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1.
Vet Clin North Am Food Anim Pract ; 36(3): 715-723, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-33032701

RESUMO

The liver is one of the most commonly affected organs by ingested toxicants. This article familiarizes veterinarians with clinical signs, serum biochemistry changes, necropsy findings, and field information found in livestock poisonings with hepatotoxic plants. The focus is on the most common plant-derived hepatotoxins important to livestock in North America. Pyrrolizidine alkaloids are covered in greater detail than the other toxins, because they are likely the most important plant-derived toxins worldwide in livestock, wildlife, and even human exposure. Additionally, many of the principles discussed regarding clinical diagnosis of pyrrolizidine alkaloid intoxication can be applied to the other poisonous plants listed.


Assuntos
Doenças dos Bovinos/etiologia , Hepatopatias/veterinária , Intoxicação por Plantas/veterinária , Plantas Tóxicas/envenenamento , Animais , Bovinos , Hepatopatias/etiologia , Gado , América do Norte , Intoxicação por Plantas/etiologia , Alcaloides de Pirrolizidina/envenenamento
2.
Semin Liver Dis ; 40(3): 321-330, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32886936

RESUMO

Liver injury can result from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with more than one-third of COVID-19 patients exhibiting elevated liver enzymes. Microvesicular steatosis, inflammation, vascular congestion, and thrombosis in the liver have been described in autopsy samples from COVID-19 patients. Several factors, including direct cytopathic effect of the virus, immune-mediated collateral damage, or an exacerbation of preexisting liver disease may contribute to liver pathology in COVID-19. Due to its immunological functions, the liver is an organ likely to participate in the viral response against SARS-CoV-2 and this may predispose it to injury. A better understanding of the mechanism contributing to liver injury is needed to develop and implement early measures to prevent serious liver damage in patients suffering from COVID-19. This review summarizes current reports of SARS-CoV-2 with an emphasis on how direct infection and subsequent severe inflammatory response may contribute to liver injury in patients with and without preexisting liver disease.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Hepatopatias/etiologia , Pandemias , Pneumonia Viral/complicações , Infecções por Coronavirus/epidemiologia , Humanos , Pneumonia Viral/epidemiologia
3.
BMC Pregnancy Childbirth ; 20(1): 511, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32887569

RESUMO

BACKGROUND: It has been proposed that pregnant women and their fetuses may be particularly at risk for poor outcomes due to the coronavirus (COVID-19) pandemic. From the few case series that are available in the literature, women with high risk pregnancies have been associated with higher morbidity. It has been suggested that pregnancy induced immune responses and cardio-vascular changes can exaggerate the course of the COVID-19 infection. CASE PRESENTATION: A 26-year old Somalian woman (G2P1) presented with a nine-day history of shortness of breath, dry cough, myalgia, nausea, abdominal pain and fever. A nasopharyngeal swab returned positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Her condition rapidly worsened leading to severe liver and coagulation impairment. An emergency Caesarean section was performed at gestational week 32 + 6 after which the patient made a rapid recovery. Severe COVID-19 promptly improved by the termination of the pregnancy or atypical HELLP (Hemolysis, Elevated Liver Enzymes and Low Platelet Count) exacerbated by concomitant COVID-19 infection could not be ruled out. There was no evidence of vertical transmission. CONCLUSIONS: This case adds to the growing body of evidence which raises concerns about the possible negative maternal outcomes of COVID-19 infection during pregnancy and advocates for pregnant women to be recognized as a vulnerable group during the current pandemic.


Assuntos
Transtornos da Coagulação Sanguínea/sangue , Cesárea , Infecções por Coronavirus/sangue , Hepatopatias/sangue , Obesidade Materna , Pneumonia Viral/sangue , Complicações Infecciosas na Gravidez/sangue , Adulto , Antitrombina III/metabolismo , Índice de Apgar , Betacoronavirus , Transtornos da Coagulação Sanguínea/etiologia , Infecções por Coronavirus/complicações , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/fisiopatologia , Diagnóstico Diferencial , Feminino , Produtos de Degradação da Fibrina e do Fibrinogênio/metabolismo , Síndrome HELLP/diagnóstico , Humanos , Recém-Nascido , Recém-Nascido Prematuro , L-Lactato Desidrogenase/sangue , Hepatopatias/etiologia , Pulmão/diagnóstico por imagem , Masculino , Pandemias , Tempo de Tromboplastina Parcial , Contagem de Plaquetas , Pneumonia Viral/complicações , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/fisiopatologia , Gravidez , Complicações Infecciosas na Gravidez/fisiopatologia , Suécia , Tomografia Computadorizada por Raios X
4.
Ups J Med Sci ; 125(4): 293-296, 2020 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-32990149

