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1.
Trop Doct ; 52(1): 171-173, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1745564

ABSTRACT

Hepatitis B virus infection is a global problem and causes several liver diseases including acute and chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Though uncommon, some immune mediated extra-hepatic manifestations may develop during the infection. Exudative ascites during HBV infection is one such.


Subject(s)
Carcinoma, Hepatocellular , Hepatitis B, Chronic , Hepatitis B , Liver Neoplasms , Ascites/complications , Ascites/etiology , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/diagnosis , Hepatitis B/complications , Hepatitis B/diagnosis , Hepatitis B virus , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/diagnosis , Humans , Liver Neoplasms/complications , Liver Neoplasms/diagnosis
2.
PLoS One ; 16(12): e0258450, 2021.
Article in English | MEDLINE | ID: covidwho-1581814

ABSTRACT

BACKGROUND AND AIMS: Patients with liver cirrhosis (LC) are considered to be at increased risk for mortality when acquiring SARS-CoV-2 infection and subsequently developing Corona Virus Disease 2019 (COVID-19). During the COVID-19 pandemic, hospitals are regarded as sites with increased risk of infection. Therefore, patient contacts are often limited to urgent indications, which could negatively affect disease monitoring. However, data regarding actual infection rates in cirrhotic patients is limited. The aim of this prospective study was to assess the incidence of COVID-19 in patients with LC with/without hepatocellular carcinoma (HCC) with physical presentation at our University Medical Center. METHODS: Patients were enrolled between 1st April and 30th June 2020 at the University Medical Center Hamburg-Eppendorf, Germany. Symptoms of upper airway infection at baseline and presence of SARS-CoV-2 antibodies (IgG/IgM/IgA) were assessed at baseline and follow-up (FU) using an Electro-chemiluminescence immunoassay (Roche Elecsys). FU visits, including liver function test, clinical assessment and symptom questionnaire, were conducted after 6-8 weeks (FU-1) and 6 months (FU-2). Prior to inclusion of the first patient, obligatory face masks and personal distance were implemented as protective measures. RESULTS: A total of 150 patients were enrolled, 23% (n = 35) also had diagnosis of HCC (median age: 64 years, range: 19-86), 69% were male. Liver function according to Child-Pugh score (CPS) was: CPS A: 46% (n = 62); CPS B: 37% (n = 50); CPS C: 17% (n = 23). Clinical symptoms indicating upper airway infection were present in 53% (n = 77): shortness of breath (n = 40) and coughing (n = 28) were the most frequent. For the 150 patients enrolled, 284 outpatient visits were registered and 33 patients were admitted to the University Medical Center during the follow-up period. After a median of 52 days, n = 110 patients completed FU-1 and n = 72 completed FU-2 after a median of 6.1 months. Only in one patient, an 80-year-old man with stable liver function (CPS A) and advanced HCC, SARS-CoV-2 antibodies were detected at baseline and FU-1, while antibody testing was negative in the remaining patients at baseline, FU-1 and FU-2. CONCLUSION: The incidence of COVID-19 at our tertiary medical center during the pandemic was low in LC and HCC patients, when simple protective measures were implemented. Therefore, a routine care for patients with chronic liver diseases does not increase the risk of SARS-CoV-2 infection and should be maintained with protective measures.


Subject(s)
COVID-19/epidemiology , Carcinoma, Hepatocellular/virology , Liver Cirrhosis/virology , Adult , Aged , Aged, 80 and over , Carcinoma, Hepatocellular/complications , Cohort Studies , Female , Germany/epidemiology , Humans , Incidence , Liver Cirrhosis/complications , Liver Neoplasms/complications , Liver Neoplasms/virology , Male , Middle Aged , Pandemics , Prospective Studies , SARS-CoV-2/pathogenicity , Tertiary Care Centers/trends
3.
In Vivo ; 35(6): 3377-3383, 2021.
Article in English | MEDLINE | ID: covidwho-1485630

