Risk factors for clinical outcomes of COVID-19 pneumonia have not yet been well established in patients with underlying liver diseases. Our study aimed to describe the clinical characteristics and outcomes of COVID-19 infection among patients with underlying liver diseases and determine the risk factors for severe COVID-19 among them. In a retrospective analytical study, 1002 patients with confirmed COVID-19 pneumonia were divided into two groups: patients with and without underlying liver diseases. The admission period was from 5 March to 14 May 2020. The prevalence of underlying conditions, Demographic data, clinical parameters, laboratory data, and participants' outcomes were evaluated. Logistic regression was used to estimate the predictive factors. Eighty-one (8%) of patients had underlying liver diseases. The frequencies of gastrointestinal symptoms such as diarrhea and vomiting were significantly higher among patients with liver diseases (48% vs. 25% and 46.1% vs. 30% respectively, both P < 0.05). Moreover, ALT and AST were significantly higher among patients with liver diseases (54.5 ± 45.6 vs. 37.1 ± 28.4, P = 0.013 and 41.4 ± 27.2 vs. 29.2 ± 24.3, P = 0.028, respectively). Additionally, the mortality rate was significantly high in patients with liver disease (12.4% vs. 7%, P = 0.018). We also observed that the parameters such as neutrophil to leukocyte ratio [Odds Ratio Adjusted (ORAdj) 1.81, 95% CI 1.21–3.11, P = 0.011] and blood group A (ORAdj 1.59, 95% CI 1.15–2.11, P = 0.001) were associated with progression of symptoms of COVID-19. The presence of underlying liver diseases should be considered one of the poor prognostic factors for worse outcomes in patients with COVID-19.
Background Pancreatic cancer (PC) is among the deadliest cancers of the gastrointestinal tract worldwide and a growing global health concern. Aim This study was aimed to evaluate the survival rate and prognostic factors of survival in patients with PC. Methods In this retrospective cohort study, the records of 556 patients with PC registered in the hospital cancer registration system from September 2007 to September 2020 were evaluated. In this regard, demographic data, tumor characteristics, received treatments, and patients' final status were analyzed. Kaplan–Meier and Cox's regression were used for univariate and multivariate analyses, respectively. Results The 5‐year survival rate was found to be 4.3%. The median survival time was 12.4 ± 6.6 months. Univariate analysis showed that age, BMI (kg/m 2 ), blood transfusions, differentiation, tumor stage, tumor size, number of involved lymph nodes, lymph node ratio (LNR), and type of treatment received were significantly associated with patient survival ( p < .05). Multivariate Cox regression indicated that the age ≥60 years [Hazard Ratio (HR) = 1.25, 95% confidence interval (CI) = 1.03–1.49], BMI <18 (kg/m 2 ; HR = 1.56, 95% CI = 1.13–2.14), poor differentiation (HR = 2.12, 95% CI = 1.75–2.49), tumor size >2.5 cm (HR = 4.61, 95% CI = 3.30–6.78), metastasis presence (HR = 1.97, 95% CI = 1.49–2.60), more than two involved lymph nodes (HR = 1.52, 95% CI = 1.31–1.77), LNR <0.2 (HR = 0.56, 95% CI = 0.36–0.77), and adjuvant therapy with surgery and chemotherapy (HR = 0.44, 95% CI = 0.28–0.61) are the most important prognostic factors of survival in patients with PC ( p < .05). Conclusions This study showed that the survival rate of patients with pancreatic cancer varies based on the characteristics of the tumor and the type of treatment received.
Acute hepatitis B cases with very high viral load are rare in communities. This study presents an experience of treating a patient suffering from severe acute hepatitis B with a very high viral load. A 38-year-old Iranian male was diagnosed with acute hepatitis B with early and progressive liver dysfunction and a very high viral load. Treatment with Tenofovir was started. The complete response to treatment was achieved with multidisciplinary management; the patient was discharged after a week. A history of not being vaccinated against the hepatitis B virus and the job conditions could be the main causes of increased risks for his illness. However, the high viral load can be considered as the cause of severe acute hepatitis B development. The prompt and accurate diagnosis followed by suitable treatment choice led to the most favorable outcome.
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