• 13С-mixed triglyceride breath test
• COVID-19
• exocrine pancreatic insufficiency
• insulin resistance
• nonalcoholic fatty liver disease
• type 2 diabetes mellitus

• Humans
• Diabetes Mellitus, Type 2/complications
• COVID-19/complications
• Non-alcoholic Fatty Liver Disease/complications
• Male
• Female
• Exocrine Pancreatic Insufficiency/etiology
• Middle Aged
• Adult
• SARS-CoV-2
• Insulin Resistance
• Breath Tests

The recent and still ongoing pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entailed various long-term complications, including post-infectious cholangiopathy.

To identify the available studies concerning post-coronavirus disease 2019 (COVID-19) cholangiopathy.

An extensive bibliographical search was carried out in PubMed and in Cochrane Library to identify the articles (retrospective and prospective studies, cohort studies, case series and case reports) published between January 1, 2020 and August 22, 2022, using both MeSH terms and free-language keywords: cholangiopathy; COVID-19; post-COVID-19 cholangiopathy; SARS-CoV-2.

Thirteen studies fulfilled the inclusion criteria, which included 64 patients suffering from this condition. The patients were male in 82.8% of cases. Liver transplant was executed in 6 patients and scheduled in 7 patients, while 2 patients refused the surgical approach. Therefore in 23.4% of the cases, performing this procedure appeared to be necessary.

This review has revealed that generally the involvement of the liver in the course of SARS-CoV-2 infection is mild and transient, inducing cholestasis of cholangiocytes but can also be severe enough to cause organ failure in some cases.

• Cholangiopathy
• COVID-19
• Post-COVID-19 cholangiopathy
• SARS-CoV-2
• Transplantation

The recent and still ongoing pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entailed various long-term complications, including post-infectious cholangiopathy.

To identify the available studies concerning post-coronavirus disease 2019 (COVID-19) cholangiopathy.

An extensive bibliographical search was carried out in PubMed and in Cochrane Library to identify the articles (retrospective and prospective studies, cohort studies, case series and case reports) published between January 1, 2020 and August 22, 2022, using both MeSH terms and free-language keywords: cholangiopathy; COVID-19; post-COVID-19 cholangiopathy; SARS-CoV-2.

Thirteen studies fulfilled the inclusion criteria, which included 64 patients suffering from this condition. The patients were male in 82.8% of cases. Liver transplant was executed in 6 patients and scheduled in 7 patients, while 2 patients refused the surgical approach. Therefore in 23.4% of the cases, performing this procedure appeared to be necessary.

This review has revealed that generally the involvement of the liver in the course of SARS-CoV-2 infection is mild and transient, inducing cholestasis of cholangiocytes but can also be severe enough to cause organ failure in some cases.

• Cholangiopathy
• COVID-19
• Post-COVID-19 cholangiopathy
• SARS-CoV-2
• Transplantation

Millions of people have died of coronavirus disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and retrospective studies of the disease in local regions are necessary.

To characterize the epidemiological features and dynamic changes in blood biochemical indices for SARS-CoV-2-infected patients in Hebi, a representative city with a large floating population in North China.

From January 25 to February 10, 2020, the clinical data of patients who tested positive for SARS-CoV-2 by quantitative real-time polymerase chain reaction in Hebi city (China) were evaluated at admission, and laboratory data for hematologic parameters, inflammatory indices, coagulation function indices, liver function indices, blood lipid indices, renal function indices, myocardial enzyme activities and five blood biochemical markers of immunity were evaluated at admission, upon hospitalization and before discharge.

Sixteen confirmed COVID-19 patients developed pneumonia but were cured after adequate treatment. Fever and fatigue were the common symptoms. The most common laboratory abnormalities of patients at admission were leukopenia, eosinopenia, decreased percentage of eosinophils, elevated high sensitivity C-reactive protein and fibrinogen levels, hypoalbuminemia, mildly increased aspartate transferase activity and levels of bilirubin, and increased levels of β2-microglobulin. Importantly, aggravated liver dysfunction was detected in most patients, which may be partially attributed to virus infection as well as medicinal treatment.

This study provides several potential diagnostic markers and dynamic biochemical indices of disease progression to better prevent, diagnose and treat COVID-19 infection.

