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Abdellatif Z, Abdel-Haleem H, Abdalaziz RA, Ramadan A, Al-Sharif AM, El-Korashy RIM, Soliman YMA, Hussein SA, Kamal MM, Abdullatif MMA, AbdelRazik MM, Eldessouky NMT, Atef M. Coronavirus disease 19 (Covid-19): A comparative study of pattern of liver injury in adult patients in different waves of Covid-19 infection. Arab J Gastroenterol 2024:S1687-1979(24)00008-X. [PMID: 38378355 DOI: 10.1016/j.ajg.2024.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 10/10/2023] [Accepted: 01/07/2024] [Indexed: 02/22/2024]
Abstract
BACKGROUND AND STUDY AIMS Liver dysfunction is a common manifestation of the COVID-19 infection. We aimed to study transaminase abnormalities through different waves of COVID-19 and their relations to disease severity or mortality. PATIENTS AND METHODS A retrospective study included 521 Egyptian patients diagnosed with COVID-19. Data was retrieved from the medical records of patients who were admitted from April 2020 to October 2021 in Kasr Al-Ainy Hospitals, Cairo University, with categorization according to disease severity in correspondence to the four waves. RESULTS The median age was lower in the first wave compared to other waves, with male predominance across all waves. The most commonly encountered comorbidity overall was hypertension, followed by diabetes mellitus. White blood cells, ferritin, and interleukin-6 showed the highest median values in the second wave, with significantly higher median C-reactive protein on day 1 in the first wave. Forty percent of the patients showed elevated hepatic transaminases on admission in four waves, with no statistically significant difference between waves. On day 5, around half of the patients had elevated transaminases, with no significant difference between waves. Most CT findings were of moderate severity. Clinical severity was higher in the second wave. It was observed that the higher the disease severity, the greater the proportion of patients with elevated hepatic transaminases. The mortality rate was markedly high in cases who had elevated ALT or AST on day 5. The association between elevated enzymes on admission and mortality was seen in the first wave only, with a fatality rate of 22.5% in cases with increased baseline ALT and AST versus 5% in those with normal baseline enzymes. CONCLUSION There was no significant difference in transaminases between the four waves. Elevated transaminases were positively associated with increased mortality and severity, reflecting their prognostic value.
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Affiliation(s)
- Zeinab Abdellatif
- Hepatogastroenterology and Endemic Medicine Department - Faculty of Medicine, Cairo University, Egypt.
| | - Hanan Abdel-Haleem
- Hepatogastroenterology and Endemic Medicine Department - Faculty of Medicine, Cairo University, Egypt
| | - Rasha Ahmed Abdalaziz
- Hepatogastroenterology and Endemic Medicine Department - Faculty of Medicine, Cairo University, Egypt.
| | - Ahmed Ramadan
- Hepatogastroenterology and Endemic Medicine Department - Faculty of Medicine, Cairo University, Egypt.
| | - Aya Mohamed Al-Sharif
- Hepatogastroenterology and Endemic Medicine Department - Faculty of Medicine, Cairo University, Egypt
| | | | | | - Sabah Ahmed Hussein
- Pulmonary Medicine Department - Faculty of Medicine, Cairo University, Egypt.
| | - Manal Mohamed Kamal
- Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Egypt
| | | | | | | | - Mira Atef
- Hepatogastroenterology and Endemic Medicine Department - Faculty of Medicine, Cairo University, Egypt.
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Bakkaloglu OK, Onal U, Eskazan T, Kurt EA, Candan S, Karaali R, Borekci S, Urkmez S, Dikmen Y, Tabak F, Tuncer M, Hatemi I. Increase in transaminase levels during COVID-19 infection and its association with poor prognosis. Singapore Med J 2023; 64:640-644. [PMID: 37861645 PMCID: PMC10645006 DOI: 10.4103/singaporemedj.smj-2021-111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 08/01/2021] [Indexed: 05/13/2023]
Affiliation(s)
- Oguz Kagan Bakkaloglu
- Section of Gastroenterology, Department of Internal Medicine, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ugur Onal
- Section of Gastroenterology, Department of Internal Medicine, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Tugce Eskazan
- Section of Gastroenterology, Department of Internal Medicine, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Enes Ali Kurt
- Section of Gastroenterology, Department of Internal Medicine, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Selcuk Candan
- Section of Gastroenterology, Department of Internal Medicine, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ridvan Karaali
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Sermin Borekci
- Department of Chest Diseases, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Seval Urkmez
- Department of Anesthesiology and Intensive Care, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Yalim Dikmen
- Department of Anesthesiology and Intensive Care, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Fehmi Tabak
- Department of Infectious Diseases and Clinical Microbiology, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Murat Tuncer
- Section of Gastroenterology, Department of Internal Medicine, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Ibrahim Hatemi
- Section of Gastroenterology, Department of Internal Medicine, Cerrahpasa School of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Karatas M, Keles N, Parsova KE, Ciftci HO, Ozkok S, Kahraman E, Durak F, Kocogullari CU, Yiyit N. High AST/ALT Ratio Is Associated with Cardiac Involvement in Acute COVID-19 Patients. Medicina (Kaunas) 2023; 59:1163. [PMID: 37374367 DOI: 10.3390/medicina59061163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 06/02/2023] [Accepted: 06/13/2023] [Indexed: 06/29/2023]
Abstract
Background and Objectives: We aimed to assess the effect of AST/ALT ratio on echocardiographic and cardiac magnetic resonance imaging (CMRI) parameters after COVID-19 patients recover. Materials and Methods: 87 patients with COVID-19 were included in the study. The patients were hospitalized with COVID-19 pneumonia, but the patients did not need intensive care unit follow-up or non-invasive mechanical ventilation support. After a discharge and two weeks following the positive swab test result, patients were considered eligible if they had any symptoms. Transthoracic echocardiography (TTE) was performed within 24 h prior to CMRI. The median value of AST/ALT ratio was found, and the study population was divided into two subgroups based on the median AST/ALT ratio value. The clinical features, blood test, TTE and CMRI results were compared between subgroups. Results: C-reactive protein, D-dimer and fibrinogen were found to be significantly higher in patients with high AST/ALT ratio. LVEF, TAPSE, S', and FAC were significantly lower in patients with high AST/ALT ratio. LV-GLS were significantly lower in patients with high AST/ALT ratio. In CMRI, native T1 mapping signal, native T2 mapping signal and extracellular volume raised significantly in patients with high AST/ALT ratio. Right ventricle stroke volume and right ventricle ejection fraction were significantly lower in patients with high AST/ALT ratio, but right ventricle end systolic volume was significantly higher in patients with high AST/ALT ratio. Conclusion: High AST/ALT ratio is related to impaired right ventricular function parameters with CMRI and echocardiography after recovery from acute COVID-19. Assessment of AST/ALT ratio at hospital admission may be used to assess the risk of cardiac involvement in COVID-19 disease, and these patients may require closer follow-up during and after the course of COVID-19.
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Affiliation(s)
- Mesut Karatas
- Department of Cardiology, Kartal Kosuyolu Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Istanbul 34865, Turkey
| | - Nursen Keles
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul 34668, Turkey
| | | | - Hatice Ozge Ciftci
- Department of Radiology, Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, University of Health Sciences, Istanbul 34785, Turkey
| | - Sercin Ozkok
- Department of Radiology, Acıbadem International Hospital, Istanbul 34149, Turkey
- Biomedical Science and Engineering, Koc University, Istanbul 34450, Turkey
| | - Erkan Kahraman
- Department of Cardiology, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul 34668, Turkey
| | - Furkan Durak
- Department of Cardiology, University of Health Sciences Sancaktepe Şehit Prof. Dr. İlhan Varank Training and Research Hospital, Istanbul 34785, Turkey
| | - Cevdet Ugur Kocogullari
- Department of Cardiovascular Surgery, Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, University of Health Sciences, Istanbul 34668, Turkey
| | - Nurettin Yiyit
- Department of Thoracic Surgery, Basaksehir Cam & Sakura City Hospital, Istanbul 34480, Turkey
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Sun W, Xia L, Ji C, Wei Q, Zhang J, He S, Wang X, Shen X, Zhang X, Li C. Relationship between covid-pandemic anxiety and sleep disorder with menstrual disorders among female medical workers. BMC Womens Health 2023; 23:210. [PMID: 37118730 PMCID: PMC10147349 DOI: 10.1186/s12905-023-02314-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Accepted: 03/29/2023] [Indexed: 04/30/2023] Open
Abstract
BACKGROUND It has been more than 2 years since the 2019 novel coronavirus disease (COVID-19) pandemic destabilized the world, adversely affecting not only physical health, but also mental health. During this time, frontline medical workers were at a greater health risk, especially female medical workers. Changes or abnormalities in the menstrual cycle-an important indicator of women's health-may jeopardize female reproductive functioning. Considering that emotional health and sleep status may be related to the menstrual cycle, this study aimed to investigate the association between menstrual cycle changes, anxiety, sleep dysfunction, and other factors among female medical workers during the COVID-19 pandemic. METHODS A cross-sectional survey was conducted by distributing online questionnaires to female medical workers in China from February to May 2022. The study included 160 women aged 18-45 years old. The questionnaires covered data related to the participants' sociodemographic characteristics, medical and reproductive history, and lifestyle. The Rating Scale for Clinical Manifestations of Menopathy (SCMM), Self-Rating Anxiety Scale (SAS), and Sleep Dysfunction Rating Scale (SDRS) were utilized. Data were analyzed using chi-square tests, t-tests, and linear regression analysis. RESULTS A total of 160 female medical staff were randomly selected in this research, of whom seven scored less than 3 points, 85 scored 3-11 points, and 68 scored more than 11 points on the total score of the SCMM. Compared to pre-pandemic scores, scores of dizziness and tinnitus were significantly higher during the COVID-19 pandemic. Scores corresponding to the following clinical symptoms were also higher during the pandemic: Menopathy, including hypaphrodisia, dim complexion, abnormal urination, languidness, dim menstruation, thin menstruation, dysmenorrhea, and empty or saggy lower abdomen (p < 0.05). However, pre-pandemic scores of vaginal bleeding quantity were significantly higher than those found during the COVID-19 pandemic (p < 0.05). Scores of vaginal bleeding quantity were significantly lower in cabin hospitals than other types of hospitals, and a similar finding was observed for vaginal bleeding duration (all p < 0.05). Moreover, the findings of the univariable and multivariable linear regression analysis revealed a link between consistent exercise, the underlying illness, the SDRS score, the SAS score, and the total score of SCMM (p < 0.05). CONCLUSIONS In this study, we found that menstruation in female medical workers was affected by the COVID-19 pandemic. Furthermore, regular exercise and good physical condition were protective factors, while anxiety and insomnia were risk factors for menstrual abnormalities.
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Affiliation(s)
- Wenxi Sun
- Psychiatry department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu Province, China
| | - Liping Xia
- Psychiatry department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu Province, China
| | - Caifang Ji
- Psychiatry department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu Province, China
| | - Qianqian Wei
- Psychiatry department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu Province, China
| | - Jun Zhang
- Psychiatry department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu Province, China
| | - Sidi He
- Psychiatry department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu Province, China
| | - Xuqin Wang
- Psychiatry department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu Province, China
| | - Xueqin Shen
- The Affiliated Jiangsu Shengze Hospital of Nanjing Medical University, Suzhou, 215100, Jiangsu Province, China
| | - Xiaobin Zhang
- Psychiatry department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu Province, China.
| | - Chuanwei Li
- Psychiatry department of Suzhou Guangji Hospital, Affiliated Guangji Hospital of Soochow University, Suzhou, 215137, Jiangsu Province, China.
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Khullar N, Bhatti JS, Singh S, Thukral B, Reddy PH, Bhatti GK. Insight into the liver dysfunction in COVID-19 patients: Molecular mechanisms and possible therapeutic strategies. World J Gastroenterol 2023; 29:2064-2077. [PMID: 37122601 PMCID: PMC10130970 DOI: 10.3748/wjg.v29.i14.2064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 10/23/2022] [Accepted: 03/21/2023] [Indexed: 04/13/2023] Open
Abstract
As of June 2022, more than 530 million people worldwide have become ill with coronavirus disease 2019 (COVID-19). Although COVID-19 is most commonly associated with respiratory distress (severe acute respiratory syndrome), meta-analysis have indicated that liver dysfunction also occurs in patients with severe symptoms. Current studies revealed distinctive patterning in the receptors on the hepatic cells that helps in viral invasion through the expression of angiotensin-converting enzyme receptors. It has also been reported that in some patients with COVID-19, therapeutic strategies, including repurposed drugs (mitifovir, lopinavir/ritonavir, tocilizumab, etc.) triggered liver injury and cholestatic toxicity. Several proven indicators support cytokine storm-induced hepatic damage. Because there are 1.5 billion patients with chronic liver disease worldwide, it becomes imperative to critically evaluate the molecular mechanisms concerning hepatotropism of COVID-19 and identify new potential therapeutics. This review also designated a comprehensive outlook of comorbidities and the impact of lifestyle and genetics in managing patients with COVID-19.
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Affiliation(s)
- Naina Khullar
- Department of Zoology, Mata Gujri College, Fatehgarh Sahib 140407, Punjab, India
| | - Jasvinder Singh Bhatti
- Laboratory of Translational Medicine and Nanotherapeutics, Department of Human Genetics and Molecular Medicine, School of Health Sciences, Central University of Punjab, Bathinda 151401, Punjab, India
| | - Satwinder Singh
- Department of Computer Science and Technology, Central University of Punjab, Bathinda 151401, Punjab, India
| | - Bhawana Thukral
- Department of Nutrition and Dietetics, University Institute of Applied Health Sciences, Chandigarh University, Mohali 140413, Punjab, India
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, United States
| | - Gurjit Kaur Bhatti
- Department of Medical Lab Technology, University Institute of Applied Health Sciences, Chandigarh University, Mohali 140413, Punjab, India
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Zhai S, Zhang Z, Liao J, Cui X. Learning from real world data about combinatorial treatment selection for COVID-19. Front Artif Intell 2023; 6:1123285. [PMID: 37077235 PMCID: PMC10106735 DOI: 10.3389/frai.2023.1123285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 03/17/2023] [Indexed: 04/05/2023] Open
Abstract
COVID-19 is an unprecedented global pandemic with a serious negative impact on virtually every part of the world. Although much progress has been made in preventing and treating the disease, much remains to be learned about how best to treat the disease while considering patient and disease characteristics. This paper reports a case study of combinatorial treatment selection for COVID-19 based on real-world data from a large hospital in Southern China. In this observational study, 417 confirmed COVID-19 patients were treated with various combinations of drugs and followed for four weeks after discharge (or until death). Treatment failure is defined as death during hospitalization or recurrence of COVID-19 within four weeks of discharge. Using a virtual multiple matching method to adjust for confounding, we estimate and compare the failure rates of different combinatorial treatments, both in the whole study population and in subpopulations defined by baseline characteristics. Our analysis reveals that treatment effects are substantial and heterogeneous, and that the optimal combinatorial treatment may depend on baseline age, systolic blood pressure, and c-reactive protein level. Using these three variables to stratify the study population leads to a stratified treatment strategy that involves several different combinations of drugs (for patients in different strata). Our findings are exploratory and require further validation.
