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Aghajani M, Wong A, Azimi M, Harijani SM. Association between dietary antioxidant quality score and severity of coronavirus infection: a case-control study. Front Nutr 2023; 10:1174113. [PMID: 37485392 PMCID: PMC10358364 DOI: 10.3389/fnut.2023.1174113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 06/14/2023] [Indexed: 07/25/2023] Open
Abstract
The purpose of this study was to examine the association between the dietary antioxidant quality score (DAQS) and the severity of Coronavirus disease 2019 (COVID-19). The present case-control study was carried out on 295 patients diagnosed with COVID-19 (≥18 years old), including 104 critical patients (Intensive care unit [ICU] admission) and 191 COVID-19 patients without severe complications (Non-intensive care unit [Non-ICU] patients) as cases. Dietary intake was assessed by a 147-item, semi-quantitative food frequency questionnaire (FFQ). Logistic regression was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) for the considered risk factors. Our outcomes (after multivariate adjustment) suggested that higher adherence to DAQS was significantly associated with a decreased risk of COVID-19 infection severity (OR = 0.12; 95% CI: 0.04-0.29, p < 0.001). Similar results were seen when analyzed by sex [men (OR = 0.02; 95% CI: 0.002-0.15, p < 0.001) and women (OR = 0.21; 95% CI: 0.06-0.68, p = 0.012)]. A significant association between vitamin D3 intake and decreased risk of COVID-19 severity (OR = 0.91; 95% CI: 0.89-0.94, p < 0.001) was also observed. Moreover, multivariate results revealed that there were no significant associations between vitamin C (OR = 1.00; 95% CI: 0.99-1.00, p = 0.067), vitamin E (OR = 0.98; 95% CI: 0.86-1.11, p = 0.798), zinc (OR = 1.02; 95% CI: 0.86-1.20, p = 0.805), and selenium (OR = 0.99; 95% CI: 0.99-1.00, p = 0.077) intakes with the risk of COVID-19 severity. However, subgroup analyses by sex suggested a significant association between vitamin C intake and the risk of COVID-19 infection severity in women (OR = 1.00; 95% CI: 1.00-1.00, p = 0.028). Our findings showed a negative association between DAQS adherence and the risk of COVID-19 infection severity. Our results may be used to develop potential dietary therapies to decrease COVID-19 severity.
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Affiliation(s)
- Mobina Aghajani
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Mazandaran, Babolsar, Iran
| | - Alexei Wong
- Department of Health and Human Performance, Marymount University, Arlington, TX, United States
| | - Mehdi Azimi
- Department of Internal Medicine, School of Medicine, Firoozgar General Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Shadmehr Mirdar Harijani
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Mazandaran, Babolsar, Iran
- Athletic Performance and Health Research Center, University of Mazandaran, Babolsar, Iran
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2
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Gulisano LM, Ianiro Swiderski JJ, Fernández ML, Giuliano JF, Fernández Stepa AL, Dominguez C, Nahoum N, Jourdan J, Trombetta LÁ, García JL. Acute colonic pseudo-obstruction syndrome in patients with severe COVID-19 in Buenos Aires, Argentina. Travel Med Infect Dis 2023; 54:102604. [PMID: 37315827 PMCID: PMC10260265 DOI: 10.1016/j.tmaid.2023.102604] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 12/30/2022] [Accepted: 06/03/2023] [Indexed: 06/16/2023]
Abstract
BACKGROUND Several gastrointestinal complications have been reported in patients with COVID-19, including motility disorders, such as acute colonic pseudo-obstruction (ACPO). This affection is characterized by colonic distention in the absence of mechanical obstruction. ACPO in the context of severe COVID-19 may be related to neurotropism and direct damage of SARS-CoV-2 in enterocytes. METHOD We conducted a retrospective study of patients who were hospitalized for critical COVID-19 and developed ACPO between March 2020 and September 2021. The diagnostic criteria to define ACPO was the presence of 2 or more of the following: abdominal distension, abdominal pain, and changes in the bowel movements, associated with distension of the colon in computed tomography. Data of sex, age, past medical history, treatment, and outcomes were collected. RESULTS Five patients were detected. All required admission to the Intensive Care Unit. The ACPO syndrome developed with a mean of 33.8 days from the onset of symptoms. The mean duration of the ACPO syndrome was 24.6 days. The treatment included colonic decompression with placement of rectal and nasogastric tubes, endoscopy decompression in two patients, bowel rest, fluid, and electrolytes replacement. One patient died. The remaining resolved the gastrointestinal symptoms without surgery. CONCLUSIONS ACPO is an infrequent complication in patients with COVID-19. It occurs especially in patients with critical condition, who require prolonged stays in intensive care and multiple pharmacological treatments. It is important to recognize its presence early and thus establish an appropriate treatment, since the risk of complications is high.
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Affiliation(s)
- Luciana María Gulisano
- Hospital de Infecciosas F.J. Muñiz, Department of Infectious Diseases, Buenos Aires, Argentina.
| | | | | | | | | | - Cecilia Dominguez
- Hospital de Infecciosas F.J. Muñiz, Intensive Care Unit, Buenos Aires, Argentina
| | - Nicolás Nahoum
- Hospital de Infecciosas F.J. Muñiz, Department of Infectious Diseases, Buenos Aires, Argentina
| | - Johana Jourdan
- Hospital de Infecciosas F.J. Muñiz, Department of Infectious Diseases, Buenos Aires, Argentina
| | - Luis Ángel Trombetta
- Hospital de Infecciosas F.J. Muñiz, Department of Infectious Diseases, Buenos Aires, Argentina
| | - Julián Luis García
- Hospital de Infecciosas F.J. Muñiz, Department of Infectious Diseases, Buenos Aires, Argentina
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3
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Hagiwara J, Bunya N, Harada K, Nakase H, Narimatsu E. Fatal Gastrointestinal Disorders Due to COVID-19: A Case Series. Cureus 2023; 15:e40286. [PMID: 37448415 PMCID: PMC10336742 DOI: 10.7759/cureus.40286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2023] [Indexed: 07/15/2023] Open
Abstract
Patients with coronavirus disease 2019 (COVID-19) primarily develop respiratory symptoms, which sometimes can be serious. Respiratory failure is the most common cause of death from COVID-19. This disease also causes gastrointestinal (GI) symptoms. However, there are limited reports that severe GI disorders caused by COVID-19 can be fatal. Herein, we report three cases of fatal GI disorders caused by COVID-19. All patients developed severe pneumonia requiring mechanical ventilation and venovenous extracorporeal membrane oxygenation (V-V ECMO) support. The respiratory status improved, and the patients could be weaned off support. However, severe watery diarrhea (over a few liters per day) developed after the onset of respiratory failure. The CT, endoscopic, and pathological findings were similar to those observed in GI graft-versus-host disease (GI-GVHD). Despite various efforts, the GI disorders did not improve, and all patients died of multiple organ failures associated with sepsis due to intestinal mucosal disruption. COVID-19 can cause fatal GI disorders and may have similar characteristics to GI-GVHD. Further investigation will contribute to a comprehensive understanding of fatal GI disorders due to COVID-19.
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Affiliation(s)
- Junya Hagiwara
- Intensive Care Unit, Sapporo Medical University, Sapporo, JPN
| | - Naofumi Bunya
- Intensive Care Unit, Sapporo Medical University, Sapporo, JPN
| | - Keisuke Harada
- Intensive Care Unit, Sapporo Medical University, Sapporo, JPN
| | - Hiroshi Nakase
- Gastroenterology and Hepatology, Sapporo Medical University, Sapporo, JPN
| | - Eichi Narimatsu
- Intensive Care Unit, Sapporo Medical University, Sapporo, JPN
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4
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Gebran A, Dorken-Gallastegi A, Kaafarani HM. A Surgical Perspective of Gastrointestinal Manifestations and Complications of COVID-19 Infection. Gastroenterol Clin North Am 2023; 52:49-58. [PMID: 36813430 PMCID: PMC9537287 DOI: 10.1016/j.gtc.2022.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, has quickly spread over the world since December 2019. COVID-19 is a systemic disease that can affect various organs throughout the body. Gastrointestinal (GI) symptoms have been reported in 16% to 33% of all patients with COVID-19 and in 75% of critically ill patients. This chapter reviews the GI manifestations of COVID-19 as well as their diagnostic and treatment modalities.
