scholarly journals COVID-19 in Children With Liver Disease

2021 ◽  
Vol 9 ◽  
Author(s):  
Angelo Di Giorgio ◽  
Steffen Hartleif ◽  
Suzan Warner ◽  
Deirdre Kelly
Keyword(s):  
Liver Disease ◽  
Severe Disease ◽  
Immunosuppressive Treatment ◽  
Good Health ◽  
Asymptomatic Infection ◽  
Standards Of Care ◽  
Global Pandemic ◽  
Hepatic Transaminases ◽  
Increased Risk ◽  
Novel Coronavirus

Background: The global pandemic caused by novel Coronavirus SARS-CoV-2 disease (COVID-19) is a major threat to the general population and for patients with pre-existing chronic conditions. We report data concerning SARS-CoV-2 infection in children with chronic liver disease (CLD).Methods: A literature review using the online database PubMed was performed to summarize available findings on the association between pre-existing liver disease and COVID-19 infection in children.Results: Children with COVID-19 have preserved effector and immunosuppressive components resulting in a milder disease compared to adults. The most common hepatic manifestation is an elevation of hepatic transaminases. Liver damage may be directly caused by viral infection of liver cells, by medications or by the chronic hypoxia seen in COVID-19 patients. A multicenter study reported that the majority of children with a CLD remained healthy during the outbreak. Similarly, studies reported that children on immunosuppressive treatment, including patients with autoimmune liver disease (AILD) and liver transplantation (LT), maintained good health during the outbreak without experiencing major complications even if infected with COVID-19.Conclusion: COVID-19-related liver injury presents with a mild elevation of transaminases, although its clinical significance is unclear. Children with CLD, including those with AILD and post-LT, do not have an increased risk for severe disease course of SARS-CoV-2 infection with little or no liver dysfunction. These data highlight the necessity to ensure normal standards of care while adhering to national Covid-19 guidelines, and particularly to maintain immunosuppressive medication to prevent relapse or rejection. Further research is required to evaluate the differences in clinical course between immunosuppressed adults and children and in particular whether asymptomatic infection is a concern.

scholarly journals Management of pregnant women in times of COVID-19 our experience from Kashmir valley

2021 ◽  
Vol 10 (4) ◽  
pp. 1379
Author(s):  
Syed Naseer ◽  
Syed Uzma Andrabi ◽  
Syed Ishfa Andrabi ◽  
Humaira Tabasum
Keyword(s):  
Pregnant Women ◽  
Severe Disease ◽  
Virus Transmission ◽  
Safe Motherhood ◽  
Normal Vaginal Delivery ◽  
Global Public Health ◽  
Transmission Potential ◽  
Medical College ◽  
Global Pandemic ◽  
Increased Risk

Background: The coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, is a global public health emergency. COVID-19 is a rapidly evolving situation, and there is limited data reporting its impact on pregnant women. Our study aimed to find the symptomatology, clinical courses and outcome of pregnant women with COVID-19 and to assess the vertical transmission potential of COVID-19 in pregnancy.Methods: This prospective observational study was conducted at Sher-i-Kashmir Institute of Medical Sciences (SKIMS), Medical College, Department of Gynaecology and obstetrics, Srinagar from May 2020 to September 2020. All COVID-19 positive pregnant patients admitted in our institution were included in our study.Results: The study included 100 Covid-19 positive pregnant women. Most of them were between 30 to 40 years of age. Median gestational age was 32.8 weeks. Comorbidity was present in 18 of our patients. 7 patients had gestational diabetes and 1 with overt diabetes, 5 were hypertensive, 3 had hypothyroidism, 1 with anti-phospholipid antibody syndrome (APLA) and 1 with asthma.44 patients were primigravidae and 56 were multigravidae. 27 patients delivered preterm and 44 with term pregnancy. 47 had undergone caesarean section and 24 normal vaginal delivery.88% of our patients were asymptomatic for covid-19 disease while as 12 patients had Covid-19 disease symptoms. The main complaints reported by patients related to covid-19 disease was mild dry cough and fever (9%). Two patients developed severe covid-19 pneumonia with ARDS and were put on ventilator, expired after 20 days of illness. All neonates were subjected to RT-PCR with none producing positive results.Conclusions: Appropriate and timely management of Covid-19 positive pregnant women is a principle for safe motherhood and healthy offspring in times of global pandemic. The present data do not suggest an increased risk of severe disease among pregnant women. We encourage the breast feeding immediately after delivery as benefits overweigh any potential risks of virus transmission if any.