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Affiliation(s)
- Song Zhai
- Biostatistics and Research Decision Sciences, Merck & Co., Inc., Rahway, NJ, United States
- Department of Statistics, University of California, Riverside, Riverside, CA, United States
| | - Zhiwei Zhang
- Biostatistics Innovation Group, Gilead Sciences, Foster City, CA, United States
| | - Jiayu Liao
- Department of Bioengineering, University of California, Riverside, Riverside, CA, United States
- Jiayu Liao
| | - Xinping Cui
- Department of Statistics, University of California, Riverside, Riverside, CA, United States
- *Correspondence: Xinping Cui
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Gajula SNR, Khairnar AS, Jock P, Kumari N, Pratima K, Munjal V, Kalan P, Sonti R. LC-MS/MS: A sensitive and selective analytical technique to detect COVID-19 protein biomarkers in the early disease stage. Expert Rev Proteomics 2023; 20:5-18. [PMID: 36919634 DOI: 10.1080/14789450.2023.2191845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Abstract
INTRODUCTION The COVID-19 outbreak has put enormous pressure on the scientific community to detect infection rapidly, identify the status of disease severity, and provide an immediate vaccine/drug for the treatment. Relying on immunoassay and a real-time reverse transcription polymerase chain reaction (rRT-PCR) led to many false-negative and false-positive reports. Therefore, detecting biomarkers is an alternative and reliable approach for determining the infection, its severity, and disease progression. Recent advances in liquid chromatography and mass spectrometry (LC-MS/MS) enable the protein biomarkers even at low concentrations, thus facilitating clinicians to monitor the treatment in hospitals. AREAS COVERED This review highlights the role of LC-MS/MS in identifying protein biomarkers and discusses the clinically significant protein biomarkers such as Serum amyloid A, Interleukin-6, C-Reactive Protein, Lactate dehydrogenase, D-dimer, cardiac troponin, ferritin, Alanine transaminase, Aspartate transaminase, gelsolin and galectin-3-binding protein in COVID-19, and their analysis by LC-MS/MS in the early stage. EXPERT OPINION Clinical doctors monitor significant biomarkers to understand, stratify, and treat patients according to disease severity. Knowledge of clinically significant COVID-19 protein biomarkers is critical not only for COVID-19 caused by the coronavirus but also to prepare us for future pandemics of other diseases in detecting by LC-MS/MS at the early stages.
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Affiliation(s)
- Siva Nageswara Rao Gajula
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Balanagar, India
| | - Ankita Sahebrao Khairnar
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Balanagar, India
| | - Pallavi Jock
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Balanagar, India
| | - Nikita Kumari
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Balanagar, India
| | - Kendre Pratima
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Balanagar, India
| | - Vijay Munjal
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Balanagar, India
| | - Pavan Kalan
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Balanagar, India
| | - Rajesh Sonti
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), Hyderabad, Balanagar, India
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Kowsar R, Rahimi AM, Sroka M, Mansouri A, Sadeghi K, Bonakdar E, Kateb SF, Mahdavi AH. Risk of mortality in COVID-19 patients: a meta- and network analysis. Sci Rep 2023; 13:2138. [PMID: 36747045 PMCID: PMC9901837 DOI: 10.1038/s41598-023-29364-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Accepted: 02/03/2023] [Indexed: 02/08/2023] Open
Abstract
Understanding the most relevant hematological/biochemical characteristics, pre-existing health conditions and complications in survivors and non-survivor will aid in predicting COVID-19 patient mortality, as well as intensive care unit (ICU) referral and death. A literature review was conducted for COVID-19 mortality in PubMed, Scopus, and various preprint servers (bioRxiv, medRxiv and SSRN), with 97 observational studies and preprints, consisting of survivor and non-survivor sub-populations. This meta/network analysis comprised 19,014 COVID-19 patients, consisting of 14,359 survivors and 4655 non-survivors. Meta and network analyses were performed using META-MAR V2.7.0 and PAST software. The study revealed that non-survivors of COVID-19 had elevated levels of gamma-glutamyl transferase and creatinine, as well as a higher number of neutrophils. Non-survivors had fewer lymphocytes and platelets, as well as lower hemoglobin and albumin concentrations. Age, hypertension, and cerebrovascular disease were shown to be the most influential risk factors among non-survivors. The most common complication among non-survivors was heart failure, followed by septic shock and respiratory failure. Platelet counts, creatinine, aspartate aminotransferase, albumin, and blood urea nitrogen levels were all linked to ICU admission. Hemoglobin levels preferred non-ICU patients. Lower levels of hemoglobin, lymphocytes, and albumin were associated with increased mortality in ICU patients. This meta-analysis showed that inexpensive and fast biochemical and hematological tests, as well as pre-existing conditions and complications, can be used to estimate the risk of mortality in COVID-19 patients.
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Affiliation(s)
- Rasoul Kowsar
- Department of Animal Sciences, College of Agriculture, Isfahan University of Technology, Isfahan, 84156-83111, Iran.
| | - Amir Mohammad Rahimi
- Department of Developmental Biology, Göttingen Center for Molecular Biosciences (GZMB), Georg-August-University, 37073, Göttingen, Germany
| | - Magdalena Sroka
- University Medical Center Göttingen, Georg-August-University, 37075, Göttingen, Germany
| | - Alireza Mansouri
- Global Agromedicine Research Center (GAMRC), Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Hokkaido, Japan
| | - Khaled Sadeghi
- Department of Animal Sciences, College of Agriculture, Isfahan University of Technology, Isfahan, 84156-83111, Iran
| | - Elham Bonakdar
- Department of Animal Sciences, College of Agriculture, Isfahan University of Technology, Isfahan, 84156-83111, Iran
| | | | - Amir Hossein Mahdavi
- Department of Animal Sciences, College of Agriculture, Isfahan University of Technology, Isfahan, 84156-83111, Iran
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Abstract
Viral hepatitis is a leading cause of liver morbidity and mortality globally. The mechanisms underlying acute infection and clearance, versus the development of chronic infection, are poorly understood. In vitro models of viral hepatitis circumvent the high costs and ethical considerations of animal models, which also translate poorly to studying the human-specific hepatitis viruses. However, significant challenges are associated with modeling long-term infection in vitro. Differentiated hepatocytes are best able to sustain chronic viral hepatitis infection, but standard two-dimensional models are limited because they fail to mimic the architecture and cellular microenvironment of the liver, and cannot maintain a differentiated hepatocyte phenotype over extended periods. Alternatively, physiomimetic models facilitate important interactions between hepatocytes and their microenvironment by incorporating liver-specific environmental factors such as three-dimensional ECM interactions and co-culture with non-parenchymal cells. These physiologically relevant interactions help maintain a functional hepatocyte phenotype that is critical for sustaining viral hepatitis infection. In this review, we provide an overview of distinct, novel, and innovative in vitro liver models and discuss their functionality and relevance in modeling viral hepatitis. These platforms may provide novel insight into mechanisms that regulate viral clearance versus progression to chronic infections that can drive subsequent liver disease.
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Affiliation(s)
- Dennis McDuffie
- Department of Biomedical Engineering, University of Miami, Coral Gables, Florida
| | - David Barr
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida
| | - Madeline Helm
- Department of Biomedical Engineering, University of Miami, Coral Gables, Florida
| | - Thomas Baumert
- Inserm Research Institute for Viral and Liver Diseases, University of Strasbourg, Strasbourg, France
| | - Ashutosh Agarwal
- Department of Biomedical Engineering, University of Miami, Coral Gables, Florida
- Desai Sethi Urology Institute, Miller School of Medicine, University of Miami, Miami, Florida
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Emmanuel Thomas
- Department of Biomedical Engineering, University of Miami, Coral Gables, Florida
- Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, Florida
- Schiff Center for Liver Diseases, University of Miami Miller School of Medicine, Miami, Florida
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
- Address for correspondence Emmanuel Thomas, MD, PhD, FAASLD Department of Biomedical Engineering, University of MiamiCoral Gables, FL 33136-1015
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Cumhur Cure M, Cure E. Severe acute respiratory syndrome coronavirus 2 may cause liver injury via Na +/H + exchanger. World J Virol 2023; 12:12-21. [PMID: 36743661 PMCID: PMC9896593 DOI: 10.5501/wjv.v12.i1.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Revised: 10/03/2022] [Accepted: 11/22/2022] [Indexed: 01/18/2023] Open
Abstract
The liver has many significant functions, such as detoxification, the urea cycle, gluconeogenesis, and protein synthesis. Systemic diseases, hypoxia, infections, drugs, and toxins can easily affect the liver, which is extremely sensitive to injury. Systemic infection of severe acute respiratory syndrome coronavirus 2 can cause liver damage. The primary regulator of intracellular pH in the liver is the Na+/H+ exchanger (NHE). Physiologically, NHE protects hepatocytes from apoptosis by making the intracellular pH alkaline. Severe acute respiratory syndrome coronavirus 2 increases local angiotensin II levels by binding to angiotensin-converting enzyme 2. In severe cases of coronavirus disease 2019, high angi-otensin II levels may cause NHE overstimulation and lipid accumulation in the liver. NHE overstimulation can lead to hepatocyte death. NHE overstimulation may trigger a cytokine storm by increasing proinflammatory cytokines in the liver. Since the release of proinflammatory cytokines such as interleukin-6 increases with NHE activation, the virus may indirectly cause an increase in fibrinogen and D-dimer levels. NHE overstimulation may cause thrombotic events and systemic damage by increasing fibrinogen levels and cytokine release. Also, NHE overstimulation causes an increase in the urea cycle while inhibiting vitamin D synthesis and gluconeogenesis in the liver. Increasing NHE3 activity leads to Na+ loading, which impairs the containment and fluidity of bile acid. NHE overstimulation can change the gut microbiota composition by disrupting the structure and fluidity of bile acid, thus triggering systemic damage. Unlike other tissues, tumor necrosis factor-alpha and angiotensin II decrease NHE3 activity in the intestine. Thus, increased luminal Na+ leads to diarrhea and cytokine release. Severe acute respiratory syndrome coronavirus 2-induced local and systemic damage can be improved by preventing virus-induced NHE overstimulation in the liver.
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Affiliation(s)
- Medine Cumhur Cure
- Department of Biochemistry, Private Tanfer Hospital, Istanbul 34394, Turkey
| | - Erkan Cure
- Department of Internal Medicine, Bagcilar Medilife Hospital, Istanbul 34200, Turkey
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11
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Jiang L, An X, Duan Y, Lian F, Jin D, Zhang Y, Yang C, Zhang Y, Kang X, Sun Y. The pathological mechanism of the COVID-19 convalescence and its treatment with traditional Chinese medicine. Front Pharmacol 2023; 13:1054312. [PMID: 36703736 PMCID: PMC9872123 DOI: 10.3389/fphar.2022.1054312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 12/16/2022] [Indexed: 01/12/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus - 2 (SARS - CoV - 2) was reported to cause the Wuhan outbreak of the corona virus disease 2019(COVID-19). To date, the COVID-19 has infected more than 600 million people gloabally. As a growing number of patients recover from acute infections and are discharged from hospitals, the proportion of patients in the recovery period is gradually increasing. Many of these individuals have been reported to experience multiple symptoms during the convalescence, such as fatigue, dyspnea and pain which are designated as "long-COVID", "post-COVID syndrome" or "recovery sequelae. We searched for recent articles published in PubMed on COVID-19 convalescence and found that the pathogenesis of COVID-19 convalescence is not yet well recognized. It may be associated with incomplete recovery of immune system, parenchymal organ damage (liver or lung), coagulation abnormalities, "second hit" caused by viral infection, and Phenomenon of Cell Senescence-Associated Secretory Phenotype (SASP). Some drugs and psychological factors of patients also play a non-negligible role in it. We also found that the effect of traditional Chinese medicine (TCM) is effective in the treatment of the COVID-19 recovery phase, which can not only relieve the corresponding symptoms, but also improve the indicators and pulmonary fibrosis. Bufei Huoxue Capsule, as the only drug explicitly mentioned for COVID-19 recovery period, can exert strong rehabilitative effects on physiological activity in patients recovering from COVID-19. In addition, in previous studies, traditional Chinese medicine has been confirmed to have the ability to resist cytokine storms, as well as improve coagulation and myocardial damage, which makes it have potential therapeutic advantages in targeting the hyperimmune response, coagulation abnormalities and myocardial damage existing in the recovery period. In conclusion, the clinical symptoms of patients convalescing from COVID-19 are complex, and its pathogenesis has not been elucidated. traditional Chinese medicine, as a traditional treatment, its specific action and mechanism need to be confirmed by more studies, so that it can play a better role.
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Affiliation(s)
- Linlin Jiang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Beijing University of Chinese Medicine, Beijing, China
| | - Xuedong An
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yingying Duan
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Beijing University of Chinese Medicine, Beijing, China
| | - Fengmei Lian
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China,*Correspondence: Fengmei Lian,
| | - De Jin
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuehong Zhang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Cunqing Yang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yuqing Zhang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Xiaomin Kang
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China,Beijing University of Chinese Medicine, Beijing, China
| | - Yuting Sun
- Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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12
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Zsichla L, Müller V. Risk Factors of Severe COVID-19: A Review of Host, Viral and Environmental Factors. Viruses 2023; 15:175. [PMID: 36680215 PMCID: PMC9863423 DOI: 10.3390/v15010175] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/04/2023] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
The clinical course and outcome of COVID-19 are highly variable, ranging from asymptomatic infections to severe disease and death. Understanding the risk factors of severe COVID-19 is relevant both in the clinical setting and at the epidemiological level. Here, we provide an overview of host, viral and environmental factors that have been shown or (in some cases) hypothesized to be associated with severe clinical outcomes. The factors considered in detail include the age and frailty, genetic polymorphisms, biological sex (and pregnancy), co- and superinfections, non-communicable comorbidities, immunological history, microbiota, and lifestyle of the patient; viral genetic variation and infecting dose; socioeconomic factors; and air pollution. For each category, we compile (sometimes conflicting) evidence for the association of the factor with COVID-19 outcomes (including the strength of the effect) and outline possible action mechanisms. We also discuss the complex interactions between the various risk factors.