• COVID-19
• Epidemiology
• Blood biochemical indices
• Computed tomography imaging
• Liver dysfunction

• COVID-19
• SARS-CoV-2
• diabetes
• pancreas

• Angiotensin-Converting Enzyme 2/metabolism
• COVID-19/complications
• Diabetes Complications
• Diabetes Mellitus
• Humans
• Middle East Respiratory Syndrome Coronavirus
• Pancreas/injuries
• Pancreas/virology
• Pancreatic Neoplasms/metabolism
• Pancreatitis/chemically induced
• Pancreatitis/complications
• Severe acute respiratory syndrome-related coronavirus
• Serine Endopeptidases/metabolism
• Sodium-Hydrogen Exchangers/metabolism
• COVID-19 Drug Treatment

Aims: It is known that there is a bidirectional relationship between diabetes mellitus (DM) and coronavirus disease (COVID‐19). It has been described that those patients infected with SARS‐CoV‐2 could develop severe metabolic decompensation of pre‐existing or new‐onset DM, although diabetogenic effect of SARS‐CoV‐2 has still not been well consolidated. In fact, the coexistence of SARS‐CoV‐2 infection and new‐onset DM is an infrequent situation.

Methods: We describe the clinical and analytical characteristics of 19 patients admitted to a Spanish tertiary hospital – all 19 having COVID‐19 infection and new‐onset DM.

Results: 12/19 patients (63.2%) were female; the mean age at diagnosis of DM was 54 (39–65) years. The most frequent ethnic group was Caucasian (n=9), followed by Latin‐American (n=7); 7/19 (36.8%) previously met criteria for prediabetes due to altered basal glycaemia or HbA_1c. The mean BMI at diagnosis was 32.26kg/m² (27.62–35.18kg/m²). Eighteen of 19 patients (94.7%) showed bilateral bronchopneumonia. The mean blood glucose of the first blood was 17.5mmol/L (11.1–21.1mmol/L), and the mean HbA_1c was 88mmol/mol (60–115mmol/mol). C‐peptide was requested in eight patients and it was within normal range in 87.5% (n=7) and below the inferior threshold in one case. Autoantibodies were requested in 26.3% (five patients), being negative in 4/5 (80%) and positive in 1/5 (20%). Regarding the type of diabetes diagnosed, 18 were type 2 DM and only one case was diagnosed with type 1 DM. Seventeen had simple hyperglycaemia and two suffered a diabetic ketoacidosis. The mean HbA_1c at 8.0 months (5.0–12.0 months) follow‐up was 42mmol/mol (40–49mmol/mol).

Conclusion: The majority of those described had type 2 DM that appears to have been unmasked by the COVID‐19 infection, since they had high HbA_1c and several risk factors for diabetes development, such as obesity and prediabetes. Most of them had their pancreatic reserve preserved, and this may suggest insulin resistance as the aetiology rather than direct beta‐cell damage. A good evolution of diabetes after hospital discharge was observed in the patients followed up at our centre. Copyright © 2022 John Wiley & Sons.

• new‐onset diabetes mellitus
• covid‐19
• sars‐cov‐2
• hospital admission

Coronavirus disease-2019 (COVID-19) commonly presents with respiratory symptoms. However, symptoms involving the digestive system may be present, significance of which is not well studied in the Indian scenario.

This prospective observational cohort study included consecutive patients with severe COVID-19 admitted to intensive care unit of our tertiary care hospital from September 9, 2020, to March 14, 2021. We evaluated the frequency of preadmission digestive symptoms and compared the demographic, clinical, laboratory parameters, and organ failure at admission and during intensive care along with mortality between those with and without digestive symptoms. In the digestive group, we sought to find predictors of mortality.

Digestive symptoms were present in 76/234 (32.4%) with severe COVID-19 infection. In comparison to nondigestive group, digestive patients had higher need for noninvasive ventilation (p 0.028), invasive lines (68%, p 0.003), vasopressors (64%, p 0.01), blood product transfusion (21.1%, p <0.001), and heart failure (55.4%, p 0.041). Confounding factors of alcohol abuse, smoking, sedentary lifestyle as a causative agent for heart failure could not be ruled out. Proportional mortality rate is higher in the digestive group (65.8%, p = 0.015). Mortality is multifactorial with preadmission abdominal pathologies (HR 4.3) or central nervous system (CNS)-related comorbidities (HR 2.829), presentation with multiple digestive symptoms (HR 6.9), higher sequential organ failure assessment score (SOFA) score at admission (HR 1.258) and discharge (HR 1.162), and presence of acute kidney injury (AKI) Grade 3 (HR 2.95) as predictors of mortality. After adjusting for all confounders, need for vasopressor was observed to be associated with 11.58 times higher risk of mortality.