scholarly journals Metabolic Associated Fatty Liver Disease Is Associated With an Increased Risk of Severe COVID-19: A Systematic Review With Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Péter Jenő Hegyi ◽  
Szilárd Váncsa ◽  
Klementina Ocskay ◽  
Fanni Dembrovszky ◽  
Szabolcs Kiss ◽  
...  
Keyword(s):  
Liver Disease ◽  
Fatty Liver ◽  
Fatty Liver Disease ◽  
Negative Impact ◽  
Meta Analysis ◽  
Severe Disease ◽  
Close Monitoring ◽  
Alcoholic Fatty Liver ◽  
Icu Admission ◽  
Increased Risk

Background: The most common pre-existing liver disease, the metabolic dysfunction-associated fatty liver disease (MAFLD) formerly named as non-alcoholic fatty liver disease (NAFLD), may have a negative impact on the severity of COVID-19. This meta-analysis aimed to evaluate if MAFLD or NAFLD are associated with a more severe disease course of COVID-19.Methods: A systematic search was performed in five databases for studies comparing severity, the rate of intensive care unit (ICU) admission, and mortality of COVID-19 patients with and without MAFLD or NAFLD. In meta-analysis, pooled odds ratios (ORs) with 95% confidence intervals (CIs) were calculated.Results: Altogether, we included nine studies in our quantitative and qualitative synthesis. MAFLD was associated with an increased risk of severe COVID-19 compared to the non-MAFLD group (28 vs. 13%, respectively; OR = 2.61, CI: 1.75–3.91). Similarly, in the NAFLD vs. non-NAFLD comparison, NAFLD proved to be a risk factor as well (36 vs. 12%, respectively; OR = 5.22, CI: 1.94–14.03). On the other hand, NAFLD was not associated with an increased risk of ICU admission (24 vs. 7%, respectively; OR = 2.29, CI: 0.79–6.63). We were unable to perform meta-analysis to investigate the association of MAFLD with the rate of ICU admission and with mortality.Conclusion: In conclusion, patients with MAFLD and NAFLD showed a more severe clinical picture in COVID-19. Our results support the importance of close monitoring of COVID-19 patients with MAFLD. Further research is needed to explore the cause of increased severity of COVID-19 in MAFLD.

scholarly journals Sex Hormones and Hormone Therapy during COVID-19 Pandemic: Implications for Patients with Cancer

Cancers ◽  
2020 ◽  
Vol 12 (8) ◽  
pp. 2325
Author(s):  
Carlo Cattrini ◽  
Melissa Bersanelli ◽  
Maria Maddalena Latocca ◽  
Benedetta Conte ◽  
Giacomo Vallome ◽  
...  
Keyword(s):  
Hormone Therapy ◽  
Sex Hormones ◽  
Wide Spectrum ◽  
Severe Disease ◽  
Host Cells ◽  
Testosterone Levels ◽  
Increased Risk ◽  
Hormonal Therapies ◽  
Novel Coronavirus ◽  
Transmembrane Serine Protease

