COVID-19 impact on the liver

Eosinophils and COVID-19: Insights into immune complexity and vaccine safety

BACKGROUND

COVID-19 exhibits a variety of symptoms and may lead to multi-organ failure and death. This clinical complexity is exacerbated by significant immune dysregulation affecting nearly all cells of the innate and adaptive immune system. Granulocytes, including eosinophils, are affected by SARS-CoV-2.

OBJECTIVES

Eosinophil responses remain poorly understood despite early recognition of eosinopenia as a hallmark feature of COVID-19 severity.

RESULTS

The heterogeneous nature of eosinophil responses categorizes them as dual-function cells with contradictory effects. Eosinophil activation can suppress virus-induced inflammation by releasing type 2 cytokines like IL-13 and granular proteins with antiviral action such as eosinophil-derived neurotoxins and eosinophil cationic protein, and also by acting as antigen-presenting cells. In contrast, eosinophil accumulation in the lungs can induce tissue damage triggered by cytokines or hormones like IFN-γ and leptin. Additionally, they can affect adaptive immune functions by interacting with T cells through direct formation of membrane complexes or soluble mediator action. Individuals with allergic disorders who have elevated levels of eosinophils in tissues and blood, such as asthma, do not appear to be at an increased risk of developing severe COVID-19 following SARS-CoV-2 infection. However, the SARS-CoV-2 vaccine appears to be associated with complications and eosinophilic infiltrate-induced immunopathogenicity, which can be mitigated by corticosteroid, anti-histamines and anti-IL-5 therapy and avoided by modifying adjuvants or excipients.

CONCLUSION

This review highlights the importance of eosinophils in COVID-19 and contributes to a better understanding of their role during natural infection and vaccination.

Pre-hospital oxygen therapy and saturation variability in COVID-19 patients with and without glucose metabolism disorders: part of the COLOS Study

The COVID-19 pandemic has revealed that viruses can have multiple receptor properties, penetrating various tissues and causing mutations in various genes, thus promoting a range of metabolic disorders. The purpose of this study was to investigate the connection between three factors: diabetic status, pre-hospitalization oxygen therapy, and saturation levels, to the values of morphological, inflammatory, and biochemical parameters in the blood serum of COVID-19 patients. The study group consisted of 2139 patients, 1076 women (50.30%) and 1063 men (49.70%), with an average age of 63.73 ± 15.69 years. The population was divided into three groups based on a three-stage scale, taking into account patients with either type 2 diabetes/prediabetes (473 patients), those who received oxygen therapy before hospitalization, and those with a saturation value of below 95% (cut-off value). Among patients who did not receive pre-hospitalization oxygen therapy, those with diabetes and a SpO2 level < 95% had significantly higher levels of D-dimers, procalcitonin, albumin, lymphocytes, RDW-SD ≥ 47, potassium, creatinine, and troponin T when compared to diabetic patients with a SpO2 level ≥ 95%. Similarly, in the same group of patients without pre-hospitalization oxygen therapy, those without diabetes but with a SpO2 level < 95% showed significantly increased levels of IL-6, CRP, albumin, lymphocytes, RDW-SD ≥ 47, glucose, potassium, sodium, creatinine, and ALT, compared to patients without diabetes and with a SpO2 level ≥ 95%. The findings suggest that lower saturation levels may result in increased potassium and glucose levels in patients who did not receive any oxygen therapy before hospitalization due to COVID-19. It is hypothesized that this may be caused by damage to pancreatic β-cells by SARS-CoV-2, and disturbances in the potassium channel, leading to cell membrane depolarization and insulin secretion.

The Impact of Cardiovascular Antecedents on the Prognosis of COVID-19 Critically Ill Patients

Background/Objectives: The objective of the study is to analyze the impact of cardiovascular history on mortality in COVID-19 patients, hospitalized in the intensive care unit with indications for continuous positive airway pressure (CPAP) and subsequently mechanical ventilation, without oncological disease. Methods: A retrospective observational study was carried out on a group of 108 critical COVID-19 patients. We compared demographic data, paraclinical and clinical parameters, days of hospitalization, and mortality rate between two groups of patients, one group with a history of cardiovascular disease (81 patients) and a group without a history of cardiovascular disease (27 patients). Results: Patients with cardiovascular antecedents had a higher mortality rate than those without cardiovascular antecedents, presenting severe forms with shorter survival time in the intensive care unit and increased inflammatory evidence. Compared to patients without a history of cardiovascular illness, those with cardiovascular disease had a lower average age, and developed a severe form of COVID-19. Conclusions: Cardiovascular antecedents can worsen the prognosis of patients with COVID-19, requiring a careful screening and multidisciplinary approach.