Preadmission digestive symptoms may be associated with a turbulent illness with invasive interventions, heart failure, and greater proportional mortality in severe COVID-19. AKI Grade 3 is identified as a preventable risk factor predicting mortality. CTRI/2021/03/032325.

Karna ST, Singh P, Revadi G, Khurana A, Shivhare A, Saigal S, et al. Frequency and Impact of Preadmission Digestive Symptoms on Outcome in Severe COVID-19: A Prospective Observational Cohort Study. Indian J Crit Care Med 2021;25(11):1247–1257.

• Gastrointestinal complications
• Intensive care
• Mortality prediction
• Severe COVID-19

• COVID‐19
• Children
• Liver
• SARS‐CoV‐2
• Transaminasemia

• covid-19
• gastroenterology
• hepatology
• inflammatory bowel disease
• endoscopy practice

• COVID-19
• Gastroenterology
• Gastrointestinal Diseases/epidemiology
• Humans
• Pandemics
• SARS-CoV-2

• COVID-19
• SARS-CoV-2 pandemic
• infectious diseases
• pathogenesis
• treatment

• Antiviral Agents/therapeutic use
• COVID-19/epidemiology
• COVID-19/history
• COVID-19/transmission
• Climate
• Disease Reservoirs/virology
• Genome, Viral
• History, 19th Century
• History, 20th Century
• History, 21st Century
• Humans
• Mutation
• Pandemics/history
• RNA Viruses/pathogenicity
• RNA Viruses/physiology
• Reinfection/epidemiology
• Reinfection/history
• Reinfection/transmission
• Reinfection/virology
• Respiratory Tract Infections/drug therapy
• Respiratory Tract Infections/epidemiology
• Respiratory Tract Infections/history
• Respiratory Tract Infections/transmission
• SARS-CoV-2/pathogenicity
• SARS-CoV-2/physiology
• Virus Replication
• COVID-19 Drug Treatment

• COVID-19
• SARS-CoV-2 infection
• endoscopy

• COVID-19
• Mortality
• Proton pump inhibitors
• SARS-CoV-2, Severity

• angiotensin-converting enzyme 2 receptor
• coronavirus disease 2019
• critical illness
• pandemic
• severe acute respiratory syndrome–associated coronavirus 2

• K08 AI139371 NIAID NIH HHS
• K08 GM129763 NIGMS NIH HHS
• R35 GM126928 NIGMS NIH HHS
• UL1 TR002345 NCATS NIH HHS

Très rapidement après le début de la pandémie de la maladie à coronavirus 2019 (COVID-19), le diabète a été identifié comme facteur associé aux formes graves, et facteur pronostique. Depuis, de nombreuses études se sont intéressées à cette relation et ont pu préciser un certain nombre d’éléments : impact des comorbidités associées au diabète, phénotype des sujets diabétiques à risque de formes graves, impact de l’équilibre glycémique, impact de la COVID-19 sur le risque de diabète. Il persiste cependant un certain nombre de questions ou d’hypothèses, concernant notamment l’influence de traitements antidiabétiques sur le pronostic ou les mécanismes physiopathologiques impliqués dans les formes graves associées au diabète. Une mise à jour de l’ensemble de ces points est présentée dans cet article, mais les données de la littérature évoluent très vite…

• angiotensin converting enzyme 2
• dysbiosis
• gastrointestinal abnormality
• hepatic injury
• severe acute respiratory syndrome coronavirus 2

• COVID-19/complications
• Dysbiosis/virology
• Gastrointestinal Diseases/virology
• Gastrointestinal Microbiome
• Humans
• Liver/pathology
• Liver Diseases/virology
• Virus Shedding

• 5/4/3-1/14/NCD-II Jawaharlal Institute of Postgraduate Medical Education and Research Intramural Grant; Indian Council of Medical Research, Grant/Award Number:

• COVID-19
• SARS—CoV-2
• hepatology
• pandemic (COVID-19)
• prognosis

• COVID-19
• Hepatitis
• Liver Biopsy
• Liver Injury
• Non-hepatotropic Virus
• SARS-CoV-2

