Impact of non-alcoholic fatty liver disease on coronavirus disease 2019: A systematic review

BACKGROUND Many studies have revealed a link between non-alcoholic fatty liver disease(NA-FLD)and coronavirus disease 2019(COVID-19),making understanding the relationship between these two conditions an absolute requirement.AIM To provide a qualitative synthesis on the currently present data evaluating COVID-19 and NAFLD.METHODS This systematic review was conducted in accordance with the guidelines pro-vided by preferred reporting items for systematic reviews and meta-analyses and the questionnaire utilized the population,intervention,comparison,and outcome framework.The search strategy was run on three separate databases,PubMed/MEDLINE,Scopus,and Cochrane Central,which were systematically searched from inception until March 2024 to select all relevant studies.In addition,ClinicalTrials.gov,Medrxiv.org,and Google Scholar were searched to identify grey literature.RESULTS After retrieval of 11 studies,a total of 39282 patients data were pooled.Mortality was found in 11.5%and 9.4%of people in NAFLD and non-NAFLD groups.In all,23.2%of NAFLD patients and 22%of non-NAFLD admissions diagnosed with COVID-19 were admitted to the intensive care unit,with days of stay varying.Ventilatory support ranged from 5%to 40.5%in the NAFLD cohort and from 3.1%to 20%in the non-NAFLD cohort.The incidence of acute liver injury showed significance.Clinical improvement on days 7 and 14 between the two classifications was significant.Hospitalization stay ranged from 9.6 days to 18.8 days and 7.3 days to 16.4 days in the aforementioned cohorts respectively,with 73.3%and 76.3%of patients being discharged.Readmission rates varied.CONCLUSION Clinical outcomes except mortality consistently showed a worsening trend in patients with NAFLD and concomitant COVID-19.Further research in conducting prospective longitudinal studies is essential for a more powerful conclusion.

The potential role of Gegen Qinlian decoction in the treatment of coronavirus disease 2019 based on network pharmacology and validation of lipopolysaccharide-induced macrophages

Background:Coronavirus disease 2019(COVID-19)is caused by severe acute respiratory syndrome coronavirus 2,which has led to deaths and currently lacks an efficient treatment.Despite studies suggesting the potential of the Gegen Qinlian decoction(GQD)in preventing COVID-19,comprehensive analyses of its anti-COVID-19 potential are still lacking.Methods:GQD treatment was evaluated for its efficacy in ameliorating the early stage(24 hours)of lipopolysaccharide(LPS)-induced cytokine storm in vivo.Additionally,target genes of GQD were co-analyzed with COVID-19 signature genes to identify key ingredients and their pathways.Validation was also conducted using an LPS-induced macrophage model.Results:GQD treatment effectively ameliorated the early stage of LPS-induced cytokine storm in vivo.Key ingredients such as quercetin were found to be involved in multiple pathways,including inflammation,immunity,oxidative stress,cell proliferation,and apoptosis,through the AGE-RAGE signaling pathway and IL-17 signaling pathway.In the LPS-induced macrophage model,quercetin inhibited macrophage polarization(M1)and the secretion of inflammatory factors(IL-6,TNF-α,IL-17A).Conclusions:Our results indicate that GQD can be utilized in the treatment of cytokine storm induced by COVID-19 and has the potential to treat COVID-19 by suppressing the COVID-19 signature genes and macrophage polarization.

A rapid advice guideline for the diagnosis and treatment of 2019 novel coronavirus(2019-nCoV) infected pneumonia(standard version)