Acute Myocardial Infarction in COVID-19 Patients-A Review of Literature Data and Two-Case Report Series

Background/Objectives: The newly emergent COVID-19 pandemic involved primarily the respiratory system and had also major cardiovascular system (CVS) implications, revealed by acute myocardial infarction (AMI), arrhythmias, myocardial injury, and thromboembolism. CVS involvement is done through main mechanisms-direct and indirect heart muscle injury, with high mortality rates, worse short-term outcomes, and severe complications. AMI is the echo of myocardial injury (revealed by increases in CK, CK-MB, and troponin serum markers-which are taken into consideration as possible COVID-19 risk stratification markers). When studying myocardial injury, physicians can make use of imaging studies, such as cardiac MRI, transthoracic (or transesophageal) echocardiography, coronary angiography, cardiac computed tomography, and nuclear imaging (which have been used in cases where angiography was not possible), or even endomyocardial biopsy (which is not always available or feasible). Two-case-series presentations: We present the cases of two COVID-19 positive male patients who were admitted into the Clinical Department of Cardiology in "Sfântul Apostol Andrei" Emergency Clinical Hospital of Galați (Romania), who presented with acute cardiac distress symptoms and have been diagnosed with ST elevation AMI. The patients were 82 and 57 years old, respectively, with moderate and severe forms of COVID-19, and were diagnosed with anteroseptal left ventricular AMI and extensive anterior transmural left ventricular AMI (with ventricular fibrillation at presentation), respectively. The first patient was a non-smoker and non-drinker with no associated comorbidities, and was later discharged, while the second one died due to AMI complications. Conclusions: From this two-case series, we extract the following: old age alone is not a significant risk factor for adverse outcomes in COVID-19-related CVS events, and that the cumulative effects of several patient-associated risk factors (be it either for severe forms of COVID-19 and/or acute cardiac injury) will most probably lead to poor patient prognosis (death). At the same time, serum cardiac enzymes, dynamic ECG changes, along with newly developed echocardiographic modifications are indicators for poor prognosis in acute cardiac injury in COVID-19 patients with acute myocardial injury, regardless of the presence of right ventricular dysfunction (due to pulmonary hypertension).

COVID-19, Possible Hepatic Pathways and Alcohol Abuse-What Do We Know up to 2023?

The pandemic period due to coronavirus disease 2019 (COVID-19) revolutionized all possible areas of global health. Significant consequences were also related to diverse extrapulmonary manifestations of this pathology. The liver was found to be a relatively common organ, beyond the respiratory tract, affected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Multiple studies revealed the essential role of chronic liver disease (CLD) in the general outcome of coronavirus infection. Present concerns in this field are related to the direct hepatic consequences caused by COVID-19 and pre-existing liver disorders as risk factors for the severe course of the infection. Which mechanism has a key role in this phenomenon-previously existing hepatic disorder or acute liver failure due to SARS-CoV-2-is still not fully clarified. Alcoholic liver disease (ALD) constitutes another not fully elucidated context of coronavirus infection. Should the toxic effects of ethanol or already developed liver cirrhosis and its consequences be perceived as a causative or triggering factor of hepatic impairment in COVID-19 patients? In the face of these discrepancies, we decided to summarize the role of the liver in the whole picture of coronavirus infection, paying special attention to ALD and focusing on the pathological pathways related to COVID-19, ethanol toxicity and liver cirrhosis.

Efficiency of continuous positive airway pressure and high-flow nasal oxygen therapy in critically ill patients with COVID-19

OBJECTIVE

Critically ill patients with COVID-19 develop acute respiratory distress syndrome characterized by relatively well-preserved pulmonary compliance but severe hypoxemia. The challenge in managing such patients lies in optimizing oxygenation, which can be achieved through either high oxygen flow or noninvasive mechanical ventilation. This study was performed to compare the efficiency of two methods of noninvasive oxygen therapy: continuous positive airway pressure (CPAP) and high-flow nasal oxygen therapy (HFNO).

