• Appendicitis
• COVID-19
• Children
• Gastrointestinal
• Hepatic

• Humans
• Male
• Child
• COVID-19/complications
• COVID-19/diagnosis
• Female
• Adolescent
• Child, Preschool
• Retrospective Studies
• Infant
• Liver Diseases/etiology
• Liver Diseases/virology
• Iran/epidemiology
• Gastrointestinal Diseases/virology
• Gastrointestinal Diseases/etiology
• Hospitalization
• Severity of Illness Index
• Appendectomy
• SARS-CoV-2
• Prognosis

• COVID-19
• Liver enzymes
• Liver injury
• Mortality
• Prognosis

• COVID-19
• SARS-CoV-2
• aging
• cytokine storm
• interleukin
• liver injury

• Adult
• Aged
• Humans
• COVID-19/complications
• SARS-CoV-2
• Liver
• Aging
• Cytokines

• COVID-19
• Molecular biology
• VIROLOGY

• Male
• Humans
• Female
• COVID-19/complications
• SARS-CoV-2
• L-Lactate Dehydrogenase
• Multiple Organ Failure/etiology
• Reperfusion Injury
• Inflammation
• Aspartate Aminotransferases
• Alanine Transaminase

Metabolic associated fatty liver disorder (MAFLD) characterizes the contributing etiologies (i.e., type 2 diabetes mellitus, metabolic syndrome, overweight) of individuals with fatty liver disease that affects 1/3^rd of the world population. In 2020, the coronavirus disease 2019 (COVID-19) crisis was unprecedented, and people with different comorbidities became more susceptible to the infection caused by severe acute respiratory syndrome coronavirus 2. MAFLD patients are frequently obese with added metabolic menace like diabetes, hypertension, and dyslipidemia leading to greater jeopardy of COVID-19. MAFLD patients are 4 to 6-fold more prone towards infections. COVID-19 induces liver injury with elevated levels of aspartate aminotransferase and alanine aminotransferase and insignificantly elevated bilirubin. Hence, MAFLD in COVID-19 patients worsens the condition significantly. The evidence highlighting the interaction between MAFLD and altered liver functioning in COVID-19 suggested that COVID-19 patients with pre-existing MAFLD are at greater risk of morbidity or intensive care unit admission. Direct hepatic injury, enhanced levels of inflammatory cytokines, declined hepatic mitochondrial activity, and compromised immunity are considered as some underlying mechanisms. The main focus of this review is to discuss the implications of metabolic dysfunction associated with fatty liver disease in COVID-19 patients. The review systematically analyzes the effect of striking two worldwide pandemics (MAFLD and COVID-19) together in the present era.

• Metabolic associated fatty liver disorder
• COVID-19
• Metabolic dysfunction
• Hepatic damage
• Cytokine storm

• COVID-19
• SARS-CoV-2
• case–control study
• liver disease
• liver enzyme
• liver injury

• Blood Platelets
• COVID-19
• Case-Control Studies
• Humans
• Liver
• Lymphocytes
• Neutrophils
• Prognosis
• Retrospective Studies
• SARS-CoV-2

Background

Coronavirus disease 2019 (COVID-19) classically presents as a respiratory illness with fever, dry cough, and dyspnea on exertion. Along with respiratory signs and symptoms, gastrointestinal (GI) manifestations and liver injury have been recognized during the progression of the disease. This study aimed to determine the prevalence of GI symptoms and hepatic injury during COVID-19 infections and their consequences on the outcome of the disease.

Methodology

We conducted a retrospective survey of 715 participants age 16 or older diagnosed with COVID-19 and reported GI and hepatic manifestations in the Dammam Medical Complex in Dammam, Eastern Province, Saudi Arabia, from March 1, 2020, to May 31, 2020. We recorded clinical manifestations, laboratory test results, patient demographics, comorbidities, and treatments.

Results

The mean age of the study population was 46 years (88% were male, 12% were female), and 80% were non-Saudi. While most patients recovered and were discharged (n=603, 84.62%), 100 (13.99%) died due to COVID-19. Type 2 diabetes was present in 182 patients (79%) discharged and 45 patients (21%) who died. Hypertension was present in 26 (67%) discharged and 158 patients (81%) who died. Cardiovascular disease was present in 26 patients (67%) discharged and 13 (33%) who died. Chronic kidney disease was found in 11 patients (61%) discharged and six (33%) who died. Diarrhea was present in 11% of patients, nausea in 8%, and vomiting in 9% of patients. Twenty percent of patients had at least one GI symptom. Only 10% of those who died had GI symptoms, while 88% of those discharged had GI symptoms. Serum levels of alanine aminotransferase, aspartate aminotransferase, total bilirubin, alkaline phosphatase, and γ-glutamyl transpeptidase were generally higher in the patients who died than in those who were discharged.