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Affiliation(s)
- Levente Zsichla
- Institute of Biology, Eötvös Loránd University, 1117 Budapest, Hungary
- National Laboratory for Health Security, Eötvös Loránd University, 1117 Budapest, Hungary
| | - Viktor Müller
- Institute of Biology, Eötvös Loránd University, 1117 Budapest, Hungary
- National Laboratory for Health Security, Eötvös Loránd University, 1117 Budapest, Hungary
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Chavda VP, Patel AB, Pandya A, Vora LK, Patravale V, Tambuwala ZM, Aljabali AAA, Serrano-Aroca Á, Mishra V, Tambuwala MM. Co-infection associated with SARS-CoV-2 and their management. Future Sci OA 2022; 8:FSO819. [PMID: 36788985 PMCID: PMC9912272 DOI: 10.2144/fsoa-2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 10/18/2022] [Indexed: 02/05/2023] Open
Abstract
SARS-CoV-2 was discovered in Wuhan, China and quickly spread throughout the world. This deadly virus moved from person to person, resulting in severe pneumonia, fever, chills and hypoxia. Patients are still experiencing problems after recovering from COVID-19. This review covers COVID-19 and associated issues following recovery from COVID-19, as well as multiorgan damage risk factors and treatment techniques. Several unusual illnesses, including mucormycosis, white fungus infection, happy hypoxia and other systemic abnormalities, have been reported in recovered individuals. In children, multisystem inflammatory syndrome with COVID-19 (MIS-C) is identified. The reasons for this might include uncontrollable steroid usage, reduced immunity, uncontrollable diabetes mellitus and inadequate care following COVID-19 recovery.
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Affiliation(s)
- Vivek P Chavda
- Department of Pharmaceutics & Pharmaceutical Technology, L M College of Pharmacy, Ahmedabad, Gujarat, 380009, India
| | - Aayushi B Patel
- Pharmacy Section, LM College of Pharmacy, Ahmedabad, Gujarat, 380058, India
| | - Anjali Pandya
- Department of Pharmaceutical Sciences & Technology, Institute of Chemical Technology, Mumbai, 400 019, India
| | - Lalitkumar K Vora
- School of Pharmacy, Queen's University Belfast, 97 Lisburn Road, BT9 7BL, UK
| | - Vandana Patravale
- Department of Pharmaceutical Sciences & Technology, Institute of Chemical Technology, Mumbai, 400 019, India
| | - Zara M Tambuwala
- College of Science, University of Lincoln, Brayford Campus, Lincoln, LN6 7TS, UK
| | - Alaa AA Aljabali
- Department of Pharmaceutics & Pharmaceutical Technology, Yarmouk University, Faculty of Pharmacy, Irbid, 566, Jordan
| | - Ángel Serrano-Aroca
- Biomaterials & Bioengineering Lab, Centro de Investigación Traslacional San Alberto Magno, Universidad Católica de Valencia San Vicente Mártir, c/Guillem de Castro 94, Valencia, 46001, Spain
| | - Vijay Mishra
- School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, 144411, India
| | - Murtaza M Tambuwala
- Lincoln Medical School University of Lincoln, Brayford Campus, Lincoln, LN6 7TS, UK
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14
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Nazar Hasan Anber Z, Oead Mohammed Saleh B, Waheab Al-Obidy M. Hepatocellular Damage and Severity of COVID-19 Infection in Iraqi Patients: A Biochemical Study. Rep Biochem Mol Biol 2022; 11:524-31. [PMID: 36718303 DOI: 10.52547/rbmb.11.3.524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 04/24/2022] [Indexed: 01/17/2023]
Abstract
Background Infection with COVID-19 can cause hepatic damages. Here, we aimed to examine the effect of COVID-19 infection on the serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, and procalcitonin (PCT) concentrations as markers to evaluate the liver function. Methods In this study, 56 patients infected with COVID- 19 and 28 healthy controls was recruited in Private Nursing Home Hospital of the Medical City, Baghdad. Patients were subdivided according to disease severity into severe and non-severe groups. Results The results showed that the mean±SD value of serum AST activity and serum PCT concentrations were elevated significantly in severe group in comparison to healthy control, (p< 0.01, p< 0.001) respectively. Also, the mean ±SD value of serum ALT activity was higher in severe group compared to the healthy subjects and non-severe ones, significantly (p< 0.0001, p< 0.003) respectively. While the mean value of serum albumin concentration of severe patients and non-severe group were significantly decreased compared to healthy subjects. The receiver operating characteristic curve (ROC) revealed that ROC value of albumin (0.992) differentiates between non-severe infected patients and healthy subjects, while the ROC value of serum ALT activity (0.735) differentiates between severe COVID-19 patients and non- severe ones. Conclusion Changes of liver function parameters in COVID-19 patients were mild to moderate and measurement of serum ALT activity is the best biomarker in differentiation between non-severe patients and severe ones and albumin concentration is excellent in discrimination between patients and controls.
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15
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Chavda VP, Chen Y, Dave J, Chen ZS, Chauhan SC, Yallapu MM, Uversky VN, Bezbaruah R, Patel S, Apostolopoulos V. COVID-19 and vaccination: myths vs science. Expert Rev Vaccines 2022; 21:1603-1620. [PMID: 35980281 DOI: 10.1080/14760584.2022.2114900] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION Several vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been developed since the inception of the coronavirus disease 2019 (COVID-19) in December 2019, at unprecedented speed. However, these rapidly developed vaccines raised many questions related to the efficacy and safety of vaccines in different communities across the globe. Various hypotheses regarding COVID-19 and its vaccines were generated, and many of them have also been answered with scientific evidence. Still, there are many myths/misinformation related to COVID-19 and its vaccines, which create hesitancy for COVID-19 vaccination, and must be addressed critically to achieve success in the battle against the pandemic. AREA COVERED The development of anti-SARS-CoV-2 vaccines against COVID-19, their safety and efficacy, and myths/misinformation relating to COVID-19 and vaccines are presented. EXPERT OPINION In this pandemic we have seen a global collaborative effort of researchers, governments, and industry, supported by billions of dollars in funding, have allowed the development of vaccines far more quickly than in the past. Vaccines go through rigorous testing, analysis, and evaluations in clinical settings prior to their approval, even if they are approved for emergency use. Despite the myths, vaccination represents an important strategy to get back to normality.
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Affiliation(s)
- Vivek P Chavda
- Department of Pharmaceutics and Pharmaceutical Technology, L.M. College of Pharmacy, Ahmedabad
| | - Yangmin Chen
- Peter J. Tobin College of Business, St. John's University, Queens, NY 11439, USA
| | - Jayant Dave
- Department of Pharmaceutical Quality Assurance, L.M. College of Pharmacy, Ahmedabad
| | - Zhe-Sheng Chen
- College of Pharmacy and Health Sciences, St. John's University, Queens, NY 11439, USA
| | - Subhash C Chauhan
- Department of Immunology and Microbiology, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX, USA.,South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX, USA
| | - Murali M Yallapu
- Department of Immunology and Microbiology, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX, USA.,South Texas Center of Excellence in Cancer Research, School of Medicine, University of Texas Rio Grande Valley, McAllen, TX, USA
| | - Vladimir N Uversky
- Department of Molecular Medicine and Byrd Alzheimer's Research Institure, Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Rajashri Bezbaruah
- Department of Pharmaceutical Sciences, Faculty of Science and Engineering, Dibrugarh University, Dibrugarh -786004, Assam, India
| | - Sandip Patel
- Department of Pharmacology, L.M. College of Pharmacy, Ahmedabad
| | - Vasso Apostolopoulos
- Institute for Health and Sport, Immunology and Translational Research Group, Victoria University, Melbourne, VIC, 3030, Australia.,Immunology Program, Australian Institute for Musculoskeletal Science (AIMSS), Melbourne, VIC, 3021, Australia
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16
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Nesari T, Kadam S, Vyas M, Huddar VG, Prajapati PK, Rajagopala M, More A, Rajagopala SK, Bhatted SK, Yadav RK, Mahanta V, Mandal SK, Mahto RR, Kajaria D, Sherkhane R, Bavalatti N, Kundal P, Dharmarajan P, Bhojani M, Bhide B, Harti SK, Mahapatra AK, Tagade U, Ruknuddin G, Venkatramana Sharma AP, Rai S, Ghildiyal S, Yadav PR, Sandrepogu J, Deogade M, Pathak P, Kapoor A, Kumar A, Saini H, Tripathi R. AYURAKSHA, a prophylactic Ayurvedic immunity boosting kit reducing positivity percentage of IgG COVID-19 among frontline Indian Delhi police personnel: A non-randomized controlled intervention trial. Front Public Health 2022; 10:920126. [PMID: 36052011 PMCID: PMC9424736 DOI: 10.3389/fpubh.2022.920126] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 07/18/2022] [Indexed: 01/22/2023] Open
Abstract
Objective The world continues to face the COVID-19 crisis, and efforts are underway to integrate traditional medicine interventions for its effective management. The study aimed to determine the efficacy of the "AYURAKSHA" kit in terms of post-interventional percentage of COVID-19 IgG positivity, immunity levels, and quality of life (QoL) against COVID-19. Method This was a non-randomized controlled, prospective intervention trial, done after the distribution of 80,000 AYURAKSHA kits (constituent of Sanshamani Vati, AYUSH Kadha, and Anu Taila) among Delhi police participants in India. Among 47,827 participants, the trial group (n = 101) was evaluated with the positivity percentage of IgG COVID-19 and Immune Status Questionnaire (ISQ) scores as a primary outcome and the WHO Quality of Life Brief Version (QOL BREF) scores along with hematological parameters as a secondary outcome in comparison to the control group (n = 71). Results The data showed that the percentage of COVID-19 IgG positivity was significantly lower in the trial group (17.5 %) as compared to the control group (39.4 %, p = 0.003), indicating the lower risk (55.6%) of COVID-19 infection in the trial group. The decreased incidence (5.05%) and reduced mortality percentage (0.44%) of COVID-19 among Delhi police officers during peak times of the pandemic also corroborate our findings. The ISQ score and WHO-QOL BREF tool analysis showed the improved scores in the trial group when compared with the controls. Furthermore, no dysregulated blood profile and no increase in inflammation markers like C-reactive protein, erythrocyte sedimentation rate, Interleukin-6 (IL-6) were observed in the trial group. However, significantly enhanced (p = 0.027) IL-6 levels and random blood sugar levels were found in the control group (p = 0.032), compared to a trial group (p = 0.165) post-intervention. Importantly, the control group showed more significant (p = 0.0001) decline in lymphocyte subsets CD3+ (% change = 21.04), CD4+ (% change = 20.34) and CD8+ (% change = 21.54) levels than in trial group, confirming more severity of COVID-19 infection in the control group. Conclusion The AYURAKSHA kit is associated with reduced COVID-19 positivity and with a better quality of life among the trial group. Hence, the study encourages in-depth research and future integration of traditional medicines for the prevention of the COVID-19 pandemic. Clinical trial registration http://ctri.nic.in/, identifier: CTRI/2020/05/025171.
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Affiliation(s)
- Tanuja Nesari
- All India Institute of Ayurveda (AIIA), New Delhi, India,*Correspondence: Tanuja Nesari
| | - Sujata Kadam
- Department of Prasuti and Stri Roga (Obstetrics and Gynaecology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Mahesh Vyas
- Department of Maulik Siddhant (Fundamental Principles), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Vitthal G. Huddar
- Department of Kaya Chikitsa (Internal Medicine), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Pradeep Kumar Prajapati
- Department of Ras Shastra and Bhaishajya Kalpana (Ayurvedic Pharmaceutics), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Manjusha Rajagopala
- Department of Shalakya Tantra (Eye and ENT), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Anand More
- Department of Roga Nidan and Vikriti Vigyan (Pathology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Shri krishna Rajagopala
- Department of Bala Roga (Pediatrics), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Santosh Kumar Bhatted
- Department of Panchkarma (Penta Bio-Purification Methods), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Rama Kant Yadav
- Department of Kaya Chikitsa (Internal Medicine), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Vyasdeva Mahanta
- Department of Shalya Tantra (Surgery), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Sisir Kumar Mandal
- Department of Roga Nidan and Vikriti Vigyan (Pathology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Raja Ram Mahto
- Department of Kaya Chikitsa (Internal Medicine), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Divya Kajaria
- Department of Kaya Chikitsa (Internal Medicine), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Rahul Sherkhane
- Department of Shalya Tantra (Surgery), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Narayan Bavalatti
- Department of Shalakya Tantra (Eye and ENT), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Pankaj Kundal
- Department of Shalakya Tantra (Eye and ENT), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Prasanth Dharmarajan
- Department of Panchkarma (Penta Bio-Purification Methods), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Meera Bhojani
- Department of Shareer Kriya (Physiology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Bhargav Bhide
- Department of Dravya Guna (Materia Medica and Pharmacology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Shiva Kumar Harti
- Department of Swastha Vritta (Preventive and Social Medicine), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Arun Kumar Mahapatra
- Department of Bala Roga (Pediatrics), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Umesh Tagade
- All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Galib Ruknuddin
- Department of Ras Shastra and Bhaishajya Kalpana (Ayurvedic Pharmaceutics), All India Institute of Ayurveda (AIIA), New Delhi, India
| | | | - Shalini Rai
- Department of Roga Nidan and Vikriti Vigyan (Pathology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Shivani Ghildiyal
- Department of Dravya Guna (Materia Medica and Pharmacology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Pramod R. Yadav
- Department of Ras Shastra and Bhaishajya Kalpana (Ayurvedic Pharmaceutics), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Jonah Sandrepogu
- Department of Kaya Chikitsa (Internal Medicine), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Meena Deogade
- Department of Dravya Guna (Materia Medica and Pharmacology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Pankaj Pathak
- Department of Maulik Siddhant (Fundamental Principles), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Alka Kapoor
- Hospital - All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Anil Kumar
- All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Heena Saini
- Department of Roga Nidan and Vikriti Vigyan (Pathology), All India Institute of Ayurveda (AIIA), New Delhi, India
| | - Richa Tripathi
- Department of Roga Nidan and Vikriti Vigyan (Pathology), All India Institute of Ayurveda (AIIA), New Delhi, India
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Huang J, Zhang Z, Hao C, Qiu Y, Tan R, Liu J, Wang X, Yang W, Qu H. Identifying Drug-Induced Liver Injury Associated With Inflammation-Drug and Drug-Drug Interactions in Pharmacologic Treatments for COVID-19 by Bioinformatics and System Biology Analyses: The Role of Pregnane X Receptor. Front Pharmacol 2022; 13:804189. [PMID: 35979235 PMCID: PMC9377275 DOI: 10.3389/fphar.2022.804189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
Of the patients infected with coronavirus disease 2019 (COVID-19), approximately 14–53% developed liver injury resulting in poor outcomes. Drug-induced liver injury (DILI) is the primary cause of liver injury in COVID-19 patients. In this study, we elucidated liver injury mechanism induced by drugs of pharmacologic treatments against SARS-CoV-2 (DPTS) using bioinformatics and systems biology. Totally, 1209 genes directly related to 216 DPTS (DPTSGs) were genes encoding pharmacokinetics and therapeutic targets of DPTS and enriched in the pathways related to drug metabolism of CYP450s, pregnane X receptor (PXR), and COVID-19 adverse outcome. A network, constructed by 110 candidate targets which were the shared part of DPTSGs and 445 DILI targets, identified 49 key targets and four Molecular Complex Detection clusters. Enrichment results revealed that the 4 clusters were related to inflammatory responses, CYP450s regulated by PXR, NRF2-regualted oxidative stress, and HLA-related adaptive immunity respectively. In cluster 1, IL6, IL1B, TNF, and CCL2 of the top ten key targets were enriched in COVID-19 adverse outcomes pathway, indicating the exacerbation of COVID-19 inflammation on DILI. PXR-CYP3A4 expression of cluster 2 caused DILI through inflammation-drug interaction and drug-drug interactions among pharmaco-immunomodulatory agents, including tocilizumab, glucocorticoids (dexamethasone, methylprednisolone, and hydrocortisone), and ritonavir. NRF2 of cluster 3 and HLA targets of cluster four promoted DILI, being related to ritonavir/glucocorticoids and clavulanate/vancomycin. This study showed the pivotal role of PXR associated with inflammation-drug and drug-drug interactions on DILI and highlighted the cautious clinical decision-making for pharmacotherapy to avoid DILI in the treatment of COVID-19 patients.