RESUMO

BACKGROUND: The novel coronavirus disease 2019 (COVID-19) is currently breaking out worldwide. COVID-19 patients may have different degrees of coagulopathy, but the mechanism is not yet clear. We aimed to analyse the relationship between coagulation dysfunction and liver damage in patients with COVID-19. METHODS: A retrospective analysis of 74 patients with COVID-19 admitted to the First People's Hospital of Yueyang from 1 January to 30 March 2020 was carried out. According to the coagulation function, 27 cases entered the coagulopathy group and 47 cases entered the control group. A case control study was conducted to analyse the correlation between the occurrence of coagulation dysfunction and liver damage in COVID-19 patients. RESULTS: Alanine aminotransferase (ALT) and aspartate aminotransferase (AST), markers of liver damage, were positively correlated with coagulopathy (p = 0.039, OR 2.960, 95% CI 1.055-8.304; and p = 0.028, OR 3.352, 95% CI 1.137-9.187). Alkaline phosphatase (ALP), γ-glutamyl transpeptidase (γ-GT), and total bilirubin (TBIL) were not statistically correlated with coagulopathy. According to the diagnosis and treatment plan, the included cases were classified into mild, moderate, severe, and critical. The results showed that the occurrence of coagulation dysfunction had no statistical correlation with the severity of COVID-19. CONCLUSION: Coagulation dysfunction in patients with COVID-19 is closely related to liver damage. A longer course of the disease may cause a vicious circle of coagulopathy and liver damage. Clinicians need to closely monitor coagulation and liver function tests and to give prophylactic or supportive therapy when needed.


Assuntos
Betacoronavirus , Transtornos da Coagulação Sanguínea/etiologia , Infecções por Coronavirus/complicações , Hepatopatias/etiologia , Pneumonia Viral/complicações , Adulto , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Biomarcadores/sangue , Transtornos da Coagulação Sanguínea/fisiopatologia , Estudos de Casos e Controles , China , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Feminino , Humanos , Hepatopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Estudos Retrospectivos , Fatores de Risco
5.
Hepatol Int ; 14(5): 733-742, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32886333

RESUMO

BACKGROUND AND AIMS: Liver injury is found in some of patients with COVID-19. Liver injury of COVID-19 patients based on severity grading and abdominal radiological signs have not been reported until now. The aim of our study is to determine clinical profiles of the patients based on severity grading, describe abdominal radiological signs, and investigate the correlations of the severity with clinical profiles and radiological signs. METHODS: This retrospective cohort study included 115 patients with COVID-19 from Jan 2020 to Feb 2020. Medical records of the patients were collected and CT images were reviewed. RESULTS: Common clinical manifestations of patients with COVID-19 were fever (68.70%), cough (56.52%), fatigue (31.30%); some of them had gastrointestinal symptoms (diarrhea, 12.17%; nausea or vomiting 7.83%; inappetence, 7.83%). Abnormal liver function was observed in some of patients with COVID-19. Significant differences in the levels of AST, albumin,CRP were observed among different groups classified by the severity. Common findings of upper abdominal CT scan were liver hypodensity (26.09%) and pericholecystic fat stranding (21.27%); liver hypodensity was more frequently found in critical cases (58.82%). The severity of COVID-19 correlated with semi-quantitative CT score of pulmonary lesions, CT-quantified liver/spleen attenuation ratio in patients with COVID-19. CONCLUSIONS: Some of the patients with COVID-19 displayed liver damage revealed by liver functional tests and upper abdominal CT imaging, and the severity of COVID-19 patients correlated with some of liver functional tests and CT signs; thus, it will allow an earlier identification of high-risk patients for early effective intervention.


