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3.
Ann Saudi Med ; 40(4): 273-280, 2020.
Artículo en Inglés | MEDLINE | ID: covidwho-612198

RESUMEN

In December 2019, a novel coronavirus was identified in patients in Wuhan, China. The virus, subsequently named severe acute respiratory syndrome coronavirus-2, spread worldwide and the disease (coronavirus disease 2019 or COVID-19) was declared a global pandemic by the World Health Organization in March 2020. Older adults and individuals with comorbidities have been reported as being more vulnerable to COVID-19. Patients with chronic liver disease (CLD) have compromised immune function due to cirrhosis and are more susceptible to infection. However, it is unclear if patients with CLD are more vulnerable to COVID-19 and its complications than other populations. The high number of severe cases of COVID-19 has placed an unusual burden on health systems, compromising their capacity to provide the regular care that patients with CLD require. Hence, it is incredibly crucial at this juncture to provide a set of interim recommendations on the management of patients with CLD during the current COVID-19 outbreak.


Asunto(s)
Infecciones por Coronavirus/epidemiología , Hepatopatías/epidemiología , Neumonía Viral/epidemiología , Adenosina Monofosfato/efectos adversos , Adenosina Monofosfato/análogos & derivados , Corticoesteroides/efectos adversos , Alanina/efectos adversos , Alanina/análogos & derivados , Amidas/efectos adversos , Antivirales/uso terapéutico , Azetidinas/efectos adversos , Betacoronavirus , Biopsia/métodos , Carcinoma Hepatocelular/epidemiología , Carcinoma Hepatocelular/terapia , Comorbilidad , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/prevención & control , Combinación de Medicamentos , Interacciones Farmacológicas , Inhibidores Enzimáticos/efectos adversos , Hepatitis Autoinmune/epidemiología , Hepatitis Autoinmune/terapia , Hepatitis Viral Humana/epidemiología , Hepatitis Viral Humana/terapia , Humanos , Hidroxicloroquina/efectos adversos , Inmunosupresores/uso terapéutico , Inhibidores de las Cinasas Janus/efectos adversos , Cirrosis Hepática/epidemiología , Cirrosis Hepática/terapia , Hepatopatías/terapia , Neoplasias Hepáticas/epidemiología , Neoplasias Hepáticas/terapia , Trasplante de Hígado , Lopinavir/efectos adversos , Enfermedad del Hígado Graso no Alcohólico/epidemiología , Enfermedad del Hígado Graso no Alcohólico/terapia , Pandemias/prevención & control , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/prevención & control , Pirazinas/efectos adversos , Ritonavir/efectos adversos , Arabia Saudita/epidemiología , Sulfonamidas/efectos adversos , Ultrasonografía/métodos
5.
Infez Med ; 28(suppl 1): 96-103, 2020 Jun 01.
Artículo en Inglés | MEDLINE | ID: covidwho-595083

RESUMEN

Liver injury has been reported to occur during the disease in severe cases. Therefore, this meta-analysis study aims to investigate the incidence of liver injury among published literature from 2019-Jan-01 to 2020-April-03 to provide an outline for further studies on the liver injury of COVID-19. Four databases including Pubmed, Embase, Web of Science, and the Scopus were searched for studies published from 2019-Jan-01 to 2020-April-03. Data analysis and drawing of charts were performed using the Comprehensive Meta-Analysis Software Version 2.2 (Biostat, USA). The search yielded 450 publications, of which 64 potentially eligible studies were identified for full-text review and 21 studies fulfilling the inclusion criteria remained. A total of 4191 COVID-19 patients were included in our meta-analysis. The pooled prevalence of liver injury was 19.5% (95% CI: 14.3-26.1). According to our results, there was significant heterogeneity among the 19 studies (X2 = 738.5; p < 0.001; I2 = 94.34%). Among 288 death cases, the pooled prevalence of liver injury was 22.8% (95% CI: 11.7-39.8). In summary, the COVID-19 disease itself can result in severe and even fatal respiratory diseases and even may lead to ARDS and multiple organ failure. The results of this systematic review highlight the importance of liver injury that may assist clinicians anywhere in the globe in controlling COVID-19-related infection and complications. Moreover, the prevalence of liver injury can be higher in severe cases than in mild cases.


