Corpus overview


MeSH Disease

Human Phenotype


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    Effects of COVID-19 on the Gut and the Liver - A Case Series of 711 Patients in New York City

    Authors: Sher Nazir Baig, MD; Fuad Abaleka, MD; Stephanie Herrera, MD; Mina Daniel, MD; Bisrat Nigusse, MD; Thu M Vu, MD; Tigist Gemechu, MD; George Abdelsayed, MD, FACG

    doi:10.21203/ Date: 2020-08-06 Source: ResearchSquare

    Background As the COVID-19 epidemic is wreaking havoc with a staggering number of infections MESHD and fatalities worldwide, digestive symptoms are increasingly coming to the limelight. However, the data on the extent of gut and liver involvement has been variable and somewhat conflicting.Methods We identified 711 adults TRANS who had tested positive for COVID-19 at Richmond University Medical Center in New York between March 13 and May 13, 2020. We analyzed their clinical and laboratory data from electronic medical records.Results The average age TRANS of the patients was 60.5 years; 55% were men. 27.1% reported a gastrointestinal (GI) symptom and 56.9% had at least one abnormal liver enzyme. The most common was diarrhea MESHD diarrhea HP with a frequency of 17.3% followed by nausea MESHD nausea HP 16.2% and vomiting MESHD vomiting HP/ anorexia MESHD anorexia HP 13.7%. Abdominal pain MESHD Abdominal pain HP 5.6%, dysgeusia MESHD 3.2%, and GI bleeding 2.2% was the least common. Symptoms were mostly mild and lasted 3-5 days. The liver function was deranged in more than half of the patients. AST alone was elevated in 16.6%, both AST/ALT 15.7%, alkaline phosphatase 23%, and bilirubin 10%. Potential confounders were rare but included preexisting liver disease MESHD and hepatotoxic medications. Prothrombin time (PT) was mildly elevated in 13.4%. The lipase was elevated in 2.4% without upper abdominal pain MESHD abdominal pain HP. In 75%-90% of cases, liver test abnormalities were mild (1.5-3 x normal). Overall, 86.6% of patients were admitted primarily with respiratory failure HP and 28.5% died of their illness.Conclusions 27% of COVID-19 patients experienced a digestive disturbance and >55% showed a predominantly mild degree of liver dysfunction and cholestasis MESHD cholestasis HP.

    Safety and Efficacy Concerns of Lopinavir/Ritonavir in COVID-19 Affected Patients: A Retrospective Series

    Authors: Marc-Antoine Lepage; Nicholas Rozza; Richard Kremer; Ami Grunbaum

    doi:10.1101/2020.07.23.20153932 Date: 2020-07-27 Source: medRxiv

    Context: Originally developed for the treatment of human immunodeficiency HP virus (HIV), the antiviral combination lopinavir/ritonavir (LPV/r) is being investigated for use against coronavirus disease MESHD (COVID-19). We present a case series raising safety and efficacy concerns in COVID-19 affected patients. Methods: We measured LPV trough concentrations in 12 patients treated at our center and reviewed their clinical charts for side effects known to occur in HIV patients. Results: Compared to established LPV trough concentrations in HIV treated patients, concentrations in COVID-19 affected patients were 3-fold greater (20.64 +/- 10.14 mcg/mL versus 6.25 mcg/mL). In addition, cholestasis MESHD cholestasis HP and dyslipidemia toxicity thresholds were exceeded in 12/12 and 11/12 patients respectively. No patients achieved the presumed therapeutic concentration. The side effects noted were mainly gastrointestinal symptoms (5/12, 42%), electrolytes imbalances (4/12, 33%), liver enzyme disturbances (5/12, 42%), and triglyceride elevations (2/12, 17%). Conclusion: None of our patients reached presumed therapeutic LPV concentrations despite experiencing side effects and exceeding cholestasis MESHD cholestasis HP and dyslipidemia toxicity thresholds. This raises concerns for the safety and efficacy of LPV/r. Clinicians should consider closely monitoring for side effects and not necessarily attribute them to COVID-19 itself.

    Complex Immuno-metabolic Profiling Reveals Activation of Cellular Immunity and Biliary Lesion in Patients with Severe COVID-19

    Authors: Adam Klocperk; Marketa Bloomfield; Zuzana Parackova; Irena Zentsova; Petra Vrabcova; Jan Balko; Grigorij Meseznikov; Luis Fernando Casas Mendez; Alzbeta Grandcourtova; Jan Sipek; Martin Tulach; Josef Zamecnik; Tomas Vymazal; Anna Sediva

    id:10.20944/preprints202007.0596.v1 Date: 2020-07-24 Source:

    The aim of this study was to assess the key laboratory features displayed by coronavirus disease MESHD 2019 (COVID-19) inpatients which associated with mild, moderate, severe and fatal course of the disease MESHD and, through longitudinal follow-up, to understand the dynamics of COVID-19 pathophysiology. All SARS-CoV-2 positive patients admitted to the University Hospital in Motol between March and June 2020 were included in this study. Severe course of COVID-19 was associated with elevation of proinflammatory markers, efflux of immature granulocytes into peripheral blood SERO, activation of CD8 T cells, which infiltrate lungs, and transient liver disease MESHD. In particular, the elevation of serum SERO gamma-glutamyl transferase (GGT) and histological signs of cholestasis MESHD cholestasis HP were highly specific for patients with severe disease MESHD. In contrast, patients with fatal course of COVID-19 failed to upregulate markers of inflammation MESHD, showed dyscoordination of immune response and progressed towards acute kidney failure. COVID-19 is a disease MESHD with multi-organ affinity characterized by activation of innate and cellular adaptive immunity. Biliary lesion with elevation of GGT and organ-infiltration of IL-6 producing cells are defining characteristic for patients with fulminant disease MESHD.

    Liver Chemistries in COVID-19 Patients with Survival or Death MESHD: A Meta-Analysis

    Authors: Qing-Qing Xing; Xuan Dong; Yan-Dan Ren; Wei-Ming Chen; Dan-Yi Zeng; Yan-Yan Cai; Mei-Zhu Hong; Jin-Shui Pan

    doi:10.1101/2020.04.26.20080580 Date: 2020-05-01 Source: medRxiv

    Background and Aims: Although abnormal liver chemistries are linked to higher risk of death MESHD related to coronavirus disease MESHD (COVID-19), liver manifestations may be diverse and even confused. Thus, we performed a meta-analysis of published liver manifestations and described the liver damage in COVID-19 patients with death MESHD or survival. Methods: We searched PubMed, Google Scholar, medRxiv, bioRxiv, Cochrane Library, Embase, and three Chinese electronic databases through April 22, 2020. We analyzed pooled data on liver chemistries stratified by the main clinical outcome of COVID-19 using a fixed or random-effects model. Results: In the meta-analysis of 18 studies, which included a total of 2,862 patients, the pooled mean alanine aminotransferase (ALT) was 30.9 IU/L in the COVID-19 patients with death MESHD and 26.3 IU/L in the COVID-19 patients discharged alive (p < 0.0001). The pooled mean aspartate aminotransferase (AST) level was 45.3 IU/L in the COVID-19 patients with death MESHD while 30.1 IU/L in the patients discharged alive (p < 0.0001). Compared with the discharged alive cases, the dead cases tended to have lower albumin levels but longer prothrombin time, and international standardized ratio. Conclusions: In this meta-analysis, according to the main clinical outcome of COVID-19, we comprehensively described three patterns of liver impairment related to COVID-19, hepatocellular injury, cholestasis MESHD cholestasis HP, and hepatocellular disfunction. Patients died from COVID-19 tend to have different liver chemistries from those are discharged alive. Close monitoring of liver chemistries provides an early warning against COVID-19 related death MESHD.

    Liver Chemistries in Patients with Severe or Non-Severe COVID-19: a Meta-Analysis

    Authors: Xuan Dong; Dan-Yi Zeng; Yan-Yan Cai; Wei-Ming Chen; Qing-Qing Xing; Yan-Dan Ren; Mei-Zhu Hong; Jin-Shui Pan

    doi:10.1101/2020.04.24.20074179 Date: 2020-04-29 Source: medRxiv

    Background & Aims: Cumulating observations have indicated that COVID-19 patients undergo different patterns of abnormal liver chemistries. We performed a meta-analysis of published liver manifestations and tried to describe the liver damage. Methods: We searched PubMed, google scholar, Embase, Cochrane Library, medRxiv, bioRxiv, and three Chinese electronic databases through April 18, 2020 according to the Preferred Reporting Items for Meta-Analyses. We analyzed pooled data on liver chemistries stratified by the severity of COVID-19 using a fixed or random effects model. Results: In a meta-analysis of 37 studies, comprising 6,235 patients, the pooled mean of ALT was 36.4 IU/L in the severe cases of COVID-19 while 27.8 IU/L in the non-severe cases (95% CI: -9.4- -5.1, p<0.0001). Pooled average of AST was 46.8 IU/L in the severe cases while 30.4 IU/L in the non-severe cases (95% CI: -15.1- -10.4, p<0.0001). Compared with the non-severe cases, the severe cases tended to have higher {gamma}-Glutamyltransferase while lower albumin. Conclusions: In this meta-analysis, we comprehensively described three patterns of liver impairment related to COVID-19, including hepatocellular injury, cholestasis MESHD cholestasis HP, and synthetic disfunction, according to the severity of the COVID-19. Patients with abnormal liver tests are at higher risks of progressing to severe disease MESHD. Close monitoring on liver chemistries helps to early warn against disease progression MESHD.