The novel coronavirus disease 2019 (COVID-19) shows a wide spectrum of clinical presentations, severity, and fatality rates. The reason older patients and males show increased risk of severe disease and death remains uncertain. Sex hormones, such as estradiol, progesterone, and testosterone, might be implicated in the age-dependent and sex-specific severity of COVID-19. High testosterone levels could upregulate transmembrane serine protease 2 (TMPRSS2), facilitating the entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) into host cells via angiotensin-converting enzyme 2 (ACE2). Data from patients with prostate cancer treated with androgen-deprivation therapy seem to confirm this hypothesis. Clinical studies on TMPRSS2 inhibitors, such as camostat, nafamostat, and bromhexine, are ongoing. Antiandrogens, such as bicalutamide and enzalutamide, are also under investigation. Conversely, other studies suggest that the immune modulating properties of androgens could protect from the unfavorable cytokine storm, and that low testosterone levels might be associated with a worse prognosis in patients with COVID-19. Some evidence also supports the notion that estrogens and progesterone might exert a protective effect on females, through direct antiviral activity or immune-mediated mechanisms, thus explaining the higher COVID-19 severity in post-menopausal women. In this perspective, we discuss the available evidence on sex hormones and hormone therapy in patients infected with SARS-CoV-2, and we highlight the possible implications for cancer patients, who can receive hormonal therapies during their treatment plans.

scholarly journals Endocrine Conditions and COVID-19

2020 ◽  
Vol 52 (07) ◽  
pp. 471-484 ◽  
Author(s):  
Skand Shekhar ◽  
Rachel Wurth ◽  
Crystal D. C. Kamilaris ◽  
Graeme Eisenhofer ◽  
Francisco J. Barrera ◽  
...  
Keyword(s):  
Severe Disease ◽  
Additional Risk ◽  
Global Pandemic ◽  
Increased Risk ◽  
The World

AbstractCOVID-19 was declared a global pandemic by the WHO and has affected millions of patients around the world. COVID-19 disproportionately affects persons with endocrine conditions, thus putting them at an increased risk for severe disease. We discuss the mechanisms that place persons with endocrine conditions at an additional risk for severe COVID-19 and review the evidence. We also suggest precautions and management of endocrine conditions in the setting of global curfews being imposed and offer practical tips for uninterrupted endocrine care.

scholarly journals Obesity and COVID-19: what makes obese host so vulnerable?

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Sameer Mohammad ◽  
Rafia Aziz ◽  
Saeed Al Mahri ◽  
Shuja Shafi Malik ◽  
Esraa Haji ◽  
...  
Keyword(s):  
Severe Disease ◽  
Mortality Rates ◽  
Published Data ◽  
Disease Pathogenesis ◽  
Obesity And Overweight ◽  
Increased Risk ◽  
Severity Of The Disease ◽  
Novel Coronavirus ◽  
Significant Mortality

AbstractThe disease (COVID-19) novel coronavirus pandemic has so far infected millions resulting in the death of over a million people as of Oct 2020. More than 90% of those infected with COVID-19 show mild or no symptoms but the rest of the infected cases show severe symptoms resulting in significant mortality. Age has emerged as a major factor to predict the severity of the disease and mortality rates are significantly higher in elderly patients. Besides, patients with underlying conditions like Type 2 diabetes, cardiovascular diseases, hypertension, and cancer have an increased risk of severe disease and death due to COVID-19 infection. Obesity has emerged as a novel risk factor for hospitalization and death due to COVID-19. Several independent studies have observed that people with obesity are at a greater risk of severe disease and death due to COVID-19. Here we review the published data related to obesity and overweight to assess the possible risk and outcome in Covid-19 patients based on their body weight. Besides, we explore how the obese host provides a unique microenvironment for disease pathogenesis, resulting in increased severity of the disease and poor outcome.

scholarly journals Post-COVID-19 Pulmonary Fibrosis: Novel Sequelae of the Current Pandemic

2021 ◽  
Vol 10 (11) ◽  
pp. 2452
Author(s):  
Shiva Rattan Ambardar ◽  
Stephanie L. Hightower ◽  
Nikhil A. Huprikar ◽  
Kevin K. Chung ◽  
Anju Singhal ◽  
...  
Keyword(s):  
Interstitial Lung Disease ◽  
Pulmonary Fibrosis ◽  
Lung Disease ◽  
Severe Disease ◽  
Pulmonary Complications ◽  
Patient Specific ◽  
Pulmonary Vascular Disease ◽  
Increased Risk ◽  
Risk Of Progression ◽  
Novel Coronavirus