Conclusions

We noted an increase in at least one liver enzyme with no clinically significant acute liver injury or cases of acute liver failure as sequelae of COVID-19. However, the presence of injury at the time of admission resulted in a significantly higher mortality rate. Only a small number of patients infected with COVID-19 exhibited GI manifestations. The etiology of severe acute respiratory syndrome coronavirus 2-related GI involvement is due to multiple factors. It is not yet fully understood if GI manifestations are clinical signs of high viral loads or another physiological process. The clinical manifestation and laboratory test results indicate that COVID-19 impacts the hepatic system and GI tract, indicating that COVID-19 infection may risk liver and GI tract injury.

• covid-19
• gastro-intestinal tract complications
• ksa:kingdom of saudi arabia
• liver injury
• retrospective study

COVID-19 disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), started in December 2019 in Wuhan, China, and quickly became the global pandemic. The high spread rate, relatively high mortality rate, and the lack of specific medicine have led researchers and clinicians worldwide to find new treatment strategies. Unfortunately, evidence shows that the virus-specific receptor Angiotensin-Converting Enzyme 2 (ACE-2) is present on the surface of most cells in the body, leading to immune system dysfunction and multi-organ failure in critically ill patients. In this context, the use of Mesenchymal Stem Cells (MSCs) and their secret has opened new therapeutic horizons for patients due to the lack of ACE2 receptor expression. MSCs exert their beneficial therapeutic actions, particularly anti-inflammatory and immunomodulatory properties, mainly through paracrine effects which are mediated by exosomes. Exosomes are bilayer nanovesicles that carry a unique cargo of proteins, lipids and functional nucleic acids based on their cell origin. This review article aims to investigate the possible role of exosomes and the underlying mechanism involved in treating COVID-19 disease based on recent findings.

• COVID-19
• Exosomes
• Mesenchymal Stem Cells
• Multi-organ failure

Evidence showed that partial or complete loss of smell and taste might be a possible primary symptom of the 2019 novel coronavirus (COVID-19). This study aimed to systematically review and pool all available evidence on the olfactory and gustatory dysfunction in COVID-19 patients.

In this systematic review, a comprehensive search was carried out systematically through e-databases including PubMed, EMBASE, Scopus, and Web of Science (WoS); that was limited to English-language studies published from 2019 up to 6^th May 2020. Afterward, all studies reported the taste and smell dysfunction in the COVID-19 patients were included. The quality of the studies was assessed by the Mixed Methods Appraisal Tool (MMAT). The pooled prevalence of olfactory and gustatory dysfunction was estimated using the random effects meta-analysis method.

Among 28 eligible included studies in this systematic review, finally, 22 studies met the eligibility criteria and were included in the meta-analysis. According to the random effect meta-analysis, the global pooled prevalence (95% confidence interval) of any olfactory dysfunction, anosmia, and hyposmia was 55% (40%-70%), 40% (22%-57%), and 40% (20%-61%) respectively. The pooled estimated prevalence of any gustatory dysfunction, ageusia, and dysgeusia was 41% (23%-59%), 31% (3%-59%), and 34% (19%-48%) respectively.

Olfactory and gustatory dysfunction is prevalent among COVID-19 patients. Therefore, olfactory and gustatory dysfunction seems to be part of important symptoms and notify for the diagnosis of COVID-19, especially in the early phase of the infection.

• Ageusia
• COVID-19
• and smell impairment
• anosmia
• sensation disorder
• taste

• COVID-19
• hospital
• length of stay

• COVID-19
• Liver enzymes
• Liver injury
• Prognosis
• Transaminases

• COVID-19/complications
• Cytokine Release Syndrome/complications
• Cytokine Release Syndrome/virology
• Cytokines
• Humans
• Liver Diseases/virology

• Covid-19
• Cytokine storm
• Immune response
• Mesenchymal stem cells

• COVID-19
• Critical Illness
• Cross-Sectional Studies
• Humans
• Intensive Care Units
• Nutrition Assessment
• Nutritional Status
• SARS-CoV-2

• Isfahan University of Medical Sciences

• COVID-19
• CRP
• IL-6
• SARS-CoV-2
• d-dimer
• high value care
• inpatient
• laboratory test
• labs
• troponin

• K08 AI143391 NIAID NIH HHS

• COVID-19
• Cancer
• Comorbidities
• MERS
• SARS
• Systematic review

Timely detection of the progression of the highly contagious coronavirus disease (COVID-19) is of utmost importance for management and intervention for patients in intensive care (ICU).