Asunto(s)
Infecciones por Coronavirus/complicaciones , Fallo Hepático/etiología , Neumonía Viral/complicaciones , Adulto , Anciano , Betacoronavirus/genética , Betacoronavirus/aislamiento & purificación , China/epidemiología , Infecciones por Coronavirus/epidemiología , Femenino , Hepatitis Viral Humana/epidemiología , Hepatitis Viral Humana/etiología , Humanos , Irán/epidemiología , Fallo Hepático/epidemiología , Masculino , Persona de Mediana Edad , Insuficiencia Multiorgánica/epidemiología , Insuficiencia Multiorgánica/etiología , Pandemias , Neumonía Viral/epidemiología , Prevalencia , ARN Viral/sangre , Reacción en Cadena en Tiempo Real de la Polimerasa , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Riesgo , Tamaño de la Muestra
6.
Mil Med Res ; 7(1): 28, 2020 06 07.
Artículo en Inglés | MEDLINE | ID: covidwho-548559

RESUMEN

BACKGROUND: Recent studies reported that patients with coronavirus disease-2019 (COVID-19) might have liver injury. However, few data on the combined analysis and change patterns of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil) have been shown. METHODS: This is a single-center retrospective study. A total of 105 adult patients hospitalized for confirmed COVID-19 in Beijing Ditan Hospital between January 12, and March 17, 2020 were included, and divided into mild group (n = 79) and severe group(n = 26). We compared liver functional test results between the two groups. Category of ALT change during the disease course was also examined. RESULTS: 56.2% (59/105) of the patients had unnormal ALT, AST, or total TBil throughout the course of the disease, but in 91.4% (96/105) cases the level of ALT, AST or TBil ≤3 fold of the upper limit of normal reference range (ULN). The overall distribution of ALT, AST, and TBil were all significantly difference between mild and severe group (P <  0.05). The percentage of the patients with elevated both ALT and AST was 12.7% (10/79) in mild cases vs. 46.2% (12/26) in severe cases (P = 0.001). 34.6% (9/26) severe group patients started to have abnormal ALT after admission, and 73.3% (77/105) of all patients had normal ALT before discharge. CONCLUSIONS: Elevated liver function index is very common in patients with COVID-19 infection, and the level were less than 3 × ULN, but most are reversible. The abnormality of 2 or more indexes is low in the patients with COVID-19, but it is more likely to occur in the severe group.


Asunto(s)
Alanina Transaminasa/sangre , Betacoronavirus , Infecciones por Coronavirus/sangre , Hepatitis Viral Humana/sangre , Hepatitis Viral Humana/virología , Hígado/virología , Neumonía Viral/sangre , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Aspartato Aminotransferasas/sangre , Bilirrubina/sangre , Biomarcadores/sangre , Infecciones por Coronavirus/complicaciones , Infecciones por Coronavirus/virología , Femenino , Humanos , Hígado/fisiopatología , Pruebas de Función Hepática , Masculino , Persona de Mediana Edad , Pandemias , Neumonía Viral/complicaciones , Neumonía Viral/virología , Estudios Retrospectivos , Índice de Severidad de la Enfermedad , Adulto Joven
7.
Am J Gastroenterol ; 115(7): 1075-1083, 2020 07.
Artículo en Inglés | MEDLINE | ID: covidwho-459522

RESUMEN

INTRODUCTION: Elevated liver enzyme levels are observed in patients with coronavirus disease 2019 (COVID-19); however, these features have not been characterized. METHODS: Hospitalized patients with COVID-19 in Zhejiang Province, China, from January 17 to February 12, 2020, were enrolled. Liver enzyme level elevation was defined as alanine aminotransferase level >35 U/L for men and 25 U/L for women at admission. Patients with normal alanine aminotransferase levels were included in the control group. Reverse transcription polymerase chain reaction was used to confirm severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and patients symptomatic with SARS-CoV-2 infection were defined as patients with COVID-19. Epidemiological, demographic, clinical, laboratory, treatment, and outcome data were collected and compared. RESULTS: Of 788 patients with COVID-19, 222 (28.2%) patients had elevated liver enzyme levels (median [interquartile range {IQR}] age, 47.0 [35.0-55.0] years; 40.5% women). Being male, overweight, and smoking increased the risk of liver enzyme level elevation. The liver enzyme level elevation group had lesser pharyngalgia and more diarrhea than the control group. The median time from illness onset to admission was 3 days for liver enzyme level elevation groups (IQR, 2-6), whereas the median hospitalization time for 86 (38.7%) discharged patients was 13 days (IQR, 11-16). No differences in disease severity and clinical outcomes were noted between the groups. DISCUSSION: We found that 28.2% of patients with COVID-19 presented with elevated liver enzyme levels on admission, which could partially be related to SARS-CoV-2 infection. Male patients had a higher risk of liver enzyme level elevation. With early medical intervention, liver enzyme level elevation did not worsen the outcomes of patients with COVID-19.


Asunto(s)
Infecciones por Coronavirus , Hepatitis Viral Humana/enzimología , Pruebas de Función Hepática , Pandemias , Neumonía Viral , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/complicaciones , Estudios Transversales , Femenino , Hepatitis Viral Humana/virología , Humanos , Hepatopatías/enzimología , Hepatopatías/virología , Masculino , Persona de Mediana Edad , Neumonía Viral/complicaciones , Estudios Retrospectivos , Factores de Riesgo
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