Effectiveness of COVID-19 Vaccination with mRNA Vaccines for Patients with Cirrhosis in Hungary: Multicentre Matched Cohort Study.

Patients with cirrhosis are vulnerable to hepatic decompensation events and death following COVID-19 infection. Therefore, primary vaccination with COVID-19 vaccines is fundamental to reducing the risk of COVID-19 related deaths in patients with cirrhosis. However, limited data are available about the effectiveness of mRNA vaccines compared to other vaccines. The aim of our study was to investigate the efficacy of mRNA vaccines versus other vaccines in cirrhosis. In this retrospective study, we compared clinical characteristics and vaccine effectiveness of 399 COVID-19 patients without cirrhosis (GROUP A) to 52 COVID-19 patients with cirrhosis (GROUP B). 54 hospitalised cirrhosis controls without COVID-19 (GROUP C) were randomly sampled 1:1 and matched by gender and age. Of the cirrhosis cases, we found no difference (p = 0.76) in mortality rates in controls without COVID-19 (11.8%) compared to those with COVID-19 (9.6%). However, COVID-19 patients with cirrhosis were associated with higher rates of worsening hepatic encephalopathy, ascites and esophageal varices. Patients with cirrhosis receiving mRNA vaccines had significantly better survival rates compared to viral vector or inactivated vaccines. Primary vaccination with the BNT162b2 vaccine was the most effective in preventing acute hepatic decompensating events, COVID-19 infection requiring hospital admission and in-hospital mortality.

The Elevated De Ritis Ratio on Admission Is Independently Associated with Mortality in COVID-19 Patients.

Liver damage in COVID-19 patients was documented as increased alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels or an elevated AST/ALT ratio, known as the De Ritis ratio. However, the prognostic value of the elevated De Ritis ratio in COVID-19 patients is still unknown. The aim of our study was to evaluate the prognostic value of the De Ritis ratio compared to other abnormal laboratory parameters and its relation to mortality. We selected 322 COVID-19 patients in this retrospective study conducted between November 2020 and March 2021. The laboratory parameters were measured on admission and followed till patient discharge or death. Of the 322 COVID-19 patients, 57 (17.7%) had gastrointestinal symptoms on admission. The multivariate analysis showed that the De Ritis ratio was an independent risk factor for mortality, with an OR of 29.967 (95% CI 5.266-170.514). In ROC analysis, the AUC value of the the De Ritis ratio was 0.85 (95% CI 0.777-0.923, p < 0.05) with sensitivity and specificity of 80.6% and 75.2%, respectively. A De Ritis ratio ≥1.218 was significantly associated with patient mortality, disease severity, higher AST and IL-6 levels, and a lower ALT level. An elevated De Ritis ratio on admission is independently associated with mortality in COVID-19 patients, indicating liver injury and cytokine release syndrome.

Case report of actinomycotic liver abscess following COVID-19 infection.

Introduction and importance: In the last few years, the novel coronavirus, named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), generated a large health care problem worldwide. Due to the immunomodulation effect of the virus the number of opportunistic infections has also increased. Case presentation: We present the unique case of a patient who was diagnosed with an actinomycotic liver abscess after coronavirus disease 2019 (COVID-19) without the presence of any chronic disease or mucosal injury. Clinical discussion: According to the results of the computer tomography (CT scan) and the liver biopsy, the patient was treated with antibiotics and ultrasound-guided drainage. Conclusion: With this case we would like to draw attention to the possible occurrence of liver abscesses caused by an opportunistic pathogen following COVID-19.

Relationship between the coronavirus epidemic and the use of complementary and alternative medicine prior to elective surgical procedures / A koronavírus-járvány hatása a komplementer terápiás gyógymódok igénybevételére elektív sebészeti mutétek elott.

Összefoglaló. Bevezetés: A 2019 végén Vuhanból kiinduló, SARS-CoV-2 okozta koronavírus-járvány jelentos hatást gyakorolt életünkre. Specifikus terápia hiányában az emberek egy része alternatív gyógymódokhoz fordult. Célkituzés: Vizsgálatunk célja annak feltárása volt, milyen hatást gyakorolt a koronavírus-járvány a betegek komplementer gyógymódokhoz való viszonyulására elektív sebészeti mutétek elott. Módszer: Egy magyarországi klinika és egy városi kórház elektív sebészeti mutétre váró betegei körében végeztünk anonim kérdoíves felmérést 2020. augusztus 3. és december 18. között. 279 kérdoívet dolgoztunk fel, a válaszadási arány 69,7% volt. Eredmények: A koronavírus-járvány hatására a válaszadók 91,4%-ának nem változott meg a véleménye a nem konvencionális kezelésekrol, 8,2%-a bizakodóbban tekintett ezekre. A komplementer terápia betegségmegelozo hatása iránt a kitöltok 16,8%-a volt bizakodó, 25,4%-a elutasító, 57,7%-a nem formált véleményt. A válaszadók 24,7%-a vett igénybe élete során alternatív módszereket, a koronavírus-fertozés megelozésére csak a nyilatkozók 10%-a alkalmazna ilyen gyógymódokat. Kizárólag a pandémia hatására senki nem kezdett el komplementer gyógymódokat használni. A kérdoívet kitöltok 55,6%-a használt gyógynövénykészítményt élete során. A járvány ideje alatt a válaszadók 27,5%-a vett igénybe gyógynövénykészítményeket; a gyógymód alkalmazása és a vizsgált szociodemográfiai tényezok között nem találtunk összefüggést. A gyógynövények alkalmazása alacsonyabb mértéku volt a daganatos és a thromboemboliás betegek között. Következtetés: Vizsgálatunk alapján a komplementer gyógymódok használata feltehetoen a járvány miatt elrendelt korlátozásokból adódóan csökkent, a gyógynövények alkalmazása azonban nem változott lényegesen. A válaszadók tizede használt komplementer gyógymódot a koronavírus-fertozés megelozésére. Orv Hetil. 2021; 162(42): 1678-1686. INTRODUCTION: The coronavirus epidemic caused by SARS-CoV-2 from Wuhan at the end of 2019 had considerable impact on our lives. In the absence of specific therapy, some people have resorted to alternative therapies. OBJECTIVE: The aim of our study was to explore the effect of the coronavirus epidemic on the patients' attitudes toward complementary and alternative medicine. METHOD: We have performed anonymous questionnaire survey among patients of a Hungarian university hospital and a city hospital waiting for elective surgery between August 3, 2020 and December 18, 2020. We received 279 questionnaires, the response rate was 69.7%. RESULTS: As a result of the coronavirus epidemic, 91.4% of the respondents did not change their opinion about complementary and alternative treatments, 8.2% were more optimistic about them. 16.8% of respondents were optimistic, 25.4% rejected, and 57.7% did not form an opinion about the disease-preventing effect of complementary therapy. A quarter of respondents (24.7%) had used complementary therapies in their lifetime, with only 10% of respondents using such therapies to prevent coronavirus infection. As a result of the pandemic, no one started using complementary therapies. 55.6% of the respondents used a herbal preparation during their lifetime. In the course of the epidemic, a high proportion of respondents (27.5%) used herbal preparations; no correlation was found between the use of the treatment and the socio-demographic factors examined. The use of herbs was lower among cancer and thromboembolic patients. CONCLUSION: Based on our study, the use of complementary therapies presumably decreased due to the restrictions imposed in the epidemic, however, the use of herbs did not change significantly. One-tenth of the respondents used naturopathic cure to prevent coronavirus infection. Orv Hetil. 2021; 162(42): 1678-1686.