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Affiliation(s)
| | | | - Haytham M.A. Kaafarani
- Corresponding author. Division of Trauma, Emergency Surgery and Surgical Critical Care, Massachusetts General Hospital, 165 Cambridge Street, Suite 810, Boston, MA 02114
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5
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Kocak OF, Ozgeris FB, Parlak E, Kadıoglu Y, Yuce N, Yaman ME, Bakan E. Evaluation of Serum Trace Element Levels and Biochemical Parameters of COVID-19 Patients According to Disease Severity. Biol Trace Elem Res 2022; 200:3138-3146. [PMID: 34608570 PMCID: PMC8489790 DOI: 10.1007/s12011-021-02946-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/30/2021] [Indexed: 12/21/2022]
Abstract
While the COVID-19 disease progresses mildly or asymptomatically in some people, its progression is severe and symptomatic in others, and it is an issue that requires a scientific response regarding the disease. The present study includes 60 people infected with COVID-19, and the cases were divided into the following groups: asymptomatic, mild, moderate, and severe. Serum Zn, Se, and Cu levels of these groups were analyzed by ICP-MS. All measurements in the patients were compared with those of 32 healthy individuals. When the patient group is compared with the control group, the serum Zn and Se concentrations were statistically low (p < 0.001) in the patient group. Serum Zn level decreased significantly in 4 different patient groups compared to the control group. Although the serum Se level decreased in all four patient groups compared to the control group, the change in Se level was statistically significant only in the severe and mild patient groups. This study examined serum Zn, Se concentrations, and biochemical parameters in patients with different severity of COVID-19, compared them with healthy individuals, and revealed new targets for diagnosis and treatment by revealing those data that may be important.
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Affiliation(s)
- Omer Faruk Kocak
- Department of Chemical Technology, Erzurum Vocational Training College, Ataturk University, Erzurum, Turkey, 25240.
| | - Fatma Betul Ozgeris
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Atatürk University, Erzurum, Turkey, 25240
| | - Emine Parlak
- Department of Infectious Diseases and Clinical Microbiology, Faculty of Medicine, Atatürk University, Erzurum, Turkey, 25240
| | - Yucel Kadıoglu
- Department of Analytical Chemistry, Faculty of Pharmacy, Atatürk University, Erzurum, Turkey, 25240
| | - Neslihan Yuce
- Department of Biochemistry, Faculty of Medicine, Ataturk University, Erzurum, Turkey, 25240
| | - Mehmet Emrah Yaman
- Department of Analytical Chemistry, Faculty of Pharmacy, Atatürk University, Erzurum, Turkey, 25240
| | - Ebubekir Bakan
- Department of Biochemistry, Faculty of Medicine, Ataturk University, Erzurum, Turkey, 25240
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6
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Pourabhari Langroudi A, Shokri Varniab Z, Amouei M, Pak N, Khosravi B, Mirsharifi A, Radmard AR. Findings of Abdominal Imaging in Patients with COVID-19 - Part 1: Hollow Organs. Middle East J Dig Dis 2022; 14:278-286. [PMID: 36619269 PMCID: PMC9489432 DOI: 10.34172/mejdd.2022.284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/04/2022] [Indexed: 11/06/2022] Open
Abstract
Since COVID-19 has spread worldwide, the role of imaging for early detection of the disease has become more prominent. Abdominal symptoms in COVID-19 are common in addition to respiratory manifestations. This review collected the available data about abdominal computed tomography (CT) and ultrasonography indications in hollow abdominal organs in patients with COVID-19 and their findings. Since abdominal imaging is less frequently used in COVID-19, there is limited information about the gastrointestinal findings. The most common indications for abdominal CT in patients with COVID-19 were abdominal pain and sepsis. Bowel wall thickening and fluid-filled colon were the most common findings in abdominal imaging. Acute mesenteric ischemia (AMI) was one of the COVID-19 presentations secondary to coagulation dysfunction. AMI manifests with sudden abdominal pain associated with high morbidity and mortality in admitted patients; therefore, CT angiography should be considered for early diagnosis of AMI. Ultrasonography is a practical modality because of its availability, safety, rapidity, and ability to be used at the bedside. Clinicians and radiologists should be alert to indications and findings of abdominal imaging modalities in COVID-19 to diagnose the disease and its potentially serious complications promptly.
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Affiliation(s)
| | - Zahra Shokri Varniab
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrnam Amouei
- Assistant Professor, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Pak
- Associate Professor, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Bardia Khosravi
- Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Mirsharifi
- Department of Surgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Amir Reza Radmard
- Associate Professor, Department of Radiology, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
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Novel Coronavirus is the Only Virus Causing Childhood Invasive Diarrhea: A Case Series. ARCHIVES OF PEDIATRIC INFECTIOUS DISEASES 2022. [DOI: 10.5812/pedinfect-120761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Introduction: Typical manifestations of Coronavirus disease 2019 (COVID-19) include respiratory involvement. Gastrointestinal (GI) symptoms have also been reported as early clinical manifestations. The GI involvement can represent with diarrhea, vomiting, and abdominal pain. The present research aimed to identify dysentery as one of the signs of GI involvement in the novel coronavirus infection in children. Case Presentation: We report twelve patients with COVID-19 and dysentery. All these children had positive reverse transcription-polymerase chain reaction (RT-PCR) results. None had underlying illnesses or recent travel history. However, all children had contact with a first-degree relative affected by non-digestive COVID-19. In three patients, obvious dysentery was observed, and in the rest, red and white blood cells were evident in the stool exam. Stool exams were negative for bacterial infections, parasites, and the toxin of Clostridium difficile. Abdominal ultrasonography and echocardiographic evaluations to rule out multisystem inflammatory syndrome in children were normal. Supportive treatment, such as zinc supplementation and probiotics, was prescribed. They also received intravenous fluid therapy based on their dehydration percentage. In the end, they were discharged in good general condition without any complications. No GI complications were found in the follow-up series. Conclusions: Dysentery in children can be one of the GI manifestations of COVID-19, which is usually self-limiting. It does not require invasive diagnostic measures and antiviral treatments. This symptom is in contrast to other viral infections of the GI tract.
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8
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Marreiro DDN, Cruz KJC, de Oliveira ARS, Morais JBS, Freitas BDJESDA, Melo SRDS, dos Santos LR, Cardoso BEP, Dias TMDS. Antiviral and immunological activity of zinc and possible role in COVID-19. Br J Nutr 2022; 127:1172-1179. [PMID: 34128459 PMCID: PMC8438509 DOI: 10.1017/s0007114521002099] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 05/06/2021] [Accepted: 06/08/2021] [Indexed: 12/21/2022]
Abstract
Zn deficiency compromises its biological functions, its effect on the immune system and its antiviral activity, increasing vulnerability to infectious diseases. This narrative review aims at presenting and discussing functional aspects and possible mechanisms involved in the potential role of Zn in the immune response and antiviral activity for coronavirus infectious disease-19 (COVID-19) prevention and control. The searches were conducted in PubMed and Science Direct databases, using clinical trials, experimental studies in animals and humans, case-control studies, case series, letters to the editor, and review articles published in English, without restrictions on year of publication. Search approach was based on using the terms: 'zinc', 'COVID-19', 'antiviral agents', 'immunologic factors' and 'respiratory tract infections'. Literature shows the importance of Zn as an essential mineral immunomodulator with relevant antiviral activity in the body. Thus, although there is still a scarcity of studies evaluating Zn supplementation in patients with COVID-19, the results on the topic show the necessity of controlling Zn mineral deficiency, as well as maintaining its homoeostasis in the body in order to strengthen the immune system and improve the prevention of highly complex viral infections, such as that of the COVID-19.
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Affiliation(s)
| | - Kyria Jayanne Clímaco Cruz
- Departament of Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Teresina, PI, Brasil
| | | | | | | | | | - Loanne Rocha dos Santos
- Departament of Nutrition, Federal University of Piaui, Campus Minister Petrônio Portela, Teresina, PI, Brasil
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9
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Kitaeva VE, Kotov AS, Bunak MS. [Cerebral circulation disorders in COVID-19]. Zh Nevrol Psikhiatr Im S S Korsakova 2021; 121:81-87. [PMID: 34932291 DOI: 10.17116/jnevro202112111181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Present two clinical cases of cerebral circulation disorders in COVID-19. Cerebrovascular disorders in patients have been associated with COVID-19. Despite the similarity of symptoms, the pathogenesis of neurological damage in these patients was different due to damage to the arterial system in the first case and the venous system in the second case. It is concluded that during the COVID-19 pandemic, doctors need to be alert to all patients with new-onset neurological symptoms.
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Affiliation(s)
- V E Kitaeva
- Vladimirskiy Moscow Regional Research and Clinical Institute, Moscow, Russia
| | - A S Kotov
- Vladimirskiy Moscow Regional Research and Clinical Institute, Moscow, Russia
| | - M S Bunak
- Vladimirskiy Moscow Regional Research and Clinical Institute, Moscow, Russia
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10
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Zhang MM, Chen LN, Qian JM. Gastrointestinal manifestations and possible mechanisms of COVID-19 in different periods. J Dig Dis 2021; 22:683-694. [PMID: 34738727 PMCID: PMC8652439 DOI: 10.1111/1751-2980.13065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 10/30/2021] [Accepted: 11/02/2021] [Indexed: 12/11/2022]
Abstract
Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has become a pandemic worldwide. Although COVID-19 mainly affects the respiratory system, gastrointestinal (GI) manifestations have been frequently reported in such cases, even as initial symptoms. There have been several studies on different GI manifestations in patients with mild and severe disease or in remission. In this review article we summarized different GI manifestations of COVID-19 at various disease stages and the possible mechanisms based on published literatures, as well as the significance of GI manifestations in systemic inflammatory injury.