ABSTRACT

BACKGROUND/AIM: Liver injury has been frequently reported in association with SARS-CoV-2 infection, but data are still lacking regarding the impact of pre-existing liver damage and neoplasia on SARS-CoV-2 infection outcome and vice-versa. This study aimed to assess the effects of SARS-CoV-2 infection on hepatocellular carcinoma (HCC) in chronic hepatitis C virus (HCV) infected patients, both in therapeutic-naïve and patients treated with direct acting antivirals. PATIENTS AND METHODS: We conducted a retrospective cohort study on 21 patients with a personal history of HCV infection, that have been diagnosed with different forms of HCC and who were subsequently infected with SARS-CoV-2. Patients were monitored by liver function tests, tumoral markers, blood cell count, and coagulation profile periodically. RESULTS: Solitary HCC nodules were predominant among the subjects who achieved sustained virologic response, while multinodular and infiltrative patterns were mostly prevalent among the treatment-naïve group. Most patients had mild and moderate COVID-19 infections. CONCLUSION: Within the current global pandemic crisis, cancer patients are highly vulnerable and in need of constant monitoring. Among patients with HCC, the ones with cured HCV infection may be at a lower risk of fatality than those with active HCV infection, when diagnosed with SARS-CoV-2 infection.


Subject(s)
COVID-19 , Carcinoma, Hepatocellular , Hepatitis C, Chronic , Hepatitis C , Liver Neoplasms , Antiviral Agents/therapeutic use , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/drug therapy , Carcinoma, Hepatocellular/epidemiology , Hepatitis C, Chronic/complications , Hepatitis C, Chronic/drug therapy , Hepatitis C, Chronic/epidemiology , Humans , Liver Cirrhosis/drug therapy , Liver Neoplasms/complications , Liver Neoplasms/drug therapy , Liver Neoplasms/epidemiology , Retrospective Studies , SARS-CoV-2
4.
PLoS One ; 16(9): e0257369, 2021.
Article in English | MEDLINE | ID: covidwho-1416897

ABSTRACT

Australia was one of the first countries to introduce government-funded unrestricted access to direct-acting antiviral (DAA) therapy, with 88,790 treated since March 2016. However, treatment uptake is declining which could potentially undermine Australia's progress towards the WHO HCV elimination targets. Using mathematical modelling, we updated estimates for those living with chronic HCV in Australia, new cases of decompensated cirrhosis (DC), hepatocellular carcinoma (HCC), and liver-related mortality among the HCV-cured and viraemic populations from 2015 to 2030. We considered various DAA treatment scenarios incorporating annual treatment numbers to 2020, and subsequent uptake per year of 6,790 (pessimistic), 8,100 (intermediate), and 11,310 (optimistic). We incorporated the effects of excess alcohol consumption and reduction in progression to DC and HCC among cirrhosis-cured versus viraemic individuals. At the end of 2020, we estimated 117,810 Australians were living with chronic HCV. New cases per year of DC, HCC, and liver-related mortality among the HCV viraemic population decreased rapidly from 2015 (almost eliminated by 2030). In contrast, the growing population size of those cured with advanced liver disease meant DC, HCC, and liver-related mortality declined slowly. The estimated reduction in liver-related mortality from 2015 to 2030 in the combined HCV viraemic and cured population is 25% in the intermediate scenario. With declining HCV treatment uptake and ongoing individual-level risk of advanced liver disease complications, including among cirrhosis-cured individuals, Australia is unlikely to achieve all WHO HCV elimination targets by 2030.


Subject(s)
Antiviral Agents/therapeutic use , Hepatitis C, Chronic/epidemiology , Hepatitis C, Chronic/prevention & control , Australia/epidemiology , Calibration , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/drug therapy , Carcinoma, Hepatocellular/epidemiology , Carcinoma, Hepatocellular/mortality , Disease Progression , Epidemics , Epidemiological Monitoring , Hepacivirus , Hepatitis C, Chronic/drug therapy , Hepatitis C, Chronic/mortality , Humans , Incidence , Liver Cirrhosis/complications , Liver Cirrhosis/drug therapy , Liver Cirrhosis/epidemiology , Liver Cirrhosis/mortality , Liver Neoplasms/complications , Liver Neoplasms/drug therapy , Liver Neoplasms/epidemiology , Liver Neoplasms/mortality , Models, Theoretical , Prevalence , Treatment Outcome , World Health Organization
5.
Cancer Res Treat ; 53(3): 650-656, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1403959

