Pathophysiological mechanisms of liver injury in COVID‐19

Liver International, Год журнала: 2020, Номер 41(1), С. 20 - 32

Опубликована: Ноя. 15, 2020

The recent outbreak of coronavirus disease 2019 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) has resulted in a world-wide pandemic. Disseminated lung injury with development acute respiratory distress syndrome (ARDS) is main cause mortality COVID-19. Although liver failure does not seem to occur absence pre-existing disease, hepatic involvement COVID-19 may correlate overall severity and serve as prognostic factor for ARDS. spectrum range from direct infection SARS-CoV-2, indirect systemic inflammation, hypoxic changes, iatrogenic causes such drugs ventilation exacerbation underlying disease. This concise review discusses potential pathophysiological mechanisms SARS-CoV-2 tropism well possibly long-term

Язык: Английский

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Systematic review with meta‐analysis: liver manifestations and outcomes in COVID‐19

Alimentary Pharmacology & Therapeutics, Год журнала: 2020, Номер 52(4), С. 584 - 599

Опубликована: Июль 8, 2020

Summary Background The incidence of elevated liver chemistries and the presence pre‐existing chronic disease (CLD) have been variably reported in COVID‐19. Aims To assess prevalence CLD, outcomes patients with without underlying CLD/elevated Methods A comprehensive search electronic databases from 1 December 2019 to 24 April 2020 was done. We included studies reporting CLD or patient Results 107 articles (n = 20 874 patients) were for systematic review. pooled 3.6% (95% CI, 2.5‐5.1) among 15 407 COVID‐19 patients. 23.1% (19.3‐27.3) at initial presentation. Additionally, 24.4% (13.5‐40) developed during illness. drug‐induced injury 25.4% (14.2‐41.4). 1587 severely infected 3.9% (3%‐5.2%). odds developing severe 0.81 (0.31‐2.09; P 0.67) compared non‐CLD had increased risk mortality (OR‐3.46 [2.42‐4.95, < 0.001]) (OR‐2.87 [95% 2.29‐3.6, chemistries. Conclusions Elevated are common presentation severity correlates outcome does not alter Further needed analyse compensated decompensated disease.

Язык: Английский

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Clinical determinants of the severity of COVID-19: A systematic review and meta-analysis

PLoS ONE, Год журнала: 2021, Номер 16(5), С. e0250602 - e0250602

Опубликована: Май 3, 2021

Objective We aimed to systematically identify the possible risk factors responsible for severe cases. Methods searched PubMed, Embase, Web of science and Cochrane Library epidemiological studies confirmed COVID-19, which include information about clinical characteristics severity patients’ disease. analyzed potential associations between Results identified a total 41 eligible including 21060 patients with COVID-19. Severe cases were potentially associated advanced age (Standard Mean Difference (SMD) = 1.73, 95% CI: 1.34–2.12), male gender (Odds Ratio (OR) 1.51, CI:1.33–1.71), obesity (OR 1.89, 1.44–2.46), history smoking 1.40, CI:1.06–1.85), hypertension 2.42, 2.03–2.88), diabetes 2.40, 1.98–2.91), coronary heart disease (OR: 2.87, 2.22–3.71), chronic kidney (CKD) 2.97, 1.63–5.41), cerebrovascular ( OR 2.47, 1.54–3.97), obstructive pulmonary (COPD) 2.88, 1.89–4.38), malignancy 2.60, 2.00–3.40), liver 1.06–2.17). Acute respiratory distress syndrome (ARDS) 39.59, 19.99–78.41), shock 21.50, 10.49–44.06) acute injury (AKI) 8.84, 4.34–18.00) most likely prevent recovery. In summary, conditions had higher rate comorbidities complications than non-severe conditions. Conclusion Patients who male, age, obesity, smoking, hypertension, diabetes, malignancy, disease, COPD, or CKD are more develop COVID-19 symptoms. ARDS, AKI thought be main hinderances

Язык: Английский

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Oral nano‐curcumin formulation efficacy in management of mild to moderate hospitalized coronavirus disease‐19 patients: An open label nonrandomized clinical trial

Phytotherapy Research, Год журнала: 2021, Номер 35(5), С. 2616 - 2623

Опубликована: Янв. 3, 2021

Curcumin is proposed as a potential treatment option for coronavirus disease-19 (COVID-19) by inhibiting the virus entrance, encapsulation and replication, modulating various cellular signaling pathways. In this open-label nonrandomized clinical trial, efficacy of nano-curcumin oral formulation has been evaluated in hospitalized patients with mild-moderate COVID-19. Forty-one who fulfilled inclusion criteria were allocated to (n = 21) group (Sinacurcumin soft gel, contains 40 mg curcuminoids nanomicelles, two capsules twice day) or control 20) group, 2 weeks. Patients' symptoms laboratory data assessed at baseline during follow-up period. Most including fever chills, tachypnea, myalgia, cough resolved significantly faster curcumin group. Moreover, SaO2 was higher after 2, 4, 7, 14 days lymphocyte count 7 days. Duration supplemental O2 use hospitalization also meaningfully shorter It noteworthy mention that no patient experienced deterioration infection period, but it occurred 40% Oral nano-formulation can improve recovery time COVID-19 patients. Further randomized placebo controlled trials larger sample size are recommended.

Язык: Английский

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Risk Factors of Severe COVID-19: A Review of Host, Viral and Environmental Factors

Viruses, Год журнала: 2023, Номер 15(1), С. 175 - 175

Опубликована: Янв. 7, 2023

The clinical course and outcome of COVID-19 are highly variable, ranging from asymptomatic infections to severe disease death. Understanding the risk factors is relevant both in setting at epidemiological level. Here, we provide an overview host, viral environmental that have been shown or (in some cases) hypothesized be associated with outcomes. considered detail include age frailty, genetic polymorphisms, biological sex (and pregnancy), co- superinfections, non-communicable comorbidities, immunological history, microbiota, lifestyle patient; variation infecting dose; socioeconomic factors; air pollution. For each category, compile (sometimes conflicting) evidence for association factor outcomes (including strength effect) outline possible action mechanisms. We also discuss complex interactions between various factors.