• Adult
• Apoptosis/physiology
• Biopsy
• COVID-19/virology
• Female
• Hepatitis/pathology
• Hepatitis/virology
• Humans
• Liver/pathology
• Liver/virology
• Liver Diseases/virology
• Male
• Middle Aged
• SARS-CoV-2/pathogenicity

• COVID-19
• hepatic biomarkers
• mixed models

• Diabetic complications
• Glucose control
• Mechanical ventilation
• Mortality
• Obesity
• SARS-CoV-2

• Aged
• Betacoronavirus
• Blood Glucose
• COVID-19
• Coronavirus Infections/complications
• Coronavirus Infections/diagnosis
• Coronavirus Infections/epidemiology
• Coronavirus Infections/therapy
• Diabetes Complications/complications
• Diabetes Complications/diagnosis
• Diabetes Complications/epidemiology
• Female
• Hospitalization
• Humans
• Male
• Middle Aged
• Obesity
• Pandemics
• Pneumonia, Viral/complications
• Pneumonia, Viral/diagnosis
• Pneumonia, Viral/epidemiology
• Pneumonia, Viral/therapy
• Prognosis
• Respiration, Artificial
• Risk Factors
• SARS-CoV-2

• Betacoronavirus
• COVID-19
• Cardiovascular Diseases/blood
• Cardiovascular Diseases/epidemiology
• Cardiovascular Diseases/therapy
• Coronavirus Infections/blood
• Coronavirus Infections/epidemiology
• Coronavirus Infections/therapy
• Diabetes Mellitus, Type 2/blood
• Diabetes Mellitus, Type 2/epidemiology
• Diabetes Mellitus, Type 2/therapy
• Humans
• Hyperglycemia/blood
• Hyperglycemia/epidemiology
• Hyperglycemia/therapy
• Hypertension/blood
• Hypertension/epidemiology
• Hypertension/therapy
• Obesity/blood
• Obesity/epidemiology
• Obesity/therapy
• Pandemics
• Pneumonia, Viral/blood
• Pneumonia, Viral/epidemiology
• Pneumonia, Viral/therapy
• Retrospective Studies
• Risk Factors
• SARS-CoV-2
• Treatment Outcome

• Betacoronavirus
• COVID-19
• Coronavirus Infections/complications
• Coronavirus Infections/epidemiology
• Humans
• Liver Diseases/etiology
• Pandemics
• Pneumonia, Viral/complications
• Pneumonia, Viral/epidemiology
• SARS-CoV-2

A large number of pneumonia cases due to coronavirus disease 2019 (COVID-19) have been first reported in China. Meanwhile, the virus is sweeping all around the world and has infected millions of people. Fever and pulmonary symptoms have been noticed as major and early signs of infection, whereas gastrointestinal symptoms were also observed in a significant portion of patients. The clinical investigation of disease onset was underestimated, especially due to the neglection of cases presenting with gastrointestinal symptoms.

To characterize the clinical features of coronavirus-infected patients with gastrointestinal symptoms as initial symptoms.

This is a retrospective, single-center case series of the general consecutive hospitalized patients with confirmed COVID-19 at Wuhan Union Hospital from February 2, 2020 to February 13, 2020. According to their initial symptoms, these patients were classified into two groups. Patients in group one presented with pulmonary symptoms (PS) as initial symptoms, and group two presented with gastrointestinal symptoms (GS). Epidemiological, demographic, clinical, laboratory, and treatment data were collected for analysis.

Among the 50 patients recruited, no patient has been admitted to intensive care units, and no patient died during the study. The duration of hospitalization was longer in the GS group than in the PS group (12.13 ± 2.44 vs 10.00 ± 2.13, P < 0.01). All of the 50 patients exhibited decreased lymphocytes. However, lymphocytes in the GS group were significantly lower compared to those in the PS group (0.94 ± 0.06 vs 1.04 ± 0.15, P < 0.01). Procalcitonin and hs-CRP were both significantly higher in the GS group than in the PS group. Accordingly, the duration of viral shedding was significantly longer in the GS group compared to the PS group (10.22 ± 1.93 vs 8.15 ± 1.87, P < 0.01).

COVID-19 patients presenting with gastrointestinal symptoms as initial symptoms need more days of viral shedding and hospitalization than the patients presenting with pulmonary symptoms.

• COVID-19
• Initial symptoms
• Gastrointestinal symptoms
• Hospitalization
• Viral transmission