ABSTRACT

PURPOSE: Coronavirus disease 2019 (COVID-19) pandemic has spread worldwide rapidly and patients with cancer have been considered as a vulnerable group for this infection. This study aimed to examine the expressions of angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2) in tumor tissues of six common cancer types. MATERIALS AND METHODS: The expression levels of ACE2 and TMPRSS2 in tumors and control samples were obtained from online databases. Survival prognosis and biological functions of these genes were investigated for each tumor type. RESULTS: There was the overexpression of ACE2 in colon and stomach adenocarcinomas compared to controls, meanwhile colon and prostate adenocarcinomas showed a significantly higher expression of TMPRSS2. Additionally, survival prognosis analysis has demonstrated that upregulation of ACE2 in liver hepatocellular carcinoma was associated with higher overall survival (hazard ratio, 0.65; p=0.016) and disease-free survival (hazard ratio, 0.66; p=0.007), while overexpression of TMPRSS2 was associated with a 26% reduced risk of death in lung adenocarcinoma (p=0.047) but 50% increased risk of death in breast invasive carcinoma (p=0.015). CONCLUSION: There is a need to take extra precautions for COVID-19 in patients with colorectal cancer, stomach cancer, and lung cancer. Further information on other types of cancer at different stages should be investigated.


Subject(s)
Angiotensin-Converting Enzyme 2/genetics , COVID-19/diagnosis , Neoplasms/diagnosis , Neoplasms/genetics , Serine Endopeptidases/genetics , Adenocarcinoma/complications , Adenocarcinoma/diagnosis , Adenocarcinoma/epidemiology , Adenocarcinoma/genetics , Breast Neoplasms/complications , Breast Neoplasms/diagnosis , Breast Neoplasms/epidemiology , Breast Neoplasms/genetics , COVID-19/complications , COVID-19/epidemiology , COVID-19/genetics , Case-Control Studies , Databases as Topic , Female , Gastrointestinal Neoplasms/complications , Gastrointestinal Neoplasms/diagnosis , Gastrointestinal Neoplasms/epidemiology , Gastrointestinal Neoplasms/genetics , Gene Expression Regulation, Neoplastic , Genetic Predisposition to Disease , Humans , Liver Neoplasms/complications , Liver Neoplasms/diagnosis , Liver Neoplasms/epidemiology , Liver Neoplasms/genetics , Lung Neoplasms/complications , Lung Neoplasms/diagnosis , Lung Neoplasms/epidemiology , Lung Neoplasms/genetics , Male , Mutation , Neoplasms/complications , Neoplasms/epidemiology , Pandemics , Prognosis , Prostatic Neoplasms/complications , Prostatic Neoplasms/diagnosis , Prostatic Neoplasms/epidemiology , Prostatic Neoplasms/genetics , Retrospective Studies , SARS-CoV-2/physiology , Survival Analysis
6.
Medicine (Baltimore) ; 100(21): e26143, 2021 May 28.
Article in English | MEDLINE | ID: covidwho-1242124