In December 2019, a new type viral pneumonia cases occurred in Wuhan, Hubei Province;and then named "2019 novel coronavirus(2019-nCoV)" by the World Health Organization(WHO) on 12 January 2020. For it is a never been experienced respiratory disease before and with infection ability widely and quickly, it attracted the world’s attention but without treatment and control manual. For the request from frontline clinicians and public health professionals of 2019-nCoV infected pneumonia management, an evidence-based guideline urgently needs to be developed. Therefore, we drafted this guideline according to the rapid advice guidelines methodology and general rules of WHO guideline development;we also added the first-hand management data of Zhongnan Hospital of Wuhan University. This guideline includes the guideline methodology, epidemiological characteristics, disease screening and population prevention, diagnosis, treatment and control(including traditional Chinese Medicine), nosocomial infection prevention and control, and disease nursing of the 2019-nCoV. Moreover, we also provide a whole process of a successful treatment case of the severe 2019-nCoV infected pneumonia and experience and lessons of hospital rescue for 2019-nCoV infections. This rapid advice guideline is suitable for the first frontline doctors and nurses, managers of hospitals and healthcare sections, community residents, public health persons, relevant researchers, and all person who are interested in the 2019-nCoV.

Imported cases of 2019-novel coronavirus (2019-nCoV) infections in Thailand: Mathematical modelling of the outbreak

Outbreak of a new emerging disease is usually an important consideration in medicine and public health. In December 2019, a new emerging disease started in China and becomes the global concern in early January 2020[1,2]. The disease, 2019-novel coronavirus(2019-nCoV) infection, already existed outside China and the importation of disease is the cause of emerging 2019-nCoV infections in new settings.

Dose prediction of lopinavir/ritonavir for 2019-novel coronavirus (2019-nCoV) infection based on mathematic modeling

Wuhan novel coronavirus or 2019-novel coronavirus(2019-nCoV)infection is a rapidly emerging respiratory viral disease[1].2019-nCoV infection is characterized as febrile illness with possible severe lung complication[1].The disease was firstly reported in China in December 2019 and then spread to many countries(such as Thailand,Japan and Singapore)[2,3].As a new disease,there is a limited knowledge of treatment for the infection.Lu recently proposed that some drug might be useful in treatment of 2019-nCoV infection[3].

The origin, transmission and clinical therapies on coronavirus disease 2019(COVID-19) outbreak——an update on the status

An acute respiratory disease,caused by a novel coronavirus(SARS-CoV-2,previously known as 2019-nCoV),the coronavirus disease 2019(COVID-19)has spread throughout China and received worldwide attention.On 30 January 2020,World Health Organization(WHO)officially declared the COVID-19 epidemic as a public health emergency of international concern.The emergence of SARS-CoV-2,since the severe acute respiratory syndrome coronavirus(SARSCoV)in 2002 and Middle East respiratory syndrome coronavirus(MERS-CoV)in 2012,marked the third introduction of a highly pathogenic and large-scale epidemic coronavirus into the human population in the twenty-first century.As of 1 March 2020,a total of 87,137 confirmed cases globally,79,968 confirmed in China and 7169 outside of China,with 2977 deaths(3.4%)had been reported by WHO.Meanwhile,several independent research groups have identified that SARS-CoV-2 belongs toβ-coronavirus,with highly identical genome to bat coronavirus,pointing to bat as the natural host.The novel coronavirus uses the same receptor,angiotensin-converting enzyme 2(ACE2)as that for SARS-CoV,and mainly spreads through the respiratory tract.Importantly,increasingly evidence showed sustained human-tohuman transmission,along with many exported cases across the globe.The clinical symptoms of COVID-19 patients include fever,cough,fatigue and a small population of patients appeared gastrointestinal infection symptoms.The elderly and people with underlying diseases are susceptible to infection and prone to serious outcomes,which may be associated with acute respiratory distress syndrome(ARDS)and cytokine storm.Currently,there are few specific antiviral strategies,but several potent candidates of antivirals and repurposed drugs are under urgent investigation.In this review,we summarized the latest research progress of the epidemiology,pathogenesis,and clinical characteristics of COVID-19,and discussed the current treatment and scientific advancements to combat the epidemic novel coronavirus.

