51
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A case of secondary sclerosing cholangitis due to COVID-19. Clin Imaging 2021; 80:239-242. [PMID: 34364072 PMCID: PMC8314797 DOI: 10.1016/j.clinimag.2021.07.017] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 06/24/2021] [Accepted: 07/20/2021] [Indexed: 02/06/2023]
Abstract
COVID-19 was first recognized by the World Health Organization (WHO) in December 2019 and declared a global pandemic in March 2020. Although COVID-19 primarily results in pulmonary symptoms, it is becoming apparent that it can lead to multisystemic manifestations. Liver damage with elevated AST and ALT is seen in patients with COVID-19. Although the etiology of liver damage is still debated, biliary damage is rarely seen. This case demonstrates a potential complication of COVID-19 in a previously healthy patient. The patient contracted COVID-19 in March 2020 and endured a complicated course including intubation, multiple readmissions, and chronic abdominal pain. He is now awaiting a liver transplant. Our case portrays biliary damage as an additional possible complication of COVID-19 and the importance of imaging in its diagnosis.
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52
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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] [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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53
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Gracia-Ramos AE, Jaquez-Quintana JO, Contreras-Omaña R, Auron M. Liver dysfunction and SARS-CoV-2 infection. World J Gastroenterol 2021; 27:3951-3970. [PMID: 34326607 PMCID: PMC8311530 DOI: 10.3748/wjg.v27.i26.3951] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/09/2021] [Accepted: 06/16/2021] [Indexed: 02/06/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 infection is the cause of coronavirus disease 2019 (COVID-19), which predominantly affects the respiratory system; it also causes systemic and multi-organic disease. Liver damage is among the main extrapulmonary manifestations. COVID-19-associated liver injury is defined as any liver damage occurring during the disease course and treatment of COVID-19 in patients with or without pre-existing liver disease, and occurs in approximately one in five patients. Abnormal liver test results have been associated with a more severe course of COVID-19 and other complications, including death. Mechanisms linking COVID-19 to liver injury are diverse. Particular consideration should be made for patients with pre-existing liver disease, such as metabolic dysfunction-associated fatty liver disease, chronic liver disease due to viral or autoimmune disease, liver transplant carriers, or cirrhosis, given the risk for more severe outcomes. This manuscript summarizes the current lines of evidence on COVID-19-associated liver injury regarding pathophysiology, clinical significance, and management in both patients with or without pre-existing liver disease, to facilitate clinicians' access to updated information and patient care. Finally, we mention the ideas and recommendations to be considered for future research.
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Affiliation(s)
- Abraham Edgar Gracia-Ramos
- Department of Internal Medicine, General Hospital, National Medical Center "La Raza", Instituto Mexicano del Seguro Social, Mexico City 02990, Mexico
| | - Joel Omar Jaquez-Quintana
- Gastroenterology Service and Department of Internal Medicine, Faculty of Medicine, University Hospital "Dr. José E. González”, Universidad Autónoma de Nuevo León, Monterrey 64460, Mexico
| | - Raúl Contreras-Omaña
- Centro de Estudio e Investigación en Enfermedades Hepáticas y Toxicológicas (CEIHET), Pachuca 42184, Mexico
| | - Moises Auron
- Departments of Hospital Medicine and Pediatric Hospital Medicine, Cleveland Clinic, Cleveland, OH 44195, United States
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54
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McGrowder DA, Miller F, Anderson Cross M, Anderson-Jackson L, Bryan S, Dilworth L. Abnormal Liver Biochemistry Tests and Acute Liver Injury in COVID-19 Patients: Current Evidence and Potential Pathogenesis. Diseases 2021; 9:diseases9030050. [PMID: 34287285 PMCID: PMC8293258 DOI: 10.3390/diseases9030050] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/16/2021] [Accepted: 06/24/2021] [Indexed: 02/07/2023] Open
Abstract
Globally, millions of persons have contracted the coronavirus disease 2019 (COVID-19) over the past several months, resulting in significant mortality. Health care systems are negatively impacted including the care of individuals with cancers and other chronic diseases such as chronic active hepatitis, cirrhosis and hepatocellular carcinoma. There are various probable pathogenic mechanisms that have been presented to account for liver injury in COVID-19 patients such as hepatotoxicity cause by therapeutic drugs, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of the bile duct cells and hepatocytes, hypoxia and systemic inflammatory response. Liver biochemistry tests such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) are deranged in COVID-19 patients with liver injury. Hepatocellular damage results in the elevation of serum AST and ALT levels in early onset disease while a cholestatic pattern that develops as the disease progress causes higher levels of ALP, GGT, direct and total bilirubin. These liver biochemistry tests are prognostic markers of disease severity and should be carefully monitored in COVID-19 patients. We conducted a systematic review of abnormal liver biochemistry tests in COVID-19 and the possible pathogenesis involved. Significant findings regarding the severity, hepatocellular pattern, incidence and related clinical outcomes in COVID-19 patients are highlighted.
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Affiliation(s)
- Donovan A. McGrowder
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (L.A.-J.); (L.D.)
- Correspondence:
| | - Fabian Miller
- Department of Physical Education, Faculty of Education, The Mico University College, 1A Marescaux Road, Kingston 5, Jamaica;
- Department of Biotechnology, Faculty of Science and Technology, The University of the West Indies, Kingston 7, Jamaica
| | - Melisa Anderson Cross
- School of Allied Health and Wellness, College of Health Sciences, University of Technology, Kingston 7, Jamaica;
| | - Lennox Anderson-Jackson
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (L.A.-J.); (L.D.)
| | - Sophia Bryan
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica;
| | - Lowell Dilworth
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (L.A.-J.); (L.D.)