METHODS

This retrospective cohort study involved 668 patients hospitalized in the intensive care unit (ICU) of the "Sf. Apostol Andrei" Emergency Clinical Hospital, Galati, Romania from 1 April 2020 to 31 March 2021 (CPAP, n = 108; HFNO, n = 108).

RESULTS

Mortality was significantly lower in the CPAP and HFNO groups than in the group of patients who underwent intubation and mechanical ventilation after ICU admission. Mortality in the ICU was not significantly different between the CPAP and HFNO groups.

CONCLUSIONS

HFNO and CPAP represent efficient alternative therapies for patients with severe COVID-19 whose respiratory treatment has failed. Studies involving larger groups of patients are necessary to establish a personalized, more complex management modality for critically ill patients with COVID-19.

Liver Injury in Patients with COVID-19: A Retrospective Study

Objectives: The objective of this study is to explore the incidence, characteristics, risk factors, and prognosis of liver injury in patients with COVID-19. Methods: We collected clinical data of 384 cases of COVID-19 and retrospectively analyzed the incidence, characteristics, and risk factors of liver injury of the patients. In addition, we followed the patient two months after discharge. Results: A total of 23.7% of the patients with COVID-19 had liver injury, with higher serum AST (P < 0.001), ALT (P < 0.001), ALP (P = 0.004), GGT (P < 0.001), total bilirubin (P = 0.002), indirect bilirubin (P = 0.025) and direct bilirubin (P < 0.001) than the control group. The median serum AST and ALT of COVID-19 patients with liver injury were mildly elevated. Risk factors of liver injury in COVID-19 patients were age (P = 0.001), history of liver diseases (P = 0.002), alcoholic abuse (P = 0.036), body mass index (P = 0.037), severity of COVID-19 (P < 0.001), C-reactive protein (P < 0.001), erythrocyte sedimentation rate (P < 0.001), Qing-Fei-Pai-Du-Tang treatment (P = 0.032), mechanical ventilation (P < 0.001), and ICU admission (P < 0.001). Most of the patients (92.3%) with liver injury were treated with hepatoprotective drugs. 95.6% of the patients returned to normal liver function tests at 2 months after discharge. Conclusions: Liver injury was commen in COVID-19 patients with risk factors, most of them have mild elevations in transaminases, and conservative treatment has a good short-term prognosis.

Histopathological Features of SARS-CoV-2 in Extrapulmonary Organ Infection: A Systematic Review of Literature

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global health concern responsible for the ongoing pandemic. Histopathological pieces of evidence on COVID-19 are not fully investigated. This review aims to provide, through microscopy investigations, a histopathological overview of COVID-19 structural and ultrastructural alterations in different organs and tissues, excluding the respiratory system. The authors systematically reviewed the literature over the period February 2020–July 2022. Selected databases were PubMed, Scopus, and Google Scholar. The search strategy included the following terms: “COVID-19” or SARS-CoV-2 and “histopathology” or “pathology”; and “microscopy” and “liver”, “myocardium”,” spleen”, “testis”, and “placenta”. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used. Thirty-one articles included in this systematic review demonstrated, at a histopathological level, that COVID-19 exerts detrimental effects on tissues, often promoting degenerative processes. Even if COVID-19 shows a histopathological tropism for the respiratory system, other tissues, from cardiovascular to reproductive, are affected by COVID-19. Therefore, this paper provides an up-to-date view of histopathological observations of the structural and ultrastructural alterations associated with COVID-19 and may contribute to a better knowledge of the physiopathological bases of this disease.

A Systematic Review of SARS-CoV-2-Associated Hepatic Dysfunction and the Impact on the Clinical Outcome of COVID-19

