-
Journal of Gastrointestinal and Liver... Jun 2024During the coronavirus disease 2019 (COVID-19) pandemic a significant proportion of patients with severe acute respiratory distress syndrome (ARDS) due to COVID-19...
BACKGROUND AND AIMS
During the coronavirus disease 2019 (COVID-19) pandemic a significant proportion of patients with severe acute respiratory distress syndrome (ARDS) due to COVID-19 infection developed secondary sclerosing cholangitis (SSC) as a hepatobiliary complication.
METHODS
17 patients were endoscopically diagnosed and treated with COVID-19 SSC from February 2020 until October 2022 at our center. We retrospectively reviewed and analyzed the data to define risk factors, establish endoscopic treatment options, and to estimate incidence and outcomes.
RESULTS
258 patients with COVID-19 infection were admitted to our tertiary center and mechanically ventilated. 10 patients developed COVID-19 SSC in-house, and 7 patients were transferred for further endoscopic treatment. All 17 patients were mechanically ventilated, received vasoactive substances and 12 of them were treated with extracorporeal membrane oxygenation therapy. Endoscopic retrograde cholangiography (ERC) was performed in all patients to establish the diagnosis of COVID-19 SSC and evaluate endoscopic treatment options. All ERCs revealed biliary casts. 9 patients had developed severe rarefication of the intrahepatic bile ducts and 4 showed biliary strictures. As endoscopic treatment approaches, casts were removed repeatedly, and strictures were dilated. During the study period, 14 patients died (82%). 3 patients are in follow-up to reassess the need for liver transplantation.
CONCLUSIONS
COVID-19 SSC was observed in 2.6 % of the patients with severe COVID-19 in our center. We show that endoscopic approaches offer the opportunity to extract casts and to treat biliary strictures. As the mortality rate of COVID-19 SSC is high, endoscopic treatment can be of great clinical relevance as a bridge to liver transplantation.
Topics: Humans; COVID-19; Male; Female; Cholangitis, Sclerosing; Middle Aged; Retrospective Studies; Cholangiopancreatography, Endoscopic Retrograde; Tertiary Care Centers; Aged; SARS-CoV-2; Adult; Treatment Outcome; Risk Factors; Liver Transplantation
PubMed: 38944874
DOI: 10.15403/jgld-5476 -
Journal of Gastrointestinal and Liver... Jun 2024
Topics: Humans; Mucormycosis; COVID-19; Melena; SARS-CoV-2; Male; Antifungal Agents; Middle Aged
PubMed: 38944868
DOI: 10.15403/jgld-5302 -
Journal of Gastrointestinal and Liver... Jun 2024
Topics: Humans; COVID-19; COVID-19 Vaccines; SARS-CoV-2; Vaccination; Liver Diseases; Chronic Disease
PubMed: 38944866
DOI: 10.15403/jgld-5619 -
Journal of Gastrointestinal and Liver... Jun 2024
Topics: Humans; Antiviral Agents; Hepatitis D; Hepatitis Delta Virus
PubMed: 38944856
DOI: 10.15403/jgld-5627 -
Advances in Gerontology = Uspekhi... 2024In the treatment of coronavirus infections, it is important not only to understand the course of the disease, but also to understand what is happening in the human body,... (Review)
Review
In the treatment of coronavirus infections, it is important not only to understand the course of the disease, but also to understand what is happening in the human body, especially in the circulatory system, that is, which disorders lead to deterioration and further complications. Hemostasis disorder in COVID-19 plays an important role in the etiology and clinical manifestations of the disease. The ability to identify factors and risk groups for the development of thrombotic complications, the ability to dynamically interpret peripheral blood parameters and coagulograms, knowledge of diagnostic criteria for possible hemostasis disorders (for example, DIC syndrome, sepsis-associated coagulopathy, antiphospholipids, hemophagocytosis and hypercoagulation syndrome) are necessary to determine the indications for the test. Differentiated prescribing of clinically justified therapy (including anticoagulants and blood components) is important, which determines the complexity of treatment and prognosis for patients with COVID-19. This article is a review of the literature on the topic of hemostasis disorders in elderly and senile patients with mesenteric thrombosis in COVID 19 over the past few years.
Topics: Humans; COVID-19; Aged; Thrombosis; SARS-CoV-2; Blood Coagulation Disorders; Hemostasis; Anticoagulants
PubMed: 38944786
DOI: No ID Found -
Advances in Gerontology = Uspekhi... 2024Understanding the recovery process of functional abilities post-COVID-19 in older inpatients with arterial hypertension and ischemic heart disease is important for...