Assuntos
Betacoronavirus/isolamento & purificação , Infecções por Coronavirus , Hepatopatias , Testes de Função Hepática/métodos , Fígado , Pandemias , Pneumonia Viral , Tomografia Computadorizada por Raios X/métodos , China/epidemiologia , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/fisiopatologia , Feminino , Humanos , Fígado/diagnóstico por imagem , Fígado/metabolismo , Hepatopatias/diagnóstico , Hepatopatias/epidemiologia , Hepatopatias/etiologia , Hepatopatias/fisiopatologia , Masculino , Pessoa de Meia-Idade , Pneumonia Viral/diagnóstico , Pneumonia Viral/epidemiologia , Pneumonia Viral/fisiopatologia , Estudos Retrospectivos , Índice de Gravidade de Doença
6.
Gastroenterol Hepatol ; 43(8): 464-471, 2020 Oct.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-32859408

RESUMO

The SARS-CoV-2 pandemic is leading to high mortality and a global health crisis. The primary involvement is respiratory; however, the virus can also affect other organs, such as the gastrointestinal tract and liver. The most common symptoms are anorexia and diarrhea. In about half of the cases, viral RNA could be detected in the stool, which is another line of transmission and diagnosis. covid19 has a worse prognosis in patients with comorbidities, although there is not enough evidence in case of previous digestive diseases. Digestive endoscopies may give rise to aerosols, which make them techniques with a high risk of infection. Experts and scientific organizations worldwide have developed guidelines for preventive measures. The available evidence on gastrointestinal and hepatic involvement, the impact on patients with previous digestive diseases and operating guidelines for Endoscopy Units during the pandemic are reviewed.


Assuntos
Betacoronavirus/patogenicidade , Infecções por Coronavirus/complicações , Doenças do Sistema Digestório/etiologia , Sistema Digestório/virologia , Pandemias , Pneumonia Viral/complicações , Aerossóis , Anorexia/etiologia , Antivirais/efeitos adversos , Betacoronavirus/isolamento & purificação , Betacoronavirus/fisiologia , Estudos de Coortes , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/prevenção & controle , Infecções por Coronavirus/transmissão , Diarreia/etiologia , Doenças do Sistema Digestório/virologia , Endoscopia do Sistema Digestório/efeitos adversos , Fezes/virologia , Humanos , Imunossupressores/efeitos adversos , Intestinos/química , Intestinos/virologia , Hepatopatias/etiologia , Estudos Multicêntricos como Assunto , Pandemias/prevenção & controle , Peptidil Dipeptidase A/análise , Peptidil Dipeptidase A/fisiologia , Equipamento de Proteção Individual , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/prevenção & controle , Pneumonia Viral/transmissão , Receptores Virais/análise , Receptores Virais/fisiologia , Risco , Precauções Universais
7.
Eur Rev Med Pharmacol Sci ; 24(14): 7855-7860, 2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32744713

RESUMO

We present the case details of seven patients diagnosed with severe novel coronavirus disease 2019 (2019-nCoV, hereafter COVID-19) with hepatic injury. Most of these patients were elderly and had hypertension, diabetes mellitus, coronary heart disease, and other underlying health conditions prior to admission for COVID-19. Liver injury occurred in all seven cases during the course of the disease. Serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels initially increased (1.2-times to 2.0-times the normal value, respectively) in the second week. The liver function recovered in all patients within one week of conventional liver protection treatment. Elevated serum transaminase levels in these patients were due to the COVID-19 infection but could also be related to systemic immune response caused by cytokine storm syndrome (CSS) and hepatocyte damage caused by ischemia and hypoxia. COVID-19 is highly infectious and mainly affects the lungs. In some cases, especially in patients with severe disease type, COVID-19 may also cause liver injury. The liver function of patients with severe COVID-19 should be very carefully monitored, especially if the patients are elderly and have underlying comorbidities.


