LitCovid-sentences  

PMC:7301188 / 1619-15849 JSONTXT 13 Projects

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Id Subject Object Predicate Lexical cue
T17 0-2 Sentence denotes 1.
T18 3-15 Sentence denotes Introduction
T19 16-146 Sentence denotes COVID-19 which emerged in Wuhan, Hubei Province, China, is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
T20 147-220 Sentence denotes It is typically spread via respiratory droplets and during close contact.
T21 221-274 Sentence denotes The main clinical manifestation is lung injury[1, 2].
T22 275-475 Sentence denotes Most of the patients have a favorable prognosis, but some rapidly progress to severe and critical cases with respiratory distress syndrome, coagulation dysfunction, multiple organ failure, etc.[3, 4].
T23 476-598 Sentence denotes Therefore, early identification of the severity is very important to the clinical diagnosis of and treatment for COVID-19.
T24 599-843 Sentence denotes Commonly used clinical laboratory coagulation indexes, such as D-dimer (DD), prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), and fibrinogen (Fg), could sensitively reflect the clotting state of the body.
T25 844-1007 Sentence denotes The aim of the report is to investigate role of the dynamic changes of DD, PT, APTT, TT, and Fg in predicting the severity and prognosis in patients with COVID-19.
T26 1009-1011 Sentence denotes 2.
T27 1012-1033 Sentence denotes Materials and Methods
T28 1035-1039 Sentence denotes 2.1.
T29 1040-1081 Sentence denotes Source of Patients and Diagnosis Criteria
T30 1082-1307 Sentence denotes The information of a total of 115 patients with confirmed COVID-19 who were admitted to Tianyou Hospital affiliated to the Wuhan University of Science and Technology between January 18, 2020, and March 5, 2020, was collected.
T31 1308-1425 Sentence denotes The confirmed patients had a positive result of the nucleic acid test of SARS-CoV-2 by real-time fluorescence RT-PCR.
T32 1426-1508 Sentence denotes Three clinical disease assessments were conducted using laboratory data collected.
T33 1509-1657 Sentence denotes Cases of hospital discharge, death, and under treatment with a duration of hospitalization longer than 14 days prior to March 5, 2020, were studied.
T34 1658-1793 Sentence denotes Cases with incomplete laboratory data or with a duration of hospitalization shorter than 14 days prior to March 5, 2020, were excluded.
T35 1794-1903 Sentence denotes This study was approved by the Medical Ethics Review Board of Wuhan University of Science and Technology (No.
T36 1904-1912 Sentence denotes 202009).
T37 1914-1918 Sentence denotes 2.2.
T38 1919-1943 Sentence denotes Clinical Classifications
T39 1945-1951 Sentence denotes 2.2.1.
T40 1952-1971 Sentence denotes Case Identification
T41 1972-2028 Sentence denotes According to the Guidance for Corona Virus Disease 2019:
T42 2029-2724 Sentence denotes Prevention, Control, Diagnosis, and Management edited by the National Health Commission of the People's Republic of China, all cases were identified into four categories of mild cases, ordinary cases, severe cases, and critical cases. (1) Mild cases had mild clinical symptoms and no pneumonia manifestation in imaging. (2) Ordinary cases had symptoms like fever and respiratory tract symptoms, and pneumonia manifestation can be seen in imaging. (3) Severe cases met any of the following: respiratory distress, RR ≥ 30 breaths/min; the oxygen saturation is less than 93% at a rest state; or arterial partial pressure of oxygen (PaO2)/oxygen concentration (FiO2) ≤ 300 mmHg (1 mmHg = 0.133 kPa).
T43 2725-3049 Sentence denotes Patients with >50% lesion progression within 24 to 48 hours in pulmonary imaging were treated as severe cases. (4) Critical cases met any of the following: respiratory failure occurs, and mechanical ventilation is required; shock occurs; or complicated with other organ failure that requires monitoring and treatment in ICU.
T44 3051-3057 Sentence denotes 2.2.2.
T45 3058-3076 Sentence denotes Outcome of Illness
T46 3077-3218 Sentence denotes According to clinical progression, outcomes in endpoints were divided into four types: hospital discharge, improved, exacerbation, and death.
T47 3220-3224 Sentence denotes 2.3.
T48 3225-3240 Sentence denotes Data Collection
T49 3241-3368 Sentence denotes The laboratory data were collected at three time points: admission, 3-5 days of hospitalization, and at the composite endpoint.
