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.

Adsorption kinetics of 20 glucocorticoids at environmentally relevant concentrations in wastewater by powdered activated carbons and development of surrogate models.

Glucocorticoids (GCs) are widely used in the treatment of the coronavirus disease of 2019 (COVID-19), and the toxicity of GCs to aquatic organisms has aroused widespread concern. Powdered activated carbon (PAC) has proven effective in removing various trace organic pollutants. In this study, the adsorption behaviors of 20 typical GCs onto PACs were investigated at environmentally relevant concentrations (ng/L) in real wastewater, using four commercially available PACs (HDB, WPH, 20BF, PWA). The results showed that PAC adsorption was feasible for GC removal at ng/L concentrations. After adsorption for 60 min, the GC removal efficiencies obtained by HDB, WPH, 20BF, and PWA were 90-98 %, 89-97 %, 84-96 %, and 71-90 %, respectively. The adsorption processes of 20 GCs on PACs were well fitted by the pseudo-second-order kinetics model (with R 2 >0.98). Among the four PACs, HDB achieved the highest rates because of the electrostatic attraction between HDB (positively charged) and the complex of GCs and natural organic matter (GC-NOM, negatively charged). Among the 20 GCs, compounds with substitutions of halogen atoms or five-membered rings at C-17 achieved higher adsorption rates because of the enhanced formation of hydrogen bonds and a resulting increase in electron density. In addition, surrogate models with total fluorescence (TF) and ultraviolet absorbance at 254 nm (UV254) were developed to monitor the attenuation trend of GCs during adsorption processes. Compared with the UV254 model, the TF model showed better sensitivity to GC monitoring, which could greatly simplify the water quality monitoring process and facilitate online monitoring of GCs in water.

Exploring the impacts of COVID-19 on the lifestyles of community-living adults in Singapore: A qualitative study.

INTRODUCTION: Disruptions caused by the COVID-19 pandemic have not only restricted people from performing occupations but also adversely affected their health and quality of life. However, the impact of the pandemic on Singaporean adults at different life stages remains unclear. This study aimed to understand the impact of COVID-19 on a range of community-living age groups' occupations and sense of well-being. METHODS: Community-living adults in Singapore were invited to participate in this qualitative descriptive study. Thematic analysis was conducted to generate themes and identify common patterns (e.g. impacts on different occupations) in different age groups. FINDINGS: Twenty-nine semi-structured interviews (young adults: 10, middle-aged adults: 10, older adults: 9) were conducted and thematically analysed, revealing three main themes: (1) impact on occupations, (2) impacts on personal well-being, and (3) responses to COVID-19 situation. Participants from all age groups experienced both positive and negative impacts across various occupations, such as productivity (work and study), leisure, and self-care activities. Young and middle-aged adults were less affected as they were more proficient in using technology to make adequate adaptations. Older adults were least equipped with coping strategies and thus the most compromised. In response to the impacts of the pandemic on occupations and well-being, participants from different age groups adjusted differently (e.g. adopting a sedentary lifestyle and developing different coping strategies). CONCLUSION: This study identified the impacts of COVID-19 on the daily occupations of Singaporean adults and how it is intricately linked with their well-being. Findings also revealed the significant role of technology in adapting to the COVID-19 situation. The younger Singaporean adults were more agile to make occupational changes and adaptations. More can be done by occupational therapists to assist community-living older adults to enable continued participation in meaningful occupations during pandemics.