Decompensated Csirrhosis and COVID 19; Report of Two Cases.

Coronavirus disease 2019 (COVID-19) has turned to be the primary health concern worldwide and for critical patients in particular. Patients with cirrhosis may experience decompensation, as presented in the current case report. An 82-year-old man with cirrhosis was admitted for hepatorenal syndrome, and hemodialysis was initiated. Due to manifestations of COVID-19 in computed tomography (CT), the therapeutic protocols of coronavirus were initiated, and the patient was successfully rehabilitated by COVID-19 treatment and trice-a-week hemodialysis. The other case was a 59-year-old woman with cirrhosis and hematemesis, elevated creatinine, and progressive loss of consciousness. CT scan was compatible with COVID-19 confirmed by Real-time polymerase chain reaction (RT-PCR). Irresponsiveness to medical therapy led to four courses of hemodialysis. Respiratory distress led to intubation, and eventually, the cardiopulmonary arrest occurred, which led to unsuccessful cardiopulmonary resuscitation. Cirrhosis may be decompensated by COVID-19 and lead to fatal outcomes. Despite all the conventional efforts to help the patients survive, prevention from coronavirus infection remains the mainstay for patients with cirrhosis.

Clinical Significance of Serum IL-6 and TNF-α Levels in Patients with Metabolic Syndrome.

BACKGROUND: Several components of metabolic syndrome (MetS) facilitate its diagnosis, including abdominal obesity, hyperlipidemia, high blood pressure, and insulin resistance. The production of interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-α) seem to be associated with MetS components. The aim of this study was to evaluate the correlation between IL-6 and TNF-α serum levels with MetS and its components. METHODS: This case-control study investigated 250 subjects, comprising 125 healthy controls from the Kerman Blood Transfusion Organization and 125 MetS patients. Serum IL-6 and TNF-α levels were measured using the enzyme-linked immunosorbent assay (ELISA). RESULTS: Serum IL-6 and TNF-α levels were greater in MetS patients than in controls. However, no correlation was observed between MetS components and IL-6 or TNF-α serum levels. CONCLUSION: Patients with MetS had significantly greater serum IL-6 and TNF-α levels than the controls, supporting the evidence that inflammation plays an important role in the immunopathogenesis of the disease. Additionally, IL-6 and TNF-α serum levels may predict MetS. The lack of association between IL-6 and TNF-α serum levels and MetS components remains to be investigated by further research.