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Affiliation(s)
- Jingjing Huang
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhaokang Zhang
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chenxia Hao
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- Department of Pharmacy, Shanghai Children’s Medical Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yuzhen Qiu
- Department of Critical Care, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Ruoming Tan
- Department of Critical Care, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jialin Liu
- Department of Critical Care, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaoli Wang
- Department of Critical Care, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- *Correspondence: Xiaoli Wang, ; Wanhua Yang, ; Hongping Qu,
| | - Wanhua Yang
- Department of Pharmacy, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- *Correspondence: Xiaoli Wang, ; Wanhua Yang, ; Hongping Qu,
| | - Hongping Qu
- Department of Critical Care, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
- *Correspondence: Xiaoli Wang, ; Wanhua Yang, ; Hongping Qu,
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18
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Chavda VP, Chhabria MT, Apostolopoulos V. Aged Population and Immunocompromised Patients: Impact on SARS-CoV-2 Variants and Treatment Outcomes. Biologics 2022; 2:165-70. [DOI: 10.3390/biologics2030013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Patients with an immunocompromised state are at risk of developing a long-term infection from the coronavirus 2 that causes severe acute respiratory syndrome (SARS-CoV-2) [...]
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Mukherjee PK, Efferth T, Das B, Kar A, Ghosh S, Singha S, Debnath P, Sharma N, Bhardwaj PK, Haldar PK. Role of medicinal plants in inhibiting SARS-CoV-2 and in the management of post-COVID-19 complications. Phytomedicine 2022; 98:153930. [PMID: 35114450 PMCID: PMC8730822 DOI: 10.1016/j.phymed.2022.153930] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 12/30/2021] [Accepted: 01/03/2022] [Indexed: 05/07/2023]
Abstract
BACKGROUND The worldwide corona virus disease outbreak, generally known as COVID-19 pandemic outbreak resulted in a major health crisis globally. The morbidity and transmission modality of COVID-19 appear more severe and uncontrollable. The respiratory failure and following cardiovascular complications are the main pathophysiology of this deadly disease. Several therapeutic strategies are put forward for the development of safe and effective treatment against SARS-CoV-2 virus from the pharmacological view point but till date there are no specific treatment regimen developed for this viral infection. PURPOSE The present review emphasizes the role of herbs and herbs-derived secondary metabolites in inhibiting SARS-CoV-2 virus and also for the management of post-COVID-19 related complications. This approach will foster and ensure the safeguards of using medicinal plant resources to support the healthcare system. Plant-derived phytochemicals have already been reported to prevent the viral infection and to overcome the post-COVID complications like parkinsonism, kidney and heart failure, liver and lungs injury and mental problems. In this review, we explored mechanistic approaches of herbal medicines and their phytocomponenets as antiviral and post-COVID complications by modulating the immunological and inflammatory states. STUDY DESIGN Studies related to diagnosis and treatment guidelines issued for COVID-19 by different traditional system of medicine were included. The information was gathered from pharmacological or non-pharmacological interventions approaches. The gathered information sorted based on therapeutic application of herbs and their components against SARSCoV-2 and COVID-19 related complications. METHODS A systemic search of published literature was conducted from 2003 to 2021 using different literature database like Google Scholar, PubMed, Science Direct, Scopus and Web of Science to emphasize relevant articles on medicinal plants against SARS-CoV-2 viral infection and Post-COVID related complications. RESULTS Collected published literature from 2003 onwards yielded with total 625 articles, from more than 18 countries. Among these 625 articles, more than 95 medicinal plants and 25 active phytomolecules belong to 48 plant families. Reports on the therapeutic activity of the medicinal plants belong to the Lamiaceae family (11 reports), which was found to be maximum reported from 4 different countries including India, China, Australia, and Morocco. Other reports on the medicinal plant of Asteraceae (7 reports), Fabaceae (8 reports), Piperaceae (3 reports), Zingiberaceae (3 reports), Ranunculaceae (3 reports), Meliaceae (4 reports) were found, which can be explored for the development of safe and efficacious products targeting COVID-19. CONCLUSION Keeping in mind that the natural alternatives are in the priority for the management and prevention of the COVID-19, the present review may help to develop an alternative approach for the management of COVID-19 viral infection and post-COVID complications from a mechanistic point of view.
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Affiliation(s)
- Pulok K Mukherjee
- Institute of Bioresources and Sustainable Development, Imphal-795001, India; School of Natural Product Studies, Department of Pharmaceutical Technology, Jadavpur University, Kolkata -700 032, India.
| | - Thomas Efferth
- Department of Pharmaceutical Biology, Institute of Pharmaceutical and Biomedical Sciences, Johannes Gutenberg University, Mainz, Germany
| | - Bhaskar Das
- School of Natural Product Studies, Department of Pharmaceutical Technology, Jadavpur University, Kolkata -700 032, India
| | - Amit Kar
- Institute of Bioresources and Sustainable Development, Imphal-795001, India
| | - Suparna Ghosh
- School of Natural Product Studies, Department of Pharmaceutical Technology, Jadavpur University, Kolkata -700 032, India
| | - Seha Singha
- School of Natural Product Studies, Department of Pharmaceutical Technology, Jadavpur University, Kolkata -700 032, India
| | - Pradip Debnath
- School of Natural Product Studies, Department of Pharmaceutical Technology, Jadavpur University, Kolkata -700 032, India
| | - Nanaocha Sharma
- Institute of Bioresources and Sustainable Development, Imphal-795001, India
| | | | - Pallab Kanti Haldar
- School of Natural Product Studies, Department of Pharmaceutical Technology, Jadavpur University, Kolkata -700 032, India
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Alkattan W, Yaqinuddin A, Shafqat A, Kashir J. NET-Mediated Pathogenesis of COVID-19: The Role of NETs in Hepatic Manifestations. Journal of Health and Allied Sciences NU 2022. [DOI: 10.1055/s-0041-1741418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
AbstractSome coronavirus disease-2019 (COVID-19) patients exhibit multi-organ failure, which often includes the liver. Indeed, liver disease appears to be an emerging feature of COVID-19 infections. However, the exact mechanism behind this remains unknown. Neutrophil extracellular traps (NETs) have increasingly been attributed as major contributors to various liver pathologies, including sepsis, ischemic-reperfusion (I/R) injury, and portal hypertension in the setting of chronic liver disease. Although vital in normal immunity, excessive NET formation can drive inflammation, particularly of the endothelium. Collectively, we propose that NETs observed to be elevated in severe COVID-19 infection play principal roles in liver injury in addition to acute lung injury. Herein, we discuss the potential mechanisms underlying COVID-induced liver injury including cytopathic effects from direct liver infection, systemic inflammatory response syndrome, and hypoxic injury, encompassing I/R injury and coagulopathy. Further research is required to further elucidate the role of NETs in COVID. This holds potential therapeutic significance, as inhibition of NETosis could alleviate the symptoms of acute respiratory distress syndrome and liver injury, as well as other organs.
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Affiliation(s)
- Wael Alkattan
- College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Ahmed Yaqinuddin
- College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Areez Shafqat
- College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
| | - Junaid Kashir
- College of Medicine, Alfaisal University, Riyadh, Kingdom of Saudi Arabia
- Department of Comparative Medicine, King Faisal Specialist Hospital and Research Center, Riyadh, Kingdom of Saudi Arabia
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Molavi G, Zadeh Hosseingholi E, Maddahi S, Jabbari S. Identification of high death risk coronavirus disease-19 patients using blood tests. Adv Biomed Res 2022; 11:58. [PMID: 36124024 PMCID: PMC9482375 DOI: 10.4103/abr.abr_178_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 10/27/2021] [Accepted: 12/18/2021] [Indexed: 11/04/2022] Open
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Zhao W, Zhang X, Zhu F, Jiang X. Dynamic Changes of Liver Function Indexes in Patients with Different Clinical Types of COVID-19. Int J Gen Med 2022; 15:877-884. [PMID: 35115814 PMCID: PMC8801727 DOI: 10.2147/ijgm.s347291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/13/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Wei Zhao
- Department of Respiratory and Critical Care Medicine, Wuxi Fifth People’s Hospital, Wuxi, 214000, People’s Republic of China
| | - Xiaoqing Zhang
- Department of Respiratory and Critical Care Medicine, Wuxi Fifth People’s Hospital, Wuxi, 214000, People’s Republic of China
| | - Feng Zhu
- Department of Respiratory and Critical Care Medicine, Wuxi Fifth People’s Hospital, Wuxi, 214000, People’s Republic of China
- Correspondence: Feng Zhu; Xiufeng Jiang, Department of Respiratory and Critical Care Medicine, Wuxi Fifth People’s Hospital, Wuxi, 214000, People’s Republic of China, Tel +86-13914135026; +86-13013630369, Email ;
| | - Xiufeng Jiang
- Department of Respiratory and Critical Care Medicine, Wuxi Fifth People’s Hospital, Wuxi, 214000, People’s Republic of China
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Sobotka LA, Esteban J, Volk ML, Elmunzer BJ, Rockey DC; North American Alliance for the Study of Digestive Manifestation of COVID-19*. Acute Liver Injury in Patients Hospitalized with COVID-19. Dig Dis Sci 2022; 67:4204-14. [PMID: 34487314 DOI: 10.1007/s10620-021-07230-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 08/15/2021] [Indexed: 02/06/2023]
Abstract
INTRODUCTION The prevalence and significance of acute liver injury in patients with COVID-19 are poorly characterized. METHODS Patients with confirmed COVID-19 who were hospitalized in geographically diverse medical centers in North America were included. Demographics, symptoms, laboratory data results, and outcomes were recorded. Linear and logistic regression identified factors associated with liver injury, in-hospital mortality, and length of stay (LOS). RESULTS Among 1555 patients in the cohort, most (74%) had an elevated alanine aminotransferase (ALT) during hospitalization, which was very severe (> 20 × upper limit of normal [ULN]) in 3%. Severe acute liver injury (ALI) was uncommon, occurring in 0.1% on admission and 2% during hospitalization. No patient developed acute liver failure (ALF). Higher ALT was associated with leukocytosis (per mL3) (β 10.0, 95% confidence interval (CI) 6.7-12.6, p < 0.001) and vasopressors use (β 80.2, 95%CI 21.5-138.8, p = 0.007). In-hospital mortality was associated with ALT > 20 × ULN (unadjusted OR 6.0, 95%CI 3.1-11.5, p < 0.001), ALP > 3 × ULN (unadjusted OR 4.4, 95%CI 2.5-7.7, p < 0.001), and severe ALI (unadjusted OR 6.8, 95%CI 3.0-15.3, p < 0.001) but lost significance after adjusting for covariates related to severe COVID-19 and hemodynamic instability. Elevated ALP and ALT were associated with longer LOS, admission to intensive care, mechanical ventilation, vasopressor use, and extracorporeal membrane oxygenation use (p < 0.001). CONCLUSIONS Transaminase elevation is common in hospitalized patients with COVID-19. Severe ALI is rare, and ALF may not be a complication of COVID-19. Extreme elevations in liver enzymes appear to be associated with mortality and longer LOS due to more severe systemic disease rather than SARS-CoV-2-related hepatitis.
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Abbas M, Alqahtani MS, Almohiy HM, Alqahtani FF, Alhifzi R, Jambi LK. The Potential Contribution of Biopolymeric Particles in Lung Tissue Regeneration of COVID-19 Patients. Polymers (Basel) 2021; 13:4011. [PMID: 34833310 PMCID: PMC8623030 DOI: 10.3390/polym13224011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 11/12/2021] [Accepted: 11/16/2021] [Indexed: 02/08/2023] Open
Abstract
The lung is a vital organ that houses the alveoli, which is where gas exchange takes place. The COVID-19 illness attacks lung cells directly, creating significant inflammation and resulting in their inability to function. To return to the nature of their job, it may be essential to rejuvenate the afflicted lung cells. This is difficult because lung cells need a long time to rebuild and resume their function. Biopolymeric particles are the most effective means to transfer developing treatments to airway epithelial cells and then regenerate infected lung cells, which is one of the most significant symptoms connected with COVID-19. Delivering biocompatible and degradable natural biological materials, chemotherapeutic drugs, vaccines, proteins, antibodies, nucleic acids, and diagnostic agents are all examples of these molecules' usage. Furthermore, they are created by using several structural components, which allows them to effectively connect with these cells. We highlight their most recent uses in lung tissue regeneration in this review. These particles are classified into three groups: biopolymeric nanoparticles, biopolymeric stem cell materials, and biopolymeric scaffolds. The techniques and processes for regenerating lung tissue will be thoroughly explored.
