Postmortem Liver Pathology Findings in Patients With COVID-19: A Systematic Review

Background: The Coronavirus Disease 2019 (COVID-19) pandemic promptly became a significant public health challenge with extra-pulmonary manifestations, including liver damage. Postmortem examination is crucial for gaining a better understanding of these manifestations and improving patient management. This study summarized the current knowledge of the postmortem liver pathology of patients with COVID-19. Methods: This review was conducted on studies evaluating the postmortem macroscopic and microscopic findings of the liver in patients with COVID-19. Accordingly, we searched 4 electronic databases (PubMed, Scopus, Google Scholar, & Web of Science) until June 2021. From the 317 screened articles, 16 articles examining a total of 332 patients who had died due to COVID-19 were selected. Results: The significant findings of the liver were moderate macro and microvesicular steatosis with mild sinusoidal dilation, active lobular and portal vein thrombosis, mildly-increased lymphocyte filtration in sinusoidal space, and multifocal hepatic necrosis. Additionally, the most common comorbidities were hypertension and other metabolic diseases. In conclusion, liver damage due to COVID-19 infection has various manifestations in patients who have expired due to COVID-19. Conclusion: Therefore, monitoring liver function during the course and treatment of this disease is necessary for better patient management and to decrease the COVID-19-induced mortality rate COVID.

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Pulmonary Manifestations in Rheumatoid Arthritis, Psoriatic Arthritis and Peripheral Spondyloarthritis Prevalence, Diagnostic Approach and Treatment Options

Current Rheumatology Reviews ◽

10.2174/1573397116666200905122757 ◽

2020 ◽

Vol 16 ◽

Author(s):

Daniel Dejcman ◽

Valentin Sebastian Schäfer ◽

Dirk Skowasch ◽

Carmen Pizarro ◽

Andreas Krause ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Psoriatic Arthritis ◽

Lung Disease ◽

Current Knowledge ◽

Treatment Options ◽

Pulmonary Diseases ◽

Chronic Obstructive ◽

Pulmonary Manifestations ◽

Major Cluster ◽

Peripheral Spondyloarthritis

: Interstitial lung disease (ILD) is the most common form of pulmonary impairment in patients with rheumatoid arthritis (RA). However, patients with RA or other arthritic diseases such as psoriatic arthritis (PsA) or peripheral spondyloarthritis (pSpA) may develop several other pulmonary diseases such as chronic obstructive lung disease (COPD) with a higher risk than patients without arthritis. The article at hand aims at summarizing the current knowledge on the prevalence of pulmonary diseases in the above-mentioned forms of arthritis, the challenges for prevalence studies and detecting pulmonary diseases in patients with arthritis as well as possible treatment options. Dyspnea, cough or other pulmonary symptoms or findings in arthritis patients should prompt gradual diagnostic procedures considering pulmonary manifestations as a major cluster of differential diagnosis. Considering its poor prognosis and morbidity burden, RA-ILD needs to be ruled out. Treatment of manifestations often lacks solid evidencebased guidelines and referrals to specialized centers are often necessary.

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The relevance of adhesion G protein-coupled receptors in metabolic functions

Biological Chemistry ◽

10.1515/hsz-2021-0146 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Isabell Kaczmarek ◽

Tomáš Suchý ◽

Simone Prömel ◽

Torsten Schöneberg ◽

Ines Liebscher ◽

...

Keyword(s):

G Protein ◽

Drug Targets ◽

Metabolic Diseases ◽

Current Knowledge ◽

G Protein Coupled Receptors ◽

Specific Expression ◽

Physiological Functions ◽

Metabolic Functions ◽

Central Nervous Systems ◽

G Protein Coupled

Abstract G protein-coupled receptors (GPCRs) modulate a variety of physiological functions and have been proven to be outstanding drug targets. However, approximately one-third of all non-olfactory GPCRs are still orphans in respect to their signal transduction and physiological functions. Receptors of the class of Adhesion GPCRs (aGPCRs) are among these orphan receptors. They are characterized by unique features in their structure and tissue-specific expression, which yields them interesting candidates for deorphanization and testing as potential therapeutic targets. Capable of G-protein coupling and non-G protein-mediated function, aGPCRs may extend our repertoire of influencing physiological function. Besides their described significance in the immune and central nervous systems, growing evidence indicates a high importance of these receptors in metabolic tissue. RNAseq analyses revealed high expression of several aGPCRs in pancreatic islets, adipose tissue, liver, and intestine but also in neurons governing food intake. In this review, we focus on aGPCRs and their function in regulating metabolic pathways. Based on current knowledge, this receptor class represents high potential for future pharmacological approaches addressing obesity and other metabolic diseases.

