RESUMEN
Aim of the study: Our aim was to evaluate the impact of COVID-19 infection on the liver and alimentary tract. Material and methods: This is a retrospective multicenter study that was performed in non-intensive care units (ICU) at Minia, Assiut, and Sohag University Hospitals from March 1st, 2020 to August 1st, 2020. The clinical characteristics of 1238 consecutively confirmed COVID-19 discharged cases were enrolled. Patients with respiratory distress were recorded as severe cases, while others were recorded as mild-moderate cases. Patients with ≥ 2× upper limit of normal of alanine aminotransferase (ALT), aspartate aminotransferase (AST), or bilirubin were defined as patients with liver injury, while others were recorded as patients without liver injury. Results: The severe group included 460 patients (37.2%) while the mild-moderate group included 778 patients (62.8%). Fever, white blood cell (WBC) and C-reactive protein (CRP) levels were significantly higher in the severe group (p < 0.05). The hepatic injury group included 296 patients (23.9%) while the group without hepatic injury included 942 patients (76.1%). Males were more likely to have liver injury (p < 0.05). Fever and abdominal pain were significantly higher in the hepatic injury group. Patients with liver injury had increased levels of WBCs, CRP and chest computed tomography (CT) score and had a longer hospital stay (p < 0.05). Chest CT score was a predictor of liver injury (p < 0.05). Conclusions: Liver injury in non-ICU hospitalized COVID-19 patients is common but it is mild and has a good prognosis. Liver injury may be related to the degree of chest CT lesions.
RESUMEN
BACKGROUND: Data are scarce on ocular complications in Egyptian patients with chronic hepatitis C treated with pegylated interferon and ribavirin therapy. The aim of this study was to investigate the development of retinal lesions induced by interferon therapy for chronic hepatitis C. METHODS: We prospectively analyzed 84 patients with chronic hepatitis C (total 168 eyes), who underwent combination pegylated interferon and ribavirin therapy for 48 weeks. Visual acuity, color vision, and visual field were measured, and a fundus assessment was made at baseline, at 12, 24, and 48 weeks post the commencement of treatment, and at follow-up, 1 month after treatment. Past medical and ocular histories, visual symptoms, and the results of a full ophthalmologic assessment were recorded for each patient. RESULTS: Twenty-two patients (26%) developed retinopathy. Retinal hemorrhage was observed in eight patients. Four patients complained of visual disturbance. Retinopathy disappeared in 16 patients (73%) despite the continuation of combination therapy. However, retinopathy persisted in six patients with retinal hemorrhage and three of them stopped treatment. A comparison of the clinical backgrounds between the patients with and without retinopathy showed no significant differences with regard to gender, HCV RNA level, white blood cell count, platelet count, hemoglobin level, or fibrosis score. However patients with retinopathy were of older age, had a higher prevalence of hypertension and diabetes mellitus, and more often did not respond to therapy. Multiple logistic regression analysis revealed that hypertension and diabetes were factors predicting retinopathy. CONCLUSION: Retinopathy associated with interferon α-2a and ribavirin combination therapy tends to develop in patients of older age with hypertension and diabetes.
