RESUMEN
The SARS-CoV-2 pandemic has proven to be a serious challenge for the Spanish healthcare system. The impact of the virus on the liver is not well known, but in patients with chronic liver disease, mostly in advanced stages, it can critically compromise survival and trigger decompensation. Treatment in this subpopulation is complex due to the potential hepatotoxicity of some of the medicinal products used. Moreover, the pandemic has also negatively impacted patients with liver disease who have not contracted COVID-19, since the reallocation of human and material resources to the care of patients with the virus has resulted in a decrease in the treatment, diagnosis and follow-up of patients with liver disease, which will surely have negative consequences in the near future. Efficient reorganization of hepatology units is a priority to minimise the impact of the pandemic on a population as vulnerable as liver disease patients.
Asunto(s)
Betacoronavirus , Infecciones por Coronavirus/epidemiología , Hepatopatías/epidemiología , Pandemias , Neumonía Viral/epidemiología , Adenosina Monofosfato/efectos adversos , Adenosina Monofosfato/análogos & derivados , Adenosina Monofosfato/uso terapéutico , Factores de Edad , Alanina/efectos adversos , Alanina/análogos & derivados , Alanina/uso terapéutico , Antivirales/efectos adversos , Antivirales/uso terapéutico , Conductos Biliares/virología , COVID-19 , Enfermedad Hepática Inducida por Sustancias y Drogas/etiología , Enfermedad Crónica , Comorbilidad , Infecciones por Coronavirus/tratamiento farmacológico , Susceptibilidad a Enfermedades , Gastroenterología/organización & administración , Recursos en Salud/provisión & distribución , Hepatitis Crónica/tratamiento farmacológico , Hepatitis Crónica/epidemiología , Humanos , Inmunosupresores/efectos adversos , Hígado/efectos de los fármacos , Hígado/patología , Hígado/virología , Pruebas de Función Hepática , Trasplante de Hígado , Obesidad/epidemiología , Asignación de Recursos , Factores de Riesgo , SARS-CoV-2 , Tratamiento Farmacológico de COVID-19RESUMEN
The burden and impact of secondary superadded infections in critically ill coronavirus disease 2019 (COVID-19) patients is widely acknowledged. However, there is a dearth of information regarding the impact of COVID-19 in patients with tuberculosis, HIV, chronic hepatitis, and other concurrent infections. This review was conducted to evaluate the consequence of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in patients with concurrent co-infections based on the publications reported to date. An extensive comprehensive screening was conducted using electronic databases up to 3rd September 2020 after obtaining registration with PROSPERO (CRD420202064800). The observational studies or interventional studies in English, evaluating the impact of SARS-CoV-2 in patients with concurrent infections are included for the meta-analyses. Our search retrieved 20 studies, with a total of 205,702 patients. Patients with tuberculosis (RR = 2.10; 95% CI, 1.75-2.51; I2 = 0%), influenza (RR = 2.04; 95% CI, 0.15-28.25, I2 = 99%) have an increased risk of mortality during a co-infection with SARS-CoV-2. No significant impact is found in people living with HIV (RR = 0.99; 95% CI, 0.82-1.19; I2 = 30%), Chronic hepatitis (RR = 1.15; 95% CI, 0.73-1.81; I2 = 10%). Several countries (Brazil, Paraguay, Argentina, Peru, Colombia, and Singapore) are on the verge of a dengue co epidemic (cumulative 878,496 and 5,028,380 cases of dengue and COVID-19 respectively). The impact of COVID-19 in patients of concurrent infections with either tuberculosis or influenza is detrimental. The clinical outcomes of COVID-19 in HIV or chronic hepatitis patients are comparable to COVID-19 patients without these concurrent infections.