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Analysis of common causes of liver damage among children 12 years and younger in Weifang

Journal of International Medical Research ◽

10.1177/03000605211006661 ◽

2021 ◽

Vol 49 (4) ◽

pp. 030006052110066

Author(s):

Qinghong Meng ◽

Na Li ◽

Lianmei Yuan ◽

Xiaona Gao

Keyword(s):

Liver Damage ◽

Epstein Barr Virus ◽

Metabolic Diseases ◽

Unknown Etiology ◽

Severe Liver ◽

Drug Induced ◽

Barr Virus ◽

Common Causes ◽

Severe Liver Damage ◽

Epstein Barr

Aims To explore the causes of liver damage among children 12 years and younger in Weifang and to provide a theoretical basis for early diagnosis of liver damage in children. Methods Retrospective study of clinical data from pediatric patients (age ≤12 years) with liver damage in diagnosed at Weifang People's Hospital from June 2010 to May 2020. Results A total of 2632 children (1572 boys, 1060 girls) aged ≤12 years were diagnosed with liver damage including infectious liver damage (2100 cases), non-infectious liver damage (446 cases) and liver damage of unknown etiology (86 cases). The most common causes of infectious liver damage were viral infection (1515 cases), Mycoplasma pneumoniae infection (343 cases), and bacterial infection (197 cases). The most common causes of viral liver damage were Epstein–Barr virus, cytomegalovirus, and enterovirus. The most common causes of non-infectious liver damage were drug-induced liver damage, Kawasaki disease, and genetic metabolic diseases. There were 31 cases of severe liver damage. Conclusion There were many causes of liver damage among children in Weifang. Infections, and especially viral infections such as Epstein–Barr virus, were the most common causes of liver damage. Severe liver damage was primarily caused by drugs or poisons.

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COVID-19 Infection during Pregnancy: Risk of Vertical Transmission, Fetal, and Neonatal Outcomes

Journal of Personalized Medicine ◽

10.3390/jpm11060483 ◽

2021 ◽

Vol 11 (6) ◽

pp. 483

Author(s):

Marwa Saadaoui ◽

Manoj Kumar ◽

Souhaila Al Khodor

Keyword(s):

Pregnant Women ◽

Vertical Transmission ◽

Current Knowledge ◽

Limited Data ◽

Pregnancy Risk ◽

Public Health Challenge ◽

Short And Long Term ◽

Critical Public Health ◽

The Impact

The COVID-19 pandemic is a worldwide, critical public health challenge and is considered one of the most communicable diseases that the world had faced so far. Response and symptoms associated with COVID-19 vary between the different cases recorded, but it is amply described that symptoms become more aggressive in subjects with a weaker immune system. This includes older subjects, patients with chronic diseases, patients with immunosuppression treatment, and pregnant women. Pregnant women are receiving more attention not only because of their altered physiological and immunological function but also for the potential risk of viral vertical transmission to the fetus or infant. However, very limited data about the impact of maternal infection during pregnancy, such as the possibility of vertical transmission in utero, during birth, or via breastfeeding, is available. Moreover, the impact of infection on the newborn in the short and long term remains poorly understood. Therefore, it is vital to collect and analyze data from pregnant women infected with COVID-19 to understand the viral pathophysiology during pregnancy and its effects on the offspring. In this article, we review the current knowledge about pre-and post-natal COVID-19 infection, and we discuss whether vertical transmission takes place in pregnant women infected with the virus and what are the current recommendations that pregnant women should follow in order to be protected from the virus.

