Id |
Subject |
Object |
Predicate |
Lexical cue |
T23 |
0-16 |
Sentence |
denotes |
Case Description |
T24 |
17-117 |
Sentence |
denotes |
A 63-year-old male without comorbidities presented with 1 week of dry cough, myalgias, and diarrhea. |
T25 |
118-212 |
Sentence |
denotes |
On examination, he was afebrile but appeared to be in distress, saturating at 89% on room air. |
T26 |
213-265 |
Sentence |
denotes |
Chest X-ray showed bilateral interstitial opacities. |
T27 |
266-389 |
Sentence |
denotes |
Initial laboratory tests revealed an elevated C-reactive protein of 24.49 mg/dL and a high interleukin-6 level of 58 pg/mL. |
T28 |
390-496 |
Sentence |
denotes |
Fibrinogen and D-dimer were also elevated to 708 mg/dL and 1.44 fibrinogen equivalent units, respectively. |
T29 |
497-567 |
Sentence |
denotes |
The platelet count and liver function tests were within normal limits. |
T30 |
568-665 |
Sentence |
denotes |
He was diagnosed with COVID-19 by nasopharyngeal reverse-transcriptase–polymerase chain reaction. |
T31 |
666-730 |
Sentence |
denotes |
Low-molecular-weight heparin was started for thromboprophylaxis. |
T32 |
731-853 |
Sentence |
denotes |
On day 2 of admission, he developed progressive worsening of dyspnea and was transferred to the intensive care unit (ICU). |
T33 |
854-914 |
Sentence |
denotes |
On day 7, his right lower extremity was noted to be swollen. |
T34 |
915-1003 |
Sentence |
denotes |
Ultrasound duplex revealed a nonocclusive thrombus within the right common femoral vein. |
T35 |
1004-1182 |
Sentence |
denotes |
He was started on therapeutic anticoagulation for deep vein thrombosis with enoxaparin, which was switched to unfractionated heparin (UFH) later, due to worsening renal function. |
T36 |
1183-1283 |
Sentence |
denotes |
On the same day, due to worsening respiratory failure, he was intubated and mechanically ventilated. |
T37 |
1284-1382 |
Sentence |
denotes |
Between days 11 and 12 of hospitalization, platelet count dropped from 304 000 to 96 000 cells/µL. |
T38 |
1383-1446 |
Sentence |
denotes |
He had a high pretest probability for HIT with a 4T score of 6. |
T39 |
1447-1612 |
Sentence |
denotes |
HIT antibody testing (anti-PF4/heparin antibody, by enzyme-linked immunosorbent assay) was sent, which returned positive with an optical density (OD) of 1.243 units. |
T40 |
1613-1674 |
Sentence |
denotes |
Heparin drip was discontinued and was switched to argatroban. |
T41 |
1675-1738 |
Sentence |
denotes |
Unfortunately, he died a day later, following a cardiac arrest. |
T42 |
1739-1914 |
Sentence |
denotes |
Serotonin release assay (SRA) eventually returned positive, with 49% serotonin release at low UFH dose (0.1 IU/mL) with a reduction to 0% release at high UFH dose (100 IU/mL). |
T43 |
1915-1951 |
Sentence |
denotes |
This confirmed the diagnosis of HIT. |