COVID-19, MERS and SARS with Concomitant Liver Injury—Systematic Review of the Existing Literature
Liver, coronavirus, Pandemic, SARS, MERS, SARS-CoV-2
The novel coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection has been predominantly linked to respiratory distress syndrome, but gastrointestinal symptoms and hepatic injury have also been reported. The mechanism of liver injury is poorly understood and may result as a consequence of viral hepatitis, systemic inflammatory response, gut barrier and microbiome alterations, intensive care treatment or drug toxicity. The incidence of hepatopathy among patients with coronavirus disease 2019 (COVID-19) is unclear, but studies have reported liver injury in patients with SARS and Middle East respiratory syndrome (MERS). We aimed to systematically review data on the prevalence of hepatic impairments and their clinical course in SARS and MERS Coronaviridae infections. A systematic literature search (PubMed/Embase/Cinahl/Web of Science) according to preferred reporting items for systematic review and meta-analysis protocols (PRISMA) was conducted from database inception until 17/03/2020 for studies that evaluated the incidence of hepatic abnormalities in SARS CoV-1, SARS CoV-2 and MERS infected patients with reported liver-related parameters. A total of forty-three studies were included. Liver anomalies were predominantly mild to moderately elevated transaminases, hypoalbuminemia and prolongation of prothrombin time. Histopathology varied between non-specific inflammation, mild steatosis, congestion and massive necrosis. More studies to elucidate the mechanism and importance of liver injury on the clinical course and prognosis in patients with novel SARS-CoV-2 infection are warranted.
Karolina Skonieczna-Żydecka, Mariusz Kaczmarczyk, Anastasios Koulaouzidis, Michał Kukla, Wojciech Marlicz, Ewa Stachowska, Monika Pazgan-Simon, Dominika Maciejewska, Katarzyna Kotfis, Igor Łoniewski, Luis F. Lara
Role of lung ultrasound in identifying COVID-19 pneumonia in patients with negative swab during the outbreak
Pneumonia, Lung ultrasound, rRT-PCR, COVID-19, negative swab
Lung ultrasound is a reasonable tool for detection of manifestations of COVID-19, to facilitate the division of patients flow of infected with SARS-CoV-2 from those affected by other pathologies. Often, a reason for the incorrect separation of the flows is the possibility of false-negative rRT-PCR results. We aimed to evaluate the advantages of performing Lung Ultrasound (LUS) in patients with a negative swab, to confirm the suspicious of COVID-19 at the bedside, according to the recent findings of typical lung ultrasound lesions of COVID19 related pneumonia. We analyzed 11 non-critical patients admitted to Emergency Department in the Internal Medicine ward, during outbreak, as Covid-19 negative patients affected by pneumonia. The result of the ultrasound findings conditioned the consequent allocation of the patient. 9/11 patients had typical LUS findings for COVID-19, but only 3/11 patients had a second positive nasopharyngeal swab, and 2/11 had positive swab on pleural fluid. 6/11 patients remained negative with strongly suspicious LUS lesions, and so treated and isolated as Covid-19 positive. 2/11 had negative swab and none LUS findings, thus treated as affected by other pathologies. These findings clearly show how LUS plays an important role together with the chest x-ray in identifying patients with interstitial pneumonia from COVID-19.
Piero Davio, Giuseppe Aiosa, Romina Gianfreda, Marco Pastorino
We write in response to the COVID-19 pandemic and the important recognition of co-existing frailty [COVID-19 rapid guideline: critical care in adults; NICE NG159] [...]
Phyo Kyaw Myint, Ben Carter, Jonathan Hewitt, Lyndsay Pearce, Kathryn McCarthy, Susan Moug
Potential Cytoprotective Activity of Ozone Therapy in SARS-CoV-2/COVID-19
NF-κB, Nrf2, Keap1-Nrf2-ARE pathway, SARS-CoV-2, ozone therapy 1
(1) Background: The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) disease (COVID-19) in China at the end of 2019 has caused a large global outbreak. Systemic ozone therapy (OT) could be potentially useful in the clinical management of several complications secondary to SARS-CoV-2. The rationale and mechanism of action has already been proven clinically in other viral infections and has been shown in research studies to be highly effective at decreasing organ damage mediated by inflammation and oxidative stress. This review summarizes the OT studies that illustrate the possible cytoprotective mechanism of action of ozone and its physiological by-products in target organs affected by SARS-CoV-2. (2) Methods: This review encompasses a total of 74 peer-reviewed original articles. It is mainly focused on ozone as a modulator of the NF-κ B/Nrf2 pathways and IL-6/IL-1β expression. (3) Results: In experimental models and the few existent clinical studies, homeostasis of the free radical and antioxidant balance by OT was associated with a modulation of NF-κ B/Nrf2 balance and IL-6 and IL-1β expression. These molecular mechanisms support the cytoprotective effects of OT against tissue damage present in many inflammatory diseases, including viral infections. (4) Conclusions: The potential cytoprotective role of OT in the management of organ damage induced by COVID-19 merits further research. Controlled clinical trials are needed.