ABSTRACT

INTRODUCTION: Coronavirus disease 2019 (COVID-19) is a rapidly emerging infectious respiratory disease caused by severe acute respiratory syndrome coronavirus 2. Currently, more than 100 million cases of COVID-19 have been confirmed worldwide, with over 2.4 million mortalities. The pandemic affects people of all ages but older individuals and those with severe chronic illnesses, including cancer patients, are at higher risk. PATIENT CONCERNS: The impact of cancer treatment on the progression of COVID-19 is unclear. Therefore, we assessed the effects of chemotherapy on COVID-19 outcomes for 2 cancer patients. On January 24, 2020, a level I response to a major public health emergency was initiated in Hubei Province, China, which includes Enshi Autonomous Prefecture that has a population of 4.026 million people. As of April 30, 2020, 252 confirmed cases of COVID-19 and 11 asymptomatic carriers were identified in Enshi. DIAGNOSIS: Among the confirmed cases and asymptomatic carriers, 2 patients were identified who were previously diagnosed with malignant tumors, including one with hepatocellular carcinoma and the other with cardia carcinoma. INTERVENTIONS: These 2 patients were receiving or just completed chemotherapy at the time of their COVID-19 diagnosis. OUTCOMES: Both patients were followed and presented favorable outcomes. The positive outcomes for these 2 patients could be partially explained by their recent chemotherapy that impacted their immune status. Also, their relatively younger ages and lack of comorbidities were likely factors in their successful recovery from COVID-19. CONCLUSIONS: Anticancer treatment might enhance a patient's ability to respond favorably to COVID-19 infection. However, anticancer treatment is likely to impact immune function differently in different individuals, which can influence disease outcomes.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols/therapeutic use , COVID-19/immunology , Liver Neoplasms/drug therapy , SARS-CoV-2/immunology , Stomach Neoplasms/drug therapy , Adult , COVID-19/complications , COVID-19/diagnosis , COVID-19/drug therapy , COVID-19 Nucleic Acid Testing , Cyclobutanes/therapeutic use , Docetaxel/therapeutic use , Drug Therapy, Combination/methods , Humans , Liver Neoplasms/complications , Liver Neoplasms/immunology , Lung/diagnostic imaging , Male , Middle Aged , Organoplatinum Compounds/therapeutic use , RNA, Viral/isolation & purification , SARS-CoV-2/genetics , SARS-CoV-2/isolation & purification , Sorafenib/therapeutic use , Stomach Neoplasms/complications , Stomach Neoplasms/immunology , Tomography, X-Ray Computed , Treatment Outcome
8.
Hepatol Int ; 14(6): 920-929, 2020 Dec.
Article in English | MEDLINE | ID: covidwho-919762

ABSTRACT

BACKGROUND: COVID-19 has been giving the devastating impact on the current medical care system. There are quite many guidelines on COVID-19, but only a few on the management of hepatocellular carcinoma (HCC) during COVID-19 pandemic. AIMS: We develop these recommendations to preserve adequate clinical practice for the management of HCC. METHODS: Experts of HCC in the Asia-Pacific region exchanged opinions via webinar, and these recommendations were formed. RESULTS: Close contact should be minimized to reduce possible exposure of both medical staff and patients to the novel coronavirus. To prevent transmission of the virus, meticulous hygiene measures are important. With the decrease in regular medical service, the medical staff may be mobilized to provide COVID-19-related patient care. However, diagnosis and treatment of HCC should not be delayed because of COVID-19 pandemic. The management of HCC should be the same as in non-pandemic circumstances. HCC is highly malignant, thus it is recommended not to delay curative treatment such as surgery and ablation. However, a kind of triage is necessary even among patients with HCC when resources are insufficient for all to be treated. Curative treatments should be periodized and cytoreductive or non-curative treatment such as vascular interventions and systemic therapy may be postponed until it can be performed safely with sufficient resources. For patients with confirmed or suspected to be infected with the novel coronavirus, diagnosis and treatment should be postponed until the virus is eliminated or they are confirmed as not being infected with it. CONCLUSIONS: These are collection of measures implemented by front-line medical professionals. We would evolve these recommendations over time as more real-world data becomes available.


Subject(s)
COVID-19 , Carcinoma, Hepatocellular/diagnosis , Carcinoma, Hepatocellular/therapy , Liver Neoplasms/diagnosis , Liver Neoplasms/therapy , COVID-19/complications , Carcinoma, Hepatocellular/complications , Humans , Liver Neoplasms/complications
9.
Bull Cancer ; 107(10): 1019-1023, 2020 Oct.
Article in French | MEDLINE | ID: covidwho-797097

ABSTRACT

In this review, we report a case of a bone's metastatic breast cancer in Malian patient treated by chemotherapy in whom SRAS-COV-2's diagnosis was made 9days after the onset gastrointestinal symptoms. Patient quickly died before any COVID-19's treatment. According to the poor outcomes of cancer patients with COVID-19, authors emphasize to an intensive attention to such patients in order to find the best therapeutic balance between the two pathologies during this pandemic.