Coronavirus disease 2019 (COVID-19) has rapidly spread across the globe since December 2019. The spectrum of clinical manifestations of COVID-19 ranges from mild to life-threatening forms. Alteration of hepatic function in COVID-19 is multifactorial. The objective of this systematic review is to assess the relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced hepatic dysfunction and the clinical outcome in patients infected with COVID-19. We methodically explored several electronic databases (PubMed, PubMed Central, MEDLINE, and Google Scholar) in April 2022 using focused words and terms of medical subject headings for appropriate studies. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for conducting our systematic review. Hepatic dysfunction was identified as elevation of liver function tests (LFTs) above the upper limit of normal. The clinical outcome was described as a combination of mortality, intensive care unit (ICU) transfer, and the need for mechanical ventilation (MV). The initial search yielded a total of 7187 studies. After elimination of duplicates, exclusion of studies based on irrelevant titles and abstracts, comprehensive analysis of full-text formats, and evaluation of quality, a total of 16 studies were eligible to be included in our systematic review. In the 16 selected studies, there were 23,962 patients. The SARS-CoV-2 virus can negatively affect several organ systems by interacting with specific receptors widely expressed in the human body. A multifactorial etiology of hepatic dysfunction is observed in COVID-19. SARS-CoV-2 infection is associated with abnormal LFTs. Significantly higher mortality, ICU admissions, and requirement for MV are associated with LFT alterations. For this reason, patients infected with COVID-19 must have their hepatic function closely monitored.

Performance of Thermoplastic Extrusion, Germination, Fermentation, and Hydrolysis Techniques on Phenolic Compounds in Cereals and Pseudocereals

Bioactive compounds, such as phenolic compounds, are phytochemicals found in significant amounts in cereals and pseudocereals and are usually evaluated by spectrophotometric (UV-VIS), HPLC, and LC-MS techniques. However, their bioavailability in grains is quite limited. This restriction on bioavailability and bioaccessibility occurs because they are in conjugated polymeric forms. Additionally, they can be linked through chemical esterification and etherification to macro components. Techniques such as thermoplastic extrusion, germination, fermentation, and hydrolysis have been widely studied to release phenolic compounds in favor of their bioavailability and bioaccessibility, minimizing the loss of these thermosensitive components during processing. The increased availability of phenolic compounds increases the antioxidant capacity and favor their documented health promoting.

The Influence of Living in Rural Areas on the Evolution and Management of Pediatric Ovarian Cystic Lesions: A Retrospective Study on a Cohort from South Eastern Romania

BACKGROUND

The incidence of ovarian cystic lesions (OCLs) in pediatric patients has been increasing in recent years. An early diagnosis is mandatory for a favourable prognosis but it depends on the primary medical care services and on the socioeconomic status of the patient. The present study aims at assessing the prevalence and the age-specific frequencies of pediatric OCLs, as well as identifying disparities between subjects in the urban and the rural areas, in order to explore the extent to which OCLs occurrence, diagnosis, evolution and treatment differ in the case of patients living in rural areas.

METHODS

A 3-year retrospective study was conducted between 2017 and 2019. All the female patients aged between 0 and 18 with OCLs ≥10 mm (N = 488), diagnosed and treated at "Sf.Ioan" Clinical Emergency Hospital for Children in Galaţi were included in the study. The Chi2 test was used for comparing the distributions of frequencies, and the t-Student test was used for comparing the means of any two normally distributed variables. The statistical significance threshold (p) was set at 0.05.

RESULTS

The prevalence of OCLs ≥10 mm was 14.85%, 47.13% of the subjects originating in rural area (p = 0.62). Different from the urban areas, the rural ones are characterised by a lower proportion of patients with BMI ≥25 (p = 0.002), larger OCLs mean size (p = 0.278), a more frequent complex aspect on ultrasonography (p = 0.01), and a smaller number of general physician referrals (p = 0.005). Moreover, a higher proportion of rural patients were intraoperatively diagnosed with OCLs (p = 0.044), had complicated OCLs (p = 0.012) and had their OCLs surgically treated OCLs (p < 0.01).

CONCLUSION

Taking into consideration the socio-economic situation of south eastern Romania, patients living in rural areas have proven exposed to a higher risk of presenting with larger, complex and complicated OCLs, which most often require surgical treatment.