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55
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Archambault AS, Zaid Y, Rakotoarivelo V, Turcotte C, Doré É, Dubuc I, Martin C, Flamand O, Amar Y, Cheikh A, Fares H, El Hassani A, Tijani Y, Côté A, Laviolette M, Boilard É, Flamand L, Flamand N. High levels of eicosanoids and docosanoids in the lungs of intubated COVID-19 patients. FASEB J 2021; 35:e21666. [PMID: 34033145 PMCID: PMC8206770 DOI: 10.1096/fj.202100540r] [Citation(s) in RCA: 89] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/29/2021] [Accepted: 04/30/2021] [Indexed: 12/13/2022]
Abstract
Severe acute respiratory syndrome coronavirus 2 is responsible for coronavirus disease 2019 (COVID-19). While COVID-19 is often benign, a subset of patients develops severe multilobar pneumonia that can progress to an acute respiratory distress syndrome. There is no cure for severe COVID-19 and few treatments significantly improved clinical outcome. Dexamethasone and possibly aspirin, which directly/indirectly target the biosynthesis/effects of numerous lipid mediators are among those options. Our objective was to define if severe COVID-19 patients were characterized by increased bioactive lipids modulating lung inflammation. A targeted lipidomic analysis of bronchoalveolar lavages (BALs) by tandem mass spectrometry was done on 25 healthy controls and 33 COVID-19 patients requiring mechanical ventilation. BALs from severe COVID-19 patients were characterized by increased fatty acids and inflammatory lipid mediators. There was a predominance of thromboxane and prostaglandins. Leukotrienes were also increased, notably LTB4 , LTE4 , and eoxin E4 . Monohydroxylated 15-lipoxygenase metabolites derived from linoleate, arachidonate, eicosapentaenoate, and docosahexaenoate were also increased. Finally yet importantly, specialized pro-resolving mediators, notably lipoxin A4 and the D-series resolvins, were also increased, underscoring that the lipid mediator storm occurring in severe COVID-19 involves pro- and anti-inflammatory lipids. Our data unmask the lipid mediator storm occurring in the lungs of patients afflicted with severe COVID-19. We discuss which clinically available drugs could be helpful at modulating the lipidome we observed in the hope of minimizing the deleterious effects of pro-inflammatory lipids and enhancing the effects of anti-inflammatory and/or pro-resolving lipid mediators.
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Affiliation(s)
- Anne-Sophie Archambault
- Centre de Recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Faculté de médecine, Département de médecine, Université Laval, Québec, QC, Canada.,Canada Excellence Research Chair in the Microbiome-Endocannabinoidome Axis in Metabolic Health, Université Laval, Québec, QC, Canada
| | - Younes Zaid
- Biology Department, Faculty of Sciences, Mohammed V University, Rabat, Morocco.,Cheikh Zaïd Hospital, Abulcasis University of Health Sciences, Rabat, Morocco
| | - Volatiana Rakotoarivelo
- Centre de Recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Faculté de médecine, Département de médecine, Université Laval, Québec, QC, Canada.,Canada Excellence Research Chair in the Microbiome-Endocannabinoidome Axis in Metabolic Health, Université Laval, Québec, QC, Canada
| | - Caroline Turcotte
- Centre de Recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Faculté de médecine, Département de médecine, Université Laval, Québec, QC, Canada.,Canada Excellence Research Chair in the Microbiome-Endocannabinoidome Axis in Metabolic Health, Université Laval, Québec, QC, Canada
| | - Étienne Doré
- Centre de Recherche du Centre Hospitalier, Universitaire de Québec-Université Laval, Québec, QC, Canada.,Centre de Recherche Arthrite, Université Laval, Québec, QC, Canada
| | - Isabelle Dubuc
- Centre de Recherche du Centre Hospitalier, Universitaire de Québec-Université Laval, Québec, QC, Canada
| | - Cyril Martin
- Centre de Recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Faculté de médecine, Département de médecine, Université Laval, Québec, QC, Canada.,Canada Excellence Research Chair in the Microbiome-Endocannabinoidome Axis in Metabolic Health, Université Laval, Québec, QC, Canada
| | - Olivier Flamand
- Centre de Recherche du Centre Hospitalier, Universitaire de Québec-Université Laval, Québec, QC, Canada
| | - Youssef Amar
- Moroccan Foundation for Advanced Science, Innovation & Research (MAScIR), Rabat, Morocco
| | - Amine Cheikh
- Cheikh Zaïd Hospital, Abulcasis University of Health Sciences, Rabat, Morocco
| | - Hakima Fares
- Cheikh Zaïd Hospital, Abulcasis University of Health Sciences, Rabat, Morocco
| | - Amine El Hassani
- Cheikh Zaïd Hospital, Abulcasis University of Health Sciences, Rabat, Morocco
| | - Youssef Tijani
- Faculty of Medicine, Mohammed VI University of Health Sciences, Casablanca, Morocco
| | - Andréanne Côté
- Centre de Recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Faculté de médecine, Département de médecine, Université Laval, Québec, QC, Canada
| | - Michel Laviolette
- Centre de Recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Faculté de médecine, Département de médecine, Université Laval, Québec, QC, Canada
| | - Éric Boilard
- Centre de Recherche du Centre Hospitalier, Universitaire de Québec-Université Laval, Québec, QC, Canada.,Centre de Recherche Arthrite, Université Laval, Québec, QC, Canada.,Département de Microbiologie-Infectiologie et d'immunologie, Université Laval, Québec, QC, Canada
| | - Louis Flamand
- Centre de Recherche du Centre Hospitalier, Universitaire de Québec-Université Laval, Québec, QC, Canada.,Département de Microbiologie-Infectiologie et d'immunologie, Université Laval, Québec, QC, Canada
| | - Nicolas Flamand
- Centre de Recherche de l'Institut universitaire de cardiologie et de pneumologie de Québec, Faculté de médecine, Département de médecine, Université Laval, Québec, QC, Canada.,Canada Excellence Research Chair in the Microbiome-Endocannabinoidome Axis in Metabolic Health, Université Laval, Québec, QC, Canada