Since the initial identification of the novel coronavirus SARS-CoV-2 in December 2019, the COVID-19 pandemic has become a leading cause of morbidity and mortality worldwide. As effective vaccines and treatments begin to emerge, it will become increasingly important to identify and proactively manage the long-term respiratory complications of severe disease. The patterns of imaging abnormalities coupled with data from prior coronavirus outbreaks suggest that patients with severe COVID-19 pneumonia are likely at an increased risk of progression to interstitial lung disease (ILD) and chronic pulmonary vascular disease. In this paper, we briefly review the definition, classification, and underlying pathophysiology of interstitial lung disease (ILD). We then review the current literature on the proposed mechanisms of lung injury in severe COVID-19 infection, and outline potential viral- and immune-mediated processes implicated in the development of post-COVID-19 pulmonary fibrosis (PCPF). Finally, we address patient-specific and iatrogenic risk factors that could lead to PCPF and discuss strategies for reducing risk of pulmonary complications/sequelae.

scholarly journals Acute and Post-Acute Neurological Complications of COVID-19

2021 ◽  
Vol 13 (1) ◽  
pp. 102-119
Author(s):  
Ali Al-Ramadan ◽  
Omar Rabab’h ◽  
Jawad Shah ◽  
Abeer Gharaibeh
Keyword(s):  
Altered Mental Status ◽  
Neurological Complications ◽  
Asymptomatic Infection ◽  
World Health ◽  
The Novel ◽  
Global Pandemic ◽  
Severity Of The Disease ◽  
Novel Coronavirus ◽  
Health Organization

Coronavirus disease 2019 (COVID-19) is an emerging global health emergency caused by the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The global outbreak of SARS-CoV-2 infection has been declared a global pandemic by the World Health Organization (WHO). The clinical presentation of SARS-CoV-2 infection depends on the severity of the disease and may range from an asymptomatic infection to a severe and lethal illness. Fever, cough, and shortness of breath are among the most common symptoms associated with SARS-CoV-2 infection. Accumulating evidence indicates that COVID-19 patients commonly develop neurological symptoms, such as headache, altered mental status, anosmia, and myalgia. In this comprehensive literature review, we have summarized the most common neurological complications and reported neurological case studies associated with COVID-19, and neurological side effects associated with COVID-19 treatments. Additionally, the post-acute COVID-19 syndrome and long-term neurological complications were discussed. We also explained the proposed mechanisms that are involved in the pathogenesis of these neurological complications.

scholarly journals Elevated D-Dimer Levels are Associated with Increased Risk of Mortality in COVID-19: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Siddharth Shah ◽  
Kuldeep Shah ◽  
Siddharth B Patel ◽  
Forum S Patel ◽  
Mohammed Osman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Severe Disease ◽  
Case Fatality ◽  
Inclusion Criteria ◽  
Risk Of Mortality ◽  
Increased Risk ◽  
Novel Coronavirus ◽  
D Dimer

AbstractIntroductionThe 2019 novel Coronavirus (2019-nCoV), now declared a pandemic has an overall case fatality of 2–3% but it is as high as 50% in critically ill patients. D-dimer is an important prognostic tool, often elevated in patients with severe COVID-19 infection and in those who suffered death. In this systematic review, we aimed to investigate the prognostic role of D-dimer in COVID-19 infected patients.MethodsWe searched PubMed, Medline, Embase, Ovid, and Cochrane for studies reporting admission D-dimer levels in COVID-19 patients and its effect on mortality.Results18 studies (16 retrospective and 2 prospective) with a total of 3,682 patients met the inclusion criteria. The pooled mean difference (MD) suggested significantly elevated D-dimer levels in patients who died versus those survived (MD 6.13 mg/L, 95% CI 4.16 − 8.11, p <0.001). Similarly, the pooled mean D-dimer levels were significantly elevated in patients with severe COVID-19 infection (MD 0.54 mg/L, 95% CI 0.28 − 0.8, p< 0.001). In addition, the risk of mortality was four-fold higher in patients with positive D-dimer vs negative D-dimer (RR 4.11, 95% CI 2.48 − 6.84, p< 0.001) and the risk of developing the severe disease was two-fold higher in patients with positive D-dimer levels vs negative D-dimer (RR 2.04, 95% CI 1.34 − 3.11, p < 0.001).ConclusionOur meta-analysis demonstrates that patients with COVID-19 presenting with elevated D-dimer levels have an increased risk of severe disease and mortality.