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Affiliation(s)
- Meng Meng Zhang
- Department of GastroenterologyPeking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
| | - Lu Ni Chen
- Department of Microbiology and Tumor and Cell BiologyKarolinska InstituteSolnaSweden
| | - Jia Ming Qian
- Department of GastroenterologyPeking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijingChina
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11
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Comment on "Gastrointestinal Complications in Critically Ill Patients With COVID-19". Ann Surg 2021; 274:e819-e820. [PMID: 32740252 DOI: 10.1097/sla.0000000000004271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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12
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Al-Hadidi SH, Alhussain H, Abdel Hadi H, Johar A, Yassine HM, Al Thani AA, Eltai NO. The Spectrum of Antibiotic Prescribing During COVID-19 Pandemic: A Systematic Literature Review. Microb Drug Resist 2021; 27:1705-1725. [PMID: 34077290 PMCID: PMC8713256 DOI: 10.1089/mdr.2020.0619] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objectives: Over the last decades, there has been a significant increase in antimicrobial prescribing and consumption associated with the development of patients' adverse events and antimicrobial resistance (AMR) to the point of becoming a global priority. This study aims at evaluating antibiotic prescribing during COVID-19 pandemic from November 2019 to December 2020. Materials and Methods: A systematic review was conducted primarily through the NCBI database, using PRISMA guidelines to identify relevant literature for the period between November 1, 2019 and December 19, 2020, using the keywords: COVID-19 OR SARS-Cov-2 AND antibiotics restricted to the English language excluding nonclinical articles. Five hundred twenty-seven titles were identified; all articles fulfilling the study criteria were included, 133 through the NCBI, and 8 through Google Scholar with a combined total of 141 studies. The patient's spectrum included all ages from neonates to elderly with all associated comorbidities, including immune suppression. Results: Of 28,093 patients included in the combined studies, 58.7% received antibiotics (16,490/28,093), ranging from 1.3% to 100% coverage. Antibiotics coverage was less in children (57%) than in adults with comorbidities (75%). Broad-spectrum antibiotics were prescribed presumptively without pathogen identifications, which might contribute to adverse outcomes. Conclusions: During the COVID-19 pandemic, there has been a significant and wide range of antibiotic prescribing in patients affected by the disease, particularly in adults with underlying comorbidities, despite the paucity of evidence of associated bacterial infections. The current practice might increase patients' immediate and long-term risks of adverse events, susceptibility to secondary infections as well as aggravating AMR.
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Affiliation(s)
| | | | - Hamad Abdel Hadi
- Infectious Disease Division, Communicable Diseases Centre, Hamad Medical Corporation, Doha, Qatar
| | | | | | | | - Nahla O. Eltai
- Biomedical Research Center, Qatar University, Doha, Qatar
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13
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Rezazadeh A, Sadeghzadeh S, Namakin K, Tamimi A, Khanjani Z. The role of zinc in the pathogenesis and treatment of COVID-19: A review. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2021. [DOI: 10.3233/mnm-211524] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Destructive outcomes of coronavirus pandemic call for medical research which can report all of the influential agents not only for the treatment of the disease but also preventing its severe impacts on the societal health in the most efficient manner. Zinc plays an integral role in the function of cellular enzymes and transcription factors. Owing to its anti-inflammatory and cellular immunity regulation activity, zinc is regarded to be effective on strengthening the immune system. Its crucial antiviral effects have long been established as well. Studies suggest that low serum zinc level predisposes the patient to severe COVID-19 infection, which makes patient’s zinc profile a potential determinant of prognosis and severity of this disease. Furthermore, zinc supplementation has indicated promising outcomes of coronavirus infection management. Zinc modulates cell-mediated immunity and participates in the killing of microorganisms in cytotoxic immune cells. Zn2 + has anti-inflammatory effects by inhibiting IL-6 production. Although there is still not enough evidence, it seems that zinc could be a promising supplementary treatment for COVID-19 especially in zinc-deficient patients. The aim of this review is to clarify the role of zinc in pathogenesis and therapy of COVID-19 in detail.
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Affiliation(s)
- Arezoo Rezazadeh
- Department of Community Nutrition, NationalNutrition and Food Technology Research Institute, Faculty ofNutrition Sciences and Food Technology, Shahid Behehshti Universityof Medical Sciences, Tehran, Iran
| | - Sara Sadeghzadeh
- StudentResearch Committee, Faculty of Medicine, Shahid Beheshti Universityof Medical Sciences, Tehran, Iran
| | - Kosar Namakin
- StudentResearch Committee, Faculty of Medicine, Shahid Beheshti Universityof Medical Sciences, Tehran, Iran
| | - Atena Tamimi
- StudentResearch Committee, Faculty of Medicine, Shahid Beheshti Universityof Medical Sciences, Tehran, Iran
| | - Zahra Khanjani
- StudentResearch Committee, Faculty of Medicine, Shahid Beheshti Universityof Medical Sciences, Tehran, Iran
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14
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Marsafi O, Ijim F, Elkourchi M, Chahbi Z, Adnor S, Wakrim S. [Acute venous mesenteric ischemia in a young COVID-19 positive subject: a case report]. Pan Afr Med J 2021; 39:273. [PMID: 34754350 PMCID: PMC8556724 DOI: 10.11604/pamj.2021.39.273.30454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Accepted: 08/05/2021] [Indexed: 11/11/2022] Open
Abstract
L'ischémie mésentérique aiguë (IMA) résulte d'une diminution ou d'une interruption brutale du flux sanguin mésentérique ayant pour conséquence un apport sanguin inadéquat au tractus gastro-intestinal, responsable de lésions ischémiques et inflammatoires évoluant souvent vers une nécrose en l'absence de traitement adapté, l´insuffisance vasculaire peut résulter d'une embolie ou d'une thrombose artérielle ou d'une thrombose veineuse. Nous présentons un cas rare d´ischémie veineuse mésentérique chez un homme de 33 ans dû au coronavirus (COVID-19) chez qui le diagnostic était fait grâce à l´échographie et surtout à la tomodensitométrie (TDM).
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Affiliation(s)
- Oussama Marsafi
- Service de Radiologie, Centre Hospitalier Universitaire Agadir, Faculté de Médecine et de Pharmacie, Université Ibn Zohr Agadir, Agadir, Maroc
| | - Fadoua Ijim
- Service de Radiologie, Centre Hospitalier Universitaire Agadir, Faculté de Médecine et de Pharmacie, Université Ibn Zohr Agadir, Agadir, Maroc
| | - Mehdi Elkourchi
- Service de Radiologie, Centre Hospitalier Universitaire Agadir, Faculté de Médecine et de Pharmacie, Université Ibn Zohr Agadir, Agadir, Maroc
| | - Zakaria Chahbi
- Service de Radiologie, Centre Hospitalier Universitaire Agadir, Faculté de Médecine et de Pharmacie, Université Ibn Zohr Agadir, Agadir, Maroc
| | - Said Adnor
- Service de Radiologie, Centre Hospitalier Universitaire Agadir, Faculté de Médecine et de Pharmacie, Université Ibn Zohr Agadir, Agadir, Maroc
| | - Soukaina Wakrim
- Service de Radiologie, Centre Hospitalier Universitaire Agadir, Faculté de Médecine et de Pharmacie, Université Ibn Zohr Agadir, Agadir, Maroc
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15
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Hunter J, Arentz S, Goldenberg J, Yang G, Beardsley J, Myers SP, Mertz D, Leeder S. Zinc for the prevention or treatment of acute viral respiratory tract infections in adults: a rapid systematic review and meta-analysis of randomised controlled trials. BMJ Open 2021; 11:e047474. [PMID: 34728441 PMCID: PMC8578211 DOI: 10.1136/bmjopen-2020-047474] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 09/08/2021] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To evaluate the benefits and risks of zinc formulations compared with controls for prevention or treatment of acute viral respiratory tract infections (RTIs) in adults. METHOD Seventeen English and Chinese databases were searched in April/May 2020 for randomised controlled trials (RCTs), and from April/May 2020 to August 2020 for SARS-CoV-2 RCTs. Cochrane rapid review methods were applied. Quality appraisals used the Risk of Bias 2.0 and Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. RESULTS Twenty-eight RCTs with 5446 participants were identified. None were specific to SARS-CoV-2. Compared with placebo, oral or intranasal zinc prevented 5 RTIs per 100 person-months (95% CI 1 to 8, numbers needed to treat (NNT)=20, moderate-certainty/quality). Sublingual zinc did not prevent clinical colds following human rhinovirus inoculations (relative risk, RR 0.96, 95% CI 0.77 to 1.21, moderate-certainty/quality). On average, symptoms resolved 2 days earlier with sublingual or intranasal zinc compared with placebo (95% CI 0.61 to 3.50, very low-certainty/quality) and 19 more adults per 100 were likely to remain symptomatic on day 7 without zinc (95% CI 2 to 38, NNT=5, low-certainty/quality). There were clinically significant reductions in day 3 symptom severity scores (mean difference, MD -1.20 points, 95% CI -0.66 to -1.74, low-certainty/quality), but not average daily symptom severity scores (standardised MD -0.15, 95% CI -0.43 to 0.13, low-certainty/quality). Non-serious adverse events (AEs) (eg, nausea, mouth/nasal irritation) were higher (RR 1.41, 95% CI 1.17 to 1.69, NNHarm=7, moderate-certainty/quality). Compared with active controls, there were no differences in illness duration or AEs (low-certainty/quality). No serious AEs were reported in the 25 RCTs that monitored them (low-certainty/quality). CONCLUSIONS In adult populations unlikely to be zinc deficient, there was some evidence suggesting zinc might prevent RTIs symptoms and shorten duration. Non-serious AEs may limit tolerability for some. The comparative efficacy/effectiveness of different zinc formulations and doses were unclear. The GRADE-certainty/quality of the evidence was limited by a high risk of bias, small sample sizes and/or heterogeneity. Further research, including SARS-CoV-2 clinical trials is warranted. PROSPERO REGISTRATION NUMBER CRD42020182044.