Subject(s)
Betacoronavirus , Breast Neoplasms/complications , Carcinoma, Ductal, Breast/secondary , Coronavirus Infections/complications , Diarrhea/etiology , Pandemics , Pneumonia, Viral/complications , Spinal Neoplasms/secondary , Vomiting/etiology , Adult , Antineoplastic Agents, Phytogenic/therapeutic use , Bone Density Conservation Agents/therapeutic use , Breast Neoplasms/drug therapy , COVID-19 , Carcinoma, Ductal, Breast/complications , Carcinoma, Ductal, Breast/drug therapy , Docetaxel/therapeutic use , Fatal Outcome , Female , HIV Infections/complications , Humans , Liver Neoplasms/complications , Liver Neoplasms/diagnostic imaging , Liver Neoplasms/drug therapy , Liver Neoplasms/secondary , SARS-CoV-2 , Spinal Neoplasms/complications , Spinal Neoplasms/diagnostic imaging , Spinal Neoplasms/drug therapy , Tomography, X-Ray Computed , Zoledronic Acid/therapeutic use
10.
Pediatr Transplant ; 25(5): e13880, 2021 08.
Article in English | MEDLINE | ID: covidwho-796050

ABSTRACT

We describe the successful pediatric liver transplant for unresectable hepatoblastoma in a 4-year-old male with COVID-19 prior to transplant. The first negative NP swab was documented 1 month after initial diagnosis, when SARS-CoV-2 antibodies were also detected. The patient was actively listed for liver transplant after completing four blocks of a SIOPEL-4 based regimen due to his PRETEXT IV disease which remained unresectable. Following three additional negative NP swabs and resolution of symptoms for 4 weeks, he underwent a whole-organ pediatric liver transplant. COVID-19 positivity determined via NP swab SARS-CoV-2 real-time RT-PCR (Hologic Aptima SARS-CoV-2 RT-PCR assay). IgG and IgM total SARS- CoV-2 antibodies detected by Ortho Clinical Diagnostics VITROS® Immunodiagnostics Products Anti-SARS-CoV-2 Test. Patient received standard prednisone and tacrolimus-based immunosuppression without induction therapy following transplant. Post-transplant course was remarkable for neutropenia and thrombocytopenia, with discharge home on post-transplant day #11. Surveillance tests have remained negative with persistent SARS-CoV-2 IgG antibodies at 6 weeks after transplant. We describe one of the earliest, if not the first case of liver transplant following recent recovery from COVID-19 in a pediatric patient with a lethal malignant liver tumor. A better understanding of how to balance the risk profile of transplant in the setting of COVID-19 with disease progression if transplant is not performed is needed. We followed existing ASTS guidelines to document clearance of the viral infection and resolution of symptoms before transplant. This case highlights that pediatric liver transplantation can be safely performed upon clearance of COVID-19.


Subject(s)
COVID-19/therapy , Hepatoblastoma/surgery , Liver Neoplasms/surgery , Liver Transplantation/methods , COVID-19/complications , COVID-19 Testing , Child, Preschool , Disease Progression , Hepatoblastoma/complications , Humans , Immunoglobulin G , Immunoglobulin M , Immunosuppressive Agents/administration & dosage , Liver Neoplasms/complications , Male , Neutropenia/complications , Prednisone/administration & dosage , Tacrolimus/administration & dosage , Thrombocytopenia/complications , Treatment Outcome
12.
HPB (Oxford) ; 22(8): 1128-1134, 2020 08.
Article in English | MEDLINE | ID: covidwho-592305

