BACKGROUND: In Coronavirus disease 2019 (COVID-19), the main manifestations were fever, cough, and anosmia. AIM: We aimed to investigate coagulopathy and disseminated intravascular coagulation in severe COVID-19 patients. METHODS: Five cases of COVID-19 with coagulopathy have been reported. RESULTS: All patients presented with various main complaints such as fever, cough, shortness of breath, and diarrhea. An increase in D-dimer value was found in all cases, with an increase of 4–5 times from the upper limit of normal. All patients were evaluated with the IMPROVE-VTE and PADUA thrombotic risk assessment models. Thromboprophylaxis with low molecular weight heparin LMWH intensive dosage was given to four patients. However, one patient was not given thromboprophylaxis because of the high risk of bleeding. All cases were not given long-term thromboprophylaxis after the patients were discharged from the hospital. All hospitalized COVID-19 patients can be considered to give thromboprophylaxis unless contraindicated. Thromboprophylaxis is preferable to use LMWH with a dose adjusted to the severity of COVID-19. Administration of thromboprophylaxis after hospitalization may be considered in patients who have thromboembolic risk factors. CONCLUSION: More research is being encouraged to increase understanding of the prevention and treatment of thrombotic complications of COVID-19.
Introduction: COVID 19 was a disease caused by the SARS-CoV 2 virus with severe respiratory distress syndrome. SARS-CoV 2 can attack the gastrointestinal and liver system. In several studies, elevated levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were reported, ranging from 14% to 53%. The increase of neutrophil to lymphocyte ratio (NLR) also increases the risk of mortality in COVID 19. This research wants to study ALT, AST, and NLR as prognostic and predictor in COVID 19. Methods: A cross sectional retrospective study conducted on COVID 19 patients. The diagnostic criteria are based on the recommendations of the Indonesian Ministry of Health. The patient's blood was examined in a central laboratory at hospital. Data analysis were done using SPSS version 22. Results: A total of 126 patients with COVID 19 were included in this study. There are 57 (45.2%) patients having abnormal liver test. There was a significant difference in the mean AST and NLR between COVID 19 patients with nonsurvival and survive outcome (82.91 ± 103.82 vs. 40.54 ± 33.59 U/L; p = 0.0001 and 7.42 ± 3.65 vs. 3.47 ± 2.41; p = 0.0001). High AST (≥34.5 U/L) and NLR (≥4.7) independently associated with nonsurvival outcome in COVID 19 patient with odds ratio (OR) 5.31 and 9.49 [1.89 – 14.95, 95% CI; p = 0.002 and 3.57 – 25.22, 95% CI; p = 0.0001]. Conclusion: This study revealed that high AST and NLR at hospital admission was associated with high mortality risk in COVID 19 patients. Therefore, the AST and NLR can be a significant prognostic of outcome in COVID 19 patients.
The World Health Organization have declared COVID-19 as a pandemic. The COVID-19, caused by SARS-CoV-2, is spreading at an alarming rate and creates a significant worldwide burden to the economy while increasing morbidity and mortality. While COVID-19 was primarily considered as a respiratory-infection disease, several reports have shown that many COVID-19 infected patients have presented or developed some digestive symptoms. Many studies also demonstrated, using reverse transcriptase-polymerase chain reaction method, that SARS-CoV-2 are present in stools or other gastrointestinal tract secretions. All these reports raised the possibility of COVID-19 transmission via the fecal-oral route and the involvement of the gastrointestinal-liver system. Until further studies are available, physicians should be aware of the digestive manifestation of COVID-19 and use universal precautions to avoid the transmission of COVID-19 via the fecal-oral route.
Polycystic liver disease is characterized by multiple cystic lesions on the liver. Liver cysts are typically incidental findings, with occasional complications including cyst hemorrhage, infection and rupture. Polycystic liver disease may be part of autosomal dominant polycystic liver disease (ADPLD). Autosomal dominant polycystic liver disease is considered rare autosomal dominant disease, with prevalence of 1/100,000-1,000,000. Without family history of polycystic liver disease, ADPLD is defined as the presence of more than 20 liver cysts with no renal cysts, however up to third of ADPLD may have small number of renal cysts without kidney function impairment. This case of a 73-year-old woman with symptomatic polycystic liver disease, and we performed cyst fenestration-deroofing via laparoscopic.
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