LitCovid-sentences  

PMC:7386785 / 51804-59505 JSONTXT 9 Projects

Annnotations TAB TSV DIC JSON TextAE

Id Subject Object Predicate Lexical cue
T473 0-8 Sentence denotes Findings
T474 9-80 Sentence denotes The main characteristics of all included studies are listed in Table 3.
T475 81-388 Sentence denotes There were four studies in hospital inpatients (Ai 2020a; Chen X 2020; Yang 2020d; Zhao 2020a), seven studies in hospital outpatients (Cheng 2020a; Liang 2020; Nobel 2020; Peng 2020a; Song 2020b; Sun 2020a; Yan 2020a), and four studies in emergency departments (Feng 2020a; Tolia 2020; Wee 2020; Zhu 2020b).
T476 389-690 Sentence denotes The setting was not specified in one study (Rentsch 2020); in the 'Summary of findings' table, we classified this study setting as being hospital outpatient under the assumption that at that time in the pandemic (February 2020 to March 2020) tests were not commonly available outside hospital clinics.
T477 691-758 Sentence denotes There were no studies conducted in community primary care services.
T478 759-1172 Sentence denotes Seven studies assessed the accuracy of signs and symptoms for the diagnosis of COVID‐19 pneumonia (Ai 2020a; Chen X 2020; Cheng 2020a; Feng 2020a; Liang 2020; Yang 2020d; Zhao 2020a); the remaining studies had COVID‐19 disease as the target condition, with no further description of the severity, meaning some patients could have suffered from mild or moderate COVID‐19 disease and others from COVID‐19 pneumonia.
T479 1173-1293 Sentence denotes The distinction between these two target conditions was not always very clear, and a degree of overlap is to be assumed.
T480 1294-1403 Sentence denotes All studies used RT‐PCR testing as the reference standard, with some variation in the samples that were used.
T481 1404-1483 Sentence denotes In all, 7706 patients were included, the median number of participants was 134.
T482 1484-1551 Sentence denotes Prevalence of infection varied from 5% to 38% with a median of 17%.
T483 1552-1746 Sentence denotes There were no studies in children or elderly populations, except for Rentsch 2020, which included a cohort of a median age of 65.7 years old from the Veterans Affairs Healthcare System database.
T484 1747-1908 Sentence denotes We found data on 27 signs and symptoms, which fall into four different categories: systemic, respiratory, gastrointestinal and cardiovascular signs and symptoms.
T485 1909-1998 Sentence denotes There were no analyses for combinations of tests, only for individual signs and symptoms.
T486 1999-2037 Sentence denotes The results are summarised in Table 3.
T487 2038-2366 Sentence denotes Results for the cross‐sectional studies are presented in forest plots (Figure 4; Figure 5; Figure 6; Figure 7), and are plotted in ROC (receiver operating characteristic) space (Figure 8; Figure 9; Figure 10; Figure 11), results for the other studies are only listed in forest plots (Figure 12; Figure 13; Figure 14; Figure 15).
T488 2367-2441 Sentence denotes 4 Forest plot of respiratory signs and symptoms (cross‐sectional studies)
T489 2442-2513 Sentence denotes 5 Forest plot of systemic signs and symptoms (cross‐sectional studies)
T490 2514-2593 Sentence denotes 6 Forest plot of gastrointestinal signs and symptoms (cross‐sectional studies)
T491 2594-2671 Sentence denotes 7 Forest plot of cardiovascular signs and symptoms (cross‐sectional studies)
T492 2672-2751 Sentence denotes 8 Summary ROC plot of respiratory signs and symptoms (cross‐sectional studies)
T493 2752-2828 Sentence denotes 9 Summary ROC plot of systemic signs and symptoms (cross‐sectional studies)
T494 2829-2914 Sentence denotes 10 Summary ROC Plot of gastrointestinal signs and symptoms (cross‐sectional studies)
T495 2915-2998 Sentence denotes 11 Summary ROC plot of cardiovascular signs and symptoms (cross‐sectional studies)
T496 2999-3024 Sentence denotes 12 Forest plot of tests:
T497 3025-3404 Sentence denotes 27 cough (non‐cross‐sectional study), 28 sore throat (non‐cross‐sectional study), 29 rhinorrhoea (non‐cross‐sectional study), 30 nasal obstruction (non‐cross‐sectional study), 34 dyspnoea (non‐cross‐sectional study), 31 loss of sense of smell (non‐cross‐sectional study), 32 loss of taste (non‐cross‐sectional study), 33 positive auscultation findings (non‐cross‐sectional study)
T498 3405-3430 Sentence denotes 13 Forest plot of tests:
T499 3431-3602 Sentence denotes 37 fatigue (non‐cross‐sectional study), 36 fever (non‐cross‐sectional study), 39 headache (non‐cross‐sectional study), 38 myalgia or arthralgia (non‐cross‐sectional study)
T500 3603-3628 Sentence denotes 14 Forest plot of tests:
T501 3629-3790 Sentence denotes 40 diarrhoea (non‐cross‐sectional study), 41 nausea/vomiting (non‐cross‐sectional study), 42 gastrointestinal symptoms, not specified (non‐cross‐sectional study)