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56
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Grinevich VB, Kravchuk YA, Ped VI, Sas EI, Salikova SP, Gubonina IV, Tkachenko EI, Sitkin SI, Lazebnik LB, Golovanova EV, Belousova EA, Makarchuk PA, Eremina EY, Sarsenbaeva AS, Abdulganieva DI, Tarasova LV, Gromova OA, Ratnikov VA, Kozlov KV, Ratnikova AK. Management of patients with digestive diseases during the COVID-19 pandemic. Clinical Practice Guidelines by the Russian scientific medical society of internal medicine (RSMSIM) and the Gastroenterological Scientific Society of Russia (2nd edition). EXPERIMENTAL AND CLINICAL GASTROENTEROLOGY 2021:5-82. [DOI: 10.31146/1682-8658-ecg-187-3-5-82] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
The presented clinical practice guidelines of the Gastroenterological Scientific Society of Russia (GSSR), diagnostic, and therapeutic approaches for patients with digestive diseases during the COVID-19 pandemic. The guidelines were approved by the XXIII Congress of the GSSR and the 22nd International Slavonic-Baltic Scientifi c Forum “St. Petersburg - Gastro-2020 ON-LINE” (St. Petersburg, June 11, 2020). The presented clinical practice guidelines of the Russian Scientific Medical Society of Internal Medicine (RSMSIM) and the Gastroenterological Scientific Society of Russia (GSSR), diagnostic, and therapeutic approaches for patients with digestive diseases during the COVID-19 pandemic. The recommendations were approved at the XV National Congress of Internal Medicine, XXIII Congress of NOGR on the basis of the 1st edition, adopted at the 22nd International Slavic- Baltic Scientific Forum “St. Petersburg - Gastro-2020 ON-LINE”.
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Affiliation(s)
| | | | - V. I. Ped
- Military Medical Academy named after S. M. Kirov
| | - E. I. Sas
- Military Medical Academy named after S. M. Kirov
| | | | | | | | - S. I. Sitkin
- State Research Institute of Highly Pure Biopreparations of FMBA of Russia; Almazov National Medical Research Centre; North-Western state medical University named after I. I. Mechnikov, Ministry of health of the Russian Federation
| | - L. B. Lazebnik
- Moscow state University of Medicine a. Densitry named after A. I. Yevdokimov of the Ministry of Health of Russia
| | - E. V. Golovanova
- Moscow state University of Medicine a. Densitry named after A. I. Yevdokimov of the Ministry of Health of Russia
| | - E. A. Belousova
- State Budgetary Institution of Moscow Region “Moscow Regional Research Clinical Institute n.a. M. F. Vladimirsky”
| | - P. A. Makarchuk
- State Budgetary Institution of Moscow Region “Moscow Regional Research Clinical Institute n.a. M. F. Vladimirsky”
| | - E. Yu. Eremina
- Federal State Budgetary Educational Institution of Higher Education “National Research Ogarev Mordovia State University”
| | - A. S. Sarsenbaeva
- FSBEI HE SUSMU MOH Russia, st. Vorovskogo, 64, Ural Federal District
| | | | - L. V. Tarasova
- FSBEI of HE “The Chuvash State University n.a. I. N. Ulyanov”; BI of HE “The Surgut State University”
| | - O. A. Gromova
- Federal Research Center “Informatics and Management” of the Russian Academy of Sciences; Federal State Educational Institution of Higher Education Lomonosov Moscow State University
| | - V. A. Ratnikov
- Federal state budgetary institution “North-West District Scientific and Clinical Center named after L. G. Sokolov Federal Medical and Biological Agency“
| | - K. V. Kozlov
- Military Medical Academy named after S. M. Kirov
| | - A. K. Ratnikova
- Military Medical Academy named after S. M. Kirov; Federal state budgetary institution “North-West District Scientific and Clinical Center named after L. G. Sokolov Federal Medical and Biological Agency“
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57
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Chinnici CM, Russelli G, Bulati M, Miceli V, Gallo A, Busà R, Tinnirello R, Conaldi PG, Iannolo G. Mesenchymal stromal cell secretome in liver failure: Perspectives on COVID-19 infection treatment. World J Gastroenterol 2021; 27:1905-1919. [PMID: 34007129 PMCID: PMC8108038 DOI: 10.3748/wjg.v27.i17.1905] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 03/05/2021] [Accepted: 04/05/2021] [Indexed: 02/06/2023] Open
Abstract
Due to their immunomodulatory potential and release of trophic factors that promote healing, mesenchymal stromal cells (MSCs) are considered important players in tissue homeostasis and regeneration. MSCs have been widely used in clinical trials to treat multiple conditions associated with inflammation and tissue damage. Recent evidence suggests that most of the MSC therapeutic effects are derived from their secretome, including the extracellular vesicles, representing a promising approach in regenerative medicine application to treat organ failure as a result of inflammation/fibrosis. The recent outbreak of respiratory syndrome coronavirus, caused by the newly identified agent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has forced scientists worldwide to use all available instruments to fight the infection, including the inflammatory cascade caused by this pandemic disease. The use of MSCs is a valid approach to combat organ inflammation in different compartments. In addition to the lungs, which are considered the main inflammatory target for this virus, other organs are compromised by the infection. In particular, the liver is involved in the inflammatory response to SARS-CoV-2 infection, which causes organ failure, leading to death in coronavirus disease 2019 (COVID-19) patients. We herein summarize the current implications derived from the use of MSCs and their soluble derivatives in COVID-19 treatment, and emphasize the potential of MSC-based therapy in this clinical setting.
