and risk factors associated with those ocular manifestations. |
T114 |
1183-1281 |
Sentence |
denotes |
Results of our study suggest that 20.5% of the COVID patients had at least one ocular abnormality. |
T115 |
1282-1460 |
Sentence |
denotes |
Mean age, fever, neutrophil count, CRP, PCT, and ESR levels were significantly higher in patients with ocular involvement; whereas, mean lymphocyte count was significantly lower. |
T116 |
1461-1629 |
Sentence |
denotes |
The aggressive inflammatory response is a significant component in the pathophysiology of SARS-CoV-2 infection, strongly implicated in the resulting airway damage [15]. |
T117 |
1630-1740 |
Sentence |
denotes |
Severity of the disease is reported to be not only due to the viral infection but also the host response [16]. |
T118 |
1741-1902 |
Sentence |
denotes |
There are many studies highlighting the role of inflammatory markers such as ESR, CRP, and PCT to predict the onset of an inflammatory process or infection [17]. |
T119 |
1903-2054 |
Sentence |
denotes |
In the case of SARS-CoV-2 infection, many studies demonstrated that most of the patients present with elevated levels of acute immune markers [18, 19]. |
T120 |
2055-2164 |
Sentence |
denotes |
C-reactive protein begins to rise within 4–6 h in settings of inflammation and has a half-life of 4–7 h [20]. |
T121 |
2165-2248 |
Sentence |
denotes |
Therefore, serum level of CRP is considered to be a measure of active inflammation. |
T122 |
2249-2392 |
Sentence |
denotes |
CRP levels were found to be positively correlated with the diameter of lung lesions and severity of the presentation in COVID-19 patients [21]. |
T123 |
2393-2547 |
Sentence |
denotes |
In our study, all of the ocular findings were correlated with high CRP levels which may indicate active inflammatory response and severity of the disease. |
T124 |
2548-2688 |
Sentence |
denotes |
Procalcitonin is a peptide precursor of calcitonin, released primarily by lung and intestine, in response to bacterial toxins and cytokines. |
T125 |
2689-2862 |
Sentence |
denotes |
Production of PCT is amplified during bacterial infections but downregulated during viral infections which make it a particularly interesting acute inflammatory marker [22]. |
T126 |
2863-3005 |
Sentence |
denotes |
Levels of PCT become detectable in patient’s serum in 3–6 h after onset of inflammation and remain elevated for 12–36 h after resolution [22]. |
T127 |
3006-3150 |
Sentence |
denotes |
A metaanalysis of the literature suggests that serial PCT measurement may be beneficial to evaluate progression towards a more severe form [23]. |
T128 |
3151-3262 |
Sentence |
denotes |
The production of PCT is inhibited by interferon-γ, whose concentration increases during viral infections [24]. |
T129 |
3263-3535 |
Sentence |
denotes |
PCT levels remain within the reference range in several patients with noncomplicated SARS-CoV-2 infection, whereas substantially increase in the severe form of the disease, possibly secondary to a bacterial coinfection which contributes to complicate the clinical picture. |
T130 |
3536-3735 |
Sentence |
denotes |
Procalcitonine levels of the patients with ocular symptoms were higher than the patients without ocular involvement, which may also be indicative for the severity of the disease in those individuals. |
T131 |
3736-3832 |
Sentence |
denotes |
Patients with ocular manifestations had higher ESR levels according to the results of our study. |
T132 |
3833-3937 |
Sentence |
denotes |
Erythrocyte sedimentation rate typically begins to increase within 24 h after the onset of inflammation. |
T133 |
3938-4105 |
Sentence |
denotes |
ESR can be a useful tool to aid in the diagnosis and management of certain specific situations, like inflammation or infection, but like CRP it lacks specificity [25]. |
T134 |
4106-4181 |
Sentence |
denotes |
Elder patients seemed to be at certain risk for developing ocular symptoms. |
T135 |
4182-4376 |
Sentence |
denotes |
This may be secondary to the already existing age related changes in the ocular tissues of the older population such as dry eye disease, meibomian gland dysfunction, or demodex infestation [26]. |
T136 |
4377-4548 |
Sentence |
denotes |
It may be expected that ocular problems would be exacerbated in older adults, where the communication between innate and adaptive immunity is known to be compromised [27]. |
T137 |
4549-4641 |
Sentence |
denotes |
The pathogenesis and organ manifestations of SARS-CoV-2 virus are not fully understood [28]. |
T138 |
4642-4774 |
Sentence |
denotes |
Cytokine storm and viral evasion of cellular immune responses are considered to have crucial roles in the severity of COVID-19 [29]. |
T139 |
4775-4978 |
Sentence |
denotes |
In this study, patients with COVID-19 who had ocular manifestations had significantly high levels of CRP, PCT, and ESR, perhaps as a result of the active immune response of the host and disease severity. |
T140 |
4979-5073 |
Sentence |
denotes |
This may partly explain the positive association between high fever and ocular manifestations. |
T141 |
5074-5235 |
Sentence |
denotes |
Lymphocytopenia and increased levels of neutrophils have been reported to reflect an enhanced inflammatory process and suggest a poor prognosis in COVID-19 [28]. |
T142 |
5236-5367 |
Sentence |
denotes |
In our group, patients with higher neutrophil-to-lymphocyte ratio seemed to be in higher risk for developing ocular manifestations. |
T143 |
5368-5476 |
Sentence |
denotes |
This can also be secondary to the severity of the disease with generalized aggressive inflammatory response. |
T144 |
5477-5576 |
Sentence |
denotes |
Limited sample size and absence of conjunctival RT-PCR evaluation are the limitations of our study. |
T145 |
5577-5734 |
Sentence |
denotes |
A larger cohort study of patients with COVID-19 from multiple centers would help to further define the ocular manifestations and risk factors of the disease. |
T146 |
5735-5926 |
Sentence |
denotes |
Regardless, the findings of our study are the preliminary results shared in an effort to serve as a starting platform for research into ocular involvement immunological responses of COVID-19. |
T147 |
5927-6100 |
Sentence |
denotes |
Older age, high fever, increased neutrophil/lymphocyte ratio, and high levels of acute phase reactants were associated with greater risk of developing ocular manifestations. |
T148 |
6101-6298 |
Sentence |
denotes |
Care must be taken when evaluating patients with those characteristics to prevent ocular complications and viral spread, since other organ involvements might be alternative routes of transmissions. |
T149 |
6299-6432 |
Sentence |
denotes |
As the current pandemic continues, a better understanding of both the transmission routes and manifestations of COVID-19 will emerge. |