Background The coronavirus disease 2019 (COVID-19) pneumonia, outbreak in Wuhan, China, has led to a global pandemic. The high mortality of COVID-19 patients makes it significant to evaluate possible disease progression. This study was designed to explore the prognostic value of Controlling Nutritional Status (CONUT) score in patients with COVID-19. Methods Patients diagnosed with COVID-19 of a single center in Wuhan, China from January 2020 to February 2020 were enrolled in this study. Logistic regression analysis was performed to find independent risk factor of mortality. Receiver operating characteristics (ROC) curve was drawn to evaluate the prognostic value of CONUT score. Results Among 442 included patients, there were 79 non-survivors with mortality of 17.9%. Compared with survivors, the median age (p < 0.001) and male ratio (p = 0.042) were higher in non-survivors. Non-survivors had higher incidence of comorbidities including hypertension (p < 0.001), chronic lung disease (p = 0.001) and cardiovascular disease (p = 0.005). Complications such as respiratory failure(p < 0.001), acute kidney injury (AKI) (p < 0.001) occurred more frequently in non-survivors. Multivariate logistic regression analysis showed that CONUT (p = 0.002), lactate dehydrogenase (LDH) (p < 0.001), C-reactive protein (CRP) (p = 0.020) were risk factor of mortality in COVID-19 patients. Area under the ROC curve (AUC) of CONUT and Nutrition risk screening 2002 (NRS2002) score were 0.813 and 0.795, respectively. Comprised of CONUT, LDH, CRP, the constructed prognostic model had higher AUC of 0.923 (Z = 3.5210, p < 0.001). Conclusion CONUT is an independent risk factor of mortality in COVID-19 patients. Evaluating CONUT is beneficial for clinicians to predict the progression of COVID-19 patients and strengthen monitoring and management to improve prognosis.

Both combination therapies led to a significant decrease in HBV DNA. HBeAg serological outcomes were higher with telbivudine plus ADV combination therapy.

BackgroundAntithyroid drugs carry a potential risk of hepatotoxicity. Propylthiouracil (PTU) is commonly prescribed for patients with hyperthyroidism. PTU, however, can induce liver injury, ranging from mild asymptomatic elevation of aminotransferases to acute liver failure (ALF).Case presentationThis case reports on a 16-year-old Chinese girl with hyperthyroidism, who was admitted to our hospital for jaundice, nausea, and fatigue associated with severe hyperbilirubinemia and coagulopathy. She had been prescribed PTU 5 months earlier. There was no history of hypersensitivity to drugs, viral liver diseases, blood transfusion, or surgery. On the basis of her symptoms and the clinical data, she was diagnosed with PTU-induced ALF. Due to the limited number of available donor organs for liver transplantation, she was started on treatment with artificial liver support system (ALSS). After four sessions of ALSS, her clinical signs and symptoms were found to be markedly improved, and she was discharged 25 days after admission. Four months later, her liver function normalized.ConclusionAlthough PTU-induced liver failure is rare in clinical practice, liver function should be appropriately monitored during treatment with PTU. PTU-induced ALF in this patient was successfully managed with an ALSS, suggesting that the latter may be an alternative to liver transplantation.

Background— Some patients with comorbidities and rapid disease progression have a poor prognosis.Aim—In this study, we aimed to investigate the distribution characteristics of comorbidities and their relationship with disease progression and outcomes of COVID-19 patients.Methods— A total of 718 COVID-19 patients were divided into five clinical type groups and eight age-interval groups. The distribution characteristics of comorbidities were compared between the different clinical type groups and between the different age-interval groups, and their relationships with disease progression and outcomes of COVID-19 patients were assessed.Results—Approximately 88.62% (637/718) of the COVID-19 patients were twenty to fifty-nine years old. Approximately 65.73% (554/718) had one or more comorbidities, and common comorbidities included non-alcoholic fatty liver disease (NAFLD), hyperlipidaemia, hypertension, diabetes mellitus (DM), chronic hepatitis B (CHB), hyperuricaemia and gout. COVID-19 patients with comorbidities were older, especially those with chronic obstructive pulmonary disease (COPD) and cardiovascular disease (CVD). Hypertension, DM, COPD, chronic kidney disease (CKD) and CVD were mainly found in severe COVID-19 patients, and hypertension, CKD and CVD were primarily associated with those who died. Risk factors included the number of comorbidities and hyperlipidaemia for disease severity, age, the number of comorbidities, hyperlipidaemia, NAFLD and COPD for the virus negative conversion time, and the number of comorbidities and CKD for prognosis. Number of comorbidities played a predictive role in disease progression and outcomes.Conclusions—These findings provide a reference for clinicians to focus on the number and specific comorbidities in COVID-19 patients to predict disease progression and prognosis.Clinical Trial Registry: Chinese Clinical Trial Register ChiCTR2000034563

Tenofovir (TFV), an acyclic nucleoside analog, exhibits potent anti-HBV activity. However, poor bioavailability, nephrotoxicity and bone toxicity limit its further clinical application. In this work, a novel tenofovir-loaded glycyrrhetinic acidmodified cationic liposome (TGCL) was prepared for targeted therapy of HBV. The TGCL had an average particle size of 107.39 ± 1.21 nm and an entrapment efficiency of 89.83 ± 2.70% with a positive zeta potential of 37.63 ± 1.22 mV. The results of in vitro indicated that the inhibitory effects on HBsAg, HBeAg and HBV cccDNA of TGCL in HepG2.2.15 cells were significantly better than that of free TFV and non-targeted cationic liposome. In the DHBV-infected duck model, TGCL showed remarkably suppression on DHBV DNA than that of free TFV. Overall, TGCL is a promising formulation of TFV for targeted therapy of HBV.

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Background: The contributing factors of abnormal glucose metabolism and the characteristics of the homeostasis model assessment of β cell function (HOMA-β) value in chronic hepatitis B (CHB) patients are unclear and worth studying.Method: This cross-sectional study recruited 110 CHB patients (CHB group) and 110 patients without hepatitis B virus (non-HBV group); the groups were matched according to sex, age, and body mass index. The contributing factors of abnormal glucose metabolism and the characteristics and differences in glucose metabolism parameters between the two groups were analyzed.Results: The abnormal glucose metabolism rate was higher in CHB patients with liver cirrhosis (LC) and patients with hepatitis B envelope antigen (HBeAg) (-) status. In addition, under the same glucose metabolism conditions, the fasting plasma glucose (FPG) levels of the CHB group was higher than that of the non-HBV group, especially in those with LC that had higher FPG levels (all p=0.000), while the HOMA-β values was significantly lower in the CHB group than in the non-HBV group, especially under normal glucose tolerance conditions (all p=0.000). Further analyses revealed that the main contributing factors of abnormal glucose metabolism were HBeAg (-) status and hepatitis B envelope antibody levels, but HBV serological and virological indicators had no direct effect on the HOMA-β value.Conclusion: These findings provide a reference that will allow clinicians to monitor abnormal glucose metabolism in CHB patients, especially those with LC or HBeAg (-) status, focus on the protection of islet β-cell function, and avoid the application of insulin secretagogues in CHB patients with abnormal glucose metabolism.

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