T50 3369-3473 Sentence denotes DD, PT, APTT, and Fg were obtained and labeled as DD1-3, PT1-3, APTT1-3, TT1-3, and Fg1-3, respectively.
T51 3474-3566 Sentence denotes Meanwhile, case identification, imaging identification, and outcome of illness were defined.
T52 3568-3572 Sentence denotes 2.4.
T53 3573-3592 Sentence denotes Statistical Methods
T54 3593-3657 Sentence denotes Statistical analysis was conducted using the SPSS 25.0 software.
T55 3658-3720 Sentence denotes Descriptive statistics included means and standard deviations.
T56 3721-3834 Sentence denotes The Kruskal-Wallis H-test and independent sample chi-square test were used to analyze differences between groups.
T57 3835-4074 Sentence denotes The Receiver Operating Characteristic curve (ROC curve) was used to calculate the area under the curve (AUC) of DD and PT in order to evaluate the sensitivity and specificity of these factors in predicting mortality and hospital discharge.
T58 4075-4221 Sentence denotes Spearman's rank correlation analysis was utilized to measure the degree of correlation between the hierarchically ordered variables in this study.
T59 4222-4280 Sentence denotes A P value < 0.05 was considered statistically significant.
T60 4282-4286 Sentence denotes 2.5.
T61 4287-4317 Sentence denotes Patient and Public Involvement
T62 4318-4478 Sentence denotes This was a retrospective case series study, and no patients were involved in the study design, setting the research questions, or the outcome measures directly.
T63 4479-4559 Sentence denotes No patients were asked to advise on the interpretation or writing up of results.
T64 4561-4563 Sentence denotes 3.
T65 4564-4586 Sentence denotes Results and Discussion
T66 4588-4592 Sentence denotes 3.1.
T67 4593-4620 Sentence denotes Demographic Characteristics
T68 4621-4811 Sentence denotes Among 115 patients with COVID-19, the median ages were 63.55 ± 13.86 (27-96) years old, male were 66 (57.4%) cases, female were 49 (42.6%) cases, and over 60 years old were 78 (67.8%) cases.
T69 4812-4981 Sentence denotes At the time of admission, mild and ordinary patients were 39 (33.9%) cases, severe patients were 48 (41.7%) cases, and critical patients were 28 (24.3%) cases (Table 1).
T70 4982-5113 Sentence denotes In this study, more patients were male and more patients were more than 60 years, consistently with previous literature report [1].
T71 5115-5119 Sentence denotes 3.2.
T72 5120-5208 Sentence denotes The Relationship between the Levels of DD1, PT1, APTT1, Fg1, and Clinical Classification
T73 5209-5304 Sentence denotes There are significant differences in DD1 between different clinical classifications (P < 0.05).
T74 5305-5360 Sentence denotes The severity of the disease increased as DD1 increased.
T75 5361-5409 Sentence denotes 81 (70.4%) patients had Fg1 increased (Table 2).
T76 5411-5415 Sentence denotes 3.3.
T77 5416-5512 Sentence denotes Relationship between the Dynamics Changes of DD, PT, APTT, TT, Fg, and the Prognosis of COVID-19
T78 5513-5635 Sentence denotes Significant difference (P < 0.05) and positive correlation were found between DD, PT, and outcomes at composite endpoints.
T79 5636-5720 Sentence denotes Correlation in third detection was stronger than that in first and second detection.
T80 5721-5924 Sentence denotes Among 23 patients who died, 18 (78.3%) cases had DD1 increased, 12 of 18 had DD1 two times higher (>1.10 mg/L), 22 cases had DD2 and DD3 increased, 21 of 22 had DD2 and DD3 two times higher (>1.10 mg/L).
T81 5925-6025 Sentence denotes Eight cases in exacerbated patients occurred increased DD2 and DD3 all higher (1.10 mg/L) (Table 3).
T82 6027-6031 Sentence denotes 3.4.
T83 6032-6112 Sentence denotes Analysis of DD and PT in Predicting Hospital Discharge and Mortality of COVID-19
T84 6113-6229 Sentence denotes We used the ROC curve analysis to evaluate the diagnostic value of hospital discharge and mortality in 115 patients.
T85 6230-6361 Sentence denotes The AUCs of DD1, DD2, and DD3 to predict hospital discharge and mortality were 0.742, 0.818, and 0.851, respectively (Figure 1(a)).
T86 6362-6493 Sentence denotes The AUCs of PT1, PT2, and PT3 to predict hospital discharge and mortality were 0.643, 0.824, and 0.937, respectively (Figure 1(b)).
