SARS-CoV-2 and the liver: clinical and immunological features in chronic liver disease

Gut, Год журнала: 2023, Номер 72(9), С. 1783 - 1794

Опубликована: Июнь 14, 2023

SARS-CoV-2 infection may affect the liver in healthy individuals but also influences course of COVID-19 patients with chronic disease (CLD). As described individuals, a strong SARS-CoV-2-specific adaptive immune response is important for outcome COVID-19, however, knowledge on CLD limited.Here, we review clinical and immunological features CLD. Acute injury occurs many cases be induced by multiple factors, such as cytokines, direct viral or toxic effects drugs. In CLD, have more severe promote decompensation particularly cirrhosis. Compared responses impaired after both, natural vaccination improves at least partially booster vaccination.Following vaccination, rare acute vaccine-induced development autoimmune-like hepatitis been reported. However, concomitant elevation enzymes reversible under steroid treatment.

Язык: Английский

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COVID-19 Vaccine Hesitancy among Parents of Children with Chronic Liver Diseases

Vaccines, Год журнала: 2022, Номер 10(12), С. 2094 - 2094

Опубликована: Дек. 7, 2022

Children with chronic medical conditions are more susceptible to developing a serious negative outcome from corona virus disease 2019 (COVID-19) than healthy children. This study investigated the extent of COVID-19 vaccine hesitancy (VH) and its predictors in parents children liver (CLD) Egypt. Methods: A cross-sectional was conducted at National Liver Institute September October 2022, using random sampling method. Data were collected validated Arabic version parents’ attitudes about childhood vaccines (PACV) scale. Structural equation modeling (SEM) discriminant analysis used identify direct indirect determinants VH. Results: Of 173 participating parents, 81.5% hesitated vaccinate their child. Relevant characteristics for included being mother child (88.2%), younger 40 years (92.9%), illiterate (92%), unemployed (88.8%), without health insurance (87.8%), unvaccinated against (97.2%), refused complete vaccinations (85.7%), not having (85.7%) (p < 0.05). Previous infection motivated vaccination 0.0001). Median total PACV, attitude, trust scores significantly higher hesitant group vaccinated = 0.023). SEM suggests that age family size have effect, while education level, income effects on hesitancy. The model showed acceptable goodness fit (GFI 0.994, CFI 1, RMSEA 92.9% corrected classification discriminator VH variables determined (safety efficacy, attitude trust, age, size). Conclusions: Many socioeconomic factors affect toward child’s vaccination. Thus, increasing awareness importance vaccination, especially among this risky group, may enhance decision-making ability regarding vaccinating

Язык: Английский

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Clinical outcomes of COVID-19 in patients with liver cirrhosis - a propensity-matched analysis from a multicentric Brazilian cohort

BMC Infectious Diseases, Год журнала: 2025, Номер 25(1)

Опубликована: Янв. 15, 2025

Cirrhosis has been pointed out as a clinical entity that leads to worse prognosis in COVID-19 patients. However, this concept is controversial the literature. We aimed evaluate outcomes by comparing patients with cirrhosis those without Brazilian cohort. Data from 20,164 inpatients were collected 41 hospitals Brazil between March September 2020 and 2021 August 2022. compared 117 632 matched controls. A propensity score model was used adjust for potential confounding variables, incorporating some predictors: age, sex at birth, number of comorbidities, hospital admission, whether it an in-hospital manifestation COVID-19, admission year. Closeness defined being within 0.16 standard deviations logit score. The median age 61 (IQR 50–70) years old, 63.4% men. There no significant differences self-reported symptoms. Patients had lower hemoglobin levels (10.8 vs. 13.1 g/dl), platelets (127,000 200,000 cells/mm3), leukocyte counts, well C-reactive protein (63.0 76.0 p = 0.044) when They also higher mortality controls (51.3% 21.7%, < 0.001). frequencies intensive care unit 38.0%, 0.007), invasive mechanical ventilation (43.9% 26.6%, 0.001), dialysis (17.9% 11.1%, 0.038), septic shock (23.9% 14.9%; 0.015) institution palliative (19.7% 7.4%; This study shown significantly incidence severe outcomes, frequency Our findings underscore need these receive particular attention healthcare teams allocated resources.

Язык: Английский

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Erosion of Trust, Polarization, and Changing Public Perceptions of Vaccines

Опубликована: Март 21, 2025

Public perception of vaccines reflects a complex interplay historic progress, evolving societal values, and persistent challenges in public health communication. While widespread immunization remains one modern medicine’s crowning achievements, attitudes toward are shaped by legacy scientific advancements, institutional trust dynamics, cultural narratives. Despite enduring support for childhood immunizations as imperative, evidenced broad consensus on school vaccination requirements, shifts confidence among certain groups highlight vulnerabilities understanding. Lingering misconceptions about vaccine safety, amplified fragmented information ecosystems, coexist with majority belief their life-saving benefits. The tension between individual autonomy collective responsibility continue to shape attitudes, underscoring the delicate balance forces that challenge it. At its core, discourse reveals paradox: even remain cornerstone disease prevention, perceived value is increasingly contested ways mirror broader debates expertise, equity, accountability.