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Affiliation(s)
- Mohamed Abbas
- Electrical Engineering Department, College of Engineering, King Khalid University, Abha 61421, Saudi Arabia
- Computers and Communications Department, College of Engineering, Delta University for Science and Technology, Gamasa 35712, Egypt
| | - Mohammed S. Alqahtani
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (M.S.A.); (H.M.A.); (R.A.)
- BioImaging Unit, Space Research Centre, Michael Atiyah Building, University of Leicester, Leicester LE1 7RH, UK
| | - Hussain M. Almohiy
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (M.S.A.); (H.M.A.); (R.A.)
| | - Fawaz F. Alqahtani
- Department of Radiological Sciences, College of Applied Medical Sciences, Najran University, Najran 1988, Saudi Arabia;
| | - Roaa Alhifzi
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia; (M.S.A.); (H.M.A.); (R.A.)
| | - Layal K. Jambi
- Radiological Sciences Department, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia;
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Kim J, Hong K, Gómez Gómez RE, Kim S, Chun BC. Lack of Evidence of COVID-19 Being a Risk Factor of Alopecia Areata: Results of a National Cohort Study in South Korea. Front Med (Lausanne) 2021; 8:758069. [PMID: 34722594 PMCID: PMC8550157 DOI: 10.3389/fmed.2021.758069] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 09/14/2021] [Indexed: 12/23/2022] Open
Abstract
Background: Concerns about alopecia areata (AA) in coronavirus disease 2019 (COVID-19) patients have emerged among dermatologists. However, most of the extant kinds of literature have limited implications by relying on cross-sectional studies with restricted study subjects without the control group. Objective: Our study aims to investigate the risk of developing AA among COVID-19 patients in South Korea using national representative data. Methods: We used the National Health Insurance Service COVID-19 cohort database, comprising COVID-19 patients and the control group, all of whom were diagnosed from January 1, 2020, to June 4, 2020. Patients were defined as individuals who were confirmed as COVID-19 positive, regardless of disease severity. Controls were defined as those who were confirmed as COVID-19 negatives. People with a history of AA during the period 2015-2019 were excluded. The primary endpoint was a new diagnosis of AA (ICD-10-Code: L63). The adjusted incidence rate ratio (IRR) of developing AA was estimated using a log-link Poisson regression model based on incidence density. The model adjusted for (1) age and sex and (2) demographic variables (age, sex, place of residence, and income level). Results: A total of 226,737 individuals (7,958 [3.5%] cases and 218,779 [96.5%] controls) were included in the final analysis. The ratio of newly diagnosed AA was 18/7,958 (0.2%) in cases and 195/218,779 (0.1%) in controls. IRRs of COVID-19 patients having newly diagnosed AA compared to controls were 0.78 (95% CI: 0.48-1.27) when age and sex were adjusted for and 0.60 (95% CI: 0.35-1.03) when all demographic variables were adjusted for. Conclusion: Diagnosis of COVID-19 was not significantly associated with the development of AA even after appropriately adjusting for covariates.
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Affiliation(s)
- Jeehyun Kim
- Graduate School of Public Health, Korea University, Seoul, South Korea.,Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea.,Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, Seoul, South Korea
| | - Kwan Hong
- Graduate School of Public Health, Korea University, Seoul, South Korea.,Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Raquel Elizabeth Gómez Gómez
- Graduate School of Public Health, Korea University, Seoul, South Korea.,Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea
| | - Soojin Kim
- Graduate School of Public Health, Korea University, Seoul, South Korea.,Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea.,Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, Seoul, South Korea
| | - Byung Chul Chun
- Graduate School of Public Health, Korea University, Seoul, South Korea.,Department of Preventive Medicine, Korea University College of Medicine, Seoul, South Korea.,Transdisciplinary Major in Learning Health Systems, Department of Healthcare Sciences, Graduate School, Korea University, Seoul, South Korea
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Ali N, Fariha KA, Islam F, Mishu MA, Mohanto NC, Hosen MJ, Hossain K. Exposure to air pollution and COVID-19 severity: A review of current insights, management, and challenges. Integr Environ Assess Manag 2021; 17:1114-1122. [PMID: 33913626 PMCID: PMC8239695 DOI: 10.1002/ieam.4435] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 03/29/2021] [Accepted: 04/19/2021] [Indexed: 05/12/2023]
Abstract
Several epidemiological studies have suggested a link between air pollution and respiratory tract infections. The outbreak of coronavirus disease 2019 (COVID-19) poses a great threat to public health worldwide. However, some parts of the globe have been worse affected in terms of prevalence and deaths than others. The causes and conditions of such variations have yet to be explored. Although some studies indicated a possible correlation between air pollution and COVID-19 severity, there is yet insufficient data for a meaningful answer. This review summarizes the impact of air pollution on COVID-19 infections and severity and discusses the possible management strategies and challenges involved. The available literature investigating the correlation between air pollution and COVID-19 infections and mortality are included in the review. The studies reviewed here suggest that exposure to air pollution, particularly to PM2.5 and NO2 , is positively correlated with COVID-19 infections and mortality. Some data indicate that air pollution can play an important role in the airborne transmission of SARS-CoV-2. A high percentage of COVID-19 incidences has been reported in the most polluted areas, where patients needed hospital admission. The available data also show that both short-term and long-term air pollution may enhance COVID-19 severity. However, most of the studies that showed a link between air pollution and COVID-19 infections and mortality did not consider potential confounders during the correlation analysis. Therefore, more specific studies need to be performed focusing on some additional confounders such as individual age, population density, and pre-existing comorbidities to determine the impact of air pollution on COVID-19 infections and deaths. Integr Environ Assess Manag 2021;17:1114-1122. © 2021 SETAC.
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Affiliation(s)
- Nurshad Ali
- Department of Biochemistry and Molecular BiologyShahjalal University of Science and TechnologySylhetBangladesh
| | - Khandaker A. Fariha
- Department of Biochemistry and Molecular BiologyShahjalal University of Science and TechnologySylhetBangladesh
| | - Farjana Islam
- Department of Biochemistry and Molecular BiologyShahjalal University of Science and TechnologySylhetBangladesh
| | - Moshiul A. Mishu
- Department of Biochemistry and Molecular BiologyShahjalal University of Science and TechnologySylhetBangladesh
| | - Nayan C. Mohanto
- Department of Biochemistry and Molecular BiologyShahjalal University of Science and TechnologySylhetBangladesh
| | - Mohammad J. Hosen
- Department of Genetic Engineering and BiotechnologyShahjalal University of Science and TechnologySylhetBangladesh
| | - Khaled Hossain
- Department of Biochemistry and Molecular BiologyUniversity of RajshahiRajshahiBangladesh
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Elemam NM, Hannawi H, Naeem KB, Hannawi S. A single centered study reveals association between liver injury and COVID-19 infection. Saudi J Biol Sci 2021; 28:6017-6022. [PMID: 34220212 PMCID: PMC8233059 DOI: 10.1016/j.sjbs.2021.06.064] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 06/20/2021] [Accepted: 06/21/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND AND AIM Despite the fact that it has been over a year with the pandemic COVID-19 infection, ongoing research and analysis reveal many complications and comorbidities associated with COVID-19. In this study, we aimed at investigating the clinical and laboratory assessments in COVID-19 patients with and without liver injury. METHODS Symptomatic 541 COVID-19 positive patients, who were admitted to Al Kuwait Hospital, Dubai, United Arab Emirates (UAE), were recruited in this study. Their data was collected retrospectively, including demographic data, blood tests, symptoms, radiographical assessments, and clinical outcomes of COVID-19. RESULTS Around 19% of the recruited COVID-19 patients displayed signs of acute liver injury. Also, there was an increase in the percentage of critical, ICU-admitted and mortality rates in COVID-19 cases with liver injury, as well as a higher percentage of septic shock and acute respiratory distress syndrome (ARDS). COVID-19 patients with liver injury had more pronounced bilateral consolidation, lymphopenia and neutrophilia. Additionally, these patients had higher levels of CRP, LDH, procalcitonin, ferritin and D dimer levels. Finally, there was a higher percentage of patients taking various COVID-19 therapies in the COVID-19 patients with liver injury group. CONCLUSION COVID-19 patients with acute liver injury are at a higher risk for serious outcomes including death.
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Affiliation(s)
- Noha M. Elemam
- Sharjah Institute for Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Haifa Hannawi
- Ministry of Health and Prevention, Department of Medicine, Dubai, United Arab Emirates
- Mohammed bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates
| | - Kashif Bin Naeem
- Ministry of Health and Prevention, Department of Medicine, Dubai, United Arab Emirates
| | - Suad Hannawi
- Ministry of Health and Prevention, Department of Medicine, Dubai, United Arab Emirates
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Su YJ, Chang CW, Chen MJ, Lai YC. Impact of COVID-19 on liver. World J Clin Cases 2021. [PMID: 34621856 DOI: 10.12998/wjcc.v9.i27.7998.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The incidence of liver injury after coronavirus disease 2019 (COVID-19) infection ranged from 15%-53%. The mechanism includes direct viral cytopathic effect, cytokinesis, and treatment drug-induced liver injury. The symptoms include nausea, vomiting, diarrhea, and loss of appetite. The laboratory results include increased liver enzyme levels, decreased monocyte count, and longer prothrombin time. The most common imaging findings are hepatomegaly on ultrasound, ground-glass opacity on chest computed tomography (CT), and liver hypodensity and pericholecystic fat stranding on abdominal CT. Patients may also have different presentations and poor outcomes of different liver diseases concomitant with COVID-19 infection. Liver function test (LFT) results should be monitored, and all factors known to cause or predispose liver injury should be investigated while managing the patients. The risks of transfer to an intensive care unit, need for mechanical ventilator support, and acute kidney injury is higher in COVID-19 patients with than without abnormal LFTs. Increased mortality and length of hospital stay are both observed.
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Affiliation(s)
- Yu-Jang Su
- Department of Emergency Medicine, MacKay Memorial Hospital, Taipei City 10449, Taiwan
| | - Chen-Wang Chang
- MacKay Junior College of Medicine, Nursing and Management, Taipei City 25245, Taiwan
| | - Ming-Jen Chen
- MacKay Junior College of Medicine, Nursing and Management, Taipei City 25245, Taiwan
| | - Yen-Chun Lai
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei City 110301, Taiwan
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Abstract
The incidence of liver injury after coronavirus disease 2019 (COVID-19) infection ranged from 15%-53%. The mechanism includes direct viral cytopathic effect, cytokinesis, and treatment drug-induced liver injury. The symptoms include nausea, vomiting, diarrhea, and loss of appetite. The laboratory results include increased liver enzyme levels, decreased monocyte count, and longer prothrombin time. The most common imaging findings are hepatomegaly on ultrasound, ground-glass opacity on chest computed tomography (CT), and liver hypodensity and pericholecystic fat stranding on abdominal CT. Patients may also have different presentations and poor outcomes of different liver diseases concomitant with COVID-19 infection. Liver function test (LFT) results should be monitored, and all factors known to cause or predispose liver injury should be investigated while managing the patients. The risks of transfer to an intensive care unit, need for mechanical ventilator support, and acute kidney injury is higher in COVID-19 patients with than without abnormal LFTs. Increased mortality and length of hospital stay are both observed.
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Affiliation(s)
- Yu-Jang Su
- Department of Emergency Medicine, MacKay Memorial Hospital, Taipei City 10449, Taiwan
- Poison Center, Department of Emergency Medicine, MacKay Memorial Hospital, Taipei City 10449, Taiwan
- Yuanpei University of Medical Technology, HsinChu 30015, Taiwan
- MacKay Junior College of Medicine, Nursing and Management, Taipei City 25245, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City 25245, Taiwan
| | - Chen-Wang Chang
- MacKay Junior College of Medicine, Nursing and Management, Taipei City 25245, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei City 10449, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City 25245, Taiwan
| | - Ming-Jen Chen
- MacKay Junior College of Medicine, Nursing and Management, Taipei City 25245, Taiwan
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei City 10449, Taiwan
- Department of Medicine, MacKay Medical College, New Taipei City 25245, Taiwan
| | - Yen-Chun Lai
- Department of Anesthesiology, Taipei Medical University Hospital, Taipei City 110301, Taiwan
- Heroic Faith Medical Science Company, Taipei 11493, Taiwan
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Rahman MA, Shanjana Y, Tushar MI, Mahmud T, Rahman GMS, Milan ZH, Sultana T, Chowdhury AMLH, Bhuiyan MA, Islam MR, Reza HM. Hematological abnormalities and comorbidities are associated with COVID-19 severity among hospitalized patients: Experience from Bangladesh. PLoS One 2021; 16:e0255379. [PMID: 34314447 PMCID: PMC8315496 DOI: 10.1371/journal.pone.0255379] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 07/15/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The hematological abnormalities are assumed to be involved in the disease progression of COVID-19. However, the actual associations between specific blood parameters and COVID-19 are not well understood. Here we aimed to assess the correlations between hematological parameters and the severity of COVID-19. METHODS We included COVID-19 patients who were admitted to Evercare Hospital Ltd, Dhaka, Bangladesh, between November 10, 2020, to April 12, 2021, with a confirmed case of RT-PCR test. We recorded demographic information, clinical data, and routine hematological examination results of all COVID-19 patients. We performed statistical analyses and interpretation of data to compare severe COVID-19 patients (SCP) and non-severe COVID-19 patients (NSCP). RESULTS The age and BMI of the admitted COVID-19 patients were 48.79±8.53 years and 25.82±3.75 kg/m2. This study included a total of 306 hospitalized COVID-19 patients. Among them, NSCP and SCP were 198 and 108, respectively. And we recorded 12 deaths from SCP. We observed the alterations of several hematological parameters between SCP and NSCP. Among them, we noticed the increased levels of C-reactive protein (CRP), d-dimer, and ferritin showed good indicative value to evaluate the severity of COVID-19. Also, there were positive correlations among these parameters. Moreover, we found correlations between the outcomes of COVID-19 patients with patient's demographics and comorbid diseases. CONCLUSION Based on our results, CRP, d-dimer, and ferritin levels at admission to hospitals represent simple assessment factors for COVID-19 severity and the treatment decisions at the hospital setup. These blood parameters could serve as indicators for the prognosis and severity of COVID-19. Therefore, our study findings might help to develop a treatment protocol for COVID-19 patients at the hospital setup.