Assuntos
Infecções por Coronavirus/patologia , Hepatopatias/diagnóstico , Pneumonia Viral/patologia , Idoso , Alanina Transaminase/sangue , Aspartato Aminotransferases/sangue , Betacoronavirus/isolamento & purificação , Doença das Coronárias/complicações , Infecções por Coronavirus/complicações , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/virologia , Feminino , Humanos , Hipertensão/complicações , Hepatopatias/etiologia , Pulmão/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/imunologia , Pneumonia Viral/virologia , Índice de Gravidade de Doença , Tomografia Computadorizada por Raios X
9.
Indian J Gastroenterol ; 39(3): 268-284, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32749643

RESUMO

BACKGROUND: Many case series on Corona Virus Disease (COVID-19) have reported gastrointestinal (GI) and hepatic manifestations in a proportion of cases; however, the data is conflicting. The relationship of GI and hepatic involvement with severe clinical course of COVID-19 has also not been explored. OBJECTIVES: The main objectives were to determine the frequency of GI and hepatic manifestations of COVID-19 and to explore their relationship with severe clinical course. METHODS: We searched PubMed for studies published between January 1, 2020, and March 25, 2020, with data on GI and hepatic manifestations in adult patients with COVID-19. These data were compared between patients with severe and good clinical course using the random-effects model and odds ratio (OR) as the effect size. If the heterogeneity among studies was high, sensitivity analysis was performed for each outcome. RESULTS: We included 62 studies (8301 patients) in the systematic review and 26 studies (4676 patients) in the meta-analysis. Diarrhea was the most common GI symptom (9%), followed by nausea/vomiting (5%) and abdominal pain (4%). Transaminases were abnormal in approximately 25%, bilirubin in 9%, prothrombin time (PT) in 7%, and low albumin in 60%. Up to 20% patients developed severe clinical course, and GI and hepatic factors associated with severe clinical course were as follows: diarrhea (OR 2), high aspartate aminotransferase (OR 1.4), high alanine aminotransferase (OR 1.6), high bilirubin (OR 2.4), low albumin (OR 3.4), and high PT (OR 3). CONCLUSIONS: GI and hepatic involvement should be sought in patients with COVID-19 since it portends severe clinical course. The pathogenesis of GI and hepatic involvement needs to be explored in future studies.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Gastroenteropatias , Trato Gastrointestinal/fisiopatologia , Hepatopatias , Pandemias , Pneumonia Viral , Betacoronavirus/isolamento & purificação , Betacoronavirus/patogenicidade , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/fisiopatologia , Gastroenteropatias/diagnóstico , Gastroenteropatias/etiologia , Humanos , Hepatopatias/diagnóstico , Hepatopatias/etiologia , Pneumonia Viral/diagnóstico , Pneumonia Viral/fisiopatologia , Índice de Gravidade de Doença
10.
Artigo em Inglês | MEDLINE | ID: mdl-32665398

RESUMO

OBJECTIVE: Severe liver damage is associated with worse outcome in COVID-19. Our aim was to explore the degree of liver damage, liver stiffness (LS) and severity of illness in patients with COVID-19. DESIGN: We investigated 32 patients with COVID-19 admitted to the University Hospital of Innsbruck in a prospective cross-sectional study. We performed laboratory testing, liver and spleen sonography and elastography to measure organ stiffness. RESULTS: 12 patients (38%) showed elevated aminotransferases and gamma-glutamyltransferase levels. LS was positively correlated with elevated aminotransferase levels in patients with COVID-19 compared with those without elevated enzymes. Even mild liver damage raised LS significantly in COVID-19 as it was in patients with gastrointestinal symptoms. Furthermore, higher LS measurements were significantly associated with illness severity like pneumonia, need for mechanical ventilation, and even death. CONCLUSION: Transient elastography is a useful and non-invasive tool to assess onset and severity of acute liver injury in patients with COVID-19 patients. Increased LS seems to be predictive for a more severe and complicated course of disease.