T502 3791-3950 Sentence denotes 15 Forest plot of 35 chest tightness (non‐cross‐sectional study) Overall, diagnostic accuracy of individual signs and symptoms is low, especially sensitivity.
T503 3951-4054 Sentence denotes In addition, results were highly variable across studies, making it difficult to draw firm conclusions.
T504 4055-4175 Sentence denotes Signs and symptoms for which sensitivity was reported above 50% in at least one cross‐sectional study are the following.
T505 4176-4247 Sentence denotes Cough: sensitivity between 43% and 71%, specificity between 14% and 54%
T506 4248-4324 Sentence denotes Sore throat: sensitivity between 5% and 71%, specificity between 55% and 80%
T507 4325-4395 Sentence denotes Fever: sensitivity between 7% and 91%, specificity between 16% and 94%
T508 4396-4483 Sentence denotes Myalgia or arthralgia: sensitivity between 19% and 86%, specificity between 45% and 91%
T509 4484-4557 Sentence denotes Fatigue: sensitivity between 10% and 57%, specificity between 60% and 94%
T510 4558-4631 Sentence denotes Headache: sensitivity between 3% and 71%, specificity between 78% and 98%
T511 4632-4827 Sentence denotes For fever, six of nine studies report a sensitivity of at least 80%, which is unsurprising considering fever was a key feature of COVID‐19 that was used in selecting patients for further testing.
T512 4828-4919 Sentence denotes As a result, most participants in these studies would have fever, both cases and non‐cases.
T513 4920-5079 Sentence denotes The same applies to cough, which was also listed as one of the main criteria for SARS‐CoV‐2 testing and may have contributed to inflated sensitivity estimates.
T514 5080-5147 Sentence denotes Specificity of at least 90% was achieved for 19 signs and symptoms.
T515 5148-5351 Sentence denotes In only four signs and symptoms did this go along with sensitivity of at least 50% which would correspond to a positive likelihood ratio of at least 5, a commonly used arbitrary definition of a red flag.
T516 5352-5457 Sentence denotes Using this definition, fever, myalgia or arthralgia, fatigue, or headache are to be considered red flags.
T517 5458-5599 Sentence denotes Strikingly, most of the respiratory symptoms such as cough, sore throat and sputum production are below the diagonal in ROC space (Figure 8).
T518 5600-5859 Sentence denotes The diagonal line in ROC space is where sensitivity equals 1‐specificity, meaning a test that is on the diagonal line has a positive likelihood ratio of 1 and is therefore not diagnostic because disease probability is left unchanged after conducting the test.
T519 5860-6037 Sentence denotes Tests that lie below the diagonal line have a positive likelihood ratio that is smaller than 1, meaning the probability of COVID‐19 disease decreases when this test is positive.
T520 6038-6226 Sentence denotes For example, in Sun 2020a, pretest probability of COVID‐19 is 6.9%; probability decreases to 6.4% when the patient has a cough and increases to 8.0% when the patient does not have a cough.
T521 6227-6316 Sentence denotes We hypothesise on the reason for this counterintuitive finding in the discussion section.
T522 6317-6493 Sentence denotes In contrast to respiratory features, systemic features are mostly above the diagonal line (Figure 9), suggesting that they do increase the probability of COVID‐19 when present.
T523 6494-6690 Sentence denotes Gastrointestinal symptoms and cardiovascular features are clustered in the bottom left corner or on the diagonal line suggesting that they have very little diagnostic value (Figure 10; Figure 11).
T524 6691-6928 Sentence denotes To further illustrate the systemic features' ability to either rule in or rule out COVID‐19 disease or COVID‐19 pneumonia, we constructed dumbbell plots showing pre‐ and post‐test probabilities for each feature in each study (Figure 16).
T525 6929-7041 Sentence denotes For each test, we have plotted the pre‐test probability, which is the prevalence of COVID‐19 disease (blue dot).
T526 7042-7169 Sentence denotes Probability then changes depending on a positive test result (red dot marked +) or a negative test result (green dot marked ‐).
T527 7170-7475 Sentence denotes The plot shows that fever, for example, increases the probability of COVID‐19 in two studies (Ai 2020a; Rentsch 2020), makes little to no difference in five studies (Feng 2020; Liang 2020; Peng 2020; Song 2020; Zhu 2020), and decreases the probability of COVID‐19 in two studies (Cheng 2020a; Tolia 2020).
T528 7476-7650 Sentence denotes 16 Dumbbell plot: this plot shows how disease probability changes after a positive test result (red dot with plus sign) or after a negative test (green dot with minus sign).
T529 7651-7701 Sentence denotes Pre‐test probability or prevalence is the blue dot