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Affiliation(s)
- Cinzia Maria Chinnici
- Department of Research, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo 90127, Italy
- Department of Regenerative Medicine, Fondazione Ri.MED, Palermo 90127, Italy
| | - Giovanna Russelli
- Department of Research, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo 90127, Italy
| | - Matteo Bulati
- Department of Research, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo 90127, Italy
| | - Vitale Miceli
- Department of Research, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo 90127, Italy
| | - Alessia Gallo
- Department of Research, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo 90127, Italy
| | - Rosalia Busà
- Department of Research, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo 90127, Italy
| | - Rosaria Tinnirello
- Neuroscience Unit, CNR Institute of Biomedicine and Molecular Immunology, Palermo 90146, Italy
| | - Pier Giulio Conaldi
- Department of Research, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo 90127, Italy
| | - Gioacchin Iannolo
- Department of Research, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (IRCCS-ISMETT), Palermo 90127, Italy
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58
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Serra F, Bonaduce I, De ruvo N, Cautero N, Brugioni L, Gelmini R. Covid-19 and hepatic injury: A systematic review. Clin Res Hepatol Gastroenterol 2021; 45:101605. [PMID: 33607550 PMCID: PMC7832993 DOI: 10.1016/j.clinre.2020.101605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Accepted: 12/20/2020] [Indexed: 02/04/2023]
Affiliation(s)
- Francesco Serra
- Department of Surgery, University of Modena and Reggio Emilia — Policlinico of Modena, Via del Pozzo, 71 41100 Modena, Italy,Corresponding author
| | - Isabella Bonaduce
- Department of Surgery, University of Modena and Reggio Emilia — Policlinico of Modena, Via del Pozzo, 71 41100 Modena, Italy
| | - Nicola De ruvo
- Department of Surgery, University of Modena and Reggio Emilia — Policlinico of Modena, Via del Pozzo, 71 41100 Modena, Italy
| | - Nicola Cautero
- Department of Surgery, University of Modena and Reggio Emilia — Policlinico of Modena, Via del Pozzo, 71 41100 Modena, Italy
| | - Lucio Brugioni
- Department of Emergency Medicine, University of Modena and Reggio Emilia — Policlinico of Modena, Via del Pozzo, 71 41100 Modena, Italy
| | - Roberta Gelmini
- Department of Surgery, University of Modena and Reggio Emilia — Policlinico of Modena, Via del Pozzo, 71 41100 Modena, Italy
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59
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Palacios S, Schiappacasse G, Valdes R, Maldonado I, Varela C. COVID-19: Abdominal and Pelvic Imaging Findings: A Primer for Radiologists. J Comput Assist Tomogr 2021; 45:352-358. [PMID: 33797437 PMCID: PMC8132568 DOI: 10.1097/rct.0000000000001152] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Accepted: 01/16/2021] [Indexed: 01/08/2023]
Abstract
ABSTRACT The COVID-19 pandemic presents an ongoing global health threat. The SARS-CoV-2 is known to cause substantial pulmonary disease, and most of the current radiological publications are dedicated to describing and characterizing these findings. However, studies regarding imaging findings in the abdomen and pelvis of infected patients are still very limited. The aim of this review is to discuss the most frequent abdominal manifestations based on the current literature and representative images from our local experience.
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Affiliation(s)
- Sofía Palacios
- From the Universidad Santiago de Chile, Hospital Militar de Santiago
| | - Giancarlo Schiappacasse
- From the Universidad Santiago de Chile, Hospital Militar de Santiago
- Body Imaging Section, Radiology Department, Universidad del Desarrollo, Clínica Alemana de Santiago
| | - Rosario Valdes
- Universidad de los Andes, Clínica Dávila, Santiago, Chile
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60
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Vasques-Monteiro IML, Souza-Mello V. Coronavirus disease 2019 severity in obesity: Metabolic dysfunction-associated fatty liver disease in the spotlight. World J Gastroenterol 2021; 27:1738-1750. [PMID: 33967554 PMCID: PMC8072197 DOI: 10.3748/wjg.v27.i16.1738] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/15/2021] [Accepted: 03/22/2021] [Indexed: 02/06/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) outbreak has drawn the scientific community's attention to pre-existing metabolic conditions that could aggravate the infection, causing extended viral shedding, prolonged hospitalization, and high death rates. Metabolic dysfunction-associated fatty liver disease (MAFLD) emerges as a surrogate for COVID-19 severity due to the constellation of metabolic alterations it entails. This review outlines the impact MAFLD exerts on COVID-19 severity in obese subjects, besides the possible mechanistic links to the poor outcomes. The data collected showed that MAFLD patients had poorer COVID-19 outcomes than non-MAFLD obese subjects. MAFLD is generally accompanied by impaired glycemic control and systemic arterial hypertension, both of which can decompensate during the COVID-19 clinical course. Also, MAFLD subjects had higher plasma inflammatory marker concentrations than non-MAFLD subjects, which might be related to an intensified cytokine storm syndrome frequently associated with the need for mechanical ventilation and death. In conclusion, MAFLD represents a higher risk than obesity for COVID-19 severity, resulting in poor outcomes and even progression to non-alcoholic steatohepatitis. Hepatologists should include MAFLD subjects in the high-risk group, intensify preventive measurements, and prioritize their vaccination.
