Liver injury in COVID-19: an insight into pathobiology and roles of risk factors.

COVID-19 is a complex disease that can lead to fatal respiratory failure with extrapulmonary complications, either as a direct result of viral invasion in multiple organs or secondary to oxygen supply shortage. Liver is susceptible to many viral pathogens, and due to its versatile functions in the body, it is of great interest to determine how hepatocytes may interact with SARS-CoV-2 in COVID-19 patients. Liver injury is a major cause of death, and SARS-CoV-2 is suspected to contribute significantly to hepatopathy. Owing to the lack of knowledge in this field, further research is required to address these ambiguities. Therefore, we aimed to provide a comprehensive insight into host-virus interactions, underlying mechanisms, and associated risk factors by collecting results from epidemiological analyses and relevant laboratory experiments. Backed by an avalanche of recent studies, our findings support that liver injury is a sequela of severe COVID-19, and certain pre-existing liver conditions can also intensify the morbidity of SARS-CoV-2 infection in synergy. Notably, age, sex, lifestyle, dietary habits, coinfection, and particular drug regimens play a decisive role in the final outcome and prognosis as well. Taken together, our goal was to unravel these complexities concerning the development of novel diagnostic, prophylactic, and therapeutic approaches with a focus on prioritizing high-risk groups.

Association between mobile phone use and hearing impairment: a systematic review and meta-analysis.

OBJECTIVES: To investigate whether a possible association of mobile phone use with hearing impairment was conducted a systematic review and meta-analysis. CONTENT: This is a systematic review and meta-analysis. A comprehensive literature search was carried out based on the Meta-analysis of Observational Studies in Epidemiology (MOOSE) methodology using PubMed, Scopus, Web of Science, OVID, and Cochrane. The Robins-I tool was used for quality assessment and risk of bias. Two investigators independently reviewed all articles. Pooled effect size was calculated and meta-analysis was performed to compute an overall effect size. SUMMARY: Overall, five relevant studies (two cross-sectional and three cohort studies) with 92,978 participants were included in the analysis. The studies were stratified by design, there was no significant association between mobile phone use and hearing impairment in cross-sectional studies (OR=0.94, 95% CI=0.57-1.31) and cohort studies (OR=1.09, 95% CI=0.93-1.25). In addition, the effect estimates did not differ significantly between cross-sectional and cohort studies (Q=0.50, p=0.48). Overall, the pooled odds ratio (OR) of hearing impairment was 1.07 (95% CI: 0.94-1.20), which indicates no significant association between mobile phone use and hearing impairment. OUTLOOK: Our findings indicate no association between mobile phone use and hearing impairment. However, these findings must be interpreted with caution.

Virus load and incidence of olfactory, gustatory, respiratory, gastrointestinal disorders in COVID-19 patients: A retrospective cohort study.

OBJECTIVES: This study investigated the relationship between viral load and the incidence of olfactory and gustatory dysfunction (OD and GD), the incidence of respiratory and gastrointestinal symptoms and the recovery of OD and GD in COVID-19 patients. DESIGN: A retrospective cohort study. SETTING AND PARTICIPANTS: This study was conducted on 599 outpatients' cases in Golestan province between February and June 2020. MAIN OUTCOME MEASURES: The incidence, severity (complete or partial) and recovery time of OD and GD and their associations with cycle threshold (CT) values of SARS-CoV-2 polymerase chain reaction were assessed. RESULTS: The mean age of patients was 38.27 ± 13.62 years. The incidence of general symptoms included myalgia 70.1%, headache 51.8%, fever 47.7% and dyspnoea 21.4%. 41.9% of patients had gastrointestinal symptoms, including abdominal pain 26.5%, diarrhoea 25.2%, nausea 20.5% and vomiting 12.9%. 12.2% of patients had comorbidity. The trimester recovery rates of OD and GD were 93.94% and 94.74% respectively. The mean recovery time of OD and GD was 14.56 ± 13.37 and 13.8 ± 3.77 days respectively. The mean CT value in all patients was 27.45 ± 4.55. There were significant associations between the mean of CT value with headache (p = 0.04), GD (p = 0.002) and OD (p = 0.001). CONCLUSIONS: The finding of this study indicates a possible association between viral load with incidence of OD and GD in COVID-19 patient's cases and assures the recovery of OD/GD in these patients.

Migraine and risk of sudden sensorineural hearing loss: A systematic review and meta-analysis.

OBJECTIVE: The pathophysiology of idiopathic sudden sensorineural hearing loss (SSNHL) is poorly understood. This study aimed to explore the association of migraine and risk of SSNHL in a meta-analysis of population-based cohort studies. METHODS: A systematic literature search of studies published until December 2019 was carried out in Medline, Embase, Scopus, Web of Science, and Google Scholar using appropriate keywords. References of the retrieved articles were also examined for inclusion. Random-effects meta-analysis was performed by calculating pooled hazard ratio (HR) and associated 95% confidence interval (CI) using the DerSimonian and Laird method while considering conceptual heterogeneity. RESULTS: Three eligible cohort studies, with 282 250 participants, were included. In total, 56 450 had migraine, and 225 800 had no migraine. Of those with migraine, 0.88% had SSNHL, and among those without migraine, 0.59% had SSNHL. Pooled HR for the risk of SSNHL was 1.84 (95% CI: 1.11-2.57; P < .001). In cohort studies on females, migraine was not significantly the risk of SSHL than no migraine. However, in male cohort studies, the migraine had a higher risk of SSHL than no migraine (HR = 1.50; 95% CI: 1.17-1.83; P < .001). The pooled HR of migraine with the risk of SSNHL was 1.37 (95% CI: 1.16-1.58, P < .001) in people with <40 years old and 1.39 (95% CI: 1.17-1.60; P < .001) in people >40 years old. CONCLUSIONS: Individuals with migraine patients are at a higher risk of developing SSHL. Different age and sex migraine subgroups showed a higher proportion of SSNHL cases compared to nonmigraineurs.

Using Anti-SARS-CoV-2 IgG and IgM Antibodies to Detect Outpatient Cases with Olfactory and Taste Disorders Suspected as Mild Form of COVID-19: a Retrospective Survey.

Many patients with olfactory disorders were referred during the COVID-19 pandemic in 2020. The aim of this study was to detect outpatient cases with olfactory and taste disorders suspected to mild form of COVID-19 disease in Gorgan city in the north of Iran retrospectively. This study was performed on patients who had the complaints of olfactory disorders during 03/01/2020 to 04/01/2020. They also had the mild symptoms of upper respiratory tract infection. The control group included patients who had similar symptoms during this period but did not report olfactory or taste disturbances. Due to the limitations of serologic kits, this study was performed 2-3 months after the onset of symptoms. The number of patients and controls was 72 and 36 respectively. The range and the mean ± SD of patient's age were 21-63 and 39.82 ± 9.82 years. In both groups, 44.44% were male and 55.56% were female. The time interval between the onset of symptoms and the serologic tests in both groups was 91.11 ± 16.20 days. In the cases and controls, the IgG titer was positive in 44.4% and 22.2% and the IgM titer was positive in 5.6% and 8.3% respectively. IgG antibody titers were higher in cases than in the control group (P = 0.024). There was no correlation among antibody titers and the severity of olfactory disturbances, the gender, and the age. The high COVID-19 IgG antibody titer in patients with olfactory disorder during the pandemic can probably be considered as a warning complaint of COVID-19 and may be used for isolation plans.