Liver and Pancreatic Involvement in Children with Multisystem Inflammatory Syndrome Related to SARS-CoV-2: A Monocentric Study

Liver and pancreatic involvement in children with Multisystem Inflammatory Syndrome related to SARS-CoV-2 (MIS-C) has been poorly investigated so far. We reviewed a cohort of MIS-C patients to analyze the prevalence of acute liver injury (ALI) and pancreatic injury and their correlation with clinical outcomes. Demographic, clinical, laboratory and imaging features of children with MIS-C at admission and during hospital stay were prospectively collected. Fifty-five patients (mean age 6.5 ± 3.7 years) were included. At admission, 16 patients showed ALI and 5 had increased total serum lipase. During observation, 10 more patients developed ALI and 19 more subjects presented raised pancreatic enzymes. In comparison to those with normal ALT, subjects with ALI were significantly older (p = 0.0004), whereas pancreatic involvement was associated to a longer duration of hospital stay compared with patients with normal pancreatic enzymes (p = 0.004). Time between hospital admission and onset of ALI was shorter compared to the onset of raised pancreatic enzymes (3.2 ± 3.9 versus 5.3 ± 2.7 days, respectively; p = 0.035). Abdominal ultrasound showed liver steatosis in 3/26 (12%) and hepatomegaly in 6/26 (16%) patients with ALI; 2 patients presented enlarged pancreas. Although liver and pancreatic involvement is commonly observed in MIS-C patients, it is mild in most cases with a complete recovery.

Risk of hepatitis B reactivation: From biologic therapies for psoriasis to immunosuppressive therapies for COVID‑19 (Review)

The cytokine storm from the evolution of severe cases of COVID-19, requiring strong immunosuppressive therapies, has raised the issue of reactivation of hepatitis B virus (HBV) infections in these patients. An analysis of the first observational studies in patients with COVID-19 and immunosuppressive therapy and HBV infection along with special clinical cases was presented, as well as personal experience on a series of cases (a group of 958 patients with COVID-19), compared with the analysis of studies performed on patients with HBV infection that underwent biological therapies for psoriasis and personal experience (a group of 81 psoriasis patients treated with biological therapies). Clinical studies have revealed that HBV reactivation in patients undergoing biological therapies for psoriasis, can be prevented with monitoring and treatment protocols and thus, these therapies have been demonstrated to be safe and effective. In COVID-19, immunosuppressive therapies are short-lived but in high doses, and the conclusions of clinical trials are contradictory, but there are published cases of HBV reactivation, which requires a unitary attitude in the prevention of HBV reactivation in these patients. An algorithm was presented for monitoring and treatment of HBV infection for patients with psoriasis treated with biological therapy and the conditions when this protocol can be used for patients with COVID-19 and immunosuppressive therapy.

Benefits and adverse events of melatonin use in the elderly (Review)

Melatonin is a hormone secreted by the pineal gland in accordance with the circadian rhythm when the light level decreases. Reduction of melatonin secretion with age may be associated with physiological aging in neurodegenerative diseases by affecting the suprachiasmatic nucleus or of the neuronal pathways of transmission to the pineal gland. A significant decrease in melatonin synthesis has been reported in various disorders and diseases, including cardiovascular diseases, metabolic disorders (particularly diabetes type 2), cancer and endocrine diseases. In addition to the fact, that melatonin is a sleep inducer, it also exerts cytoprotective properties as an antioxidant and free radical scavenger. The therapeutic role of melatonin has been demonstrated in sleep disorders, eye damage and cardiovascular disease. The association between melatonin and β-blockers has had a positive impact on sleep disorders in clinical trials. Previous studies have reported the anti-inflammatory effect of melatonin by adjusting levels of pro-inflammatory cytokines, including interleukin (IL)-6, IL-1β and tumor necrosis factor-α. Melatonin treatment has been demonstrated to decrease IL-6 and IL-10 expression levels and efficiently attenuate T-cell proliferation. Currently, there is an inconsistency of scientific data regarding the lowest optimal dose and safety of melatonin for long-term use. The aim of the present review was to summarize the evidence on the role of melatonin in various clinical conditions and highlight the future research in this area.

The Role of D-Dimers in the Initial Evaluation of COVID-19

Purpose

The COVID-19 pandemic was noted for the high degree of contagion and the large number of cases, as well as for the various clinical forms, from asymptomatic towards rapid evolution to death. The hospitals limited care capacity imposed the need to identify some markers of unfavorable evolution. The purpose of our study is to identify the parameters correlated with COVID-19 unfavorable evolution and to draw the profile of the patient at risk of unfavorable evolution. This set of parameters will help the doctor in deciding whether to hospitalize a patient and in choosing the treatment.

Patients and Methods

We performed a prospective, observational, actively controlled study on 849 patients with COVID-19, hospitalized in the Second Clinic of “Sf. Cuv. Parascheva” Infectious Diseases Clinical Hospital Galati, Romania, between 1.03.2020–30.11.2020.

