COVID-19 impact on the liver

Baroiu, Liliana; Dumitru, Caterina; Iancu, Alina Viorica; Leșe, Ana-Cristina; Drăgănescu, Miruna; Baroiu, Nicușor; Anghel, Lucreția

doi:10.12998/wjcc.v9.i16.3814

Cited by 22 publications

(17 citation statements)

References 78 publications

(73 reference statements)

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“…SARS-CoV-2 virus has infected millions of persons in the whole world, and the human lives losses, associated with COVID-19 pandemic, have frightened medical practitioners and researchers [7,10,17]. Severe COVID-19 pneumonia appeared in the second disease phase, after the initial phase of viral replication, when the immune system dysregulation can induce a cytokine storm, by hypersecretion of proinflammatory cytokines and chemokines [3,13,24], contributing to tissue damage and severe lung injury. The benefic role of tocilizumab (a monoclonal anti-IL-6 receptor alpha) in COVID-19 treatment was sustained by the Romanian National Treatment Protocol [11], which recommended TCZ from the beginning of pandemic in Romania (March 2020).…”

Section: Resultsmentioning

confidence: 99%

Efficacy of Tocilizumab in the Treatment of Patients With Severe Infection

CAMBREA¹

2022

FARMACIA

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Since the revealing of the SARS-CoV-2 virus, the broad clinical spectrum of COVID-19 and, especially, the acute severe respiratory syndrome, have alarmed the whole medical world. The pathogenesis of COVID-19 is complex and unknown since the beginning of the pandemic. Many proinflammatory cytokines, including interleukine-6 (IL-6), are involved in the occurrence of cytokine release syndrome, having an important role in the severe evolution and death of COVID-19 patients. For evaluating the role of tocilizumab (TCZ), an anti-IL-6 agent, we analysed the survival in 149 COVID-19 patients from the first day of therapy until the next 90 days of follow-up. Less than half of patients (18.79%) died. The mean survival period was 75.05 days. The evolution of the inflammatory syndrome was favourable at 3 and 7 days, after TCZ administration, with a statistically significant decreased amount of fibrinogen, erythrocyte sedimentation rate, and C-reactive protein. The risk factors of death rate were age over 60 and pre-existing co-morbidities, as heart disease and obesity. The administration of TCZ in severe COVID-19 patients as in other studies was beneficial. RezumatDupă apariția virusului SARS-CoV-2, spectrul clinic larg al COVID-19 și, în special, sindromul respirator acut sever au ridicat un mare semn de îngrijorare în întreaga lume medicală. Patogenia COVID-19 a fost complexă și necunoscută la începutul pandemiei. Multe citokine proinflamatorii, inclusiv interleukinele IL-6, sunt implicate în sindromul de eliberare a citokinelor, cu rol important în evoluția severă și decesul bolnavilor COVID. Pentru evaluarea rolului tocilizumab-ului (TCZ) ca medicație anti-IL-6, am analizat supraviețuirea în rândul a 149 pacienți COVID-19 monitorizați 90 de zile de la inițierea tratamentului. Mai puțin de jumătate dintre pacienți (18,79%) au decedat. Durata medie de supraviețuire a fost de 75,05 zile. Evoluția sindromului inflamator a fost favorabilă, cu reducerea semnificativ statistică a valorilor fibrinogenului, vitezei de sedimentare a hematiilor și proteinei C reactive. Factorii de risc ai ratei de mortalitate au fost vârsta peste 60 de ani, afecțiunile cardiace preexistente și obezitatea. Administrarea de TCZ la pacienții cu forme severe COVID-19, ca și în alte studii publicate, s-a dovedit a fi benefică.