Assuntos
Betacoronavirus/genética , Infecções por Coronavirus/complicações , Técnicas de Imagem por Elasticidade/métodos , Hepatopatias/diagnóstico , Fígado/diagnóstico por imagem , Pneumonia Viral/complicações , Idoso , Biópsia , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Estudos Transversais , DNA Viral/análise , Feminino , Humanos , Hepatopatias/etiologia , Testes de Função Hepática , Masculino , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Estudos Prospectivos , Reprodutibilidade dos Testes , Índice de Gravidade de Doença
11.
Zhonghua Gan Zang Bing Za Zhi ; 28(6): 523-527, 2020 Jun 20.
Artigo em Chinês | MEDLINE | ID: mdl-32660185

RESUMO

The highly contagious novel coronavirus pneumonia (COVID-19) that broke out in December 2019 has brought huge threats and losses to human society, so it has been the concern of every countries government. Presently, there are no specific drugs for COVID-19; however, a variety of potentially effective antiviral drugs, vaccines, cell therapies, traditional Chinese medicine and other methods are in clinical trials. Liver injury is a common complication of patients receiving COVID-19 treatment and its possible high incidence may affect the outcome of the disease. The pathogenesis of COVID-19 combined with liver injury in existing studies is still unclear, and relevant guidelines and expert consensuses are insufficient for clinical diagnosis and treatment. Therefore, the relevant progress and issues are now reviewed here.


Assuntos
Betacoronavirus , Infecções por Coronavirus , Hepatopatias/etiologia , Pandemias , Pneumonia Viral , Infecções por Coronavirus/complicações , Infecções por Coronavirus/tratamento farmacológico , Humanos , Fígado , Pneumonia Viral/complicações
13.
Expert Rev Gastroenterol Hepatol ; 14(10): 879-884, 2020 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-32649840

RESUMO

INTRODUCTION: The outbreak of COVID-19 is a serious health threat worldwide. Different degrees of liver injury or liver dysfunctions have been reported in patients with COVID-19 infection. However, currently, it remains unclear to what extent liver diseases should be considered as significant risk factors for the severity and mortality of COVID-19. Moreover, the mechanisms involved in liver injury in severe COVID-19 infection are not yet well understood. AREA COVERED: This review summarizes the current evidence on liver function abnormalities in COVID-19 patients and the effects of preexisting liver disease on the disease severity. This review also illustrates the possible underlying mechanisms linking COVID-19 to liver injury, as well as provides recommendations to prevent liver damage in COVID-19 infection. EXPERT OPINION: The elevated levels of ALT, AST, GGT and bilirubin are common in more severe patients than non-severe or mild COVID-19 patients. Patients with preexisting medical conditions including chronic hepatic diseases are at higher risk for severe illness from COVID-19 infection. The drug's effects, possible viral inclusion in liver cells, systemic inflammation and hypoxia are potential causes of liver injury in severe COVID-19. Nevertheless, further studies are needed focusing on the preexisting hepatic diseases on prevention, treatment and outcome of COVID-19.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Hepatopatias/etiologia , Pandemias , Pneumonia Viral/complicações , Infecções por Coronavirus/epidemiologia , Saúde Global , Humanos , Hepatopatias/diagnóstico , Hepatopatias/epidemiologia , Testes de Função Hepática , Morbidade/tendências , Pneumonia Viral/epidemiologia , Fatores de Risco , Índice de Gravidade de Doença
14.
Life Sci ; 257: 118130, 2020 Sep 15.
Artigo em Inglês | MEDLINE | ID: mdl-32710950

RESUMO

BACKGROUND AND OBJECTIVES: Sepsis is a life-threatening organ dysfunction syndrome arising from uncontrolled inflammatory responses. Liver injury is a crucial factor for the prognosis of sepsis. Camptothecins (CPTs) have been reported to suppress the inflammatory response induced by sepsis. G2, a CPT-bile acid conjugate, has been demonstrated the property of liver targeting in our previous research. This study aimed to research the effects of G2 on liver injury induced by cecal ligation and puncture (CLP). METHODS: C57BL/6 mice were subjected to CLP surgery, and effects of G2 on liver damage and survival rates of CLP-induced mice were evaluated. To detect the related markers of hepatic injury or neutrophil infiltration, inflammatory cytokines and protein levels, hematoxylin-eosin staining assay, corresponding Detection Kits assay, ELISA and Western blot analysis were performed. RESULTS: Intraperitoneal administration of G2 reduced liver injury and enhanced the survival rates in mice with sepsis. Treatment with G2 decreased the levels of hepatic injury markers aspartate aminotransferase (AST) and alanine aminotransferase (ALT) in the serum of mice induced by CLP. The hepatic level of neutrophil infiltration marker myeloperoxidase (MPO) was reduced in G2 administration group. And the levels of serum inflammatory cytokines, including Tumor Necrosis Factor-α (TNFα), Interleukin-6 (IL-6) and IL-1ß, were decreased by G2. Furthermore, the results of Western blot analysis indicated that G2 suppressed the up-regulation of NF-κB p-P65 and p-IκBα. It suggested that G2 suppressed the activation of NF-κB signaling pathway. CONCLUSION: G2 alleviated sepsis-induced liver injury via inhibiting the NF-κB signaling pathway.