Язык: Английский

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Liver injury in COVID-19: clinical features and treatment management

Virology Journal, Год журнала: 2021, Номер 18(1)

Опубликована: Июнь 9, 2021

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has spread to many countries around the world. In addition lung disease, severe cases also displayed varying degrees of liver injury. This article will describe latest developments regarding coronavirus and pathogenesis injury, prone population clinical characteristics these patients, as well providing some suggestions for treatment.

Язык: Английский

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Secondary sclerosing cholangitis as cause of persistent jaundice in patients with severe COVID‐19

Liver International, Год журнала: 2021, Номер 41(10), С. 2404 - 2417

Опубликована: Май 21, 2021

Little is known about cholestasis, including its most severe variant secondary sclerosing cholangitis (SSC), in critically ill patients with coronavirus disease 19 (COVID-19). In this study, we analysed the occurrence of cholestatic liver injury and SSC, clinical, serological, radiological histopathological findings.We conducted a retrospective single-centre analysis all consecutive admitted to intensive care unit (ICU) as result COVID-19 at University Hospital Zurich describe these patients. The findings were compared cohort influenza A.A total 34 ICU included. Of these, 14 (41%) had no cholestasis (group 0), 11 (32%, group 1) developed mild 9 (27%, 2) cholestasis. Patients 2 more complicated course indicated by significantly longer stay (median 51 days, IQR 25-86.5) than other groups 0: median 9.5 3.8-18.3, P = .001; 1: 16 8-30, < .05 respectively). Four SSC none A cohort. available suggest an ischaemic damage perihilar bile ducts.The development represents important complication needs be considered diagnostic work up prolonged interest ongoing pandemic since it associated considerable morbidity mortality.

Язык: Английский

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COVID 19 and liver: An A–Z literature review

Digestive and Liver Disease, Год журнала: 2020, Номер 53(2), С. 146 - 152

Опубликована: Сен. 16, 2020

The coronavirus pandemic has changed the priorities of whole medical society. During clinical course COVID-19, it been observed that hepatic injury occurs in a significant proportion patients, particularly those with severe or critical illness. In this literature review, we summarize most recent studies, which covered pathophysiology COVID-19 induced liver including; pathological findings, therapy related damage, and effects viral infection on pre-existing diseasesin context recommendations. Conclusions: This review sheds light impact liver, as well prognostic effect laboratory markers disease outcome. Temporal variations parameters during different patterns derangement are depicted. More intensive surveillance individualized therapeutic approaches should be tailored for immunocompromised patients advanced disease, hepatocellular carcinoma, transplant patients. Despite limited studies infected preexisting comprehensive overview provides perspective management COVID-19.

Язык: Английский

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Liver Disease and Coronavirus Disease 2019: From Pathogenesis to Clinical Care

Hepatology, Год журнала: 2020, Номер 74(2), С. 1088 - 1100

Опубликована: Дек. 18, 2020

Infection with the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), a novel that emerged in late 2019, is posing an unprecedented challenge to global health. Coronavirus disease 2019 (COVID‐19), clinical caused by SARS‐CoV‐2, has variable presentation ranging from asymptomatic infection life‐threatening distress and multiorgan failure. Liver involvement common during COVID‐19 exhibits spectrum of manifestations elevations liver function tests hepatic decompensation. The presence abnormal been associated more overall mortality. Although SARS‐CoV‐2 RNA detected patients COVID‐19, it remains unclear whether productively infects replicates cells direct liver‐pathogenic effect. cause injury can be attributed multiple factors, including virus‐induced systemic inflammation, hypoxia, congestion, drug‐induced disease. Among cirrhosis, decompensation liver‐related Additionally, COVID‐19’s impact on health care resources adversely affect delivery outcomes chronic Understanding underlying mechanisms will important management especially those advanced This review summarizes our current knowledge virus‐host interactions as well COVID‐19.

Язык: Английский

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Diverse Immunological Factors Influencing Pathogenesis in Patients with COVID-19: A Review on Viral Dissemination, Immunotherapeutic Options to Counter Cytokine Storm and Inflammatory Responses

Pathogens, Год журнала: 2021, Номер 10(5), С. 565 - 565

Опубликована: Май 7, 2021

The pathogenesis of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome 2 (SARS-CoV-2), is still not fully unraveled. Though preventive vaccines and treatment methods are out on the market, a specific cure for has been discovered. Recent investigations research studies primarily focus immunopathology disease. A healthy immune system responds immediately after viral entry, causing immediate annihilation recovery. However, an impaired causes extensive systemic damage due to unregulated response characterized hypersecretion chemokines cytokines. elevated levels cytokine or hypercytokinemia leads distress (ARDS) along with multiple organ damage. Moreover, against SARS-CoV-2 linked race, gender, age; hence, this infection's outcome differs among patients. Many therapeutic strategies focusing immunomodulation have tested assuage storm in patients COVID-19. thorough understanding diverse signaling pathways triggered virus essential before contemplating relief measures. This present review explains interrelationships hyperinflammatory severity. Furthermore, we thrown light mechanisms risk factors that influence molecular lead infection Recognition altered dysregulated can be loophole identify potential target markers. Identifying biomarkers pathway aid better clinical management COVID-19 special also given potent inhibitors proinflammatory cytokines, immunomodulatory immunotherapeutic options ameliorate inflammatory responses affected

Язык: Английский

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