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Affiliation(s)
- Jennifer Hunter
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Susan Arentz
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | - Joshua Goldenberg
- Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon, USA
| | - Guoyan Yang
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
| | | | - Stephen P Myers
- NICM Health Research Institute, Western Sydney University, Penrith, New South Wales, Australia
- National Centre for Naturopathic Medicine, Southern Cross University, Lismore, New South Wales, Australia
| | - Dominik Mertz
- Division of Infectious Diseases, Department of Medicine, Health Sciences, McMaster University, Hamilton, Ontario, Canada
| | - Stephen Leeder
- The Menzies Centre for Health Policy, The University of Sydney, Sydney, New South Wales, Australia
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Thuluvath PJ, Alukal JJ, Ravindran N, Satapathy SK. What GI Physicians Need to Know During COVID-19 Pandemic. Dig Dis Sci 2021; 66:2865-2875. [PMID: 33015748 PMCID: PMC7533169 DOI: 10.1007/s10620-020-06625-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 09/16/2020] [Indexed: 02/08/2023]
Abstract
The worldwide pandemic of COVID-19, caused by the virus SARS-CoV-2, continues to cause significant morbidity and mortality in both low- and high-income countries. Although COVID-19 is predominantly a respiratory illness, other systems including gastrointestinal (GI) system and liver may be involved because of the ubiquitous nature of ACE-2 receptors in various cell lines that SARS-CoV-2 utilizes to enter host cells. It appears that GI symptoms and liver enzyme abnormalities are common in COVID-19. The involvement of the GI tract and liver correlates with the severity of disease. A minority (10-20%) of patients with COVID-19 may also present initially with only GI complaints. The most common GI symptoms are anorexia, loss of smell, nausea, vomiting, and diarrhea. Viral RNA can be detected in stool in up to 50% of patients, sometimes even after pharyngeal clearance, but it is unclear whether fecal-oral transmission occurs. Liver enzymes are elevated, usually mild (2-3 times), in a substantial proportion of patients. There are many confounding factors that could cause liver enzyme abnormalities including medications, sepsis, and hypoxia. Although infection rates in those with preexisting liver disease are similar to that of general population, once infected, patients with liver disease are more likely to have a more severe disease and a higher mortality. There is a paucity of objective data on the optimal preventive or management strategies, but few recommendations for GI physicians based on circumstantial evidence are discussed.
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Affiliation(s)
- Paul J Thuluvath
- Institute of Digestive Health and Liver Diseases, Mercy Medical Center, Baltimore, MD, USA.
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Joseph J Alukal
- Department of Internal Medicine, Barbara and Zucker School of Medicine for Hofstra/Northwell Health, Manhasset, NY, USA
| | - Nishal Ravindran
- Department of Internal Medicine, Barbara and Zucker School of Medicine for Hofstra/Northwell Health, Manhasset, NY, USA
| | - Sanjaya K Satapathy
- Department of Internal Medicine, Barbara and Zucker School of Medicine for Hofstra/Northwell Health, Manhasset, NY, USA
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Singh P, Singh SP, Verma AK, Raju SN, Parihar A. A Systematic Review of Abdominal Imaging Findings in COVID-19 Patients. Visc Med 2021; 26:1-12. [PMID: 34580634 PMCID: PMC8450847 DOI: 10.1159/000518473] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Accepted: 07/13/2021] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE The objective of this systematic review was to evaluate key imaging manifestations of COVID-19 on abdominal imaging by utilizing a comprehensive review of the published literature. METHOD A systematic literature search from PubMed, Google Scholar, and Scopus was performed for studies mentioning abdominal imaging findings in COVID-19 patients. Studies published from inception to 15 March 2021 were included. RESULTS A total of 116 studies comprising 1,198 patients were included. Abdominal pain was the most common indication for abdominal imaging in 50.2% of the patients. No abnormality was seen in 48.1% of abdominopelvic computed tomography scans. Segmental bowel wall thickening (14.7%) was the most common imaging abnormality, followed by bowel ischemia (7.1%), solid organ infarction (6.7%), vessel thrombosis (6.7%), and fluid-filled colon (6.2%). Other relevant findings were dilated air-filled bowel, pancreatitis, pneumatosis/portal venous gas, bowel perforation, and appendicitis. Other than abdominal findings, COVID-19-related basal lung changes were incidentally detected in many studies. Moreover, the presence of bowel imaging findings was positively correlated with the clinical severity of COVID-19 infection. CONCLUSION This review describes the abdominal imaging findings in COVID-19 patients. This is pertinent for the early diagnosis of COVID-19 in patients presenting solely with abdominal symptoms as well as in identifying abdominal complications in a known case of COVID-19.
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Affiliation(s)
- Priya Singh
- Radiodiagnosis, King George Medical University, Lucknow, India
| | - Surya Pratap Singh
- Cardiovascular Radiology and Endovascular Intervention, All India Institute of Medical Science, New Delhi, India
| | | | - Sreenivasa Narayana Raju
- Cardiovascular Radiology and Endovascular Intervention, All India Institute of Medical Science, New Delhi, India
| | - Anit Parihar
- Radiodiagnosis, King George Medical University, Lucknow, India
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18
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Agarwal L, Agarwal A, Advani S, Katiyar V, Chaturvedi A, Madhusudhan KS. The eyes see what the mind seeks: a systematic review of abdominal imaging findings in patients with COVID-19. Br J Radiol 2021; 94:20201220. [PMID: 34260323 PMCID: PMC8523189 DOI: 10.1259/bjr.20201220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Objectives: With the increasing recognition of gastrointestinal (GI) manifestation of coronavirus disease-19 (COVID-19), various abdominal imaging findings are increasingly being noted. We scoped the existing literature on the abdominal imaging findings in COVID-19. Methods: A systematic literature search was performed on PubMed, Embase, Google scholar and World Health Organization COVID-19 database. Results: 35 studies were included in the final descriptive synthesis. Among the studies reporting positive abdominal imaging findings in patients with COVID-19, majority described imaging abnormalities of the GI tract (16 studies), of which bowel wall thickening was most frequently reported. Other findings noted were abdominal imaging manifestations of bowel ischemia with thrombosis of the splanchnic vasculature, and imaging features suggestive of pancreatitis. Imaging findings suggestive of solid organ infarction were reported in nine studies. An association between imaging evidence of hepatic steatosis and COVID-19 was noted in three studies. Incidental lung base findings on abdominal imaging were noted in 18 studies, where patients presented with predominant GI symptoms. The most common finding was bilateral ground glass opacities (90.7%) with predominant multilobar (91.1%) and peripheral (64.4%) distribution. Conclusion: This systematic review provides insight into the abdominal imaging findings in patients with COVID-19. Knowledge of these imaging manifestations will not only help in further research but also will aid in curtailing transmission of the SARS-CoV-2. Further prospective studies are needed to gain better insight into the pathophysiology of these imaging manifestations. Advances in knowledge: This review highlights the abdominal imaging findings in patients with COVID-19, to gain insight into the disease pathophysiology and gear the abdominal radiologist through the pandemic.