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Pulmonary Manifestations of Endocrine and Metabolic Diseases in Children

Pediatric Clinics of North America ◽

10.1016/j.pcl.2020.09.011 ◽

2021 ◽

Vol 68 (1) ◽

pp. 81-102

Author(s):

Alexander A. Broomfield ◽

Raja Padidela ◽

Stuart Wilkinson

Keyword(s):

Metabolic Diseases ◽

Pulmonary Manifestations

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Mechanisms involved in developmental programming of hypertension and renal diseases. Gender differences

Hormone Molecular Biology and Clinical Investigation ◽

10.1515/hmbci-2013-0054 ◽

2014 ◽

Vol 18 (2) ◽

Cited By ~ 6

Author(s):

Analia Lorena Tomat ◽

Francisco Javier Salazar

Keyword(s):

Metabolic Diseases ◽

Current Knowledge ◽

Adult Life ◽

Developmental Programming ◽

Renal Diseases ◽

Future Studies ◽

Functional Changes ◽

Regulatory Systems ◽

Increased Risk ◽

Renal Changes

AbstractA substantial body of epidemiological and experimental evidence suggests that a poor fetal and neonatal environment may “program” susceptibility in the offspring to later development of cardiovascular, renal and metabolic diseases.This review focuses on current knowledge from the available literature regarding the mechanisms linking an adverse developmental environment with an increased risk for cardiovascular, renal and metabolic diseases in adult life. Moreover, this review highlights important sex-dependent differences in the adaptation to developmental insults.Developmental programming of several diseases is secondary to changes in different mechanisms inducing important alterations in the normal development of several organs that lead to significant changes in birth weight. The different diseases occurring as a consequence of an adverse environment during development are secondary to morphological and functional cardiovascular and renal changes, to epigenetic changes and to an activation of several hormonal and regulatory systems, such as angiotensin II, sympathetic activity, nitric oxide, COX2-derived metabolites, oxidative stress and inflammation. The important sex-dependent differences in the developmental programming of diseases seem to be partly secondary to the effects of sex hormones. Recent studies have shown that the progression of these diseases is accelerated during aging in both sexes.The cardiovascular, renal and metabolic diseases during adult life that occur as a consequence of several insults during fetal and postnatal periods are secondary to multiple structural and functional changes. Future studies are needed in order to prevent the origin and reduce the incidence and consequences of developmental programmed diseases.

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PPARs in Liver Diseases and Cancer: Epigenetic Regulation by MicroRNAs

PPAR Research ◽

10.1155/2012/757803 ◽

2012 ◽

Vol 2012 ◽

pp. 1-16 ◽

Cited By ~ 26

Author(s):

Marion Peyrou ◽

Pierluigi Ramadori ◽

Lucie Bourgoin ◽

Michelangelo Foti

Keyword(s):

Liver Diseases ◽

Metabolic Diseases ◽

Viral Infections ◽

Inflammatory Responses ◽

Current Knowledge ◽

Hepatocellular Adenoma ◽

Peroxisome Proliferator ◽

Cancer Therapies ◽

Ppar Agonists ◽

Expression And Activity

Peroxisome-proliferator-activated receptors (PPARs) are ligand-activated nuclear receptors that exert in the liver a transcriptional activity regulating a whole spectrum of physiological functions, including cholesterol and bile acid homeostasis, lipid/glucose metabolism, inflammatory responses, regenerative mechanisms, and cell differentiation/proliferation. Dysregulations of the expression, or activity, of specific PPAR isoforms in the liver are therefore believed to represent critical mechanisms contributing to the development of hepatic metabolic diseases, disorders induced by hepatic viral infections, and hepatocellular adenoma and carcinoma. In this regard, specific PPAR agonists have proven to be useful to treat these metabolic diseases, but for cancer therapies, the use of PPAR agonists is still debated. Interestingly, in addition to previously described mechanisms regulating PPARs expression and activity, microRNAs are emerging as new important regulators of PPAR expression and activity in pathophysiological conditions and therefore may represent future therapeutic targets to treat hepatic metabolic disorders and cancers. Here, we reviewed the current knowledge about the general roles of the different PPAR isoforms in common chronic metabolic and infectious liver diseases, as well as in the development of hepatic cancers. Recent works highlighting the regulation of PPARs by microRNAs in both physiological and pathological situations with a focus on the liver are also discussed.