Gregorio Martínez-Sánchez, Vincenzo Di Donna, Adriana Schwartz
Evaluation of the Secondary Transmission Pattern and Epidemic Prediction of COVID-19 in the Four Metropolitan Areas of China
Basic reproduction number, SEIR, secondary transmission, novel coronavirus, COVID-19, epidemic prediction
Understanding the transmission dynamics of COVID-19 is crucial for evaluating its spread pattern, especially in metropolitan areas of China, as its spread could lead to secondary outbreaks. In addition, the experiences gained and lessons learned from China have the potential to provide evidence to support other metropolitan areas and large cities outside China with their emerging cases. We used data reported from January 24, 2020, to February 23, 2020, to fit a model of infection, estimate the likely number of infections in four high-risk metropolitan areas based on the number of cases reported, and increase the understanding of the COVID-19 spread pattern. Considering the effect of the official quarantine regulations and travel restrictions for China, which began January 23~24, 2020, we used the daily travel intensity index from the Baidu Maps app to roughly simulate the level of restrictions and estimate the proportion of the quarantined population. A group of SEIR model statistical parameters were estimated using Markov chain Monte Carlo (MCMC) methods and fitting on the basis of reported data. As a result, we estimated that the basic reproductive number, R0, was 2.91 in Beijing, 2.78 in Shanghai, 2.02 in Guangzhou, and 1.75 in Shenzhen based on the data from January 24, 2020, to February 23, 2020. In addition, we inferred the prediction results and compared the results of different levels of parameters. For example, in Beijing, the predicted peak number of cases was 467 with a peak time of March 01, 2020; however, if the city were to implement different levels (strict, moderate, or weak) of travel restrictions or regulation measures, the estimation results showed that the transmission dynamics would change and that the peak number of cases would differ by between 54% and 209%. We concluded that public health interventions would reduce the risk of the spread of COVID-19 and that more rigorous control and prevention measures would effectively contain its further spread, and awareness of prevention should be enhanced when businesses and social activities return to normal before the end of the epidemic. Further, the experiences gained and lessons learned from China offer the potential to provide evidence supporting other metropolitan areas and big cities with their emerging cases outside China.
Wei-Guo Zhu, Yingying Ma, Xiang Zhou, Jie He, Longxiang Su, Lin Han, Yun Long, Guangliang Shan, Na Hong, Huizhen Jiang, Fengxiang Chang
SEASONAL WORKERS BEFORE THE COVID-19 ERA: ANALYSIS OF THE LEGISLATION WITHIN THE CONTEXT OF EASTERN EUROPE
Eastern Europe, seasonal workers, V4 countries, intermediation job agencies, visa formalities
This paper analyzes the phenomenon of seasonal workers in Europe before the Covid-19 pandemic and discusses the legislation for intermediation job intermediation agencies in several East European countries such as Bulgaria, Romania and Poland. Additionally we discuss the typical patterns for seasonal migration in European context. We also analyze the situation of seasonal workers in Scandinavia (the berry picking activity in Sweden), in Spain (the orange picking in the Mediterranean regions) as well as the Ukrainian seasonal workers in some of the Visegrad-4 countries (Poland, Czech Republic and Slovakia). Finally, we briefly discuss some novel approaches which might be used as regulation mechanisms.
Journal of Liberty and International Affairs
Institute for Research and European Studies
Erratum to: Joint Guidance from the Society of Gastrointestinal Endoscopy of India (SGEI), Indian Society of Gastroenterology (ISG), and Indian National Association for Study of the Liver (INASL) for Gastroenterologists and Gastrointestinal Endoscopists on the Prevention, Care, and Management of Patients with COVID-19
Sundeep Lakhtakia, Mathew Philip, Kaushal Madan, Rakesh Aggarwal, Govind Makharia, Vivek Saraswat
Diseases of the digestive system. Gastroenterology
COVID-19 and the role of 3D printing in medicine
Jonathan M. Morris, Adnan Sheikh, Ryan Moore, Nicole Wake, Frank J Rybicki, Ciprian N. Ionita, Prashanth Ravi, Rance Tino, Sam Antoline, Summer J. Decker, Leonid L. Chepelev
Medical physics. Medical radiology. Nuclear medicine
Manejo y tratamiento de pacientes en áreas quirúrgicas durante la pandemia COVID-19. Revisión en el área de Ortopedia y Traumatología
coronavirus, Cirugías, pandemia, ortopedia y traumatología, Quirófano, COVID-19
La pandemia actual ocasionada por el coronavirus (COVID-19) ha promovido el desarrollo de gran cantidad de medidas en el ámbito individual y global, que afectan gravemente a los sistemas de salud. Aunque la epidemia no involucra directamente a los especialistas en Ortopedia y Traumatología, indirectamente, nos vemos compelidos a implementar medidas hospitalarias preventivas tendientes a disminuir las posibilidades de contagio durante nuestros procedimientos específicos. Esta breve revisión bibliográfica pretende aportar información dinámica básica respecto a de qué manera actuar como especialistas en las áreas quirúrgicas ante casos sospechosos/confirmados de COVID-19. Promovemos el diseño de planes de trabajo para la atención de pacientes antes de la cirugía, durante esta y después.
Andrés Cattáneo, Esteban F. Coppola, A. Federico Medina, Alejandro Pachón Guzmán
Revista de la Asociación Argentina de Ortopedia y Traumatologia
Asociacion Argentina de Ortopedia y Traumatologia
European Association for the Study of Obesity Position Statement on the Global COVID-19 Pandemic
Jens-Christian Holm, Euan Woodward, Gema Frühbeck, Dana Mullerova, Volkan Yumuk, Luca Busetto, Dror Dicker, Harry Rutter, Maria Hassapidou, Teodora Handjieva-Darlenska, Susanna Lehtinen-Jacks, Jennifer Lyn Baker, Gijs H. Goossens, Jason C.G. Halford, Grace O’Malley, Jørn V. Sagen, Ximena Ramos Salas, Nathalie J. Farpour-Lambert
Nutrition. Foods and food supply, Nutritional diseases. Deficiency diseases