Assuntos
Ácidos e Sais Biliares/uso terapêutico , Camptotecina/uso terapêutico , Hepatopatias/etiologia , NF-kappa B/metabolismo , Sepse/complicações , Transdução de Sinais/efeitos dos fármacos , Alanina Transaminase/sangue , Animais , Aspartato Aminotransferases/sangue , Ácidos e Sais Biliares/administração & dosagem , Western Blotting , Camptotecina/administração & dosagem , Citocinas/sangue , Modelos Animais de Doenças , Ensaio de Imunoadsorção Enzimática , Hepatopatias/metabolismo , Hepatopatias/prevenção & controle , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Peroxidase/metabolismo
15.
Indian J Gastroenterol ; 39(3): 232-235, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32621206

RESUMO

The novel coronavirus Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) infection has been mostly leading to respiratory distress syndrome, but liver injury has also been documented. The mechanism of liver injury is limited and poorly understood. However, the hepatic injury could be due to a consequence of systemic inflammatory response, viral infection of hepatocytes, or as a result of intensive care treatment or drug toxicity. Based on the current studies, this review article emphasizes on the demographic and potential mechanisms of Corona Virus Disease (COVID)-19-related liver dysfunction.


Assuntos
Betacoronavirus/fisiologia , Infecções por Coronavirus , Hepatopatias , Pandemias , Pneumonia Viral , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/terapia , Infecções por Coronavirus/virologia , Interações entre Hospedeiro e Microrganismos/fisiologia , Humanos , Hepatopatias/diagnóstico , Hepatopatias/epidemiologia , Hepatopatias/etiologia , Hepatopatias/metabolismo , Testes de Função Hepática/métodos , Pneumonia Viral/epidemiologia , Pneumonia Viral/terapia , Pneumonia Viral/virologia
17.
World J Gastroenterol ; 26(19): 2286-2293, 2020 May 21.
Artigo em Inglês | MEDLINE | ID: covidwho-494377

RESUMO

In December 2019, a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified in Wuhan, China causing coronavirus disease-2019 (COVID-19). Numerous studies have shown varying degrees of liver damage in patients infected with SARS-CoV-2. However, in previous case studies of COVID-19, the exact cause of liver injury has not been clearly elucidated, nor is there clear evidence of the interaction between liver injury and COVID-19. This study will analyze the causes of liver injury in COVID-19 and the influence of liver-related complications on the treatment and prognosis of COVID-19.


Assuntos
Infecções por Coronavirus/complicações , Hepatopatias/terapia , Hepatopatias/virologia , Pneumonia Viral/complicações , Adulto , Idoso , Betacoronavirus , Comorbidade , Infecções por Coronavirus/virologia , Feminino , Humanos , Fígado/virologia , Hepatopatias/etiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Prognóstico
18.
World J Gastroenterol ; 26(19): 2323-2332, 2020 May 21.
Artigo em Inglês | MEDLINE | ID: covidwho-482512