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Affiliation(s)
- Md. Ashrafur Rahman
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - Yeasna Shanjana
- Department of Environmental Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - Md. Ismail Tushar
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - Tarif Mahmud
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | | | - Zahid Hossain Milan
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | - Tamanna Sultana
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
| | | | | | - Md. Rabiul Islam
- Department of Pharmacy, University of Asia Pacific, Farmgate, Dhaka, Bangladesh
- * E-mail: (RI); (HMR)
| | - Hasan Mahmud Reza
- Department of Pharmaceutical Sciences, North South University, Bashundhara, Dhaka, Bangladesh
- * E-mail: (RI); (HMR)
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31
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Pott-Junior H, Bittencourt NQP, Chacha SFG, Luporini RL, Cominetti MR, Anibal FDF. Elevations in Liver Transaminases in COVID-19: (How) Are They Related? Front Med (Lausanne) 2021; 8:705247. [PMID: 34336904 PMCID: PMC8319468 DOI: 10.3389/fmed.2021.705247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/18/2021] [Indexed: 01/08/2023] Open
Abstract
Liver involvement in COVID-19 is not yet well-understood, but elevations in liver transaminases have been described to occur in 14–53% of the cases and are more frequently seen in severe disease. This cross-sectional study explored the relationship between the elevations in liver transaminases and inflammatory parameters in 209 adults with COVID-19. Demographic and clinical data, serum levels of inflammatory cytokines and liver aminotransferases were analyzed. Three groups were formed according to the liver transaminase abnormalities: (I) Normal transaminases, (II) Borderline transaminases elevation, and (III) Mild to severe transaminases elevation. Altered liver transaminases were directly related to disease severity, showing association with the NEWS2 score at admission and greater need for ICU or death. Moreover, higher levels of IL-2 and CRP were associated with borderline transaminases elevations, whereas higher levels of IL-10 and Neutrophil to Lymphocyte ratio were associated with mild to severe transaminases elevation. These results reinforce the importance of liver transaminases in patients with COVID-19 as a complementary marker for disease severity and also point to them as a parameter reflecting the continuous dynamics between viral infection and the immune response.
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Affiliation(s)
| | | | - Silvana F G Chacha
- Department of Medicine, Federal University of São Carlos, São Carlos, Brazil
| | - Rafael Luís Luporini
- Department of Medicine, Federal University of São Carlos, São Carlos, Brazil.,Biotechnology Graduate Program, Federal University of São Carlos, São Carlos, Brazil
| | | | - Fernanda de Freitas Anibal
- Biotechnology Graduate Program, Federal University of São Carlos, São Carlos, Brazil.,Department of Biological Sciences Parasitology, Federal University of São Carlos, São Carlos, Brazil
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32
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Hoque MN, Akter S, Mishu ID, Islam MR, Rahman MS, Akhter M, Islam I, Hasan MM, Rahaman MM, Sultana M, Islam T, Hossain MA. Microbial co-infections in COVID-19: Associated microbiota and underlying mechanisms of pathogenesis. Microb Pathog 2021; 156:104941. [PMID: 33962007 PMCID: PMC8095020 DOI: 10.1016/j.micpath.2021.104941] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 04/08/2021] [Accepted: 04/08/2021] [Indexed: 01/08/2023]
Abstract
The novel coronavirus infectious disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has traumatized the whole world with the ongoing devastating pandemic. A plethora of microbial domains including viruses (other than SARS-CoV-2), bacteria, archaea and fungi have evolved together, and interact in complex molecular pathogenesis along with SARS-CoV-2. However, the involvement of other microbial co-pathogens and underlying molecular mechanisms leading to extortionate ailment in critically ill COVID-19 patients has yet not been extensively reviewed. Although, the incidence of co-infections could be up to 94.2% in laboratory-confirmed COVID-19 cases, the fate of co-infections among SARS-CoV-2 infected hosts often depends on the balance between the host's protective immunity and immunopathology. Predominantly identified co-pathogens of SARS-CoV-2 are bacteria such as Streptococcus pneumoniae, Staphylococcus aureus, Klebsiella pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Acinetobacter baumannii, Legionella pneumophila and Clamydia pneumoniae followed by viruses including influenza, coronavirus, rhinovirus/enterovirus, parainfluenza, metapneumovirus, influenza B virus, and human immunodeficiency virus. The cross-talk between co-pathogens (especially lung microbiomes), SARS-CoV-2 and host is an important factor that ultimately increases the difficulty of diagnosis, treatment, and prognosis of COVID-19. Simultaneously, co-infecting microbiotas may use new strategies to escape host defense mechanisms by altering both innate and adaptive immune responses to further aggravate SARS-CoV-2 pathogenesis. Better understanding of co-infections in COVID-19 is critical for the effective patient management, treatment and containment of SARS-CoV-2. This review therefore necessitates the comprehensive investigation of commonly reported microbial co-pathogens amid COVID-19, their transmission pattern along with the possible mechanism of co-infections and outcomes. Thus, identifying the possible co-pathogens and their underlying molecular mechanisms during SARS-CoV-2 pathogenesis may shed light in developing diagnostics, appropriate curative and preventive interventions for suspected SARS-CoV-2 respiratory infections in the current pandemic.
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Affiliation(s)
- M Nazmul Hoque
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Department of Gynecology, Obstetrics and Reproductive Health, Bangabandhu Sheikh Mujibur Rahman Agricultural University (BSMRAU), Gazipur, 1706, Bangladesh
| | - Salma Akter
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Department of Microbiology, Jahangirnagar University, Savar, Dhaka, 1342, Bangladesh
| | | | - M Rafiul Islam
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - M Shaminur Rahman
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Masuda Akhter
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Israt Islam
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Mehedi Mahmudul Hasan
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Department of Fisheries and Marine Science, Noakhali Science and Technology University, Noakhali, 3814, Bangladesh
| | - Md Mizanur Rahaman
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Munawar Sultana
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh
| | - Tofazzal Islam
- Institute of Biotechnology and Genetic Engineering (IBGE), BSMRAU, Gazipur, 1706, Bangladesh
| | - M Anwar Hossain
- Department of Microbiology, University of Dhaka, Dhaka, 1000, Bangladesh; Jashore University of Science and Technology, Jashore, 7408, Bangladesh.
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33
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Rahman MM, Ahmed M, Islam MT, Khan MR, Sultana S, Maeesa SK, Hasan S, Hossain MA, Ferdous KS, Mathew B, Rauf A, Uddin MS. Nanotechnology-Based Approaches and Investigational Therapeutics against COVID-19. Curr Pharm Des 2021; 28:948-968. [PMID: 34218774 DOI: 10.2174/1381612827666210701150315] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 04/30/2021] [Indexed: 01/08/2023]
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a novel coronavirus which is currently responsible for the global pandemic since December 2019. This class of coronavirus has affected 217 countries around the world. Most of the countries have taken some non-remedial preventive actions like country lockdown, work from home, travel bans, and the most significant one is social isolation. Pharmacists, doctors, nurses, technologists, and all other healthcare professionals are playing a pivotal role during this pandemic. Unluckily, there is no specific drug that can treat patients who are confirmed with COVID-19, though favipiravir and remdesivir have appeared as favorable antiviral drugs. Some vaccines have already developed, and vaccination has started worldwide. Different nanotechnologies are in the developing stage in many countries for preventing SARS-COV-2 and treating COVID-19 conditions. In this article, we review the COVID-19 pandemic situation as well as the nanotechnology-based approaches and investigational therapeutics against COVID-19.
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Affiliation(s)
- Md Mominur Rahman
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Muniruddin Ahmed
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Mohammad Touhidul Islam
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Md Robin Khan
- Bangladesh Reference Institute for Chemical Measurements, Dhaka. Bangladesh
| | - Sharifa Sultana
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Saila Kabir Maeesa
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Sakib Hasan
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Md Abid Hossain
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Kazi Sayma Ferdous
- Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Dhaka. Bangladesh
| | - Bijo Mathew
- Department of Pharmaceutical Chemistry, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi 682041, India
| | - Abdur Rauf
- Department of Chemistry, University of Swabi, Swabi, Anbar, Khyber Pakhtunkhwa. Bangladesh
| | - Md Sahab Uddin
- Department of Pharmacy, Southeast University, Dhaka. Bangladesh
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34
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D'Amico FE, Glavas D, Noaro G, Bassi D, Boetto R, Gringeri E, De Luca M, Cillo U. Case Report: Liver Cysts and SARS-CoV-2: No Evidence of Virus in Cystic Fluid. Front Surg 2021; 8:677889. [PMID: 34222319 PMCID: PMC8249569 DOI: 10.3389/fsurg.2021.677889] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/11/2021] [Indexed: 01/08/2023] Open
Abstract
Background: In December 2019, an outbreak of pneumonia, caused by a new type of coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It quickly spread worldwide, resulting in a pandemic. The clinical manifestations of SARS-CoV-2 range from mild non-specific symptoms to severe pneumonia with organ function damage. In addition, up to 60% of patients have liver impairment or dysfunction, confirmed by several studies by the presence of SARS-CoV-2 in the liver tissue. Methods: We report two cases of symptomatic liver cyst requiring fenestration after recent SARS-CoV-2 infection. Both patients had hospital admission due to documented SARS-CoV-2 infection. Recently, after the infection, they developed symptoms caused by an enlarged hepatic cyst: one had abdominal pain, and the other had jaundice. They underwent surgery after two negative swab tests for SARS-CoV-2. Results: Cystic fluid was sent for microbiological test, and real-time fluorescence polymerase chain reaction COVID-19 nucleic-acid assay of the cyst fluid was found to be negative in both cases. Discussion: Although there are no current data that can document a viral contamination of cystic fluid, there are data that document a hepatotropism of COVID-19 virus. Herein we report that after viral clearance at pharyngeal and nasal swab, there is no evidence of viral load in such potential viral reservoir.
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Affiliation(s)
- Francesco Enrico D'Amico
- Department of Surgical, Oncological and Gastroenterologica Sciences (DiSCOG), University of Padova, Padua, Italy.,Hepatobiliary and Liver Transplant Surgery, Padova Teaching Hospital, Padua, Italy
| | - Dajana Glavas
- Department of Surgical, Oncological and Gastroenterologica Sciences (DiSCOG), University of Padova, Padua, Italy.,Hepatobiliary and Liver Transplant Surgery, Padova Teaching Hospital, Padua, Italy
| | - Giulia Noaro
- Department of Surgery, Montebelluna Hospital ULSS2, Montebelluna, Italy
| | - Domenico Bassi
- Hepatobiliary and Liver Transplant Surgery, Padova Teaching Hospital, Padua, Italy
| | - Riccardo Boetto
- Hepatobiliary and Liver Transplant Surgery, Padova Teaching Hospital, Padua, Italy
| | - Enrico Gringeri
- Department of Surgical, Oncological and Gastroenterologica Sciences (DiSCOG), University of Padova, Padua, Italy.,Hepatobiliary and Liver Transplant Surgery, Padova Teaching Hospital, Padua, Italy
| | - Maurizio De Luca
- Department of Surgery, Montebelluna Hospital ULSS2, Montebelluna, Italy
| | - Umberto Cillo
- Department of Surgical, Oncological and Gastroenterologica Sciences (DiSCOG), University of Padova, Padua, Italy.,Hepatobiliary and Liver Transplant Surgery, Padova Teaching Hospital, Padua, Italy
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35
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Bzeizi K, Abdulla M, Mohammed N, Alqamish J, Jamshidi N, Broering D. Effect of COVID-19 on liver abnormalities: a systematic review and meta-analysis. Sci Rep 2021; 11:10599. [PMID: 34012016 PMCID: PMC8134580 DOI: 10.1038/s41598-021-89513-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 04/13/2021] [Indexed: 02/06/2023] Open
Abstract
Emerging evidence suggest association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with the development of many liver abnormalities. The overarching aim of this study was therefore to assess the available evidence on the clinical effects of SARS-CoV-2 on the profiles of liver chemistries and coagulation in COVID-19 diagnosed patients. We considered all study designs including epidemiological and observational that reported liver function test abnormalities in patients confirmed with SARS-CoV-2 infection. Medline, Embase databases and Google Scholar as well as relevant reviews were searched to identify appropriate studies from inception to 31st of August 2020. We calculated the pooled mean with 95% confidence intervals (95% CI) through a random-effect model meta-analysis. A total of 35 studies with 10,692 participants were considered for the review from which 23 studies with sufficient quantitative data were included in the meta-analysis. The pooled mean for liver enzymes and coagulation parameters did not significantly change in patients diagnosed with COVID-19 and remained within normal range. Notwithstanding potential bias from confounding factors in interpretation of data in this review, findings from the observational studies and case reports suggest that COVID-19 does not appear to have a significant impact on the transaminases or total bilirubin levels of patients with confirmed SARS-CoV-2 infection. Further controlled studies and larger sample size observational studies are needed with adequate reporting of other liver function parameters are warranted.
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Affiliation(s)
- Khalid Bzeizi
- Department of Liver & Small Bowel Transplantation & Hepatobiliary-Pancreatic Surgery, King Faisal Specialist Hospital & Research Center, P.O. Box 3354, Riyadh, 11211, Saudi Arabia.
| | - Maheeba Abdulla
- Internal Medicine Department, Salmaniya Medical Complex, Manama, Bahrain
| | - Nafeesa Mohammed
- Internal Medicine Department, Salmaniya Medical Complex, Manama, Bahrain
| | | | - Negar Jamshidi
- School of Science, RMIT University, Melbourne, VIC, 3000, Australia
| | - Dieter Broering
- Organ Transplant Center & Department of Surgery, King Faisal Specialist Hospital & Research Centre (Gen. Org) MBC 96, AlFaisal University, P.O. Box 3354, Riyadh, 11211, Saudi Arabia
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36
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Suklan J, Cheaveau J, Hill S, Urwin SG, Green K, Winter A, Hicks T, Boath AE, Kernohan A, Price DA, Allen AJ, Moloney E, Graziadio S. Utility of Routine Laboratory Biomarkers to Detect COVID-19: A Systematic Review and Meta-Analysis. Viruses 2021; 13:803. [PMID: 33946171 PMCID: PMC8147047 DOI: 10.3390/v13050803] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/23/2021] [Accepted: 04/28/2021] [Indexed: 12/21/2022] Open
Abstract
No routine laboratory biomarkers perform well enough in diagnosing COVID-19 in isolation for them to be used as a standalone diagnostic test or to help clinicians prioritize patients for treatment. Instead, other diagnostic tests are needed. The aim of this work was to statistically summarise routine laboratory biomarker measurements in COVID-19-positive and -negative patients to inform future work. A systematic literature review and meta-analysis were performed. The search included names of commonly used, routine laboratory tests in the UK NHS, and focused on research papers reporting laboratory results of patients diagnosed with COVID-19. A random effects meta-analysis of the standardized mean difference between COVID-19-positive and -negative groups was conducted for each biomarker. When comparing reported laboratory biomarker results, we identified decreased white blood cell, neutrophil, lymphocyte, eosinophil, and platelet counts; while lactate dehydrogenase, aspartate aminotransferase, and alanine aminotransferase were elevated in COVID-19-positive compared to COVID-19-negative patients. Differences were identified across a number of routine laboratory biomarkers between COVID-19-positive and -negative patients. Further research is required to identify whether routine laboratory biomarkers can be used in the development of a clinical scoring system to aid with triage of patients.