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Paracetamol overdose

Drug and Therapeutics Bulletin ◽

10.1136/dtb.14.2.5 ◽

1976 ◽

Vol 14 (2) ◽

pp. 5-7

Keyword(s):

At Risk ◽

Liver Damage ◽

Fulminant Hepatitis ◽

Therapeutic Dose ◽

Renal Damage ◽

Hepatic Necrosis ◽

Paracetamol Overdose ◽

Microsomal Enzymes ◽

Concomitant Increase ◽

Main Metabolite

Paracetamol is a main metabolite of phenacetin, and since its introduction it has become increasingly popular as a mild analgesic which is available without prescription. When taken in the recommended therapeutic dose of l g 6-hourly, paracetamol is relatively free from unwanted effects, and in particular, unlike phenacetin, there is little to associate it with renal damage. However, when taken as a single overdose, paracetamol can cause hepatic necrosis, the severity of which seems to be proportional to the dose of drug absorbed. All patients ingesting over 10 g (20 × 500 mg tablets) are at risk from liver damage, which may be potentiated by previous consumption of substances that induce microsomal enzymes, such as barbiturates or alcohol. Since the first reported cases of fulminant hepatitis due to paracetamol overdose in 1966 the number of cases of such self-poisoning has risen annually, with a concomitant increase in the number of deaths.

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Disease and Trauma in the Children from Roman Britain

10.1093/oxfordhb/9780199670697.013.25 ◽

2018 ◽

Author(s):

Mary E. Lewis

Keyword(s):

Iron Deficiency Anaemia ◽

Metabolic Diseases ◽

Current Knowledge ◽

Skeletal Remains ◽

Future Research ◽

Roman Britain ◽

Deficiency Anaemia ◽

Roman World ◽

The Uk ◽

The Impact

This chapter explores our current knowledge of pathology and trauma in Romano-British non-adult samples focusing on the children from the late Roman cemetery of Poundbury Camp, Dorset. Evidence for metabolic diseases (rickets, scurvy, iron deficiency anaemia), fractures, thalassemia, congenital disorders and tuberculosis, are presented with emphasis on what their presence tells us about the impact of the Romans in Britain. Many of the large Roman sites from the UK were excavated long before diagnostic criteria for recognizing pathology in child remains were fully developed, and European studies tend only to focus on anaemia and its link to malaria. A lack of environmental evidence for the sites from which our skeletal remains are derived is also problematic, and this chapter hopes to set the agenda for future research into the health and life of children living in the Roman World.

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Update on FXR Biology: Promising Therapeutic Target?

International Journal of Molecular Sciences ◽

10.3390/ijms19072069 ◽

2018 ◽

Vol 19 (7) ◽

pp. 2069 ◽

Cited By ~ 40

Author(s):

Chang Han

Keyword(s):

Therapeutic Target ◽

Energy Homeostasis ◽

Metabolic Diseases ◽

Current Knowledge ◽

Farnesoid X Receptor ◽

Metabolic Effects ◽

Metabolic Dysfunction ◽

Energy Status ◽

Safety Issues ◽

Attractive Therapeutic Target

Farnesoid X receptor (FXR), a metabolic nuclear receptor, plays critical roles in the maintenance of systemic energy homeostasis and the integrity of many organs, including liver and intestine. It regulates bile acid, lipid, and glucose metabolism, and contributes to inter-organ communication, in particular the enterohepatic signaling pathway, through bile acids and fibroblast growth factor-15/19 (FGF-15/19). The metabolic effects of FXR are also involved in gut microbiota. In addition, FXR has various functions in the kidney, adipose tissue, pancreas, cardiovascular system, and tumorigenesis. Consequently, the deregulation of FXR may lead to abnormalities of specific organs and metabolic dysfunction, allowing the protein as an attractive therapeutic target for the management of liver and/or metabolic diseases. Indeed, many FXR agonists have been being developed and are under pre-clinical and clinical investigations. Although obeticholic acid (OCA) is one of the promising candidates, significant safety issues have remained. The effects of FXR modulation might be multifaceted according to tissue specificity, disease type, and/or energy status, suggesting the careful use of FXR agonists. This review summarizes the current knowledge of systemic FXR biology in various organs and the gut–liver axis, particularly regarding the recent advancement in these fields, and also provides pharmacological aspects of FXR modulation for rational therapeutic strategies and novel drug development.

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