ABSTRACT
The liver is one of the common extrapulmonary organs involved in the coronavirus disease 2019 (COVID-19) infection. We aimed to find the prevalence of liver injury at hospital admission and its effects on outcomes. Methods: This is a single-center prospective observational study. All consecutive patients with COVID-19 admitted during the months of May to August 2021 were included in the study. Liver injury was defined as at least 2 times elevation of aspartate transaminase, alanine transaminase, alkaline phosphatase, and bilirubin above the upper limits on normal. The predictive efficacy of liver injury was measured as its effects on outcome variables, that is duration of hospital stay, requirement of ICU admission, mechanical ventilation, and mortality. Presence of liver injury compared with existing biomarkers markers of severe disease, that is lactate dehydrogenase, D-dimer, and C-reactive protein. Results: A total of 245 consecutive adult patients with COVID-19 infection were included in the study. Liver injury was present in 102 (41.63%) of patients. There was a significant association between the presence of liver injury and duration of hospital stay (10.74 vs. 8.9 days; P=0.013), the requirement of ICU admission (12.7 vs. 10.2%; P=0.018), mechanical ventilation (10.6% vs. 6.5%; P=0.003), and mortality (13.1% vs. 6.1%; P<0.001). Liver injury was significantly associated (P<0.001) with the corresponding elevation of serum biomarkers of severity. Conclusion: The presence of liver injury in patients with COVID-19 infection at the time of hospital admission is the independent predictor of poor outcomes and can also be used as the marker of disease severity.
ABSTRACT
The corona virus disease 2019 (COVID-19) pandemic was triggered by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). SARS-CoV-2 infected millions of individuals globally. Despite the recent clearance of several medications, effective and safe COVID-19 vaccinations are still urgently needed, not only to prevent the disease from spreading but also to restore social and economic activity through mass vaccination. We present a case of a 72-year-old female who presented with sudden right abducens nerve palsy after receiving the 2nd dose of booster vaccine following the AstraZeneca COVID-19 vaccine. Because of the temporal association between vaccination and abducens nerve palsy, they assumed her vaccine caused it. The onset of symptoms, the absence of any prior medical conditions, and normal magnetic resonance imaging. This case highlights the importance of determining whether a COVID-19 vaccine could generate neurologic side effects similar to those found with the virus and previous vaccinations.
ABSTRACT
Leprosy is a rare, chronic granulomatous disease, and India accounts for two-thirds of the new cases reported worldwide. Hypercalcemia is a rare complication of granulomatous disease. Here, we report a case of an older adult patient with leprosy and type I lepra reaction presenting with severe hypercalcemia.