Understanding the recovery process of functional abilities post-COVID-19 in older inpatients with arterial hypertension and ischemic heart disease is important for optimising healthcare delivery and resources. Participants in this study were individuals undergoing hospital-based rehabilitation following COVID-19 (average age 66, n=183). They were categorised into groups with arterial hypertension (n=92), ischemic heart disease (n=18), both conditions (n=38), and a control group without these diseases (n=35). Functional abilities were assessed via the distance walked until signs of exhaustion (meters), handgrip strength (kilograms), and breath-holding time (seconds). Multiple regression analysis revealed that inpatients with arterial hypertension walked shorter distances (β=-19,183; p=0,050) but showed higher handgrip strength (β=3,735; p=0,025) compared to the control group. Post-rehabilitation, inpatients with hypertension demonstrated greater performance (β=40,435, p=0,024) and better improvement rates (β=47,337; p=0,016) in walked distance than those in the control group. Significant interaction effects between groups and pre-/post-rehabilitation changes were observed only for walking distance (β=34,74; p=0,02), with no significant interactions found for other measures. The findings indicate that older inpatients with arterial hypertension may experience comparable or enhanced recovery of functional abilities post-COVID-19. The presence of ischemic heart disease, alone or combined with hypertension, does not significantly impair rehabilitation outcomes compared to those without such conditions.
Topics: Humans; COVID-19; Male; Female; Aged; Myocardial Ischemia; Hypertension; Recovery of Function; Hand Strength; SARS-CoV-2; Middle Aged; Inpatients
PubMed: 38944782
DOI: No ID Found -
Mymensingh Medical Journal : MMJ Jul 2024Objective of the study was the effect of Covid-19 infection on pregnancy and neonatal outcomes. This prospective cohort study was conducted in Combined Military Hospital... (Comparative Study)
Comparative Study
Objective of the study was the effect of Covid-19 infection on pregnancy and neonatal outcomes. This prospective cohort study was conducted in Combined Military Hospital (CMH) Bogura, Obstetrics and Gynaecology department from June 2020 to October 2020. We have collected and analyzed data of 29 pregnant ladies positive for Covid-19. Control group was Covid-19 negative pregnant patients. Nasopharyngeal swab was taken for real time polymerase chain reaction for detection of Covid-19. We observed symptoms, compared any complication in mother and fetus, mode of termination, and duration of hospital stay. Only six patients were asymptomatic (10.3%). Fifteen (25.9%) had fever, six (6) had weakness (10.3%), 5(8.6%) had sore throat, 3(5.2%) had nausea and 5(8.6%) presented with loss of smell. Among twenty-nine patients, 5(8.6%) delivered normally, 24(41.4%) were delivered through caesarean section which was significantly higher than control group (p value <0.001). No mother became critical or expired, neonatal death was also absent. Mean duration of hospital stay was 14.13±6.192 days in case and 5.18±4.99 in control which was significantly (p value <0.001) higher. Breast feeding was significantly higher in control group (p value <0.001). This study shows feto-maternal outcome of Covid-19 pregnancy is almost same as those of normal pregnancy.
Topics: Humans; Pregnancy; Female; COVID-19; Pregnancy Complications, Infectious; Adult; Prospective Studies; Pregnancy Outcome; Bangladesh; Infant, Newborn; SARS-CoV-2; Length of Stay; Cesarean Section; Young Adult
PubMed: 38944726
DOI: No ID Found -
Mymensingh Medical Journal : MMJ Jul 2024The extremely contagious global outbreak of the novel Coronavirus disease 2019 (Covid-19) caused by Severe acute respiratory syndrome coronavirus-2(SARS- CoV-2) is... (Observational Study)
Observational Study
The extremely contagious global outbreak of the novel Coronavirus disease 2019 (Covid-19) caused by Severe acute respiratory syndrome coronavirus-2(SARS- CoV-2) is causing concern worldwide since its emergence. Healthcare workers (HCWs) are more susceptible for acquiring Covid-19 due to direct or indirect exposure to Covid-19 patients. Therefore, it is important to investigate demographic, clinical characteristics and outcome of affected persons and possible source of infection with exposure details. This study aimed at determining the demographic and clinical profile, outcome and possible risk factors for infection among the HCWs at Kurmitola General Hospital (KGH), Bangladesh. This retrospective observational study was done among the SARS-CoV-2 positive HCWs of Kurmitola General Hospital (KGH) from April 2020 to January 2021. Out of total 1323 HCWs, 180(13.9%) cases were detected Covid-19 positive. Among the infected HCWs, 76(42.2%) were male and 104(57.8%) were female. The mean age was 32.8±6.95 years. Eighty nine (89) were nurses (49.4%) and 67 were physicians (37.2%). Among them, 23(13.0%) had no definite symptoms. Mild symptoms had in 137(76.11%) and 40(22.22%) had moderate symptoms. Most common symptoms were fever 112(62.0%), weakness 108(60.0%), cough 102(57.0%) and myalgia 54(30.0%). Pre-existing comorbidities had 43(24.0%). Bronchial asthma 27(15.0%), HTN 24(13.0%) and DM 21(12.0%) were the most prevalent comorbidities. All completely were recovered ultimately. Fatigue 52(28.89%), shortness of breath 15(8.3%), cough 13(7.2%) were the most common long-term complications. Among them, 53(29.0%) pointed toward lack of maintaining a hygienicatmosphere, as their possible cause of being infected, whereas 37(21.0%) could not identify the cause. Maximum HCWs, 170 cases (94.44%) used PPE during their duty. Adequate training get 26(14.44%) on PPE use and Infection prevention and control (IPC). This study concludes almost 1.4 in 10 HCWs at KGH were infected with SARS-CoV-2 while working in hospital during the Covid-19 pandemic. Affected HCWs have relatively female predominance with younger age, milder symptoms, and less underlying diseases in this study. Fatigue and shortness of breath are most common long-term complications, which hampers their working ability. Most of them did not get any training on PPE use and IPC.