ABSTRACT

BACKGROUND: The extent of the COVID-19 pandemic and the resulting response has varied globally. The European and African Hepato-Pancreato-Biliary Association (E-AHPBA), the premier representative body for practicing HPB surgeons in Europe and Africa, conducted this survey to assess the impact of COVID-19 on HPB surgery. METHODS: An online survey was disseminated to all E-AHPBA members to assess the effects of the pandemic on unit capacity, management of HPB cancers, use of COVID-19 screening and other aspects of service delivery. RESULTS: Overall, 145 (25%) members responded. Most units, particularly in COVID-high countries (>100,000 cases) reported insufficient critical care capacity and reduced HPB operating sessions compared to COVID-low countries. Delayed access to cancer surgery necessitated alternatives including increased neoadjuvant chemotherapy for pancreatic cancer and colorectal liver metastases, and locoregional treatments for hepatocellular carcinoma. Other aspects of service delivery including COVID-19 screening and personal protective equipment varied between units and countries. CONCLUSION: This study demonstrates that the COVID-19 pandemic has had a profound adverse impact on the delivery of HPB cancer care across the continents of Europe and Africa. The findings illustrate the need for safe resumption of cancer surgery in a "new" normal world with screening of patients and staff for COVID-19.


Subject(s)
Betacoronavirus , Biliary Tract Neoplasms/surgery , Coronavirus Infections/complications , Digestive System Surgical Procedures/methods , Liver Neoplasms/surgery , Pancreatic Neoplasms/surgery , Pneumonia, Viral/complications , Africa/epidemiology , Biliary Tract Neoplasms/complications , COVID-19 , Coronavirus Infections/epidemiology , Cross-Sectional Studies , Delivery of Health Care/methods , Europe/epidemiology , Female , Humans , Liver Neoplasms/complications , Male , Pancreatic Neoplasms/complications , Pandemics , Pneumonia, Viral/epidemiology , SARS-CoV-2 , Societies, Medical
14.
Am J Transplant ; 20(7): 1916-1921, 2020 07.
Article in English | MEDLINE | ID: covidwho-210165

ABSTRACT

Over 1 000 000 cases of coronavirus disease 2019 (COVID-19) have been confirmed since the worldwide outbreak began. Not enough data on infected solid organ transplant (SOT) recipients are available, especially data about the management of immunosuppressants. We report two cases of COVID-19 in two transplant recipients, with different treatments and prognoses. The first patient received liver transplantation due to hepatitis B virus-related hepatocellular carcinoma and was confirmed to have COVID-19 9 days later. Following a treatment regimen consisting of discontinued immunosuppressant use and low-dose methylprednisolone-based therapy, the patient developed acute rejection but eventually recovered. The other patient had undergone a renal transplant from a living-related donor 17 years ago, and was admitted to the hospital because of persistent fever. This patient was also diagnosed with COVID-19. His treatment regimen consisted of reduced immunosuppressant use. No signs of rejection were observed during the regimen. In the end, the patient successfully recovered from COVID-19. These effectively treated cases can provide a basis for immunosuppressant management of COVID-19-positive SOT recipients.


Subject(s)
Coronavirus Infections/complications , Coronavirus Infections/therapy , Immunosuppressive Agents/therapeutic use , Organ Transplantation , Pneumonia, Viral/complications , Pneumonia, Viral/therapy , Transplant Recipients , Adult , Betacoronavirus , COVID-19 , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/surgery , Hepatitis B/complications , Hepatitis B/surgery , Hepatitis B virus , Humans , Kidney Failure, Chronic/complications , Kidney Failure, Chronic/surgery , Kidney Transplantation , Liver Neoplasms/complications , Liver Neoplasms/surgery , Liver Transplantation , Male , Methylprednisolone/administration & dosage , Middle Aged , Pandemics , Prognosis , SARS-CoV-2 , Treatment Outcome
15.
Am J Transplant ; 20(8): 2254-2259, 2020 08.
Article in English | MEDLINE | ID: covidwho-155106

ABSTRACT

The novel coronavirus disease 2019 (COVID-19) is a highly infectious and rapidly spreading disease. There are limited published data on the epidemiology and outcomes of COVID-19 infection among organ transplant recipients. After initial flulike symptoms, progression to an inflammatory phase may occur, characterized by cytokine release rapidly leading to respiratory and multiorgan failure. We report the clinical course and management of a liver transplant recipient on hemodialysis, who presented with COVID-19 pneumonia, and despite completing a 5-day course of hydroxychloroquine, later developed marked inflammatory manifestations with rapid improvement after administration of off-label, single-dose tocilizumab. We also highlight the role of lung ultrasonography in early diagnosis of the inflammatory phase of COVID-19. Future investigation of the effects of immunomodulators among transplant recipients with COVID-19 infection will be important.