scholarly journals COVID-19 Global Pandemic Planning: Decontamination and Reuse Processes for N95 Respirators

2020 ◽  
Author(s):  
Douglas J Perkins ◽  
Steven Villescas ◽  
Terry H. Wu ◽  
Timothy Muller ◽  
Steven Bradfute ◽  
...  
Keyword(s):  
Operating Room ◽  
Healthcare Providers ◽  
Respiratory Illness ◽  
Lessons Learned ◽  
Healthcare Personnel ◽  
Environmental Controls ◽  
Global Pandemic ◽  
Increased Risk ◽  
Novel Coronavirus ◽  
N95 Respirators

ABSTRACTCoronavirus disease 2019 (COVID-19) is an illness caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was first identified as a cluster of respiratory illness in Wuhan City, Hubei Province, China in December 2019, and has rapidly spread across the globe to greater than 200 countries. Healthcare providers are at an increased risk for contracting the disease due to occupational exposure and require appropriate personal protective equipment (PPE), including N95 respirators. The rapid worldwide spread of high numbers of COVID-19 cases has facilitated the need for a substantial supply of PPE that is largely unavailable in many settings, thereby creating critical shortages. Creative solutions for the decontamination and safe reuse of PPE to protect our frontline healthcare personnel are essential. Here, we describe the development of a process that began in late February 2020 for selecting and implementing the use of hydrogen peroxide vapor (HPV) as viable method to reprocess N95 respirators. Since pre-existing HPV decontamination chambers were not available, we optimized the sterilization process in an operating room after experiencing initial challenges in other environments. Details are provided about the prioritization and implementation of processes for collection and storage, pre-processing, HPV decontamination, and post-processing of filtering facepiece respirators (FFRs). Important lessons learned from this experience include, developing an adequate reserve of PPE for effective reprocessing and distribution, and identifying a suitable location with optimal environmental controls (i.e., operating room). Collectively, information presented here provides a framework for other institutions considering decontamination procedures for N95 respirators.

scholarly journals Principles of Care for Patients with Liver Disease During the Coronavirus Disease 2019 (COVID-19) Pandemic: Position Statement of the Saudi Association for the Study of Liver Disease and Transplantation

2020 ◽  
Vol 40 (4) ◽  
pp. 273-280 ◽  
Author(s):  
Saleh A. Alqahtani ◽  
Abdulrahman A. Aljumah ◽  
Almoutaz Hashim ◽  
Thamer H. Alenazi ◽  
Mohammed AlJawad ◽  
...  
Keyword(s):  
Older Adults ◽  
Liver Disease ◽  
Severe Acute Respiratory Syndrome ◽  
Position Statement ◽  
World Health ◽  
Global Pandemic ◽  
Regular Care ◽  
The World ◽  
Novel Coronavirus ◽  
Health Organization

ABSTRACT In December 2019, a novel coronavirus was identified in patients in Wuhan, China. The virus, subsequently named severe acute respiratory syndrome coronavirus-2, spread worldwide and the disease (coronavirus disease 2019 or COVID-19) was declared a global pandemic by the World Health Organization in March 2020. Older adults and individuals with comorbidities have been reported as being more vulnerable to COVID-19. Patients with chronic liver disease (CLD) have compromised immune function due to cirrhosis and are more susceptible to infection. However, it is unclear if patients with CLD are more vulnerable to COVID-19 and its complications than other populations. The high number of severe cases of COVID-19 has placed an unusual burden on health systems, compromising their capacity to provide the regular care that patients with CLD require. Hence, it is incredibly crucial at this juncture to provide a set of interim recommendations on the management of patients with CLD during the current COVID-19 outbreak.

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