COVID-19: gastrointestinal and hepatobiliary manifestations

Shih, Angela R.; Misdraji, Joseph

doi:10.1016/j.humpath.2022.07.006

Cited by 14 publications

(18 citation statements)

References 137 publications

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“…Диарея является одним из наиболее частых гастроэнтерологических проявлений COVID-19, распространенность которой в некоторых выборках фактически достигала 50% [12,13]. Представляется, что патогенез данного симптома в рамках COVID-19 носит комплексный характер и обусловлен как цитопатическим воздействием вируса, так и ятрогенным влиянием (рис.…”

Section: Discussionunclassified

“…Представляется, что патогенез данного симптома в рамках COVID-19 носит комплексный характер и обусловлен как цитопатическим воздействием вируса, так и ятрогенным влиянием (рис. 7) [1,12,13]. Поражение ЖКТ, индуцированное SARS-CoV-2, реализуется за счет прямого цитотоксического эффекта вируса, нарушения регуляции ренин-ангиотензин-альдостероновой системы, мальабсорбции триптофана в эпителии кишечника, а также нарушения микробиоты кишечника [27].…”

Section: Discussionunclassified

Section: Introductionunclassified

“…Среди множества гастроэнтерологических проявлений у пациентов с COVID-19 наиболее часто регистрируется диарея [12]. В некоторых выборках частота данного симптома достигала 49,5% [12,13]. В крупнейшей российской когорте пациентов с COVID-19 (n=3764) распространенность диареи у госпитализированных больных составила 15,04% (95% ДИ 13,90-16,19) [10].…”

Section: Introductionunclassified

“…Метаанализ, резюмирующий результаты 26 исследований (n=7860), продемонстрировал, что средняя продолжительность диареи составляет 4,2 дня (95% ДИ 3,6-4,9), тогда как среднее количество актов дефекаций -4,6 (95% ДИ 3,8-5,3) [14]. Механизмы развития диареи у пациентов с COVID-19 могут быть обусловлены как собственным цитопатическим действием вируса на энтероциты кишечника, так и ятрогенным влиянием, связанным с сопутствующей антибиотикотерапией [1,12,13]. Антибиотикоассоциированная диарея развивается у 5-35% пациентов и является значимой проблемой…”

Section: Introductionunclassified

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Efficacy of <i>Saccharomyces boulardii</i> CNCM I-745 probiotic drug in the prevention and treatment of diarrhea in hospitalized patients with new coronavirus infection COVID-19

Маев

Andreev

Sokolov

et al. 2022

Terapevticheskii arkhiv

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Aim. To evaluate the efficacy of Saccharomyces boulardii (S. boulardii) CNCM I-745 probiotic drug in preventing and treating diarrhea in hospitalized patients with COVID-19. Materials and methods. A prospective comparative study was conducted in two parallel groups. The study included males and females aged 18 to 60 with the following diagnosis confirmed by polymerase chain reaction: U07.2 Coronavirus infection COVID-19, caused by SARS-CoV-2 virus (grade 13 pneumonia according to CT scan). All patients received antibiotic therapy. The patients were subdivided into two equal groups (n=60) depending on the administration of S. boulardii CNCM I-745 probiotic drug in addition to standard treatment. The probiotic was prescribed by the attending physician; the dose was 2 capsules per day (500 mg/day) 30 min before the meal for 10 days. All patients were monitored for main clinical, laboratory, and instrumental parameters during the study. In addition, the symptom of diarrhea (stool with a frequency of more than 3 times a day of type 6 and 7 according to the Bristol stool scale), including its frequency, duration, and the number of bowel movements of loose stool per day were precisely evaluated in both groups. Results. In the overall patient pool, diarrhea was reported in 21.7% of in-patients during the observation period (95% confidence interval [CI] 14.229.1) with a mean duration of 4.6154 days (95% CI 3.7910-5.4398). The incidence of diarrhea in group 1 was 13.3% (95% CI 4.522.2), and in group 2, it was 30.0% (95% CI 18.141.9). Relative risk showed that the use of the S. boulardii CNCM I-745 probiotic drug leads to a significant reduction in the risk of diarrhea in hospitalized patients with COVID-19 infection receiving antibiotic therapy (odds ratio [OR] 0.3590, 95% CI 0.14210.9069; p=0.0303). In group 1, the duration of diarrhea was 3.1250 days (95% CI 2.58923.6608) versus 5.2778 days (95% CI 4.22906.3265) in group 2, p=0.0112. The mean daily frequency of loose stools in patients with diarrhea in group 1 was 3.2500 (95% CI 2.65883.8412) versus 4.3889 (95% CI 3.72525.0525) in group 2, p=0.0272. The secondary endpoint, duration of hospital stay, was also significantly shorter in group 1 patients 11.6833 days (95% CI 11.204212.1625) versus 12.7333 days (95% CI 12.135713.3309) in group 2, p=0.0120. Conclusion. The present prospective comparative study demonstrated that adding S. boulardii CNCM I-745 probiotic drug into the standard treatment regimen of patients with new coronavirus infection COVID-19 receiving antibiotic therapy helps reduce the incidence of diarrhea and its severity during hospitalization, as well as the duration of hospital stay.