This study aims to better understand this new infection and report the changes in the various laboratory tests identified in critically ill patients and associated with poor prognosis among COVID-19 patients admitted to the ICU.

This was a retrospective study that included 160 confirmed SARS-CoV-2-positive patients.

Elevated serum ferritin, D-dimer, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and nonconjugated bilirubin levels were present in 139 (96%), 131 (96%), 107 (68%), 52 (34%), and 89 (70%) patients, respectively. Renal parameters were abnormal in a significant number of cases with elevated creatinine and blood urea nitrogen in 93 (62%) and 102 (68%) cases, respectively. Hematological profiles revealed lower red blood cell count, hemoglobin, eosinophils, basophils, monocytes, and lymphocytes in 90 (57%), 103 (65%), 89 (62%), 105 (73%), 35 (24%), and 119 (83%) cases, respectively. The neutrophil count was found to increase in 71.3% of the cases. There was significantly higher mortality (83%) among patients older than 60 years (p=0.001) and in female patients (75%) (p=0.012). Patients with lung diseases had a poor outcome compared to patients with other comorbidities (p=0.002). There was a significant association between elevated D-dimer levels and increased mortality (p=0.003). Elevated levels of AST, creatinine, blood urea nitrogen, and bilirubin were significantly associated with unfavorable outcomes.

Different parameters can be used to predict disease prognosis, especially the risk of poor prognosis. Accurate diagnosis and monitoring of disease progression from the early stages will help in reducing mortality and unfavorable outcomes.

• Covid-19
• Laboratory
• Meta-analysis
• Mortality
• Prognosis
• Survival

• COVID-19/diagnosis
• COVID-19/mortality
• Clinical Laboratory Techniques
• Confidence Intervals
• Humans
• Intensive Care Units/statistics & numerical data
• Odds Ratio
• Prognosis

• EFOP-3.6.2-16-2017-00006 - LIVE LONGER Human Resources Development Operational Programme Grant
• University of Pécs

• COVID-19
• Hepatitis
• Infectious disease
• Liver injury
• Management
• SARS-CoV-2

• COVID-19
• effective features on prediction
• effective features on the mortality
• risk factors

• COVID-19
• SARS-CoV-2
• hematology
• laboratory findings

• COVID-19
• Chemical and Drug Induced Liver Injury/epidemiology
• Coronavirus Infections/complications
• Humans
• Incidence
• Liver Diseases/epidemiology
• Pandemics
• Pneumonia, Viral/complications
• Prevalence

• COVID-19
• chronic liver diseases
• coronaviruses
• infectious disease
• liver injuries
• medical therapy

At the end of 2019, the entire world has witnessed the birth of a new member of coronavirus family in Wuhan, China. Ever since, the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has swiftly invaded every corner on the planet. By the end of April 2020, almost 3.5 million cases have been reported worldwide, with a death toll of about 250,000 deaths. It is currently well-recognized that patient’s immune response plays a pivotal role in the pathogenesis of Coronavirus Disease 2019 (COVID-19). This inflammatory element was evidenced by its elevated mediators that, in severe cases, reach their peak in a cytokine storm. Together with the reported markers of liver injury, such hyperinflammatory state may trigger significant derangements in hepatic cytochrome P450 metabolic machinery, and subsequent modulation of drug clearance that may result in unexpected therapeutic/toxic response. We hypothesize that COVID-19 patients are potentially vulnerable to a significant disease-drug interaction, and therefore, suitable dosing guidelines with therapeutic drug monitoring should be implemented to assure optimal clinical outcomes.

• COVID-19
• Cytochrome P450
• Cytokines
• Drug interaction
• Metabolism
• Pharmacokinetics
• SARS-CoV-2

• Acute liver injury
• COVID-19
• Chronic liver disease
• Liver transplantation
• Risk factors
• SARS-Cov-2

• Betacoronavirus
• COVID-19
• Coronavirus Infections/complications
• Coronavirus Infections/virology
• Gastroenterology/methods
• Humans
• Liver Diseases/virology
• Liver Transplantation
• Pandemics
• Pneumonia, Viral/complications
• Pneumonia, Viral/virology
• SARS-CoV-2