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Affiliation(s)
- Lokesh Agarwal
- Department of Gastrointestinal Surgery and Liver Transplantation, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Ayushi Agarwal
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Shailesh Advani
- Department of Oncology, Lombardi Comprehensive cancer Center, Georgetown University, Washington, DC, Washington, DC, USA
| | - Varidh Katiyar
- Department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Aprajita Chaturvedi
- Department of Surgery, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - Kumble Seetharama Madhusudhan
- Department of Radiodiagnosis and Interventional Radiology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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19
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Amjad W, Haider R, Malik A, Qureshi W. Insights into the management of anorectal disease in the coronavirus 2019 disease era. Therap Adv Gastroenterol 2021; 14:17562848211028117. [PMID: 34290826 PMCID: PMC8274100 DOI: 10.1177/17562848211028117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Accepted: 06/08/2021] [Indexed: 02/04/2023] Open
Abstract
Coronavirus 2019 disease (COVID-19) has created major impacts on public health. The virus has plagued a large population requiring hospitalization and resource utilization. Knowledge about the COVID-19 virus continues to grow. It can commonly present with gastrointestinal symptoms; initially, this was considered an atypical presentation, which led to delays in care. The pandemic has posed serious threats to the care of anorectal diseases. Urgent surgeries have been delayed, and the care of cancer patients and cancer screenings disrupted. This had added to patient discomfort and the adverse outcomes on healthcare will continue into the future. The better availability of personal protective equipment to providers and standard checklist protocols in operating rooms can help minimize healthcare-related spread of the virus. Telehealth, outpatient procedures, and biochemical tumor marker tests can help with mitigation of anorectal-disease-related problems. There is limited literature about the clinical management of anorectal diseases during the pandemic. We performed a detailed literature review to guide clinicians around management options for anorectal disease patients. We also highlighted the health challenges seen during the pandemic.
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Affiliation(s)
- Waseem Amjad
- Internal Medicine, Albany Medical Center, Albany, NY, USA
| | - Rabbia Haider
- Internal Medicine, Nishter Medical University, Multan, Punjab, Pakistan
| | - Adnan Malik
- Internal Medicine, Loyola University School of Medicine, Chicago, IL, USA
| | - Waqas Qureshi
- Section of Cardiology in Division of Internal Medicine, University of Massachusetts School of Medicine, Worcester, MA 01655, USA
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20
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Zachariah SK, P AK, Jayadas R, Devi M. Obstructed Left Paraduodenal Hernia: A Rare Cause of Acute Abdomen in a COVID-19 Patient. Cureus 2021; 13:e16265. [PMID: 34377603 PMCID: PMC8349224 DOI: 10.7759/cureus.16265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/08/2021] [Indexed: 11/05/2022] Open
Abstract
A paraduodenal hernia (PDH) is a rare type of internal hernia, which results from anomalous rotation and reduction of the midgut loop in the embryo. The diagnosis is often difficult due to nonspecific symptoms. The mortality from an acute internal hernia can be close to 50% when the diagnosis and definitive surgical treatment are delayed. Here we present a rare case of obstructed left paraduodenal hernia (LPDH) in a COVID-positive patient. This is probably the earliest report of acute mechanical intestinal obstruction due to LPDH in a COVID-positive patient.
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Affiliation(s)
- Sanoop K Zachariah
- General and Minimal Access Surgery, Kerala Institute of Medical Sciences-KIMSHEALTH, Trivandrum, IND
| | - Anil K P
- General and Minimal Access Surgery, Kerala Institute of Medical Sciences-KIMSHEALTH, Trivandrum, IND
| | - Reji Jayadas
- General and Minimal Access Surgery, Kerala Institute of Medical Sciences-KIMSHEALTH, Trivandrum, IND
| | - Maya Devi
- General and Minimal Access Surgery, Kerala Institute of Medical Sciences-KIMSHEALTH, Trivandrum, IND
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21
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Fang LG, Zhou Q. Remarkable gastrointestinal and liver manifestations of COVID-19: A clinical and radiologic overview. World J Clin Cases 2021; 9:4969-4979. [PMID: 34307547 PMCID: PMC8283617 DOI: 10.12998/wjcc.v9.i19.4969] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 03/13/2021] [Accepted: 05/15/2021] [Indexed: 02/06/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) raging around the world still has not been effectively controlled in most countries and regions. As a severe acute respiratory syndrome coronavirus, in addition to the most common infectious pneumonia, it can also cause digestive system disease such as diarrhea, nausea, vomiting, liver function damage, etc. In medical imaging, it manifests as thickening of the intestinal wall, intestinal perforation, pneumoperitoneum, ascites and decreased liver density. Angiotensin-converting enzyme 2 has great significance in COVID-19-related digestive tract diseases. In this review, we summarized the data on the clinical and imaging manifestations of gastrointestinal and liver injury caused by COVID-19 so far and explored its possible pathogenesis.
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Affiliation(s)
- Li-Guang Fang
- Department of Medical Imaging, Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou 510630, Guangdong Province, China
| | - Quan Zhou
- Department of Medical Imaging, Third Affiliated Hospital of Southern Medical University (Academy of Orthopedics Guangdong Province), Guangzhou 510630, Guangdong Province, China
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22
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Afshar-Oromieh A, Prosch H, Schaefer-Prokop C, Bohn KP, Alberts I, Mingels C, Thurnher M, Cumming P, Shi K, Peters A, Geleff S, Lan X, Wang F, Huber A, Gräni C, Heverhagen JT, Rominger A, Fontanellaz M, Schöder H, Christe A, Mougiakakou S, Ebner L. A comprehensive review of imaging findings in COVID-19 - status in early 2021. Eur J Nucl Med Mol Imaging 2021; 48:2500-2524. [PMID: 33932183 PMCID: PMC8087891 DOI: 10.1007/s00259-021-05375-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 03/09/2021] [Indexed: 02/06/2023]
Abstract
Medical imaging methods are assuming a greater role in the workup of patients with COVID-19, mainly in relation to the primary manifestation of pulmonary disease and the tissue distribution of the angiotensin-converting-enzyme 2 (ACE 2) receptor. However, the field is so new that no consensus view has emerged guiding clinical decisions to employ imaging procedures such as radiography, computer tomography (CT), positron emission tomography (PET), and magnetic resonance imaging, and in what measure the risk of exposure of staff to possible infection could be justified by the knowledge gained. The insensitivity of current RT-PCR methods for positive diagnosis is part of the rationale for resorting to imaging procedures. While CT is more sensitive than genetic testing in hospitalized patients, positive findings of ground glass opacities depend on the disease stage. There is sparse reporting on PET/CT with [18F]-FDG in COVID-19, but available results are congruent with the earlier literature on viral pneumonias. There is a high incidence of cerebral findings in COVID-19, and likewise evidence of gastrointestinal involvement. Artificial intelligence, notably machine learning is emerging as an effective method for diagnostic image analysis, with performance in the discriminative diagnosis of diagnosis of COVID-19 pneumonia comparable to that of human practitioners.
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Affiliation(s)
- Ali Afshar-Oromieh
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, CH-3010, Bern, Switzerland.
| | - Helmut Prosch
- Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria
| | - Cornelia Schaefer-Prokop
- Department of Radiology, Meander Medical Center, Amersfoort, Netherlands
- Department of Medical Imaging, Radboud University, Nijmegen, Netherlands
| | - Karl Peter Bohn
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, CH-3010, Bern, Switzerland
| | - Ian Alberts
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, CH-3010, Bern, Switzerland
| | - Clemens Mingels
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, CH-3010, Bern, Switzerland
| | - Majda Thurnher
- Department of Biomedical Imaging and Image-guided Therapy, Medical University Vienna, Vienna, Austria
| | - Paul Cumming
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, CH-3010, Bern, Switzerland
- School of Psychology and Counselling, Queensland University of Technology, Brisbane, Australia
| | - Kuangyu Shi
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, CH-3010, Bern, Switzerland
| | - Alan Peters
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Silvana Geleff
- Clinical Institute of Pathology, Medical University of Vienna, Vienna, Austria
| | - Xiaoli Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Feng Wang
- Department of Nuclear Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Adrian Huber
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Christoph Gräni
- Department of Cardiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Johannes T Heverhagen
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, Bern University Hospital, University of Bern, Freiburgstr. 18, CH-3010, Bern, Switzerland
| | - Matthias Fontanellaz
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
- Department of Emergency Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Heiko Schöder
- Molecular Imaging and Therapy Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andreas Christe
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Stavroula Mougiakakou
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- ARTORG Center for Biomedical Engineering Research, University of Bern, Bern, Switzerland
| | - Lukas Ebner
- Department of Diagnostic, Interventional and Pediatric Radiology, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
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Samuel SV, Viggeswarpu S, Wilson BP, Gopinath KG. Acute colonic pseudo-obstruction in two patients admitted with severe acute respiratory syndrome-coronavirus-2 pneumonia. IDCases 2021; 25:e01205. [PMID: 34189047 PMCID: PMC8225289 DOI: 10.1016/j.idcr.2021.e01205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 06/22/2021] [Accepted: 06/22/2021] [Indexed: 12/29/2022] Open
Abstract
We have described two cases of severe SARS-CoV-2 pneumonia presenting with acute colonic pseudo-obstruction with normal liver enzymes and serum lactate. These older adults presented predominantly with constitutional symptoms, silent hypoxia, distended abdomen, sluggish bowel sounds, and colonic dilatation supported by abdominal imaging (plain X-ray and computerized tomography of abdomen) to a tertiary care center in South India. Both patients received standard treatment for severe SARS-CoV-2 pneumonia and acute colonic pseudo-obstruction according to available guidelines but succumbed to complications during hospital stay. Acute colonic pseudo-obstruction in patients admitted with SARS-CoV-2 infection requires high index of suspicion as it warrants early mitigation by cessation of offending agents, optimizing electrolytes, and colonic decompression to prevent morbidity and mortality.