Язык: Английский

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Erosion of Trust, Polarization, and Changing Public Perceptions of Vaccines

Опубликована: Март 27, 2025

Public perception of vaccines reflects a complex interplay historic progress, evolving societal values, and persistent challenges in public health communication. While widespread immunization remains one modern medicine’s crowning achievements, attitudes toward are shaped by legacy scientific advancements, institutional trust dynamics, cultural narratives. Despite enduring support for childhood immunizations as imperative, evidenced broad consensus on school vaccination requirements, shifts confidence among certain groups highlight vulnerabilities understanding. Lingering misconceptions about vaccine safety, amplified fragmented information ecosystems, coexist with majority belief their life-saving benefits. The tension between individual autonomy collective responsibility continue to shape attitudes, underscoring the delicate balance forces that challenge it. At its core, discourse reveals paradox: even remain cornerstone disease prevention, perceived value is increasingly contested ways mirror broader debates expertise, equity, accountability.

Язык: Английский

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Impact of chronic liver disease on SARS-CoV-2 infection outcomes: Roles of stage, etiology and vaccination

World Journal of Gastroenterology, Год журнала: 2023, Номер 29(5), С. 800 - 814

Опубликована: Фев. 2, 2023

Since the first identification in December of 2019 and fast spread severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, it has represented a dramatic global public health concern. Though affecting mainly system, SARS-CoV-2 disease, defined as disease (COVID-19), may have systemic involvement leading to multiple organ dysfunction. Experimental evidence about tropism for liver increasing hepatic cytolysis enzymes during infection support presence pathophysiological relationship between SARS-CoV-2. On other side, patients with chronic been demonstrated poor prognosis COVID-19. In particular, cirrhosis appear extremely vulnerable infection. Moreover, etiology vaccination status could affect COVID-19 outcomes. This review analyzes impact stage related causes on morbidity mortality, clinical outcomes well efficacy disease.

Язык: Английский

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Evaluating the positive predictive value of code-based identification of cirrhosis and its complications utilizing GPT-4

Hepatology, Год журнала: 2024, Номер unknown

Опубликована: Окт. 8, 2024

Background and Aims: Diagnosis code classification is a common method for cohort identification in cirrhosis research, but it often inaccurate augmented by labor-intensive chart review. Natural language processing using large models (LLMs) potentially more accurate method. To assess LLMs’ potential identification, we compared code-based versus LLM-based with review as “gold standard.” Approach Results: We extracted conducted limited of 3788 discharge summaries admissions. engineered zero-shot prompts Generative Pre-trained Transformer 4 to determine whether its complications were active hospitalization problems. calculated positive predictive values (PPVs) PPVs “silver standard” all summaries. Compared gold standard review, achieved 82.2% identifying cirrhosis, 41.7% HE, 72.8% ascites, 59.8% gastrointestinal bleeding, 48.8% spontaneous bacterial peritonitis. the 87.8%–98.8% accuracies complications. Using LLM silver standard, 79.8% 53.9% 55.3% 67.6% 65.5% Conclusions: was highly manual This allowed us performance at scale LLMs standard. These results suggest could augment or replace raise questions regarding necessity

Язык: Английский

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The vaccine-response in patients with cirrhosis after COVID-19 vaccination: A systematic analysis of 168,245 patients with cirrhosis

Journal of Hepatology, Год журнала: 2023, Номер 79(4), С. e157 - e162

Опубликована: Июль 1, 2023

Язык: Английский

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Real-world effectiveness of COVID-19 vaccination in liver cirrhosis: a systematic review with meta-analysis of 51,834 patients

Baylor University Medical Center Proceedings, Год журнала: 2023, Номер 36(2), С. 151 - 156

Опубликована: Янв. 17, 2023

SARS-CoV-2 vaccinations were found to be highly effective in phase 3 clinical trials. However, these trials have not reported data regarding the subgroup of liver disease or excluded patients with disease. The effectiveness COVID-19 vaccines among cirrhosis (LC) is unclear. We conducted this meta-analysis assess vaccination LC patients. A comprehensive literature search was include all relevant studies that compared outcomes who received vs. unvaccinated Pooled risk ratios (RRs) 95% confidence intervals (CIs) calculated by Mantel-Haenszel method within a random-effect model. Four 51,834 (20,689 at least one dose vs 31,145 unvaccinated) included. COVID-19–related complications, including hospitalization (RR 0.73, CI 0.59–0.91, P = 0.004), mortality 0.29, 0.16–0.55, 0.0001), and need for invasive mechanical ventilation 0.11–0.77, 0.01), significantly lower vaccinated group group. reduced mortality, intubation, hospitalization. LC. Further prospective studies, preferably randomized controlled trials, are necessary validate our findings determine which vaccine superior

Язык: Английский

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COVID-19 vaccine-induced liver injury

Current Opinion in Gastroenterology, Год журнала: 2024, Номер 40(3), С. 119 - 125

Опубликована: Фев. 14, 2024

Purpose of review The rapid rollout and uptake novel coronavirus disease 2019 (COVID-19) vaccines has been accompanied by a small yet noticeable accumulation reports liver injury occurring after vaccination. This describes the present evidence surrounding COVID-19 vaccine-induced (VILI). Recent findings Liver vaccine often presents clinically similar to autoimmune hepatitis, with positive autoantibodies portal lobular inflammatory infiltrate varying degrees necrosis on biopsy. overwhelming majority patients recover, spontaneously or limited course immunosuppression. overall incidence this phenomenon appears be exceedingly low. Summary Providers should remain vigilant for ongoing VILI feel reassured low high likelihood recovery. Ongoing genetic histological study, as well longer-term follow-up presently identified cases, will shed further light clinical entity VILI.

Язык: Английский

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