T87 6495-6499 Sentence denotes 3.5.
T88 6500-6568 Sentence denotes Dynamic Changes of Chest CT Imaging, DD and CTA in COVID-19 Patients
T89 6569-6850 Sentence denotes At the early stage of the disease, the correlation between CT imaging changes and DD value was not obvious; however, with the progression of the disease, the change of CT was closely related to the increase of DD value, and there was a significant statistical difference (Table 4).
T90 6851-6963 Sentence denotes The clinical observation showed that the abnormal coagulation factor was consistent with the CT imaging results.
T91 6964-7021 Sentence denotes In this paper, a typical patient was taken as an example.
T92 7022-7099 Sentence denotes The dynamic changes of chest CT imaging and DD were consistent (Figure 2(a)).
T93 7100-7194 Sentence denotes Increased DD was associated with pulmonary embolism, which was confirmed by CTA (Figure 2(b)).
T94 7196-7198 Sentence denotes 4.
T95 7199-7210 Sentence denotes Conclusions
T96 7211-7300 Sentence denotes COVID-19 is an acute infectious disease caused by a new type of coronavirus (SARS-CoV-2).
T97 7301-7378 Sentence denotes The onset of COVID-19 presents as fever, mild or sever, in a few cases [4–6].
T98 7379-7423 Sentence denotes Some patients may gradually develop dyspnea.
T99 7424-7538 Sentence denotes However, in severe cases, the disease progresses rapidly, and patients develop severe septic shock and die [7–10].
T100 7539-7677 Sentence denotes The severity and prognosis of COVID-19 are complicated by the diversity of symptoms, radiological manifestations, and disease progression.
T101 7678-7806 Sentence denotes It is particularly noteworthy that some severe, critical, and deceased patients have significant coagulation dysfunction [1, 4].
T102 7807-8104 Sentence denotes The pathological changes of the disease have been added into the seventh edition of the COVID-19 Treatment Plan issued by the National Health Commission of China, in which both autopsy and histopathologic examinations demonstrate thrombus or microthrombus in the lung, heart, kidney, and/or liver.
T103 8105-8408 Sentence denotes Upon SARS-CoV-2 entering the body through the angiotensin-converting enzyme 2 (ACE2) receptor adsorbed on the surface of mucosal epithelial cells [7, 8], its pathogen-associated molecular pattern (PAMP) can be quickly recognized by the immune system, and immune response is activated to clear the virus.
T104 8409-8477 Sentence denotes However, overactivated immune response could cause a cytokine storm.
T105 8478-8634 Sentence denotes As a result, cytokine storm causes vascular endothelial damage, activates the coagulation system, and inhibits the fibrinolytic and anticoagulating systems.
T106 8635-8833 Sentence denotes Excessive thromboses in the microvascular system lead to disseminated intravascular coagulation (DIC) and, ultimately, microcirculatory disorder and serious multiple organ dysfunction syndrome [11].
T107 8834-8938 Sentence denotes Therefore, early detection and correction of coagulation dysfunction could effectively reduce mortality.
T108 8939-9016 Sentence denotes Commonly used laboratory coagulation indicators include DD, PT, APTT, and Fg.
T109 9017-9275 Sentence denotes DD is the product of fibrinolytic solubilization of fibrin, and the elevated level of DD indicates that there is a hypercoagulating state and secondary fibrinolysis in the body, which can be seen in increased fibrinolytic activity of the body system [12–15].
T110 9276-9390 Sentence denotes PT and APTT are exogenous and endogenous coagulating system factors, which can be used for early diagnosis of DIC.
T111 9391-9536 Sentence denotes Fg is a protein with coagulation function synthesized by the liver, which is an important substance in the process of coagulation and thrombosis.
T112 9537-9617 Sentence denotes High level of Fg is an important indicator for a variety of thrombotic diseases.
T113 9618-9731 Sentence denotes DD, PT, APTT, and Fg can be used as sensitive indicators to reflect different degrees of coagulating dysfunction.
T114 9732-9845 Sentence denotes Therefore, in this article, the study was focused on if these indicators are related to the severity of COVID-19.
T115 9846-9970 Sentence denotes The results of this study showed that DD and Fg could be used as new indicators for the clinical classification of COVID-19.
T116 9971-10085 Sentence denotes In the first test of DD, 50 of 115 patients had abnormal levels of DD (>0.55 mg/L), accounting for 43.5% (50/115).