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Affiliation(s)
- Isabela Macedo Lopes Vasques-Monteiro
- Anatomy, Rio de Janeiro State University, Rio de Janeiro 20551030, Brazil
- Food Science and Technology, Federal University of the State of Rio de Janeiro, Rio de Janeiro 22290250, Brazil
| | - Vanessa Souza-Mello
- Anatomy, Rio de Janeiro State University, Rio de Janeiro 20551030, Brazil
- Laboratory of Morphometry, Metabolism, and Cardiovascular Diseases, Biomedical Center, Institute of Biology, Anatomy Department, Rio de Janeiro State University, Rio de Janeiro 20551030, Brazil
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61
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Al-Nimer MSM. Is COVID-19-induced liver injury different from other RNA viruses? World J Meta-Anal 2021; 9:108-127. [DOI: 10.13105/wjma.v9.i2.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/12/2021] [Accepted: 04/23/2021] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 is a pandemic disease caused by a novel RNA coronavirus, SARS coronavirus 2 (SARS-CoV-2), which is implicated in the respiratory system. SARS-CoV-2 also targets extrapulmonary systems, including the gastrointestinal tract, liver, central nervous system and others. SARS-CoV-2, like other RNA viruses, targets the liver and produces liver injury. This literature review showed that SARS-CoV-2-induced liver injury is different from other RNA viruses by a transient elevation of hepatic enzymes and does not progress to liver fibrosis or other unfavorable events. Moreover, SARS-CoV-2-induced liver injury usually occurs in the presence of risk factors, such as nonalcoholic liver fatty disease. This review highlights the important differences between RNA viruses inducing liver injury taking into consideration the clinical, biochemical, histopathological, postmortem findings and the chronicity of liver injury that ultimately leads to liver fibrosis and hepatocellular carcinoma.
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Affiliation(s)
- Marwan SM Al-Nimer
- Department of Clinical Pharmacy, Hawler Medical University, Erbil 44001, Iraq
- College of Medicine, University of Diyala, Baqubah 32001, Iraq
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Endothelial dysfunction and immunothrombosis as key pathogenic mechanisms in COVID-19. Nat Rev Immunol 2021; 21:319-329. [PMID: 33824483 PMCID: PMC8023349 DOI: 10.1038/s41577-021-00536-9] [Citation(s) in RCA: 544] [Impact Index Per Article: 181.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 02/07/2023]
Abstract
Coronavirus disease 2019 (COVID-19) is a clinical syndrome caused by infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Patients with severe disease show hyperactivation of the immune system, which can affect multiple organs besides the lungs. Here, we propose that SARS-CoV-2 infection induces a process known as immunothrombosis, in which activated neutrophils and monocytes interact with platelets and the coagulation cascade, leading to intravascular clot formation in small and larger vessels. Microthrombotic complications may contribute to acute respiratory distress syndrome (ARDS) and other organ dysfunctions. Therapeutic strategies aimed at reducing immunothrombosis may therefore be useful. Several antithrombotic and immunomodulating drugs have been proposed as candidates to treat patients with SARS-CoV-2 infection. The growing understanding of SARS-CoV-2 infection pathogenesis and how it contributes to critical illness and its complications may help to improve risk stratification and develop targeted therapies to reduce the acute and long-term consequences of this disease. Here, the authors propose that SARS-CoV-2 induces a prothrombotic state, with dysregulated immunothrombosis in lung microvessels and endothelial injury, which drive the clinical manifestations of severe COVID-19. They discuss potential antithrombotic and immunomodulating drugs that are being considered in the treatment of patients with COVID-19.
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Portincasa P. Meet Our Editorial Board Member. Curr Med Chem 2021. [DOI: 10.2174/092986732814210505081423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Wiśniewska H, Skonieczna-Żydecka K, Parczewski M, Niścigorska-Olsen J, Karpińska E, Hornung M, Jurczyk K, Witak-Jędra M, Laurans Ł, Maciejewska K, Socha Ł, Leonciuk A, Bander D, Karasińska-Cieślak M, Aksak-Wąs B, Wawrzynowicz-Syczewska M. Hepatotropic Properties of SARS-CoV-2-Preliminary Results of Cross-Sectional Observational Study from the First Wave COVID-19 Pandemic. J Clin Med 2021; 10:jcm10040672. [PMID: 33572429 PMCID: PMC7916209 DOI: 10.3390/jcm10040672] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 01/24/2021] [Accepted: 02/04/2021] [Indexed: 02/07/2023] Open
Abstract
Liver injury—expressed as elevated liver enzymes—is common in patients with COVID-19. Little is known about the potential mechanisms of liver damage by SARS-CoV-2. A direct cytopathic effect on hepatocytes as well as injury related to hypoxia or hepatotoxicity are being considered. The aim of the study was to compare the clinical characteristic of COVID-19 disease in patients with normal and abnormal liver enzymes activity. A group of 150 patients with COVID-19, hospitalized in our center, was analyzed. Patients with the known liver comorbidities were excluded (n = 15). Clinical features and laboratory parameters were compared between patients with normal and abnormal aminotransferase values. Liver injury expressed as any alanine aminotransferase (ALT) elevation was noted in 45.6% of patients hospitalized due to COVID-19. The frequencies of aspartate aminotransferase (AST) elevation were lower. It was noted that elevated ALT/AST unfavorably affected other parameters related to liver function such as albumin level; gamma-glutamyl transpeptidase (GGTP); and partly, ALP activity and influenced inflammation-related parameters. The most probable cause of mild hepatitis during COVID-19 was anoxia and immune-mediated damage due to the inflammatory response following SARS-CoV-2 infection. A direct cytopathic effect of SARS-CoV-2 on hepatocytes, albeit less probable, can be considered as well. The use of potentially hepatotoxic drugs may contribute to liver damage.