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Section: Discussionunclassified

Section: Introductionunclassified

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Efficacy of <i>Saccharomyces boulardii</i> CNCM I-745 probiotic drug in the prevention and treatment of diarrhea in hospitalized patients with new coronavirus infection COVID-19

Маев

Andreev

Sokolov

et al. 2022

Terapevticheskii arkhiv

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COVID-19 Clinical Manifestation Including Long COVID

Manetti,

Del Duca,

Fineschi

et al. 2024

Reference Module in Social Sciences

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Complicações hepatobiliares em pacientes com covid-19: uma revisão integrativa

Lima,

Fonseca Neto

2024

Rev. Med. (São Paulo)

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Introdução: Durante o curso clínico do COVID-19, observou-se que a lesão hepática ocorre em uma proporção significativa de pacientes, principalmente naqueles com doença grave ou crítica. Objetivos: Sintetizar as informações disponíveis que abrangem os mecanismos das lesões hepatobiliares induzidas pelo COVID-19. Métodos: Trata-se de uma revisão integrativa da literatura na base de dados PubMed e BVS usando os descritores: “Doenças Hepatobiliares”, “COVID-19”, “Gastrointestinal”, “Fisiopatologia” e “Fígado”. Para aprimoramento da busca foram utilizados os operadores booleanos “AND” e “OR”, e selecionados artigos de relevância para o tema. Inicialmente, foram selecionados 193 artigos, dos últimos 10 anos, em português e/ou inglês. Após análise, 18 artigos corresponderam ao objetivo proposto. Resultados: A disfunção hepática foi observada em 14 a 53% dos pacientes com COVID-19, principalmente naqueles com doença grave. Isso acontece em razão do mecanismo postulado de entrada viral através dos receptores da enzima conversora de angiotensina 2 que estão abundantemente presentes não apenas nas células alveolares tipo 2, mas também no trato gastrointestinal, endotélio vascular e colangiócitos do fígado. O envolvimento hepático no COVID-19 está relacionado com lesão direta por SARS-CoV-2 ao fígado, reação inflamatória sistêmica, lesão hepática por hipóxia, isquemia e reperfusão, agravamento das lesões hepáticas devido a associação das doenças hepáticas preexistentes com a COVID-19 e lesão hepática induzida por drogas. Conclusões: Alterações da função hepática, sobretudo na hipoalbuminemia, elevação de GGT e aminotransferase, são frequentes em pacientes com doença por COVID-19. Inclusive, os pacientes com doença grave, têm maior probabilidade de apresentar esses distúrbios da função hepática.

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COVID-19: gastrointestinal and hepatobiliary manifestations

Cited by 14 publications

References 137 publications

Efficacy of <i>Saccharomyces boulardii</i> CNCM I-745 probiotic drug in the prevention and treatment of diarrhea in hospitalized patients with new coronavirus infection COVID-19

Efficacy of <i>Saccharomyces boulardii</i> CNCM I-745 probiotic drug in the prevention and treatment of diarrhea in hospitalized patients with new coronavirus infection COVID-19

COVID-19 Clinical Manifestation Including Long COVID

Complicações hepatobiliares em pacientes com covid-19: uma revisão integrativa

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