    Maternal and fetal effects of covid-19 virus on a complicated triplet pregnancy. A case-report

    Authors: Maryam Rabiei; Tahereh Soori; Amene Abiri; Arshia Shizarpour; Zohreh Farsi; Reihaneh Pirjani

    doi:10.21203/ Date: 2020-04-28 Source: ResearchSquare

    Background:  COVID-19 virus it is going to be pandemic all around the world. There is still limited scientific evidence on the manifestations and potential impact of this virus on pregnancy.Case presentation She was a 38 year-old triplet pregnant with a history of primary infertility MESHD infertility HP and had become pregnant by induction ovulation and a history of hypothyroidism MESHD hypothyroidism HP and also a history of gestational diabetes MESHD. She was hospitalized at 29 weeks and 2 days gestational age TRANS due to elevated liver enzymes and finally based on a probable diagnosis of gestational cholestasis MESHD cholestasis HP, she was treated with ursodeoxycholic acid. On the first day after hospitalization, a sonography was performed in which biophysical scores and amniotic fluid were found normal in all three fetuses with normal Doppler findings in two fetuses and increased umbilical artery resistance (PI>95%) in one fetus. Four days after hospitalization, she developed fever MESHD fever HP, cough MESHD cough HP and myalgia MESHD myalgia HP and her covid-19 test was positive. After maternal infection MESHD with the virus, exacerbated placental insufficiency MESHD occurred in two of the fetuses so that absent umbilical artery end diastolic flow occurred rapidly in two fetuses and finally, six days later, she underwent cesarean section due to rapid exacerbated placental insufficiency MESHD and declined biophysical score in two of fetuses. Covid-19 test of nasopharyngeal swabs was negative for first and third babies and positive for second baby .The first and third babies died 3 and 13 days after birth respectively duo to collapsed white lung and sepsis MESHD sepsis HP. The second baby was discharged with a good general condition. The mother was discharged three days after cesarean section. She had no fever MESHD fever HP at discharge time and also she was in good general condition.Conclusions: It was a complicated triplet pregnancy, in which, after maternal infection MESHD with the Covid-19 virus, exacerbated placental insufficiency MESHD occurred in two of the fetuses, and another fetus had positive covid-19 virus test after birth. It sounds wise that in pregnancy infected by corona virus, in addition to managing the mother, special attention should also be given to the possibility of acute placental insufficiently and subsequent fetal hypoxia MESHD and also probability of vertical transmission TRANS.

    Acute liver injury and its association with death MESHD risk of patients with COVID-19: a hospital-based prospective case-cohort study

    Authors: Lin Fu; Jun Fei; Shen Xu; Hui-Xian Xiang; Ying Xiang; Zhu-Xia Tan; Meng-Die Li; Fang-Fang Liu; Ying Li; Ming-Feng Han; Xiu-Yong Li; Hui Zhao; De-Xiang Xu

    doi:10.1101/2020.04.02.20050997 Date: 2020-04-06 Source: medRxiv

    Background: Coronavirus disease MESHD 2019 (COVID-19) is a newly respiratory infectious disease MESHD caused by severe acute respiratory syndrome MESHD coronavirus-2 (SARS-CoV-2) with multiple organ injuries. The aim of this study was to analyze SARS-CoV-2-induced acute liver injury (ALI), its association with death MESHD risk and prognosis after discharge. Methods: Three-hundred and fifty-five COVID-19 patients were recruited. Clinical data were collected from electronic medical records. ALI was evaluated and its prognosis was tracked. The association between ALI and death MESHD risk was analyzed. Results: Of 355 COVID-19 patients, 211 were common, 88 severe, and 51 critical ill cases, respectively. On admission, 223 (62.8%) patients were with hypoproteinemia MESHD hypoproteinemia HP, 151(42.5%) with cholestasis MESHD cholestasis HP, and 101 (28.5%) with hepatocellular injury. As expected, ALI was more common in critical ill patients. By multivariate logistic regression, male TRANS, older age TRANS and lymphocyte reduction were three important independent risk factors predicting ALI among COVID-19 patients. Death MESHD risk analysis shows that fatality rate was higher among patients with hypoproteinemia MESHD hypoproteinemia HP than those without hypoproteinemia MESHD hypoproteinemia HP (RR=9.471, P<0.001). Moreover, fatality rate was higher among patients with cholestasis MESHD cholestasis HP than those without cholestasis MESHD cholestasis HP (RR=2.182, P<0.05). Follow-up observation found that more than one hepatic functional indexes of two-third patients remained abnormal 14 days after discharge. Conclusions: ALI at early stage elevates death MESHD risk of COVID-19 patients. SARS-CoV-2-induced ALI has not recovered completely 14 days after discharge.

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MeSH Disease
Human Phenotype

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