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Affiliation(s)
- Hanna Wiśniewska
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, 71-455 Szczecin, Poland; (H.W.); (E.K.); (M.H.); (K.J.); (Ł.L.); (Ł.S.); (D.B.)
| | | | - Miłosz Parczewski
- Department of Infectious, Tropical Diseases, and Immune Deficiency, Pomeranian Medical University, 71-455 Szczecin, Poland; (M.P.); (J.N.-O.); (M.W.-J.); (K.M.); (A.L.); (M.K.-C.); (B.A.-W.)
| | - Jolanta Niścigorska-Olsen
- Department of Infectious, Tropical Diseases, and Immune Deficiency, Pomeranian Medical University, 71-455 Szczecin, Poland; (M.P.); (J.N.-O.); (M.W.-J.); (K.M.); (A.L.); (M.K.-C.); (B.A.-W.)
| | - Ewa Karpińska
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, 71-455 Szczecin, Poland; (H.W.); (E.K.); (M.H.); (K.J.); (Ł.L.); (Ł.S.); (D.B.)
| | - Monika Hornung
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, 71-455 Szczecin, Poland; (H.W.); (E.K.); (M.H.); (K.J.); (Ł.L.); (Ł.S.); (D.B.)
| | - Krzysztof Jurczyk
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, 71-455 Szczecin, Poland; (H.W.); (E.K.); (M.H.); (K.J.); (Ł.L.); (Ł.S.); (D.B.)
| | - Magdalena Witak-Jędra
- Department of Infectious, Tropical Diseases, and Immune Deficiency, Pomeranian Medical University, 71-455 Szczecin, Poland; (M.P.); (J.N.-O.); (M.W.-J.); (K.M.); (A.L.); (M.K.-C.); (B.A.-W.)
| | - Łukasz Laurans
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, 71-455 Szczecin, Poland; (H.W.); (E.K.); (M.H.); (K.J.); (Ł.L.); (Ł.S.); (D.B.)
| | - Katarzyna Maciejewska
- Department of Infectious, Tropical Diseases, and Immune Deficiency, Pomeranian Medical University, 71-455 Szczecin, Poland; (M.P.); (J.N.-O.); (M.W.-J.); (K.M.); (A.L.); (M.K.-C.); (B.A.-W.)
| | - Łukasz Socha
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, 71-455 Szczecin, Poland; (H.W.); (E.K.); (M.H.); (K.J.); (Ł.L.); (Ł.S.); (D.B.)
| | - Agnieszka Leonciuk
- Department of Infectious, Tropical Diseases, and Immune Deficiency, Pomeranian Medical University, 71-455 Szczecin, Poland; (M.P.); (J.N.-O.); (M.W.-J.); (K.M.); (A.L.); (M.K.-C.); (B.A.-W.)
| | - Dorota Bander
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, 71-455 Szczecin, Poland; (H.W.); (E.K.); (M.H.); (K.J.); (Ł.L.); (Ł.S.); (D.B.)
| | - Malwina Karasińska-Cieślak
- Department of Infectious, Tropical Diseases, and Immune Deficiency, Pomeranian Medical University, 71-455 Szczecin, Poland; (M.P.); (J.N.-O.); (M.W.-J.); (K.M.); (A.L.); (M.K.-C.); (B.A.-W.)
| | - Bogusz Aksak-Wąs
- Department of Infectious, Tropical Diseases, and Immune Deficiency, Pomeranian Medical University, 71-455 Szczecin, Poland; (M.P.); (J.N.-O.); (M.W.-J.); (K.M.); (A.L.); (M.K.-C.); (B.A.-W.)
| | - Marta Wawrzynowicz-Syczewska
- Department of Infectious Diseases, Hepatology and Liver Transplantation, Pomeranian Medical University, 71-455 Szczecin, Poland; (H.W.); (E.K.); (M.H.); (K.J.); (Ł.L.); (Ł.S.); (D.B.)
- Correspondence: or ; Tel./Fax: +48-91-813-9456
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Tsutsumi T, Saito M, Nagai H, Yamamoto S, Ikeuchi K, Lim LA, Adachi E, Koga M, Okushin K, Akai H, Kunimatsu A, Yotsuyanagi H. Association of coagulopathy with liver dysfunction in patients with COVID-19. Hepatol Res 2021; 51:227-232. [PMID: 33047431 PMCID: PMC7675264 DOI: 10.1111/hepr.13577] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 02/06/2023]
Abstract
AIM Liver dysfunction is sometimes observed in patients with coronavirus disease 2019 (COVID-19), but most studies are from China, and the frequency in other countries is unclear. In addition, previous studies suggested several mechanisms of liver damage, but precise or additional mechanisms are not clearly elucidated. Therefore, we examined COVID-19 patients to explore the proportion of patients with liver dysfunction and also the factors associated with liver dysfunction. METHODS We retrospectively examined 60 COVID-19 patients hospitalized at the Hospital affiliated with The Institute of Medical Science, The University of Tokyo (Tokyo, Japan). Patients who presented ≥40 U/L alanine aminotransferase (ALT) levels at least once during their hospitalization were defined as high-ALT patients, and the others as normal-ALT patients. The worst values of physical and laboratory findings during hospitalization for each patient were extracted for the analyses. Univariable and multivariable logistic regression models with bootstrap (for 1000 times) were carried out. RESULTS Among 60 patients, there were 31 (52%) high-ALT patients. The high-ALT patients were obese, and had significantly higher levels of D-dimer and fibrin/fibrinogen degradation products, as well as white blood cell count, and levels of C-reactive protein, ferritin, and fibrinogen. Multivariable analysis showed D-dimer and white blood cells as independent factors. CONCLUSIONS Considering that higher D-dimer level and white blood cell count were independently associated with ALT elevation, liver dysfunction in COVID-19 patients might be induced by microvascular thrombosis in addition to systemic inflammation.
