Liver Function Status in COVID-19: An Indian Perspective.

INTRODUCTION: In SARS-CoV2 infection multi-organ involvement of heart, kidney pancreas and liver are reported. Most studies suggest that though mild derangements of liver function may be experienced by most COVID-19 patients but significant liver injury is not common. The aim of this study was to describe clinical characteristics of COVID-19 patients admitted to this level 4 COVID hospital and find out their relation to the liver parameters. MATERIALS AND METHODS: COVID-19 patients admitted in this level -4 COVID hospital during the study period were classified as mild (Group 1,n=42), moderate (Group 2,n=40) and severe (Group 3,n=35) cases as per national guidelines. Serum samples were analyzed using biochemistry autoanalyzer. Serum levels of total and direct bilirubin, Alanine Transaminase (ALT) and Aspartate Transaminase (AST), Alkaline Phosphatase (ALKP), total protein and albumin were assayed. RESULTS: Patients with higher BMI (Body mass index) had developed greater COVID-19 related complications and hence had to be admitted either in HDU (Group 2) or in ICU (Group 3) set up. Total and direct serum bilirubin levels were normal and almost similar in the various study groups. The primary liver enzymes ALT and AST were raised in the entire study population. However differences between the study groups were statistically insignificant. ALKP was within normal reference range for all the cases. Serum total Protein levels were within normal physiological limits in all the three groups. However serum albumin levels were reduced significantly in Groups 3 and 2 in comparison to Group 1. CONCLUSION: Derangements of LFT in COVID-19 Patients are common especially in patients with severe disease but its long term impact is unknown. Hence, further investigation and long term follow up of recovered COVID-19 cases is warranted to understand the pathophysiology and implication of liver injury that occurs both in overt and covert forms during infection.

A high molecular weight protein Bengalin from the Indian black scorpion (Heterometrus bengalensis C.L. Koch) venom having antiosteoporosis activity in female albino rats.

This study reports the presence of a high molecular weight protein (Bengalin) from the Indian black scorpion (Heterometrus bengalensis) venom having antiosteoporosis activity in experimental osteoporosis developed in female albino Wister rats. Bengalin was purified through DEAE-cellulose ion exchange chromatography and high performance liquid chromatography. The molecular weight of the Bengalin was found to be 72kDa and the first 20 amino acid sequence was found to be G-P-L-T-I-L-H-I-N-D-V-H-A-A/R-F-E-Q/G-F/G-N-T. Bengalin exhibited significant antiosteoporosis activity in experimental female rats, which was confirmed through analysis of urine Ca(2+), PO(4)(3-), CRE & OH-P. Bengalin (3 microg and 5 microg/100g rat/i.p.) antagonized osteoporosis by restoring urinary Ca(2+), PO(4)(3-), CRE and OH-P, serum/plasma Ca(2+), PO(4)(3-), ALP, TRAP, PTH, T(3), TSH, Osteocalcin, IL1, IL6 and TNF alpha and bone minerals Ca(2+), P, Mg(2+), Zn(2+), Na(+), as compared with the sham operated control rats. Bone minerals density of osteoporosis female rats was improved due to Bengalin, observed through DEXA scan. Subacute toxicity studies in male albino mice, Bengalin showed cardiotoxicity. In vivo experiments, Bengalin showed cardiotoxicity on isolated guinea pig heart, guinea pig auricle, and neurotoxicity on isolated rat phrenic nerve diaphragm preparation. Further detail studies on the toxicity, antiosteoporosis and structural identity of Bengalin are warranted.