Fear can be more harmful than the severe acute respiratory syndrome coronavirus 2 in controlling the corona virus disease 2019 epidemic

The current corona virus disease 2019 outbreak caused by severe acute respiratory syndrome coronavirus 2 started in Wuhan,China in December 2019 and has put the world on alert.To safeguard Chinese citizens and to strengthen global health security,China has made great efforts to control the epidemic.Many in the global community have joined China to limit the epidemic.However,discrimination and prejudice driven by fear or misinformation have been flowing globally,superseding evidence and jeopardizing the anti-severe acute respiratory syndrome coronavirus 2 efforts.We analyze this phenomenon and its underlying causes and suggest practical solutions.

Quantitative computed tomography analysis for stratifying the severity of Coronavirus Disease 2019

To examine the feasibility of using a computer tool for stratifying the severity of Coronavirus Disease 2019(COVID-19)based on computed tomography(CT)images.We retrospectively examined 44 confirmed COVID-19 cases.All cases were evaluated separately by radiologists(visually)and through an in-house computer software.The degree of lesions was visually scored by the radiologist,as follows,for each of the 5 lung lobes:0,no lesion present;1,<1/3 involvement;2,>1/3 and<2/3 involvement;and 3,>2/3 involvement.Lesion density was assessed based on the proportion of ground-glass opacity(GGO),consolidation and fibrosis of the lesions.The parameters obtained using the computer tool included lung volume(mL),lesion volume(mL),lesion percentage(%),and mean lesion density(HU)of the whole lung,right lung,left lung,and each lobe.The scores obtained by the radiologists and quantitative results generated by the computer software were tested for correlation.A Chi-square test was used to test the consistency of radiologist-and computer-derived lesion percentage in the right/left lung,upper/lower lobe,and each of the 5 lobes.The results showed a strong to moderate correlation between lesion percentage scores obtained by radiologists and the computer software(r ranged from 0.7679 to 0.8373,P<0.05),and a moderate correlation between the proportion of GGO and mean lesion density(r=-0.5894,P<0.05),and proportion of consolidation and mean lesion density(r=0.6282,P<0.05).Computer-aided quantification showed a statistical significant higher lesion percentage for lower lobes than that assessed by the radiologists(x^2=8.160,P=0.004).Our experiments demonstrated that the computer tool could reliably and accurately assess the severity and distribution of pneumonia on CT scans.

Traditional Chinese medicine for treatment of coronavirus disease 2019:a review

prevalence.A number of clinical workers and researchers have made great efforts to understand the pathogenesis and clinical characteristics and develop effective drugs for treatment.However,no effective drugs with antiviral effects on severe acute respiratory syndrome coronavirus 2 have been discovered currently.Traditional Chinese medicine(TCM)has gained abundant experience in the treatment of infectious diseases for thousands of years.In this review,the authors summarized the clinical outcome,pathogensis and current application of TCM on coronavirus disease 2019.Further,we discussed the potential mechanisms and the future research directions of TCM against severe acute respiratory syndrome coronavirus 2.

Zoonotic origins of human coronavirus 2019(HCoV-19/SARS-CoV-2):why is this work important?

The ongoing pandemic of coronavirus disease 2019 (COVID-19), caused by infection with human coronavirus 2019 (HCoV-19/SARS-CoV-2/2019-nCoV), is a global threat to the human population. Here, we briefly summarize the available data for the zoonotic origins of HCoV-19, with reference to the other two epidemics of highly virulent coronaviruses, SARSCoV and MERS-CoV, which cause severe pneumonia in humans. We propose to intensify future efforts for tracing the origins of HCoV-19, which is a very important scientific question for the control and prevention of the pandemic.

Network pharmacology studies on the effect of Chai-Ling decoction incoronavirus disease 2019

