Liver function tests in COVID 19: A retrospective record-based study from a tertiary care centre in urban Maharashtra, India.

Background: COVID-19 is a multi system disorder and causes various abnormalities in liver function tests. The aim of this study was to estimate the prevalence of abnormal liver function tests in patients of COVID-19 and to describe the association of liver function tests with clinical features and disease severity in these patients. Methods: We retrospectively evaluated and analyzed the liver function tests of all real-time polymerase chain reaction (RT-PCR) positive COVID-19 patients admitted to a tertiary care hospital in Western Maharashtra. The Institutional Ethics Committee of our hospital approved the study. Results: Of the 533 patients included in our study, 50% had abnormal albumin levels while 40.1%, 43.5%, 9.3%, and 6.3% patients had deranged alanine transaminase (ALT) aspartate transaminase (AST), total protein and bilirubin levels, respectively. Hepatocellular injury was observed in 21 (3.9%) patients, and cholestatic liver injury was observed in seven (1.3%) patients. Abnormal liver function test (LFT) was significantly associated with disease severity but not with mortality. Conclusion: Abnormal LFT in patients of COVID-19 is associated with severe disease but not mortality. Liver injury is common in patients of COVID-19.

Clinical complications seen in patients after recovery from coronavirus disease 2019: Experience from a COVID care center.

We have had recent experience that patients who have recovered from coronavirus disease 2019 (COVID-19) infection are being readmitted with thromboembolic complications, and some have had sudden cardiac death. There is paucity of literature on such presentations after clinical and microbiological recovery. In the present case series, we present five such patients recently managed at our COVID-19 care facility. All the patients described were elderly (mean age: 66 years) with multiple comorbidities (mean Charlson Comorbidity Index score: 3.5). Two were initially managed at another COVID care facility and discharged. They were admitted at our center within one week of discharge. One patient who was managed at our center was discharged and then readmitted. The other two had recovered from their illness and were planned for discharge (mean duration of hospital stay in initial admission: 14.4 days). All presented within one week of clinical and microbiological recovery (mean: 4.2 days). All were on adequate anticoagulation during initial presentation. All these patients had raised D-dimer levels (three suffered sudden cardiac arrest, one had a confirmed pulmonary thromboembolism, and one had acute ST-elevation myocardial infarction). Thromboembolic complications should be considered an important differential diagnosis in all patients who present with any complication in the immediate follow-up period of recovery from COVID-19 disease. Repeat analysis of D-dimer levels at follow-up may be considered in those who recovered from severe disease. Extended period of anticoagulation and close follow-up may be considered in all patients with COVID-19 who are at high risk of developing thromboembolic complications.

Phytochemistry and pharmacological activity of the genus artemisia.

Artemisia and its allied species have been employed for conventional medicine in the Northern temperate regions of North America, Europe, and Asia for the treatments of digestive problems, morning sickness, irregular menstrual cycle, typhoid, epilepsy, renal problems, bronchitis malaria, etc. The multidisciplinary use of artemisia species has various other health benefits that are related to its traditional and modern pharmaceutical perspectives. The main objective of this review is to evaluate the traditional, modern, biological as well as pharmacological use of the essential oil and herbal extracts of Artemisia nilagirica, Artemisia parviflora, and other allied species of Artemisia. It also discusses the botanical circulation and its phytochemical constituents viz disaccharides, polysaccharides, glycosides, saponins, terpenoids, flavonoids, and carotenoids. The plants have different biological importance like antiparasitic, antimalarial, antihyperlipidemic, antiasthmatic, antiepileptic, antitubercular, antihypertensive, antidiabetic, anxiolytic, antiemetic, antidepressant, anticancer, hepatoprotective, gastroprotective, insecticidal, antiviral activities, and also against COVID-19. Toxicological studies showed that the plants at a low dose and short duration are non or low-toxic. In contrast, a high dose at 3 g/kg and for a longer duration can cause toxicity like rapid respiration, neurotoxicity, reproductive toxicity, etc. However, further in-depth studies are needed to determine the medicinal uses, clinical efficacy and safety are crucial next steps.

Therapeutic Approach Against 2019-nCoV by Inhibition of the ACE-2 receptor.

The continued spread of the 2019 novel coronavirus (2019-nCoV) has prompted global concern. The formal name given to 2019-nCoV by the World Health Organization is COVID-19, while the International Committee on Taxonomy has named it severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Due to this viral attack, nations around the world have issued lockdown restrictions. Presently, there is no effective way to control the spread of 2019-nCoV, except through social distancing and hygienic activities. World-class scientists and researchers are trying to develop vaccines and medicines that will cure this deadly viral disease and control its spread. Our aim in presenting this article is to provide an easy therapeutic approach that effectively combats deadly viral diseases, such as COVID-19, with minimal intervention and effort. Different Ayurvedic therapeutic agents (Curcuma longa L, green tea, and Piper nigrum) inhibit the entry of viruses in the host cell and the transmission of pathogens, while improving immunity. Curcumin and piperine (1-piperoylpiperidine) interact with each other and form a π-π intermolecular complex that enhances the bioavailability of curcumin by inhibition of glucuronidation of curcumin in the liver. Two molecules, curcumin and catechin, bind directly to the receptor-binding domain of the S-protein and the angiotensin-converting enzyme 2 receptor of the host cell, by which these molecules inhibit the entry of viruses in the host cell. As a result, the animal host will survive the infection.

Therapeutic Approach against 2019-nCoV by Inhibition of ACE-2 Receptor.

The continued spread of 2019-nCoV has prompted widespread concern around the world. WHO formally named COVID-19 and International Committee on Taxonomy called it Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). Due to this viral attack, the whole world is in lockdown. Presently, there is no effective way to control it, except social distancing and hygienic activity. World class scientists and researchers are trying to make vaccine and discover the medicine against the control and cure to this deadly viral disease. Our aim to presenting this article is kick-off deadly viral disease i.e COVID-19 by an easy way with minimum intervention and effort. Different ayurvedic therapeutic agents (Curcuma Longa L, Green tea and Piper nigrum) inhabit entry of virus in host cell, transmission of pathogen and improve the immunity. Curcumin and piperine (1-piperoylpiperidine) interact to each other and form a π-π intermolecular complex which enhance the bioavailability of curcumin by inhibition of glucuronidation of curcumin in liver. Both the molecules curcumin and catechin get bound directly to receptors binding domain of S-protein and ACE-2 receptors of host cell, due to which these molecules inhibit the entry of virus in host cell i. e. animal survives from being infected.

The Interrelation of Neurological and Psychological Symptoms of COVID-19: Risks and Remedies.

COVID-19 has catastrophically affected the world's panoramic view of human well-being in terms of healthcare and management. With the increase in the number of cases worldwide, neurological symptoms and psychological illnesses from COVID-19 have increasingly upsurged. Mental health illness and affective disorders, including depression, obsessive-compulsive disorder, anxiety, phobia, and panic disorders, are highly impacted due to social distress. The COVID-19 pandemic not only affected people with pre-existing mental and affective illnesses, but also healthy individuals with anxiety, worrying, and panic symptoms, and fear conditioning. In addditon, the novel coronavirus is known to impact the central nervous system in the brain, resulting in severe and certain long-lasting neurological issues. Owing to the significance of neurological and psychological events, the present perspective has been an attempt to disseminate the impact of COVID-19 on neural injury through inflammation, and its interrelation with psychological symptoms. In this current review, we synthesize the literature to highlight the critical associations between SARS-CoV-2 infection and the nervous system, and mental health illness, and discuss potential mechanisms of neural injury through psycho-neuroimmunity.