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Affiliation(s)
- Jana Suklan
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, William Leech Building, Medical School, Newcastle University, Newcastle NE2 4HH, UK; (K.G.); (D.A.P.); (A.J.A.)
| | - James Cheaveau
- Department of Infectious Diseases, Royal Victoria Infirmary, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK;
| | - Sarah Hill
- Health Economics Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; (S.H.); (A.E.B.); (A.K.); (E.M.)
| | - Samuel G. Urwin
- NIHR Newcastle In Vitro Diagnostics Co-operative, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, William Leech Building, Medical School, Newcastle upon Tyne NE2 4HH, UK; (S.G.U.); (A.W.); (T.H.); (S.G.)
| | - Kile Green
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, William Leech Building, Medical School, Newcastle University, Newcastle NE2 4HH, UK; (K.G.); (D.A.P.); (A.J.A.)
| | - Amanda Winter
- NIHR Newcastle In Vitro Diagnostics Co-operative, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, William Leech Building, Medical School, Newcastle upon Tyne NE2 4HH, UK; (S.G.U.); (A.W.); (T.H.); (S.G.)
| | - Timothy Hicks
- NIHR Newcastle In Vitro Diagnostics Co-operative, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, William Leech Building, Medical School, Newcastle upon Tyne NE2 4HH, UK; (S.G.U.); (A.W.); (T.H.); (S.G.)
| | - Anna E. Boath
- Health Economics Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; (S.H.); (A.E.B.); (A.K.); (E.M.)
| | - Ashleigh Kernohan
- Health Economics Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; (S.H.); (A.E.B.); (A.K.); (E.M.)
| | - D. Ashley Price
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, William Leech Building, Medical School, Newcastle University, Newcastle NE2 4HH, UK; (K.G.); (D.A.P.); (A.J.A.)
- Department of Infectious Diseases, Royal Victoria Infirmary, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK;
- NIHR Newcastle In Vitro Diagnostics Co-operative, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, William Leech Building, Medical School, Newcastle upon Tyne NE2 4HH, UK; (S.G.U.); (A.W.); (T.H.); (S.G.)
| | - A. Joy Allen
- NIHR Newcastle In Vitro Diagnostics Co-operative, Translational and Clinical Research Institute, William Leech Building, Medical School, Newcastle University, Newcastle NE2 4HH, UK; (K.G.); (D.A.P.); (A.J.A.)
| | - Eoin Moloney
- Health Economics Group, Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Baddiley-Clark Building, Newcastle University, Newcastle upon Tyne NE2 4AX, UK; (S.H.); (A.E.B.); (A.K.); (E.M.)
| | - Sara Graziadio
- NIHR Newcastle In Vitro Diagnostics Co-operative, The Newcastle Upon Tyne Hospitals NHS Foundation Trust, William Leech Building, Medical School, Newcastle upon Tyne NE2 4HH, UK; (S.G.U.); (A.W.); (T.H.); (S.G.)
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37
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Ding T, Wang T, Zhang J, Cui P, Chen Z, Zhou S, Yuan S, Ma W, Zhang M, Rong Y, Chang J, Miao X, Ma X, Wang S. Analysis of Ovarian Injury Associated With COVID-19 Disease in Reproductive-Aged Women in Wuhan, China: An Observational Study. Front Med (Lausanne) 2021; 8:635255. [PMID: 33816526 PMCID: PMC8017139 DOI: 10.3389/fmed.2021.635255] [Citation(s) in RCA: 62] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 02/23/2021] [Indexed: 12/19/2022] Open
Abstract
Objective: This study was intended to investigate the relationship between COVID-19 disease and ovarian function in reproductive-aged women. Methods: Female COVID-19 patients of reproductive age were recruited between January 28 and March 8, 2020 from Tongji Hospital in Wuhan. Their baseline and clinical characteristics, as well as menstrual conditions, were recorded. Differentials in ovarian reserve markers and sex hormones (including anti-Müllerian hormone [AMH], follicle-stimulating hormone [FSH], the ratio of FSH to luteinizing hormone [LH], estradiol [E2], progesterone [P], testosterone [T], and prolactin [PRL] were compared to those of healthy women who were randomly selected and individually matched for age, region, and menstrual status. Uni- and multi-variable hierarchical linear regression analyses were performed to identify risk factors associated with ovarian function in COVID-19 women. Results: Seventy eight patients agreed to be tested for serum hormone, of whom 17 (21.79%) were diagnosed as the severe group and 39 (50%) were in the basal level group. Menstrual status (P = 0.55), menstrual volumes (P = 0.066), phase of menstrual cycle (P = 0.58), and dysmenorrhea history (P = 0.12) were similar without significant differences between non-severe and severe COVID-19 women. Significant lower serum AMH level/proportion (0.19/0.28 vs. 1.12 ng/ml, P = 0.003/0.027; AMH ≤
1.1 ng/ml: 75/70.4 vs. 49.7%, P = 0.009/0.004), higher serum T (0.38/0.39 vs. 0.22 ng/ml, P < 0.001/0.001) and PRL (25.43/24.10 vs. 12.12 ng/ml, P < 0.001/0.001) levels were observed in basal level and the all-COVID-19 group compared with healthy age-matched control. When adjusted for age, menstrual status and parity variations in multivariate hierarchical linear regression analysis, COVID-19 disease was significantly associated with serum AMH (β = −0.191; 95% CI: −1.177–0.327; P = 0.001), T (β = 0.411; 95% CI: 11.154–22.709; P < 0.001), and PRL (β = 0.497; 95% CI: 10.787–20.266; P < 0.001), suggesting an independent risk factor for ovarian function, which accounted for 3.2% of the decline in AMH, 14.3% of the increase in T, and 20.7% of the increase in PRL. Conclusion: Ovarian injury, including declined ovarian reserve and reproductive endocrine disorder, can be observed in women with COVID-19. More attention should be paid to their ovarian function under this pandemic, especially regarding reproductive-aged women. Clinical Trial Number: ChiCTR2000030015.
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Affiliation(s)
- Ting Ding
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Tian Wang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Jinjin Zhang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Pengfei Cui
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Zhe Chen
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Su Zhou
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Suzhen Yuan
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Wenqing Ma
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Minli Zhang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Yueguang Rong
- Department of Pathogen Biology, School of Basic Medicine, Huazhong University of Science and Technology, Wuhan, China
| | - Jiang Chang
- Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology, Wuhan, China
| | - Xiaoping Miao
- Department of Epidemiology and Biostatistics, Key Laboratory for Environment and Health, School of Public Health, Tongji Medical College, Huazhong University of Sciences and Technology, Wuhan, China
| | - Xiangyi Ma
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
| | - Shixuan Wang
- Department of Obstetrics and Gynecology, National Clinical Research Center for Obstetrical and Gynecological Diseases, Tongji Medical College, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China
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Ali N, Fariha KA, Islam F, Mohanto NC, Ahmad I, Hosen MJ, Ahmed S. Assessment of the role of zinc in the prevention of COVID-19 infections and mortality: A retrospective study in the Asian and European population. J Med Virol 2021; 93:4326-4333. [PMID: 33710631 PMCID: PMC8250922 DOI: 10.1002/jmv.26932] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/06/2021] [Accepted: 03/09/2021] [Indexed: 12/12/2022]
Abstract
Several studies have demonstrated an association between individual zinc status and viral respiratory infections; however, evidence regarding COVID‐19 is still missing or insufficient. This study aimed to evaluate the correlation between the prevalence of zinc deficiency and COVID‐19 cases and deaths per million population in the Asian and European countries. The COVID‐19 data from two different time points, that is, May 30 and June 30, 2020 for the Asian population and May 15 and June 15, 2020 for the European population, were analyzed to determine the correlation with the estimated zinc deficiency for these two continents. The prevalence of zinc deficiency was about two times higher in the Asian population (mean 17.5%) than in the European population (mean 8.9%). A significant positive correlation (p < .05) was observed between the prevalence of zinc deficiency and COVID‐19 cases at both time periods for the Asian population. However, the correlation between zinc deficiency prevalence and COVID‐19 deaths was not significant in the Asian population. In contrast, a significant but negative correlation (p < .05 for all cases) was observed for zinc deficiency with both COVID‐19 cases and deaths per million population at both time periods in the European countries. Considering the direct antiviral properties of zinc, it can be suggested that zinc supplementation may be beneficial for most of the population, especially older people and those who are at risk of COVID‐19 infections. In conclusion, there is not enough evidence on the association between individual zinc status and COVID‐19 infections and mortality. Therefore, cohort studies and randomized controlled trials are required to test this hypothesis.
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Affiliation(s)
- Nurshad Ali
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Khandaker A Fariha
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Farjana Islam
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Nayan C Mohanto
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Iftekhar Ahmad
- Department of Food Engineering and Tea Technology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Mohammad J Hosen
- Department of Genetic Engineering and Biotechnology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
| | - Shamim Ahmed
- Department of Biochemistry and Molecular Biology, Shahjalal University of Science and Technology, Sylhet, Bangladesh
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Hesse R, van der Westhuizen DJ, George JA. COVID-19-Related Laboratory Analyte Changes and the Relationship Between SARS-CoV-2 and HIV, TB, and HbA1c in South Africa. Adv Exp Med Biol 2021; 1321:183-97. [PMID: 33656724 DOI: 10.1007/978-3-030-59261-5_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
We conducted a retrospective analysis on data of all adults tested for SARS-CoV-2 across our laboratory network in South Africa over a 4-month period. Out of 842,197 tests, 11.7% were positive and 88.3% negative. The prevalence of HIV was 6.25 and 6.31% in the SARS-CoV-2-positive and SARS-CoV-2-negative cohort, respectively (p = 0.444). However, the prevalence of HIV-positive individuals in the critical cohort (9.15%) was higher than in the noncritical group (6.24%) (p = 0.011). Active tuberculosis infection was approximately 50% less in SARS-CoV-2-positive than in SARS-CoV-2-negative individuals. The prevalence of uncontrolled diabetes was 3.4 times higher in SARS-CoV-2-positive cases but was not higher in the critical vs. noncritical cases (p = 0.612). The neutrophil-to-lymphocyte ratio, coagulation markers, urea, and cardiac- and liver-related analytes were significantly elevated in the critical compared to noncritical cases. Platelet count and creatinine concentration did not differ significantly between the two groups. These findings do not support increased prevalence of HIV or tuberculosis in individuals with SARS-CoV-2 infection but do suggest an association of increased disease severity with HIV-positive status. Uncontrolled diabetes was positively associated with a significantly higher prevalence of SARS-CoV-2, and our investigation into analyte changes associated with SARS-CoV-2 disease severity supported previous findings of raised inflammatory markers, coagulation markers, liver- and cardiac-related analytes, and urea but not for creatinine and platelet count.
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Hatami H, Soleimantabar H, Ghasemian M, Delbari N, Aryannezhad S. Predictors of Intensive Care Unit Admission among Hospitalized COVID-19 Patients in a Large University Hospital in Tehran, Iran. J Res Health Sci 2021; 21:e00510. [PMID: 34024768 PMCID: PMC8957696 DOI: 10.34172/jrhs.2021.44] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 01/31/2021] [Accepted: 02/02/2021] [Indexed: 01/28/2023] Open
Abstract
Background: The rapid increase in the spread of COVID-19 and the numbers of infected patients worldwide has highlighted the need for intensive care unit (ICU) beds and more advanced therapy. This need is more urgent in resource-constrained settings. The present study aimed to identify the predictors of ICU admission among hospitalized COVID-19 patients.
Study design: The current study was conducted based on a retrospective cohort design.
Methods: The participants included 665 definite cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) hospitalized in Imam Hossein Hospital from February 20 to May 14, 2020. The baseline characteristics of patients were assessed, and multivariate logistic regression analysis was utilized to determine the significant odds ratio (OR) for ICU admission.
Results: Participants were aged 59.52±16.72 years, and the majority (55.6%) of them were male. Compared to non-ICU patients (n=547), the ICU patients (n=118) were older, had more baseline comorbidities, and presented more often with dyspnea, convulsion, loss of consciousness, tachycardia, tachypnea, and hypoxia, and less often with myalgia. Significant OR (95% CI) of ICU admission was observed for the 60-80 age group (2.42, 95%CI: 1.01; 5.79), ≥80 age group (3.73, 95%CI: 1.44; 9.42), ≥3 comorbidities (2.07, 95%CI: 1.31; 3.80), loss of consciousness (6.70, 95%CI: 2.94, 15.24), tachypnea (1.79, 95%CI: 1.03, 3.11), and SpO2<90 (5.83, 95%CI: 2.74; 12.4). Abnormal laboratory results were more common among ICU-admitted patients; in this regard, leukocytosis (4.45, 95%CI: 1.49, 13.31), lymphopenia (2.39, 95%CI: 1.30; 4.39), elevated creatine phosphokinase (CPK) (1.99, 95%CI: 1.04; 3.83), and increased aspartate aminotransferase (AST) (2.25, 95%CI: 1.18-4.30) had a significant OR of ICU admission. Chest computer tomography (CT) revealed that consolidation (1.82, 95%CI: 1.02, 3.24), pleural effusion (3.19, 95%CI: 1.71, 5.95), and crazy paving pattern (8.36, 95%CI: 1.92, 36.48) had a significant OR of ICU admission.
Conclusion: As evidenced by the obtained results, the predictors of ICU admission were identified among epidemiological characteristics, presenting symptoms and signs, laboratory tests, and chest CT findings.
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Affiliation(s)
- Hossein Hatami
- Department of Public Health, School of Public Health and Safety and Environmental and Occupational Hazards Control Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hussein Soleimantabar
- Department of Radiology, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mehrdad Ghasemian
- Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Negar Delbari
- School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Shayan Aryannezhad
- School of Public Health and Safety, Shahid Beheshti University of Medical Sciences, Tehran, Iran..