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Section: Resultsmentioning

confidence: 99%

Efficacy of Tocilizumab in the Treatment of Patients With Severe Infection

CAMBREA¹

2022

FARMACIA

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“…Morphopathological and clinical studies have described the impairment of the central and peripheral nervous system, of the circulatory system (heart, large vessels and small vessels), of the smooth and striated muscles, of the excretory system especially the kidneys, of the digestive system especially in the liver and intestines. Comorbidities are important factors in the therapeutic management of COPD and in the prognosis of these patients (Baroiu et al 2021;Stefanopol et al 2021). Particularly in the elderly, comorbidities, are more common and are definitely associated with a higher mortality (Charlson Score), a poorer adherence to therapy, and a lower quality of life.…”

Section: Major Comorbidities Of Copdmentioning

confidence: 99%

Impact of the Psychiatric Comorbidities in Chronic Obstructive Pulmonary Disease

Anghel

Ștefănescu

Patras

et al. 2022

BRAIN

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Chronic obstructive pulmonary disease (COPD) is one of the main causes of death with a significant impact on the quality of life and mental health of the patients as well as on the health system. The social costs of COPD are significant, because this pathology has a negative impact on patients's professional performance and daily activity. The major risk factors for COPD are age and smoking. Extrapulmonary comorbidities are frequently associated with COPD and may have an influence on the symptoms severity, and the frequency of the exacerbations, hospitalizations and mortality. Psychiatric disorders, especially anxiety and depression, have been observed in clinical trials with an increased prevalence of COPD. The relationship between anxiety, depression and COPD is complex. Psychiatric pathology is involved in influencing the pathophysiology of COPD with a proven impact on the patient's prognosis. COPD sleep disorders can aggravate pre-existing psychiatric pathology, the relationship between the two pathologies being bidirectional. The aim of this paper is to review the latest clinical trials on the existing evidence of psychiatric comorbidities impact on the evolution and prognosis of COPD and the therapeutic alternatives for their improvement. The conclusion of the present study is that anxiety and depression should be periodically assessed by a multidisciplinary team in order to provide a complete management (pharmacological, pulmonary rehabilitation and cognitive-behavioral therapy), improving the patient's quality of life and prognosis.

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“…The average level of D-dimers is 2.4 mg/L in critical cases, as compared to 0.5 mg/L in mild cases. 9 , 10 …”

Section: Introductionmentioning

confidence: 99%

“…The factors involved in causing liver damage are: the SARS-CoV-2 direct attack, drug toxicity of the COVID-19 therapy, acute inflammatory changes and hypoxia. 10 …”

Section: Introductionmentioning

confidence: 99%

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The Role of D-Dimers in the Initial Evaluation of COVID-19

Baroiu¹,

Lese²,

Ștefanopol³

et al. 2022

TCRM

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Purpose The COVID-19 pandemic was noted for the high degree of contagion and the large number of cases, as well as for the various clinical forms, from asymptomatic towards rapid evolution to death. The hospitals limited care capacity imposed the need to identify some markers of unfavorable evolution. The purpose of our study is to identify the parameters correlated with COVID-19 unfavorable evolution and to draw the profile of the patient at risk of unfavorable evolution. This set of parameters will help the doctor in deciding whether to hospitalize a patient and in choosing the treatment. Patients and Methods We performed a prospective, observational, actively controlled study on 849 patients with COVID-19, hospitalized in the Second Clinic of “Sf. Cuv. Parascheva” Infectious Diseases Clinical Hospital Galati, Romania, between 1.03.2020–30.11.2020. Results The parameters statistically significant modified at the admission of the patients with COVID-19 unfavorable evolution were age, oxygen saturation, D-dimers, creatine kinase (CK), troponin, erythrocytes sedimentation rate (ESR), leukocytes, lymphocytes, neutrophils, platelets, hemoglobin (Hb), aspartate transaminase (AST), total and direct bilirubin (TBIL, DBIL), urea, creatinine, serum glucose. Strong correlations were observed between the unfavorable evolution and the admission values of D-dimers, AST, TBIL and between D-dimers and AST, which suggests that D-dimers levels can be considered predictive for the alteration of liver function and for the negative prognosis of the patient. Conclusion Coagulation disorders and acute respiratory failure are the prevailing causes of death from COVID-19. Together with other parameters that constitute the risk profile for severe COVID-19 evolution, the D-dimers dosing at admission proved to be extremely useful in the management of COVID-19.

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COVID-19 impact on the liver

Cited by 22 publications

References 78 publications

Efficacy of Tocilizumab in the Treatment of Patients With Severe Infection

Efficacy of Tocilizumab in the Treatment of Patients With Severe Infection

Impact of the Psychiatric Comorbidities in Chronic Obstructive Pulmonary Disease

The Role of D-Dimers in the Initial Evaluation of COVID-19

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