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Affiliation(s)
- Takeya Tsutsumi
- Division of Infectious Diseases, Advanced Clinical Research Center, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Makoto Saito
- Division of Infectious Diseases, Advanced Clinical Research Center, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Hiroyuki Nagai
- Department of Infectious Diseases and Applied Immunology, IMSUT Hospital, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Shinya Yamamoto
- Division of Infectious Diseases, Advanced Clinical Research Center, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Kazuhiko Ikeuchi
- Division of Infectious Diseases, Advanced Clinical Research Center, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Lay Ahyoung Lim
- Department of Infectious Diseases and Applied Immunology, IMSUT Hospital, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Eisuke Adachi
- Department of Infectious Diseases and Applied Immunology, IMSUT Hospital, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Michiko Koga
- Division of Infectious Diseases, Advanced Clinical Research Center, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Kazuya Okushin
- Department of Infection Control and Prevention, Graduate School of MedicineThe University of TokyoTokyoJapan
| | - Hiroyuki Akai
- Department of Radiology, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Akira Kunimatsu
- Department of Radiology, The Institute of Medical ScienceThe University of TokyoTokyoJapan
| | - Hiroshi Yotsuyanagi
- Division of Infectious Diseases, Advanced Clinical Research Center, The Institute of Medical ScienceThe University of TokyoTokyoJapan,Department of Infectious Diseases and Applied Immunology, IMSUT Hospital, The Institute of Medical ScienceThe University of TokyoTokyoJapan
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Gupta S, Mitra A. Challenge of post-COVID era: management of cardiovascular complications in asymptomatic carriers of SARS-CoV-2. Heart Fail Rev 2021; 27:239-249. [PMID: 33426593 PMCID: PMC7797272 DOI: 10.1007/s10741-021-10076-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/05/2021] [Indexed: 12/26/2022]
Abstract
Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), a highly pathogenic member of family coronaviridae, has caused an exponentially growing global pandemic termed as the coronavirus disease 2019 (COVID-19) with more than 12 million cases worldwide till date. This deadly disease has average fatality rate of 6.5% and even higher among elderly patients and patients with comorbidities. SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE-2) as the entry receptor into host cell. ACE-2, a type-I transmembrane metallocarboxypeptidase, is a critical regulator of the renin-angiotensin system. The entry of SARS-CoV-2 within host cells results in a reduced availability of ACE-2 on the host cell surface followed by significant downregulation of ACE-2 gene expression. As ACE-2 is a well-known cardio-protective molecule, its downregulation could result in severe cardiac disorders. This review deals with a challenging aspect of SARS-CoV-2 infected patients who are asymptomatic or have mild syndromes similar to influenza infections. These patients are proving to be the Achilles’ heel to combat COVID-19 mainly in developing countries of South Asia, where the average number of tests conducted per million individuals is considerably low. Consequently, there is high possibility that individuals with negligible respiratory trouble will not be tested for SARS-CoV-2. Hence, a huge percentage of the population have the risk of developing cardiovascular disorders as a bystander effect of viral infection apart from being potential reservoir of disease transmission. Based on available demographic as well as molecular data, this review predicts a huge spike in cardiovascular disorders among this undetected reservoir in post COVID-19 era.
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Affiliation(s)
- Shreyasi Gupta
- Department of Zoology, Triveni Devi Bhalotia College, Paschim Bardhaman, Raniganj, 713 347, India
| | - Arkadeep Mitra
- Department of Zoology, City College, 102/1, Raja Rammohan Sarani, Kolkata, 700 009, India.
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Lucas K, Fröhlich-Nowoisky J, Oppitz N, Ackermann M. Cinnamon and Hop Extracts as Potential Immunomodulators for Severe COVID-19 Cases. FRONTIERS IN PLANT SCIENCE 2021; 12:589783. [PMID: 33719281 PMCID: PMC7952639 DOI: 10.3389/fpls.2021.589783] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 02/02/2021] [Indexed: 05/08/2023]
Affiliation(s)
- Kurt Lucas
- Multiphase Chemistry Department, Max Planck Institute for Chemistry, Mainz, Germany
- *Correspondence: Kurt Lucas
| | | | - Nicole Oppitz
- Multiphase Chemistry Department, Max Planck Institute for Chemistry, Mainz, Germany
| | - Maximilian Ackermann
- Institute of Pathology and Molecular Pathology, Helios University Clinic Wuppertal, University of Witten/Herdecke, Wuppertal, Germany
- Institute of Functional and Clinical Anatomy, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
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68
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Abstract
COVID-19 causes severe respiratory and multiorgan failure, including liver damage and elevated transaminase levels. This article addresses the potential causes of liver function abnormalities in patients diagnosed with COVID-19 and management approaches for NPs focusing on preventing and alleviating liver injury.
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Affiliation(s)
- Ricketta Clark
- Ricketta Clark is assistant professor at the University of Tennessee Health Science Center, Memphis, Tenn. Bradford Waters is Professor of Medicine, University of Tennessee Health Science Center, Memphis, Tenn., and section chief, Gastroenterology, Memphis VA Medical Center, Memphis, Tenn. Ansley Grimes Stanfill is Associate Dean of Research and associate professor at the University of Tennessee Health Science Center, Memphis, Tenn
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Román LE, Gomez ED, Solís JL, Gómez MM. Antibacterial Cotton Fabric Functionalized with Copper Oxide Nanoparticles. Molecules 2020; 25:E5802. [PMID: 33316935 PMCID: PMC7764683 DOI: 10.3390/molecules25245802] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 12/16/2022] Open
Abstract
Textiles functionalized with cupric oxide (CuO) nanoparticles have become a promising option to prevent the spread of diseases due to their antimicrobial properties, which strongly depend on the structure and morphology of the nanoparticles and the method used for the functionalization process. This article presents a review of work focused on textiles functionalized with CuO nanoparticles, which were classified into two groups, namely, in situ and ex situ. Moreover, the analyzed bacterial strains, the resistance of the antimicrobial properties of textiles to washing processes, and their cytotoxicity were identified. Finally, the possible antimicrobial mechanisms that could develop in Gram-positive and Gram-negative bacteria were described.
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Affiliation(s)
- Luz E. Román
- Faculty of Science, Universidad Nacional de Ingeniería, Av. Túpac Amaru 210, Lima 15333, Peru; (L.E.R.); (J.L.S.)
| | - Enrique D. Gomez
- Department of Chemical Engineering, The Pennsylvania State University, University Park, PA 16802, USA;
- Department of Materials Science and Engineering, Materials Research Institute, The Pennsylvania State University, University Park, PA 16802, USA
| | - José L. Solís
- Faculty of Science, Universidad Nacional de Ingeniería, Av. Túpac Amaru 210, Lima 15333, Peru; (L.E.R.); (J.L.S.)
| | - Mónica M. Gómez
- Faculty of Science, Universidad Nacional de Ingeniería, Av. Túpac Amaru 210, Lima 15333, Peru; (L.E.R.); (J.L.S.)