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24
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Vaidya T, Nanivadekar A, Patel R. Imaging spectrum of abdominal manifestations of COVID-19. World J Radiol 2021; 13:157-170. [PMID: 34249237 PMCID: PMC8245751 DOI: 10.4329/wjr.v13.i6.157] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 04/11/2021] [Accepted: 05/24/2021] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) has posed a serious threat to global public health with its rapid spread, high fatality, and severe burden on health care providers all over the world. Although COVID-19 has been established as a respiratory tract infection, it can manifest with gastrointestinal symptoms as a consequence of direct infection by the virus or due to inflammation-mediated cytotoxicity. It has been observed that COVID-19 patients presenting with gastrointestinal symptoms tend to progress to a severe form of disease with increased morbidity and mortality, thus indicating the need for timely management. COVID-19 manifests with a wide spectrum of radiologic findings on gastrointestinal tract imaging, encompassing bowel abnormalities, hepato-biliary and pancreatic involvement, vascular occlusion, and solid organ infarction. Early recognition of these imaging features can facilitate timely treatment of COVID-19 associated gastrointestinal tract complications and may prompt the diagnosis of COVID-19 in patients with atypical disease manifestations. The aim of this article is to provide an overview of the various gastrointestinal imaging manifestations that can be encountered in patients with COVID-19, with an emphasis on early diagnosis of the disease as well as treatment related complications.
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Affiliation(s)
- Tanvi Vaidya
- Department of Radiology, Ruby Hall Clinic, Pune 411001, Maharashtra, India
| | | | - Rajan Patel
- Department of Radiology, Ruby Hall Clinic, Pune 411001, Maharashtra, India
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25
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Tian C, Xiang M. Therapeutic Agents Against COVID-19 with Clinical Evidence. Curr Pharm Des 2021; 27:1608-1617. [PMID: 33459226 DOI: 10.2174/1381612827666210114150951] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 11/22/2020] [Accepted: 12/14/2020] [Indexed: 01/10/2023]
Abstract
Over 57 million people have been confirmed to have coronavirus disease 2019 (COVID-19) worldwide. Although several drugs have shown potential therapeutic effects, there is no specific drug against COVID-19. In this review, we summarized potential therapeutic agents against COVID-19 with clinical evidence, including antiviral agents, anti-cytokine storm syndrome agents, and vaccines, as well as other drugs. In addition, we briefly discussed their effects on COVID-19, which will contribute to developing treatment plans.
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Affiliation(s)
- Cheng Tian
- Department of Pharmacology, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Ming Xiang
- Department of Pharmacology, School of Pharmacy, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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26
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Nedjimi B. Can trace element supplementations (Cu, Se, and Zn) enhance human immunity against COVID-19 and its new variants? BENI-SUEF UNIVERSITY JOURNAL OF BASIC AND APPLIED SCIENCES 2021; 10:33. [PMID: 34026905 PMCID: PMC8127438 DOI: 10.1186/s43088-021-00123-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/03/2021] [Indexed: 02/04/2023] Open
Abstract
Background Coronavirus-19 (SARS-CoV-2) is constantly changed through mutation, and new stains of this virus are detected throughout the world such as B.1.1.7 (UK), B.1.351 (South Africa), and P.1 (Brazil). These strains seem to be more easily transmissible than other variants, which may lead to more cases and more deaths. Currently, there are many vaccines for SARS-CoV-2 available in the market but without full clinical data beside. Despite the existence of these vaccines, the numbers of outpatients are still increasing in many countries around the world, and the reliability of these vaccines still remains elusive. It is well known that trace element deficiencies increase the individual susceptibility to immune dysfunction and lead to global health problem. In this context, improving the immune defense system to combats this pandemic is absolutely necessary. The purpose of this review is to establish the probable relation between trace elements supplementation and COVID-19. Main body Several clinical studies confirmed that Cu, Se, and Zn insufficiencies alter the immune system and increase the vulnerability to viral infections. Based on antiviral and anti-inflammatory effects of these micronutrients, it seems logical that dietary supplementations of these components might enhance human immune system and lower the graveness of COVID-19 infection. Conclusion Based on available data, we hypothesize that the clinical use of some essential trace element supplementations such as copper, selenium, and zinc might be a preventive and promising option to enhance human immunity against the new pandemic COVID-19 and its new strains. Graphical abstract ![]()
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Affiliation(s)
- Bouzid Nedjimi
- Laboratory of EVSE, Faculty of Science of Nature and Life, Ziane Achour University of Djelfa, P.O. Box 3117, Cité Aîn Chih, 17000 Djelfa, Algeria
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Calcagno E, Sogunro O, Nepal P, Assaker R, Sapire J. COVID-19 induced mesenteric venous infarction. Radiol Case Rep 2021; 16:1999-2002. [PMID: 33995746 PMCID: PMC8112386 DOI: 10.1016/j.radcr.2021.04.083] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 04/30/2021] [Indexed: 12/12/2022] Open
Abstract
We present a rare case of mesenteric venous infarction in a 36-year-old man due to coronavirus disease-19 (COVID-19). Although COVID-19 usually presents with respiratory disease, multi-system manifestations are increasingly reported. Coagulopathy manifestations are also reported on imaging, including in vascular thrombosis, embolus, and organ infarction. Because the clinical variables poorly predict or suspect coagulopathy and its complications, it is important to be aware of imaging manifestations of coagulopathy complications of COVID-19.
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Affiliation(s)
- Emma Calcagno
- Frank H Netter MD School of Medicine, Quinnipiac University, 370 Bassett Rd, North Haven, CT, 06473, USA
| | - Olutayo Sogunro
- St. Vincent's Medical Center, 2800 Main St, Bridgeport, CT 06606, USA
| | - Pankaj Nepal
- St. Vincent's Medical Center, 2800 Main St, Bridgeport, CT 06606, USA
| | - Richard Assaker
- St. Vincent's Medical Center, 2800 Main St, Bridgeport, CT 06606, USA
| | - Joshua Sapire
- St. Vincent's Medical Center, 2800 Main St, Bridgeport, CT 06606, USA
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28
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Clostridium Difficile and COVID-19: Novel Risk Factors for Acute Portal Vein Thrombosis. Case Rep Vasc Med 2021; 2021:8832638. [PMID: 33728091 PMCID: PMC7914382 DOI: 10.1155/2021/8832638] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 02/02/2021] [Accepted: 02/12/2021] [Indexed: 01/05/2023] Open
Abstract
The COVID-19 pandemic has created an unprecedented global health care crisis. COVID-19 patients are found to have increased thrombotic risk. Despite being on prophylactic anticoagulation, many develop serious arterial and venous thromboembolic events. Emerging reports indicate COVID-19 may be considered a novel risk factor for portal vein thrombosis. Although, intra-abdominal infections are identified as risk factors, clostridium difficile colitis has not been typically seen as a risk factor for PVT. We report a case of an elderly female with a recent diagnosis of COVID-19 and no prior history of cirrhosis or malignancy who presented with diarrhea due to clostridium difficile infection. She developed sudden onset severe abdominal pain during the course of hospitalization. Acute portal vein thrombosis was identified on CT imaging of the abdomen, and she improved well with therapeutic anticoagulation. Acute portal vein thrombosis usually results from a combination of local and systemic prothrombotic risk factors. The combination of local infection by clostridium difficile and COVID-19 coagulopathy led to development of portal vein thrombosis in our patient. To the best of our knowledge, this is the first case of portal vein thrombosis reported in a patient with clostridium difficile infection in the setting of COVID-19 coagulopathy. During the current pandemic, clinicians should strongly consider abdominal imaging in patients presenting with abdominal pain due to clostridium difficile infection in the setting of COVID-19 to rule out complications such as portal vein thrombosis. Early diagnosis and treatment of portal vein thrombosis prevent complications of portal hypertension and intestinal infarctions.
