Impact of the COVID-19 pandemic on liver donation and transplantation:A review of the literature

The coronavirus disease 2019(COVID-19)pandemic has upended healthcare systems worldwide and led to an inevitable decrease in liver transplantation(LT)activity.During the first pandemic wave,administrators and clinicians were obliged to make the difficult decision of whether to suspend or continue a lifesaving procedure based on the scarce available evidence regarding the risk of transmission and mortality in immunosuppressed patients.Those centers where the activity continued or was heavily restricted were obliged to screen donors and recipients,design COVID-safe clinical pathways,and promote telehealth to prevent nosocomial transmission.Despite the ever-growing literature on COVID-19,the amount of high-quality literature on LT remains limited.This review will provide an updated view of the impact of the pandemic on LT programs worldwide.Donor and recipient screening,strategies for waitlist prioritization,and posttransplant risk of infection and mortality are discussed.Moreover,a particular focus is given to the possibility of donor-to-recipient transmission and immunosuppression management in COVID-positive recipients.

Clinical manifestations and outcomes in severe ulcerative colitis

In order to evaluate the clinical manifestations and outcomes of severe ulcerative colitis(UC),we retrospectively reviewed 41 patients with severe UC from 144 consecutively hospitalized UC cases from 1988 to 2004.Data recorded included onset,symptoms,signs,laboratory results,endoscopic,radiologic and pathologic findings,the clinical treatment process and follow-up.Of these severe cases,92.7%(38/41)had pancolitis.Clinically,36.9%(15/41)were categorized as first onset type,36.9%(15/41)were chronic persistent and 26.8%(11/41)were chronic recurrent.Steroids played a main role in the remission of severe UC(61.0%).Thirty-one cases(75.6%)were relieved by drug therapy.Seven cases(17.1%)progressed to the need for operation.An early age of onset,pancolitis,low hemoglobin and serum albumin levels,and the need for intravenous steroids tended to be associated with the need for surgery.In conclusion,most of the severe UC patients respond well to drug therapy,but for individuals who are unresponsive to drug therapy,or for those depending on steroids,after a reasonable duration of treatment,the necessity for surgery should be considered.

Recursive equations for compound distribution with the severity distribution of the mixed type

In this paper, recursive equations are obtained for compound distribution with the number of claims belonging to (a, b)-family and the severity distribution of the mixed type. Numerical methods to solve these equations are presented, and some numerical results are given.

Altered gut microbiota composition in children and their caregivers infected with the SARS‑CoV‑2 Omicron variant

Background Gut microbiota alterations have been implicated in the pathogenesis of coronavirus disease 2019(COVID-19).This study aimed to explore gut microbiota changes in a prospective cohort of COVID-19 children and their asymptomatic caregivers infected with the severe acute respiratory syndrome coronavirus type 2(SARS-CoV-2)Omicron variant.Methods A total of 186 participants,including 59 COVID-19 children,50 asymptomatic adult caregivers,52 healthy children(HC),and 25 healthy adults(HA),were recruited between 15 April and 31 May 2022.The gut microbiota composition was determined by 16S rRNA gene sequencing in fecal samples collected from the participants.Gut microbiota functional profling was performed by using Phylogenetic Investigation of Communities by Reconstruction of Unobserved States(PICRUSt)software.Results The gut microbiota analysis of beta diversity revealed that the fecal microbial community of COVID-19 children remained far distantly related to HC.The relative abundances of the phyla Actinobacteria and Firmicutes were decreased,whereas Bacteroidetes,Proteobacteria,and Verrucomicrobiota were increased in COVID-19 children.Feces from COVID-19 children exhibited notably lower abundances of the genera Blautia,Bifdobacterium,Fusicatenibacter,Streptococcus,and Romboutsia and higher abundances of the genera Prevotella,Lachnoclostridium,Escherichia-Shigella,and Bacteroides than those from HC.The enterotype distributions of COVID-19 children were characterized by a high prevalence of enterotype Bacteroides.Similar changes in gut microbiota compositions were observed in asymptomatic caregivers.Furthermore,the microbial metabolic activities of KEGG(Kyoto Encyclopedia of Genes and Genomes)and COG(cluster of orthologous groups of proteins)pathways were perturbed in feces from subjects infected with the SARS-CoV-2 Omicron variant.Conclusion Our data reveal altered gut microbiota compositions in both COVID-19 children and their asymptomatic caregivers infected with the SARS-CoV-2 Omicron variant,which further implicates the critical role of gut microbiota in COVID-19 pathogenesis.

Organ function support in patients with coronavirus disease 2019:Tongji experience

Coronavirus disease 2019(COVID-19)is a highly contagious disease and a serious threat to human health.COVID-19 can cause multiple organ dysfunction,such as respiratory and circulatory failure,liver and kidney injury,disseminated intravascular coagulation,and thromboembolism,and even death.The World Health Organization reports that the mortality rate of severe-type COVID-19 is over 50%.Currently,the number of severe cases worldwide has increased rapidly,but the experience in the treatment of infected patients is still limited.Given the lack of specific antiviral drugs,multi-organ function support treatment is important for patients with COVID-19.To improve the cure rate and reduce the mortality of patients with severe-and critical-type COVID-19,this paper summarizes the experience of organ function support in patients with severe-and criticaltype COVID-19 in Optical Valley Branch of Tongji Hospital,Wuhan,China.This paper systematically summarizes the procedures of functional support therapies for multiple organs and systems,including respiratory,circulatory,renal,hepatic,and hematological systems,among patients with severe-and critical-type COVID-19.This paper provides a clinical reference and a new strategy for the optimal treatment of COVID-19 worldwide.