RESUMO

The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) that causes coronavirus disease-2019 (COVID-19) is a global pandemic, manifested by an infectious pneumonia. Although patients primarily present with fever, cough and dyspnea, some patients also develop gastrointestinal (GI) and hepatic manifestations. The most common GI symptoms reported are diarrhea, nausea, vomiting, and abdominal discomfort. Liver chemistry abnormalities are common and include elevation of aspartate transferase, alanine transferase, and total bilirubin. Studies have shown that SARS-CoV-2 infects the GI tract via its viral receptor angiotensin converting enzyme II, which is expressed on enterocytes of the ileum and colon. Viral RNA has also been isolated from stool specimens of COVID-19 patients, which raised the concern for fecal-oral transmission in addition to droplet transmission. Although indirect evidence has suggested possible fecal-oral transmission of SARS-CoV-2, more effort is needed to establish the role of the fecal-oral transmission route. Further research will help elucidate the association between patients with underlying GI diseases, such as chronic liver disease and inflammatory bowel disease, and severity of COVID-19. In this review, we summarize the data on GI involvement to date, as well as the impact of COVID-19 on underlying GI diseases.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Gastroenteropatias/virologia , Hepatopatias/virologia , Pneumonia Viral/complicações , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Transmissão de Doença Infecciosa , Gastroenteropatias/epidemiologia , Gastroenteropatias/etiologia , Trato Gastrointestinal/virologia , Humanos , Doenças Inflamatórias Intestinais/epidemiologia , Fígado/virologia , Hepatopatias/epidemiologia , Hepatopatias/etiologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
19.
World J Gastroenterol ; 26(19): 2286-2293, 2020 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-32476793

RESUMO

In December 2019, a novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified in Wuhan, China causing coronavirus disease-2019 (COVID-19). Numerous studies have shown varying degrees of liver damage in patients infected with SARS-CoV-2. However, in previous case studies of COVID-19, the exact cause of liver injury has not been clearly elucidated, nor is there clear evidence of the interaction between liver injury and COVID-19. This study will analyze the causes of liver injury in COVID-19 and the influence of liver-related complications on the treatment and prognosis of COVID-19.


Assuntos
Infecções por Coronavirus/complicações , Hepatopatias/terapia , Hepatopatias/virologia , Pneumonia Viral/complicações , Adulto , Idoso , Betacoronavirus , Comorbidade , Infecções por Coronavirus/virologia , Feminino , Humanos , Fígado/virologia , Hepatopatias/etiologia , Masculino , Pessoa de Meia-Idade , Pandemias , Pneumonia Viral/virologia , Prognóstico
20.
World J Gastroenterol ; 26(19): 2323-2332, 2020 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-32476796

RESUMO

The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) that causes coronavirus disease-2019 (COVID-19) is a global pandemic, manifested by an infectious pneumonia. Although patients primarily present with fever, cough and dyspnea, some patients also develop gastrointestinal (GI) and hepatic manifestations. The most common GI symptoms reported are diarrhea, nausea, vomiting, and abdominal discomfort. Liver chemistry abnormalities are common and include elevation of aspartate transferase, alanine transferase, and total bilirubin. Studies have shown that SARS-CoV-2 infects the GI tract via its viral receptor angiotensin converting enzyme II, which is expressed on enterocytes of the ileum and colon. Viral RNA has also been isolated from stool specimens of COVID-19 patients, which raised the concern for fecal-oral transmission in addition to droplet transmission. Although indirect evidence has suggested possible fecal-oral transmission of SARS-CoV-2, more effort is needed to establish the role of the fecal-oral transmission route. Further research will help elucidate the association between patients with underlying GI diseases, such as chronic liver disease and inflammatory bowel disease, and severity of COVID-19. In this review, we summarize the data on GI involvement to date, as well as the impact of COVID-19 on underlying GI diseases.


Assuntos
Betacoronavirus , Infecções por Coronavirus/complicações , Gastroenteropatias/virologia , Hepatopatias/virologia , Pneumonia Viral/complicações , Comorbidade , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/transmissão , Infecções por Coronavirus/virologia , Transmissão de Doença Infecciosa , Gastroenteropatias/epidemiologia , Gastroenteropatias/etiologia , Trato Gastrointestinal/virologia , Humanos , Doenças Inflamatórias Intestinais/epidemiologia , Fígado/virologia , Hepatopatias/epidemiologia , Hepatopatias/etiologia , Pandemias , Pneumonia Viral/epidemiologia , Pneumonia Viral/transmissão , Pneumonia Viral/virologia
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