T117 10086-10236 Sentence denotes Of the 28 critically ill patients, 17 were >0.55 mg/L, accounting for 60.7%. (17/25), and 14 cases had two times more than the normal reference value.
T118 10237-10310 Sentence denotes 70.4% (81/115) of the COVID-19 patients had abnormal concentration of Fg.
T119 10311-10488 Sentence denotes Additionally, it is noticed that the level of Fg was significantly increased in severe and critically ill patients, with 70.3% of severe and critical patients (52/74) >4.00 g/L.
T120 10489-10808 Sentence denotes The results of the study indicate that the levels of DD and Fg significantly increased in severe and critically ill patients, and some patients deteriorated during treatment, suggesting that COVID-19 patients, especially severe patients, have a high risk of thrombosis, which is consistent with previous reports [1, 4].
T121 10809-11022 Sentence denotes In addition, the results of this study also show a significant correlation between coagulating factors and disease outcome, suggesting DD, PT, and APTT could serve as diagnostic indicators for disease progression.
T122 11023-11202 Sentence denotes Among the 23 patients who deceased, 18 had abnormal DD in the first test, accounting for 78.3% (18/23), among which 12 had DD level two times more than the normal reference value.
T123 11203-11280 Sentence denotes In the second and third tests, 8 exacerbating cases had DD level > 1.10 mg/L.
T124 11281-11392 Sentence denotes Additionally, among 23 deceased patients, 21 cases had DD level two times more than the normal reference value.
T125 11393-11539 Sentence denotes In the first test of PT, there were two abnormalities (15 sec) in 8 aggravating patients whereas 5 abnormalities (15 sec) in 23 deceased patients.
T126 11540-11665 Sentence denotes While in the second and third PT tests, there were 10 and 18 abnormalities (> 15 sec), respectively, in 23 deceased patients.
T127 11666-11769 Sentence denotes The gradually increasing DD and PT levels suggest the significant correlation with disease progression.
T128 11770-11947 Sentence denotes Using discharged and deceased cases as the basis of positive division, the ROC curve analyses showed the areas under the curve (AUCs) were 0.742, 0.818, and 0.851, respectively.
T129 11948-12091 Sentence denotes The third time of PT and APTT test had AUCs at 0.937 and 0.856, respectively, indicating that PT and APTT had great value in disease prognosis.
T130 12092-12415 Sentence denotes Based on the study results, the levels of D-dimer, PT, and APTT were significantly higher, whereas Fg in deceased cases was significantly lower than those in survival cases, suggesting the dynamic coagulating process in patients with COVID-19 is likely the hypercoagulating state followed by the activation of fibrinolysis.
T131 12416-12710 Sentence denotes In this study, PT and APTT prolonged in 23 deceased patients, and the prolongation was more significant in the second and third tests, indicating the patients were in the transition from the high coagulating state into fibrinolytic state due to the excessive consumption of coagulating factors.
T132 12711-12966 Sentence denotes Additionally, the study results showed DD, one of the fibrinolytic degradation products, gradually increased throughout the disease, indicating that the patients were possibly in hyperfibrinolytic state, which is consistent with Chen et al.'s report [16].
T133 12967-13054 Sentence denotes CT imaging has been regarded as a valuable tool in diagnosis and prognosis of COVID-19.
T134 13055-13160 Sentence denotes The study results showed that DD was correlated with CT imaging in predicting the progression of disease.
T135 13161-13327 Sentence denotes Specifically, the increased level of DD suggests hypercoagulating state and the possible pulmonary embolism, which could be further confirmed by CT angiography (CTA).
T136 13328-13510 Sentence denotes One limitation of this study exists on that it was carried out in a single medical center with absence of the control group design due to the emergent situation of COVID-19 breakout.
T137 13511-13663 Sentence denotes In the future, the researchers should integrate with a few medical centers in the area and draw the control group to boost the reliability of the study.
T138 13664-13798 Sentence denotes In conclusion, the results of this study showed that hypercoagulation was likely present in patients with COVID-19 at the early stage.
T139 13799-13883 Sentence denotes And hypercoagulation is closely related to disease progression and clinical outcome.
T140 13884-14025 Sentence denotes Therefore, the coagulation indicators such as DD and PT should be monitored as early as possible in order to detect thrombotic complications.
T141 14026-14230 Sentence denotes It is imperative to take preventive treatment to reduce the risk of thromboembolism and DIC secondary to coagulation disorder, thereby decreasing the morbidity and mortality of COVID-19-infected patients.