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29
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Razzaque MS. COVID-19 pandemic: Can zinc supplementation provide an additional shield against the infection? Comput Struct Biotechnol J 2021; 19:1371-1378. [PMID: 33680350 PMCID: PMC7923946 DOI: 10.1016/j.csbj.2021.02.015] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 02/17/2021] [Accepted: 02/20/2021] [Indexed: 02/08/2023] Open
Abstract
Coronavirus disease-19 (COVID-19)-induced severe acute respiratory syndrome is a global pandemic. As a preventive measure, human movement is restricted in most of the world. The Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), along with the World Health Organization (WHO) have laid out some therapeutic guidelines for the infected patients. However, other than handwashing and vigilance surrounding commonly encountered oronasal symptoms and fever, no universally available prophylactic measure has yet been established. In a pandemic, the accessibility of a prophylactic biologically active substance is crucial. Ideally, it would be something readily available at a low price to a larger percentage of the population with minimal risk. Studies have demonstrated that zinc may reduce viral replication and increase immune responses. While consuming zinc (within the recommended upper safety limits), as a prophylactic might provide an additional shield against the initiation and progression of COVID-19 would need clinical studies, the potential clearly exists. Even after vaccination, low zinc status may affect the vaccination responses.
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Affiliation(s)
- Mohammed S. Razzaque
- Department of Pathology, Lake Erie College of Osteopathic Medicine, Erie, PA, USA
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30
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Lui K, Wilson MP, Low G. Abdominal imaging findings in patients with SARS-CoV-2 infection: a scoping review. Abdom Radiol (NY) 2021; 46:1249-1255. [PMID: 32926211 PMCID: PMC7488219 DOI: 10.1007/s00261-020-02739-5] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 08/19/2020] [Accepted: 08/30/2020] [Indexed: 02/06/2023]
Abstract
PURPOSE This scoping review evaluated the currently available data related to abdominal imaging in the SARS-CoV-2 infection. METHOD A systematic review of MEDLINE, EMBASE, SCOPUS, and Web of Science was performed from inception to July 15, 2020 using PRISMA-ScR guidelines. The review included case reports and series discussing radiologic manifestations of SARS-CoV-2 infection in abdominal imaging studies. Studies published from inception to March 31, 2020, were independently screened and reviewed by one author, and another author reviewed studies published after March 31 to July 15, 2020. Study screening and full-text review for publications before March 31, 2020, was performed by one author, and another author for publications after March 31 to July 15, 2020. RESULTS Thirty-six studies were included in qualitative synthesis. The prevalence of gastrointestinal symptoms is roughly 18% and includes loss of appetite, nausea, vomiting, diarrhea, and abdominal pain. Sixteen percent of COVID-19 cases may only present with gastrointestinal symptoms. Many patients presenting this way demonstrate evidence of COVID-19 incidentally through abdominal CT imaging at the lung bases. Studies published to date have also reported abdominal imaging findings including small and large bowel wall thickening, fluid-filled colon, pneumatosis intestinalis, pneumoperitoneum, intussusception, and ascites. CONCLUSION Gastrointestinal manifestations and imaging manifestations of SARS-CoV-2 infection are increasingly reported and warrant specific attention during abdominal imaging.
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Affiliation(s)
- Kevin Lui
- Department of Radiology and Diagnostic Imaging, University of Alberta, 2B2.41 WMC, 8440-112 Street NW, Edmonton, AB T6G 2B7 Canada
| | - Mitchell P. Wilson
- Department of Radiology and Diagnostic Imaging, University of Alberta, 2B2.41 WMC, 8440-112 Street NW, Edmonton, AB T6G 2B7 Canada
| | - Gavin Low
- Department of Radiology and Diagnostic Imaging, University of Alberta, 2B2.41 WMC, 8440-112 Street NW, Edmonton, AB T6G 2B7 Canada
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31
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Bogan-Brown K, Nkrumah-Elie Y, Ishtiaq Y, Redpath P, Shao A. Potential Efficacy of Nutrient Supplements for Treatment or Prevention of COVID-19. J Diet Suppl 2021; 19:336-365. [PMID: 33594938 DOI: 10.1080/19390211.2021.1881686] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
COVID-19 (COronaVIrus Disease of 2019), the disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), represents an ongoing global health challenge and the deadliest epidemic coronavirus outbreak to date. Early sequencing of the viral genome and knowledge from past coronavirus outbreaks (SARS-CoV-1 and Middle East Respiratory Syndrome, MERS) has led to rapid advances in knowledge of how the virus spreads and infects human hosts. Unfortunately, advancing knowledge has not yet produced a treatment that substantially lowers morbidity or mortality and only recently resulted in the development of a vaccine that prevents severe disease. Mounting evidence supports the notion that dietary supplementation of key essential nutrients may contribute to the body's defenses against infection as well as bolster the body's responses to infection. Evidence supporting the potential beneficial roles of vitamin C, vitamin D, zinc, and B3 vitamins is reviewed here, revealing a combination of basic research elucidating underlying mechanisms of action, preclinical studies and human intervention studies has led to the proliferation of registered clinical trials on COVID-19. Overall, the data suggest this collection of nutrients has a promising impact on reducing the risk and/or severity of COVID-19, although firm conclusions await the results of these trials.
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Trace Elements as Immunoregulators in SARS-CoV-2 and Other Viral Infections. Indian J Clin Biochem 2021; 36:416-426. [PMID: 33613002 PMCID: PMC7879594 DOI: 10.1007/s12291-021-00961-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2020] [Accepted: 01/23/2021] [Indexed: 12/23/2022]
Abstract
Nutritional deficiency is associated with impaired immunity and increased susceptibility to infections. The complex interactions of trace elements with the macromolecules trigger the effective immune response against the viral diseases. The outcome of various viral infections along with susceptibility is affected by trace elements such as zinc, selenium, iron, copper, etc. due to their immuno-modulatory effects. Available electronic databases have been comprehensively searched for articles published with full text available and with the key words “Trace elements”, “COVID-19”, “Viral Infections” and “Immune Response” (i.e. separately Zn, Se, Fe, Cu, Mn, Mo, Cr, Li, Ni, Co) appearing in the title and abstract. On the basis of available articles we have explored the role of trace elements in viral infections with special reference to COVID-19 and their interactions with the immune system. Zinc, selenium and other trace elements are vital to triggerTH1 cells and cytokine-mediated immune response for substantial production of proinflammatory cytokines. The antiviral activity of some trace elements is attributed to their inhibitory effect on viral entry, replication and other downstream processes. Trace elements having antioxidants activity not only regulate host immune responses, but also modify the viral genome. Adequate dietary intake of trace elements is essential for activation, development, differentiation and numerous functions.
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33
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Shaikh DH, Patel H, Makker J, Badipatla K, Chilimuri S. Colonic Ileus, Distension, and Ischemia Due to COVID-19-Related Colitis: A Case Report and Literature Review. Cureus 2021; 13:e13236. [PMID: 33728185 PMCID: PMC7948695 DOI: 10.7759/cureus.13236] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) predominantly presents with respiratory symptoms, however, the involvement of the gastrointestinal system has also been reported. Isolated gastrointestinal manifestation due to COVID-19 presenting as colonic distension is uncommon. Colonic ileus from COVID-19 infection presents as dilatation on imaging, with the risk of subsequent ischemia and perforation if not recognized and treated promptly. There is no consensus on the treatment modality for COVID-19-related colitis, however, COVID-19-targeted medications in conjunction with surgical intervention have been performed for management. We present a case of a 73-year-old man who presented with abdominal pain, distention, and diarrhea. He tested positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was found to have marked dilatation of the colon on imaging. He was initially given convalescent plasma to reduce inflammatory markers, as tocilizumab was contraindicated due to suspected bowel obstruction. Once more stable, he underwent surgical intervention followed by tocilizumab infusion. Pathological specimens of the colon demonstrated hemorrhagic colitis with microthrombi suggestive of COVID-19-related colitis. Recognizing COVID-19-related colitis allows for timely diagnosis and management with targeted interventions in addition to surgery, which may prevent perforation. We suggest convalescent plasma followed by the formation of colostomy and finally infusion of tocilizumab as a feasible option for the treatment of COVID-19-related colitis. However, further research is needed in order to fully understand this entity and provide guidance for its management.