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Lei HY, Ding YH, Nie K, Dong YM, Xu JH, Yang ML, Liu MQ, Wei L, Nasser MI, Xu LY, Zhu P, Zhao MY. Potential effects of SARS-CoV-2 on the gastrointestinal tract and liver. Biomed Pharmacother 2021; 133:111064. [PMID: 33378966 DOI: 10.1016/j.biopha.2020.111064] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/07/2020] [Accepted: 11/20/2020] [Indexed: 02/07/2023] Open
Abstract
COVID-19 is a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Early reported symptoms include fever, cough, and respiratory symptoms. There were few reports of digestive symptoms. However, with COVID-19 spreading worldwide, symptoms such as vomiting, diarrhoea, and abdominal pain have gained increasing attention. Research has found that angiotensin-converting enzyme 2 (ACE2), the SARS-CoV-2 receptor, is strongly expressed in the gastrointestinal tract and liver. Whether theoretically or clinically, many studies have suggested a close connection between COVID-19 and the digestive system. In this review, we summarize the digestive symptoms reported in existing research, discuss the impact of SARS-CoV-2 on the gastrointestinal tract and liver, and determine the possible mechanisms and aetiology, such as cytokine storm. In-depth exploration of the relationship between COVID-19 and the digestive system is urgently needed.
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Zinellu A, Arru F, De Vito A, Sassu A, Valdes G, Scano V, Zinellu E, Perra R, Madeddu G, Carru C, Pirina P, Mangoni AA, Babudieri S, Fois AG. The De Ritis ratio as prognostic biomarker of in-hospital mortality in COVID-19 patients. Eur J Clin Invest 2021; 51:e13427. [PMID: 33043447 PMCID: PMC7646002 DOI: 10.1111/eci.13427] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/01/2020] [Accepted: 10/06/2020] [Indexed: 01/08/2023]
Abstract
Increased concentrations of serum aspartate transaminase (AST) and alanine transaminase (ALT) are common in COVID-19 patients. However, their capacity to predict mortality, particularly the AST/ALT ratio, commonly referred to as the De Ritis ratio, is unknown. We investigated the association between the De Ritis ratio on admission and in-hospital mortality in 105 consecutive patients with coronavirus disease of 2019 (COVID-19) admitted to three COVID-19 referral centres in Sardinia, Italy. The De Ritis ratio was significantly lower in survivors than nonsurvivors (median: 1.25; IQR: 0.91-1.64 vs 1.67; IQR: 1.38-1.97, P = .002) whilst there were no significant between-group differences in ALT and AST concentrations. In ROC curve analysis, the AUC value of the De Ritis ratio was 0.701 (95% CI 0.603-0.787, P = .0006) with sensitivity and specificity of 74% and 70%, respectively. Kaplan-Meier survival curves showed a significant association between the De Ritis ratio and mortality (logrank test P = .014). By contrast, no associations were observed between the ALT and AST concentrations and mortality (logrank test P = .83 and P = .62, respectively). In multivariate Cox regression analysis, the HR in patients with De Ritis ratios ≥1.63 (upper tertile of this parameter) remained significant after adjusting for age, gender, smoking status, cardiovascular disease, intensity of care, diabetes, respiratory diseases, malignancies and kidney disease (HR: 2.46, 95% CI 1.05-5.73, P = .037). Therefore, the De Ritis ratio on admission was significantly associated with in-hospital mortality in COVID-19 patients. Larger studies are required to confirm the capacity of this parameter to independently predict mortality in this group.
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Affiliation(s)
- Angelo Zinellu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Francesco Arru
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Andrea De Vito
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | | | - Giovanni Valdes
- Pneumology Unit, Santissima Trinità Hospital, Cagliari, Italy
| | - Valentina Scano
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Elisabetta Zinellu
- Unit of Respiratory Diseases, University Hospital Sassari (AOU), Sassari, Italy
| | - Roberto Perra
- Pneumology Unit, Santissima Trinità Hospital, Cagliari, Italy
| | - Giordano Madeddu
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Ciriaco Carru
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Pietro Pirina
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.,Unit of Respiratory Diseases, University Hospital Sassari (AOU), Sassari, Italy
| | - Arduino A Mangoni
- Department of Clinical Pharmacology, College of Medicine and Public Health, Flinders University and Flinders Medical Centre, Adelaide, Australia
| | - Sergio Babudieri
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Alessandro G Fois
- Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.,Unit of Respiratory Diseases, University Hospital Sassari (AOU), Sassari, Italy
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Galiero R, Pafundi PC, Simeon V, Rinaldi L, Perrella A, Vetrano E, Caturano A, Alfano M, Beccia D, Nevola R, Marfella R, Sardu C, Coppola C, Scarano F, Maggi P, De Lucia Sposito P, Vocciante L, Rescigno C, Sbreglia C, Fraganza F, Parrella R, Romano A, Calabria G, Polverino B, Pagano A, Bologna C, Amitrano M, Esposito V, Coppola N, Maturo N, Adinolfi LE, Chiodini P, Sasso FC. Impact of chronic liver disease upon admission on COVID-19 in-hospital mortality: Findings from COVOCA study. PLoS One 2020; 15:e0243700. [PMID: 33301529 PMCID: PMC7728173 DOI: 10.1371/journal.pone.0243700] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 11/27/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Italy has been the first Western country to be heavily affected by the spread of SARS-COV-2 infection and among the pioneers of the clinical management of pandemic. To improve the outcome, identification of patients at the highest risk seems mandatory. OBJECTIVES Aim of this study is to identify comorbidities and clinical conditions upon admission associated with in-hospital mortality in several COVID Centers in Campania Region (Italy). METHODS COVOCA is a multicentre retrospective observational cohort study, which involved 18 COVID Centers throughout Campania Region, Italy. Data were collected from patients who completed their hospitalization between March-June 2020. The endpoint was in-hospital mortality, assessed either from data at discharge or death certificate, whilst all exposure variables were collected at hospital admission. RESULTS Among 618 COVID-19 hospitalized patients included in the study, 143 in-hospital mortality events were recorded, with a cumulative incidence of about 23%. At multivariable logistic analysis, male sex (OR 2.63, 95%CI 1.42-4.90; p = 0.001), Chronic Liver Disease (OR 5.88, 95%CI 2.39-14.46; p<0.001) and malignancies (OR 2.62, 95%CI 1.21-5.68; p = 0.015) disclosed an independent association with a poor prognosis, Glasgow Coma Scale (GCS) and Respiratory Severity Scale allowed to identify at higher mortality risk. Sensitivity analysis further enhanced these findings. CONCLUSION Mortality of patients hospitalized for COVID-19 appears strongly affected by both clinical conditions on admission and comorbidities. Originally, we observed a very poor outcome in subjects with a chronic liver disease, alongside with an increase of hepatic damage.
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Affiliation(s)
- Raffaele Galiero
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Pia Clara Pafundi
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Vittorio Simeon
- Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Luca Rinaldi
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | | | - Erica Vetrano
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Alfredo Caturano
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Maria Alfano
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Domenico Beccia
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Riccardo Nevola
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
- Internal Medicine, Sant’Ottone Frangipane Hospital, Ariano Irpino, Italy
| | - Raffaele Marfella
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Celestino Sardu
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Carmine Coppola
- COVID Center "S. Anna e SS. Madonna della Neve" Hospital, Boscotrecase, Italy
| | - Ferdinando Scarano
- COVID Center "S. Anna e SS. Madonna della Neve" Hospital, Boscotrecase, Italy
| | - Paolo Maggi
- U.O.C. Infectious and Tropical Diseases, S. Anna e S. Sebastiano Hospital, Caserta, Italy
| | | | | | - Carolina Rescigno
- U.O.C. Infectious Diseases and Neurology, Cotugno Hospital, Naples, Italy
| | - Costanza Sbreglia
- U.O.C. Infectious Diseases of the Elderly, Cotugno Hospital, Naples, Italy
| | | | - Roberto Parrella
- U.O.C. Respiratory Infectious Diseases, Cotugno Hospital, Naples, Italy
| | | | - Giosuele Calabria
- IX Division of Infectious Diseases and Interventional Ultrasound, Cotugno Hospital, Naples, Italy
| | | | - Antonio Pagano
- Emergency and Acceptance Unit, "Santa Maria delle Grazie" Hospital, Pozzuoli, Italy
| | | | - Maria Amitrano
- U.O.C. Internal Medicine—Moscati Hospital, Avellino, Italy
| | - Vincenzo Esposito
- IV Division of Immunodeficiency and Gender Infectious Diseases, Cotugno Hospital, Naples, Italy
| | - Nicola Coppola
- Department of Mental Health and Public Medicine, Centro COVID A.O.U. Vanvitelli, Naples, Italy
| | - Nicola Maturo
- U.O.S.D. Infectious Diseases Emergency and Acceptance, Cotugno Hospital, Naples, Italy
| | - Luigi Elio Adinolfi
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Paolo Chiodini
- Medical Statistics Unit, Department of Physical and Mental Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Ferdinando Carlo Sasso
- Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples, Italy
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Sarkesh A, Daei Sorkhabi A, Sheykhsaran E, Alinezhad F, Mohammadzadeh N, Hemmat N, Bannazadeh Baghi H. Extrapulmonary Clinical Manifestations in COVID-19 Patients. Am J Trop Med Hyg 2020; 103:1783-1796. [PMID: 32940201 PMCID: PMC7646754 DOI: 10.4269/ajtmh.20-0986] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Accepted: 09/07/2020] [Indexed: 01/08/2023] Open
Abstract
COVID-19 manifestations in symptomatic patients can be in the form of pneumonia, acute respiratory syndrome, and multiple organ dysfunction as well. Renal complications, gastrointestinal dysfunctions, endocrine system disorders, myocardial dysfunction and arrhythmia, neurological dysfunctions, dermatological symptoms, hematological manifestations, and thromboinflammation are among the reported extrapulmonary complications. Moreover, the presence of coagulopathy, excessive and dysregulated immune responses, and autoimmunity by COVID-19 patients is considerable. The pathogenesis of infection entails the entry of the virus via receptors on cells, principally angiotensin-converting enzyme 2 receptors. Direct virus damage coupled with indirect effects of viral infection including thromboinflammation, dysfunction of the immune system, and dysregulation of the renin-angiotensin system leads to multiple organ failure. This review outlines the extrapulmonary organ-specific complications and their pathophysiology and epidemiology.
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Affiliation(s)
- Aila Sarkesh
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Amin Daei Sorkhabi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elham Sheykhsaran
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Students’ Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Bacteriology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farbod Alinezhad
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nader Mohammadzadeh
- Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
- Central Medical Laboratory of East Azerbaijan Province, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nima Hemmat
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hossein Bannazadeh Baghi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Infectious and Tropical Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
- Department of Virology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
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Sestili P, Fimognari C. Paracetamol-Induced Glutathione Consumption: Is There a Link With Severe COVID-19 Illness? Front Pharmacol 2020; 11:579944. [PMID: 33117175 PMCID: PMC7577213 DOI: 10.3389/fphar.2020.579944] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/15/2020] [Indexed: 01/02/2023] Open
Abstract
COVID-19 pandemic is posing an unprecedented sanitary threat: antiviral and host-directed medications to treat the disease are urgently needed. A great effort has been paid to find drugs and treatments for hospitalized, severely ill patients. However, medications used for the domiciliary management of early symptoms, notwithstanding their importance, have not been and are not presently regarded with the same attention and seriousness. In analogy with other airways viral infections, COVID-19 patients in the early phase require specific antivirals (still lacking) and non-etiotropic drugs to lower pain, fever, and control inflammation. Non-steroidal anti-inflammatory drugs (NSAIDs) and paracetamol (PAC) are widely used as non-etiotropic agents in common airways viral infections and hence are both theoretically repurposable for COVID-19. However, a warning from some research reports and National Authorities raised NSAIDs safety concerns because of the supposed induction of angiotensin-converting enzyme 2 (ACE2) levels (the receptor used by SARS-CoV2 to enter host airways cells), the increased risk of bacterial superinfections and masking of disease symptoms. As a consequence, the use of NSAIDs was, and is still, discouraged while the alternative adoption of paracetamol is still preferred. On the basis of novel data and hypothesis on the possible role of scarce glutathione (GSH) levels in the exacerbation of COVID-19 and of the GSH depleting activity of PAC, this commentary raises the question of whether PAC may be the better choice.
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Affiliation(s)
- Piero Sestili
- Department of Biomolecular Sciences (DISB), Università degli Studi di Urbino Carlo Bo, Urbino, Italy
| | - Carmela Fimognari
- Dipartimento di Scienze per la Qualità della Vita, Università degli Studi di Bologna, Rimini, Italy
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Sanz Segura P, Arguedas Lázaro Y, Mostacero Tapia S, Cabrera Chaves T, Sebastián Domingo JJ. Involvement of the digestive system in COVID-19. A review. Gastroenterología y Hepatología (English Edition) 2020; 43:464-471. [DOI: 10.1016/j.gastre.2020.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The SARS-CoV-2 pandemic is leading to high mortality and a global health crisis. The primary involvement is respiratory; however, the virus can also affect other organs, such as the gastrointestinal tract and liver. The most common symptoms are anorexia and diarrhea. In about half of the cases, viral RNA could be detected in the stool, which is another line of transmission and diagnosis. COVID19 has a worse prognosis in patients with comorbidities, although there is not enough evidence in case of previous digestive diseases. Digestive endoscopies may give rise to aerosols, which make them techniques with a high risk of infection. Experts and scientific organizations worldwide have developed guidelines for preventive measures. The available evidence on gastrointestinal and hepatic involvement, the impact on patients with previous digestive diseases and operating guidelines for Endoscopy Units during the pandemic are reviewed.
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47
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Sanz Segura P, Arguedas Lázaro Y, Mostacero Tapia S, Cabrera Chaves T, Sebastián Domingo JJ. Involvement of the digestive system in covid-19. A review. Gastroenterol Hepatol 2020; 43:464-471. [PMID: 32859408 PMCID: PMC7303613 DOI: 10.1016/j.gastrohep.2020.06.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 05/22/2020] [Accepted: 06/14/2020] [Indexed: 02/07/2023]
Abstract
The SARS-CoV-2 pandemic is leading to high mortality and a global health crisis. The primary involvement is respiratory; however, the virus can also affect other organs, such as the gastrointestinal tract and liver. The most common symptoms are anorexia and diarrhea. In about half of the cases, viral RNA could be detected in the stool, which is another line of transmission and diagnosis. covid19 has a worse prognosis in patients with comorbidities, although there is not enough evidence in case of previous digestive diseases. Digestive endoscopies may give rise to aerosols, which make them techniques with a high risk of infection. Experts and scientific organizations worldwide have developed guidelines for preventive measures. The available evidence on gastrointestinal and hepatic involvement, the impact on patients with previous digestive diseases and operating guidelines for Endoscopy Units during the pandemic are reviewed.
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