Topics: Humans; COVID-19; Male; Female; Adult; Risk Factors; Retrospective Studies; Health Personnel; Bangladesh; SARS-CoV-2; Middle Aged
PubMed: 38944718
DOI: No ID Found -
Mymensingh Medical Journal : MMJ Jul 2024Coronavirus disease 2019 (Covid-19) disease have been associated with significant mortality amongst doctors globally including Bangladesh. To delineate the...
Coronavirus disease 2019 (Covid-19) disease have been associated with significant mortality amongst doctors globally including Bangladesh. To delineate the clinico-epidemiological characteristics of the physician affected with Covid-19 was the objective of the study. This cross-sectional 'Facebook' based survey was conducted in the period of August 2020 to September 2020. Snowball sampling methods was followed. A total of 151 physicians affected with Covid-19 participated in this survey. Self-reported perceived severity scale (zero meaning not severe at all and ten denoting the most severe) was used. Collected data were analyzed by SPSS 25.0. Among the participants, the majority were male, 98(64.9%). The most prevalent affected age groups were 24-35 years 131(86.8%). Approximately 45.0% worked in COVID dedicated hospital. Entry-level physicians (Medical Officer or Assistant Surgeon) were the most affected 117(94.4%). One-third of the physicians had at least the one co-morbidity. Bronchial asthma, obesity and diabetes were the most frequent. Predominate symptoms of the infection were fever 94(62.3%), cough 94(62.3%) and myalgia 92(60.9%). Half of the participants had sore throat, anosmia, gastro-intestinal symptoms and one-third of the patients developed dyspnea. Perceived severity of the symptoms ranged between 2 and 6. The pattern of drug use to prevent the Covid-19 showed no uniformity. However, intake of Zinc, Vitamin C, Vitamin D, antihistamine and Ivermectin was found in 74.8%, 67.5%, 41.7%, 49.0% and 37.7% respectively. As the current pandemic continues to evolve, physicians must be equipped with appropriate knowledge, skills and must be cautious on the prevention measures against Covid-19.
Topics: Humans; COVID-19; Male; Female; Cross-Sectional Studies; Adult; Bangladesh; Physicians; Middle Aged; SARS-CoV-2; Young Adult; Comorbidity; Severity of Illness Index; Surveys and Questionnaires
PubMed: 38944716
DOI: No ID Found -
Nature Communications Jun 2024Evolution of SARS-CoV-2 alters the antigenicity of the immunodominant spike (S) receptor-binding domain and N-terminal domain, undermining the efficacy of vaccines and...
Evolution of SARS-CoV-2 alters the antigenicity of the immunodominant spike (S) receptor-binding domain and N-terminal domain, undermining the efficacy of vaccines and antibody therapies. To overcome this challenge, we set out to develop a vaccine focusing antibody responses on the highly conserved but metastable S subunit, which folds as a spring-loaded fusion machinery. We describe a strategy for prefusion-stabilization and high yield recombinant production of SARS-CoV-2 S trimers with native structure and antigenicity. We demonstrate that our design strategy is broadly generalizable to sarbecoviruses, as exemplified with the SARS-CoV-1 (clade 1a) and PRD-0038 (clade 3) S subunits. Immunization of mice with a prefusion-stabilized SARS-CoV-2 S trimer elicits broadly reactive sarbecovirus antibodies and neutralizing antibody titers of comparable magnitude against Wuhan-Hu-1 and the immune evasive XBB.1.5 variant. Vaccinated mice were protected from weight loss and disease upon challenge with XBB.1.5, providing proof-of-principle for fusion machinery sarbecovirus vaccines.
Topics: Animals; Mice; Antibodies, Neutralizing; Antibodies, Viral; Spike Glycoprotein, Coronavirus; SARS-CoV-2; Humans; COVID-19; Female; COVID-19 Vaccines; Mice, Inbred BALB C
PubMed: 38944664
DOI: 10.1038/s41467-024-49656-5