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Hepatic pathology in patients dying of COVID-19: a series of 40 cases including clinical, histologic, and virologic data. Mod Pathol 2020; 33:2147-2155. [PMID: 32792598 PMCID: PMC7424245 DOI: 10.1038/s41379-020-00649-x] [Citation(s) in RCA: 175] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 07/30/2020] [Accepted: 07/30/2020] [Indexed: 02/06/2023]
Abstract
The novel coronavirus SARS-CoV-2 (coronavirus disease 19, or COVID-19) primarily causes pulmonary injury, but has been implicated to cause hepatic injury, both by serum markers and histologic evaluation. The histologic pattern of injury has not been completely described. Studies quantifying viral load in the liver are lacking. Here we report the clinical and histologic findings related to the liver in 40 patients who died of complications of COVID-19. A subset of liver tissue blocks were subjected to polymerase chain reaction (PCR) for viral ribonucleic acid (RNA). Peak levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were elevated; median ALT peak 68 U/l (normal up to 46 U/l) and median AST peak 102 U/l (normal up to 37 U/l). Macrovesicular steatosis was the most common finding, involving 30 patients (75%). Mild lobular necroinflammation and portal inflammation were present in 20 cases each (50%). Vascular pathology, including sinusoidal microthrombi, was infrequent, seen in six cases (15%). PCR of liver tissue was positive in 11 of 20 patients tested (55%). In conclusion, we found patients dying of COVID-19 had biochemical evidence of hepatitis (of variable severity) and demonstrated histologic findings of macrovesicular steatosis and mild acute hepatitis (lobular necroinflammation) and mild portal inflammation. We also identified viral RNA in a sizeable subset of liver tissue samples.
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71
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Clinical characteristics of moderate and severe cases with COVID-19 in Wuhan, China: a retrospective study. Clin Exp Med 2020; 21:35-39. [PMID: 32949308 PMCID: PMC7501760 DOI: 10.1007/s10238-020-00662-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/11/2020] [Indexed: 12/26/2022]
Abstract
With the outbreak of COVID-19 ongoing, this infectious disease has been posing a significant threat to public health. However, we are still relatively inexperienced on recognizing the clinical characteristics of severe COVID-19 and death cases. Therefore, we hereby collected and analyzed a total of 232 cases to illustrate the clinical characteristics of such patients in Wuhan and to find notable marks for early clinical warning. We consider age, comorbidities, platelet count, albumin, D-dimer, LDH, CRP and IL-6 level might be more meaningful marks for COVID-19 prognostic evaluation.
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Stella A, Lamkanfi M, Portincasa P. Familial Mediterranean Fever and COVID-19: Friends or Foes? Front Immunol 2020; 11:574593. [PMID: 33072117 PMCID: PMC7530822 DOI: 10.3389/fimmu.2020.574593] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 09/02/2020] [Indexed: 12/14/2022] Open
Abstract
Familial Mediterranean Fever (FMF) and COVID-19 show a remarkable overlap of clinical symptoms and similar laboratory findings. Both are characterized by fever, abdominal/chest pain, elevation of C-reactive protein, and leukocytosis. In addition, colchicine and IL-1 inhibitors treatments that are effective in controlling inflammation in FMF patients have recently been proposed for off-label use in COVID-19 patients. Thus, FMF may resemble a milder recapitulation of the cytokine storm that is a hallmark of COVID-19 patients progressing to severe disease. We analyzed the sequence of the MEFV-encoded Pyrin protein - whose mutations cause FMF- in mammals, bats and pangolin. Intriguingly, although Pyrin is extremely conserved in species that are considered either a reservoir or intermediate hosts for SARS-CoV-2, some of the most common FMF-causing variants in humans are present as wildtype residues in these species. We propose that in humans, Pyrin may have evolved to fight highly pathogenic infections.
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Affiliation(s)
- Alessandro Stella
- Department of Human Oncology and Biomedical Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Mohamed Lamkanfi
- Department of Internal Medicine and Pediatrics, Ghent University, Ghent, Belgium
| | - Piero Portincasa
- Division of Internal Medicine, Clinica Medica "A Murri", Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
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Balasubramanyam M. Does COVID-19 Warn Us to Revisit Virus-Induced Diabetes? EXPLORATORY RESEARCH AND HYPOTHESIS IN MEDICINE 2020; 000:1-5. [DOI: 10.14218/erhm.2020.00046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Di Ciaula A, Palmieri VO, Migliore G, Portincasa P. COVID-19, internists and resilience: the north-south Italy outbreak. Eur J Clin Invest 2020; 50:e13299. [PMID: 32480424 PMCID: PMC7300465 DOI: 10.1111/eci.13299] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 05/21/2020] [Accepted: 05/22/2020] [Indexed: 02/06/2023]
Affiliation(s)
- Agostino Di Ciaula
- Department of Biomedical Sciences and Human OncologyClinica Medica “A. Murri”University of Bari “Aldo Moro”BariItaly
- International Society of Doctors for Environment (ISDE)ArezzoItaly
| | - Vincenzo O. Palmieri
- Department of Biomedical Sciences and Human OncologyClinica Medica “A. Murri”University of Bari “Aldo Moro”BariItaly
| | - Giovanni Migliore
- General DirectoratePoliclinico‐Giovanni XXIII Regional HospitalBariItaly
| | - Piero Portincasa
- Department of Biomedical Sciences and Human OncologyClinica Medica “A. Murri”University of Bari “Aldo Moro”BariItaly
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