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Affiliation(s)
| | - Harish Patel
- Gastroenterology, BronxCare Health System, New York, USA
| | - Jasbir Makker
- Gastroenterology, BronxCare Health System, New York, USA
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34
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Matković Z, Đekić-Matković N. Ogilvie syndrome in a COVID-19 patient with pneumonia, absolute tachyarrhythmia and heart failure: A case report. SCRIPTA MEDICA 2021. [DOI: 10.5937/scriptamed52-31646] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic has recently spread worldwide presenting primarily in form of pneumonia. Gastrointestinal manifestations such as nausea, vomiting, diarrhoea and abdominal pain are less common than respiratory symptoms. However, critically ill patients may develop digestive complications including acute pseudo-obstruction of colon-Ogilvie syndrome. Gastrointestinal symptoms can manifest before the onset of typical respiratory symptoms. Common mucosal immune response underly both-pulmonary and gastrointestinal manifestations (high expression of angiotensin-converting enzyme 2 receptors). This article described a 75-year old female patient who arise Ogilvie syndrome during viral bilateral pneumonia induced by COVID-19. Patient also had an absolute tachyarrhythmia and hearth failure. Diameter of caecum, ascending and transverse colon was 12 to 14 cm. The walls of this segment of large bowel were deserosed, with threatening perforation. Right colectomy was performed. Nine days after the surgery, despite all therapeutic measures taken, there was a fatal outcome due to pulmonary thromboembolisation.
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35
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Alukal JJ, Thuluvath PJ. Gastrointestinal Manifestations of COVID-19. GERIATRIC GASTROENTEROLOGY 2021:2299-2312. [DOI: 10.1007/978-3-030-30192-7_116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2025]
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36
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Ibrahim YS, Karuppasamy G, Parambil JV, Alsoub H, Al-Shokri SD. Case Report: Paralytic Ileus: A Potential Extrapulmonary Manifestation of Severe COVID-19. Am J Trop Med Hyg 2020; 103:1600-1603. [PMID: 32876011 PMCID: PMC7543796 DOI: 10.4269/ajtmh.20-0894] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
The COVID-19 pandemic has recently spread worldwide, presenting primarily in the form of pneumonia or other respiratory disease. In addition, gastrointestinal manifestations have increasingly been reported as one of the extrapulmonary features of the virus. We report two cases of SARS-CoV-2 infection complicated by paralytic ileus. The first patient was a 33-year-old man who was hospitalized with severe COVID-19 pneumonia requiring ventilator support and intensive care. He developed large bowel dilatation and perforation of the mid-transverse colon, and underwent laparotomy and colonic resection. Histopathology of the resected bowel specimen showed acute inflammation, necrosis, and hemorrhage, supporting a role for COVID-19–induced micro-thrombosis leading to perforation. The second patient was a 33-year-old man who had severe COVID-19 pneumonia, renal failure, and acute pancreatitis. His hospital course was complicated with paralytic ileus, and he improved with conservative management. Both cases were observed to have elevated liver transaminases, which is consistent with other studies. Several authors have postulated that the angiotensin-converting enzyme 2 receptors, the host receptors for COVID-19, that are present on enterocytes in both the small and large bowel might mediate viral entry and resultant inflammation. This is a potential mechanism of paralytic ileus in cases of severe COVID-19 infection. Recognizing paralytic ileus as a possible complication necessitates timely diagnosis and management.
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Affiliation(s)
- Yassmin S Ibrahim
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Gowri Karuppasamy
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Hussam Alsoub
- Infectious Disease Department, Hamad Medical Corporation, Doha, Qatar
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37
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Hutchinson NT, Steelman A, Woods JA. Behavioral strategies to prevent and mitigate COVID-19 infection. SPORTS MEDICINE AND HEALTH SCIENCE 2020; 2:115-125. [PMID: 34189481 PMCID: PMC7481129 DOI: 10.1016/j.smhs.2020.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 09/03/2020] [Accepted: 09/04/2020] [Indexed: 12/12/2022] Open
Abstract
The single stranded RNA virus SARS-CoV-2 has caused a massive addition to the already leading global cause of mortality, viral respiratory tract infections. Characterized by and associated with early and deleteriously enhanced production of pro-inflammatory cytokines by respiratory epithelial cells, severe COVID-19 illness has the potential to inflict acute respiratory distress syndrome and even death. Due to the fast spreading nature of COVID-19 and the current lack of a vaccine or specific pharmaceutical treatments, understanding of viral pathogenesis, behavioral prophylaxis, and mitigation tactics are of great public health concern. This review article outlines the immune response to viral pathogens, and due to the novelty of COVID-19 and the large body of evidence suggesting the respiratory and immune benefits from regular moderate intensity exercise, provides observational and mechanistic evidence from research on other viral infections that suggests strategically planned exercise regimens may help reduce susceptibility to infection, while also mitigating severe immune responses to infection commonly associated with poor COVID-19 prognosis. We propose that regular moderate intensity exercise should be considered as part of a combinatorial approach including widespread hygiene initiatives, properly planned and well-executed social distancing policies, and use of efficacious facial coverings like N95 respirators. Studies discerning COVID-19 pathogenesis mechanisms, transfer dynamics, and individual responses to pharmaceutical and adjunct treatments are needed to reduce viral transmission and bring an end to the COVID-19 pandemic.
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Affiliation(s)
- Noah T. Hutchinson
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Andrew Steelman
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Department of Animal Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Neuroscience Program, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Carle R. Woese Institute for Genomic Biology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Jeffrey A. Woods
- Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Champaign, IL, USA
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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38
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Alexander J, Tinkov A, Strand TA, Alehagen U, Skalny A, Aaseth J. Early Nutritional Interventions with Zinc, Selenium and Vitamin D for Raising Anti-Viral Resistance Against Progressive COVID-19. Nutrients 2020; 12:E2358. [PMID: 32784601 PMCID: PMC7468884 DOI: 10.3390/nu12082358] [Citation(s) in RCA: 154] [Impact Index Per Article: 30.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/04/2020] [Accepted: 08/05/2020] [Indexed: 12/14/2022] Open
Abstract
OBJECTIVES The novel coronavirus infection (COVID-19) conveys a serious threat globally to health and economy because of a lack of vaccines and specific treatments. A common factor for conditions that predispose for serious progress is a low-grade inflammation, e.g., as seen in metabolic syndrome, diabetes, and heart failure, to which micronutrient deficiencies may contribute. The aim of the present article was to explore the usefulness of early micronutrient intervention, with focus on zinc, selenium, and vitamin D, to relieve escalation of COVID-19. METHODS We conducted an online search for articles published in the period 2010-2020 on zinc, selenium, and vitamin D, and corona and related virus infections. RESULTS There were a few studies providing direct evidence on associations between zinc, selenium, and vitamin D, and COVID-19. Adequate supply of zinc, selenium, and vitamin D is essential for resistance to other viral infections, immune function, and reduced inflammation. Hence, it is suggested that nutrition intervention securing an adequate status might protect against the novel coronavirus SARS-CoV-2 (Severe Acute Respiratory Syndrome - coronavirus-2) and mitigate the course of COVID-19. CONCLUSION We recommended initiation of adequate supplementation in high-risk areas and/or soon after the time of suspected infection with SARS-CoV-2. Subjects in high-risk groups should have high priority as regards this nutritive adjuvant therapy, which should be started prior to administration of specific and supportive medical measures.
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Affiliation(s)
- Jan Alexander
- Division of Infection Control and Environment Health, Norwegian Institute of Public Health, P.O. Box 222 Skøyen, 0213 Oslo, Norway;
| | - Alexey Tinkov
- Laboratory of Biotechnology and Bioelementology, Yaroslavl State University, Sovetskaya Str. 14, Yaroslavl 150000, Russia; (A.T.); (A.S.)
- IM Sechenov First Moscow State Medical University (Sechenov University), Bolshaya Pirogovskaya St., Moscow 119146, Russia;
| | - Tor A. Strand
- Centre for International Health, University of Bergen, P.O. Box 7804, 5020 Bergen, Norway;
- Research Department, Innlandet Hospital Trust, P.O. Box 104, 2381 Brumunddal, Norway
| | - Urban Alehagen
- Division of Cardiovascular Medicine, Department of Medical and Health Sciences, Linköping University, SE-58185 Linköping, Sweden
| | - Anatoly Skalny
- Laboratory of Biotechnology and Bioelementology, Yaroslavl State University, Sovetskaya Str. 14, Yaroslavl 150000, Russia; (A.T.); (A.S.)
- IM Sechenov First Moscow State Medical University (Sechenov University), Bolshaya Pirogovskaya St., Moscow 119146, Russia;
| | - Jan Aaseth
- IM Sechenov First Moscow State Medical University (Sechenov University), Bolshaya Pirogovskaya St., Moscow 119146, Russia;
- Research Department, Innlandet Hospital Trust, P.O. Box 104, 2381 Brumunddal, Norway
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