Results

The parameters statistically significant modified at the admission of the patients with COVID-19 unfavorable evolution were age, oxygen saturation, D-dimers, creatine kinase (CK), troponin, erythrocytes sedimentation rate (ESR), leukocytes, lymphocytes, neutrophils, platelets, hemoglobin (Hb), aspartate transaminase (AST), total and direct bilirubin (TBIL, DBIL), urea, creatinine, serum glucose. Strong correlations were observed between the unfavorable evolution and the admission values of D-dimers, AST, TBIL and between D-dimers and AST, which suggests that D-dimers levels can be considered predictive for the alteration of liver function and for the negative prognosis of the patient.

Conclusion

Coagulation disorders and acute respiratory failure are the prevailing causes of death from COVID-19. Together with other parameters that constitute the risk profile for severe COVID-19 evolution, the D-dimers dosing at admission proved to be extremely useful in the management of COVID-19.

Evaluation of liver function in symptomatic COVID-19 patients

Context:

The coronavirus disease 2019 (COVID-19) is a viral respiratory illness which was first detected in Wuhan, Hubei Province, China. A few case studies demonstrated that 14–53% of the cases of COVID-19 reported abnormal levels of liver enzymes during disease progression. Patients with severe COVID-19 seem to have higher rates of hepatic dysfunction.

Aims:

Our aim was to investigate the changes in the liver function test in COVID-19 patients admitted to hospital and its association with the severity of the disease, length of hospital stay, and outcome of patients.

Settings and Design:

This was a cross-sectional study involving 678 COVID-19 patients, who were admitted at AIIMS, Bhopal.

Methods and Material:

The case records of 678 patients were evaluated by the research team from the Department of Medicine, AIIMS, Bhopal, and data were analyzed. All laboratory data were obtained. The liver function tests (LFT) including alanine aminotransferase, aspartate aminotransferase, and total bilirubin values were recorded, and liver dysfunction defined as any parameter having more than the upper limit of normal value.

Results:

From April 2020 to September 2020, a total of 678 COVID-19 patients were screened, and 600 were assessed for eligibility; 78 were excluded due to either significant alcohol history or due to prior liver disease. Among the 600 patients, 265 patients (44.16%) had liver dysfunction while 335 patients (55.83%) had a normal liver function. The patients having a severe disease were more affected by liver dysfunction than the mild disease patients. The average hospital stay was more in those patients having liver dysfunction than in those patients with normal liver function. Among the patients with normal LFT on admission, 97.9% got cured while 2.1% died. Among the patients with liver dysfunction, 80.4% got cured and 19.6% died.

Conclusions:

Hepatic injury is common in severe COVID-19 patients, which may be caused by direct injury to the bile duct cells by a virus or indirectly by a cytokine storm. The liver function should be evaluated in all symptomatic COVID-19 patients. In patients with pre-existing liver diseases, special attention should be paid to monitoring and treatment.

New Insights into the Antioxidant Compounds of Achenes and Sprouted Buckwheat Cultivated in the Republic of Moldova

It is well known that both Fagopyrum esculentum species, buckwheat achenes and buckwheat germs, contain flavonoids, and that they can be considered functional foods. In the present study we have analyzed the total content of polyphenols (TPC) and flavonoids (TFC), as well as the antioxidant activity of buckwheat ahcenes originating from the Balti region, Republic of Moldova, and also of the buckwheat sprouts over seven days of germination. The content of phytochemicals in achenes and germinated buckwheat after three and seven days was determined by HPLC–MS analysis. Using the Folin–Ciocalteu method, we recorded an increase in TPC of 360%, and of 436% in TFC after seven days of buckwheat ahcene germination. We aimed to investigate the free radical scavenging properties of methanolic extracts from ahcenes and sprouted buckwheat. We identified and quantified flavonoids and lignans such as rutin, orientin, isoorientin, vitexin, quercetin, quercitrin, isorhamnetin, lutein, apigenin, catechins, coumestrol—which have countless beneficial effects on human health—using HPLC–MS. FTIR analysis also revealed the accumulation of phenolic compounds during germination. This is the first study on the identification and quantification of phytochemicals from buckwheat achenes and sprouts from the Balti region of the Republic of Moldova.