Subject(s)
Antibodies, Monoclonal, Humanized/therapeutic use , Coronavirus Infections/complications , Liver Transplantation , Pneumonia, Viral/complications , Renal Dialysis , Transplant Recipients , COVID-19 , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/surgery , Coronavirus Infections/drug therapy , Hepatitis C/complications , Hepatitis C/surgery , Humans , Hydroxychloroquine/therapeutic use , Inflammation , Liver Cirrhosis/complications , Liver Cirrhosis/surgery , Liver Neoplasms/complications , Liver Neoplasms/surgery , Male , Middle Aged , Pandemics , Pneumonia, Viral/drug therapy , Reoperation , Treatment Outcome
16.
Singapore Med J ; 61(12): 619-623, 2020 12.
Article in English | MEDLINE | ID: covidwho-145282

ABSTRACT

In this paper, we aim to provide professional guidance to clinicians who are managing patients with chronic liver disease during the current coronavirus disease 2019 (COVID-19) pandemic in Singapore. We reviewed and summarised the available relevant published data on liver disease in COVID-19 and the advisory statements that were issued by major professional bodies, such as the American Association for the Study of Liver Diseases and European Association for the Study of the Liver, contextualising the recommendations to our local situation.


Subject(s)
COVID-19/complications , Liver Diseases/therapy , COVID-19/epidemiology , Carcinoma, Hepatocellular/complications , Carcinoma, Hepatocellular/therapy , Chronic Disease , Hepatitis B, Chronic/complications , Hepatitis B, Chronic/therapy , Hepatitis C, Chronic/complications , Hepatitis C, Chronic/therapy , Humans , Liver Cirrhosis/complications , Liver Cirrhosis/therapy , Liver Diseases/etiology , Liver Neoplasms/complications , Liver Neoplasms/therapy , Liver Transplantation , Singapore/epidemiology
17.
Am J Transplant ; 20(7): 1907-1910, 2020 07.
Article in English | MEDLINE | ID: covidwho-47494

ABSTRACT

Liver injury is common in patients with COVID-19, but little is known about its clinical presentation and severity in the context of liver transplant. We describe a case of COVID-19 in a patient who underwent transplant 3 years ago for hepatocellular carcinoma. The patient came to clinic with symptoms of respiratory disease; pharyngeal swabs for severe acute respiratory syndrome coronavirus 2 were positive. His disease progressed rapidly from mild to critical illness and was complicated by several nosocomial infections and multiorgan failure. Despite multiple invasive procedures and rescue therapies, he died from the disease. The management of COVID-19 in the posttransplant setting presents complex challenges, emphasizing the importance of strict prevention strategies.


Subject(s)
Carcinoma, Hepatocellular/complications , Coronavirus Infections/complications , End Stage Liver Disease/complications , Hepatitis B/complications , Liver Neoplasms/complications , Liver Transplantation , Pneumonia, Viral/complications , Betacoronavirus , COVID-19 , Carcinoma, Hepatocellular/surgery , Coronavirus Infections/therapy , Cross Infection/complications , End Stage Liver Disease/surgery , Fatal Outcome , Hepatitis B/surgery , Humans , Immunocompromised Host , Immunosuppressive Agents/therapeutic use , Liver Neoplasms/surgery , Male , Middle Aged , Pandemics , Pneumonia, Viral/therapy , Postoperative Complications , Radiography, Thoracic , SARS-CoV-2 , Tomography, X-Ray Computed , Transplant Recipients , Treatment Outcome
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