Background:Chai-Ling decoction(CLD),derived from a modification of Xiao-Chai-Hu(XCH)decoction and Wu-Ling-San(WLS)decoction,has been used to treat the early-stage of coronavirus disease 2019(COVID-19).However,the mechanisms of CLD in COVID-19 remain unknown.In this study,the potential mechanisms of CLD in COVID-19 were preliminarily investigated based on network pharmacology and molecular docking method.Methods:Initially,the active components and targets of CLD were screened based on Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform and PharmMapper database.The targets of COVID-19 were obtained from GeneCards database.The protein-protein interaction network was established using STRING database to analyze the key targets.Gene Oncology(GO)analysis and Kyoto Encyclopedia of Genes and Genomes analysis were also conducted to evaluate the pathways related to the targets of CLD on COVID-19.Moreover,the compound-target-pathway network was established using Cytoscape 3.2.7.Subsequently,the molecular docking method was performed to select the active compounds with high binding affinity on severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and angiotensin-converting enzyme 2(ACE2),which is the key target of SARS-CoV-2 in entering target cells.The possible binding sites were also visualized by a three-dimensional graph.Results:Network pharmacology analysis showed that there were 106 active components and 160 targets of CLD.Additionally,251 targets related to COVID-19 were identified,and 24 candidates of CLD on COVID-19 were selected.A total of 283 GO terms of CLD on COVID-19 were identified,and 181 pathways were screened based on GO and Kyoto Encyclopedia of Genes and Genomes analyses.CLD might alleviate the inflammatory response and improve lung injury to treat COVID-19 through interleukin 17 signaling,T helper cell 17 differentiation,tumor necrosis factor signaling,and hypoxia inducible factor-1 signaling.Besides,molecular docking indicated that beta-sitosterol,kaempferol,and stigmasterol were the top three candidates in CLD with the highest affinity to SARS-CoV-2 and ACE2.Conclusion:Our study identifies the potential mechanisms of CLD on COVID-19 and beta-sitosterol,kaempferol,and stigmasterol may be the key compounds that exert antiviral effects against SARS-CoV-2.

Hypoxia in acute cardiac injury of coronavirus disease 2019:lesson learned from pathological studies

Coronavirus disease 2019(COVID-19)is an infectious respiratory disease caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),which has infected 972,303 people and caused 50,322 deaths all over the world according to the latest WHO report.[1]As a highly contagious disease,COVID-19 has killed more people than severe acute respiratory syndrome(SARS)and middle east respiratory syndrome(MERS)combined,despite an relatively low case-fatality rate.[2,3]Although it mainly attacks respiratory system,other systems including cardiovascular system are also influenced by COVID-19.Acute cardiac injury(ACI)is also one of the noteworthy issues which researchers have noticed in several studies.[4–7] .

Comparison of Clinical Characteristics and Outcomes of Pediatric and Adult Patients with Coronavirus Disease 2019 in Shenzhen,China

Objective Here we aimed to investigate the difference in clinical characteristics and outcomes between pediatric and adult patients with COVID-19.Methods A total of 333 consecutive patients with laboratory-confirmed SARS-CoV-2 infection treated in the departments of Internal medicine of Shenzhen Third People’s Hospital from January 11 th to February 10 th,2020 were included.The data were obtained from electronic medical records.The epidemiological data,clinical characteristics,length of hospital stays,and outcomes of pediatric and adult patients were compared.Results Compared with adult patients,pediatric patients had a shorter time of symptom onset to hospitalization than adults[median time,1(IQR,1.0-1.0)d vs.3(IQR,2.0-6.0)d,P<0.001],milder or fewer symptoms,less severe chest CT findings.The clinical severity classification of children was less severe than adults.Up to 15 th March,the end of the follow-up,33(100%)children and 292(97.3%)adult patients had been discharged from hospital.Only 2(0.7%)adult patients died,with an overall case mortality of 0.6%.The median length of hospital stay of pediatric patients was shorter than that of adult patients[19(95%CI:16.6-21.4)d vs.21(95%CI:19.9-22.1)d,P=0.024].Conclusion Pediatric patients with COVID-19 had milder or less clinical symptoms,less evident pulmonary imaging changes,better prognosis,and shorter length of hospital stay.

Safety management of nasopharyngeal specimen collection from suspected cases of coronavirus disease 2019

This article introduces safety management strategies of nasopharyngeal specimen collection from suspected cases of coronavirus disease 2019 in a tertiary designated hospital.The key points include establishing a special sampling room,strict sterilization of the entire environment,training of professional nurses,enhancement of personal protection,standardization of methods and processes for swab collection,and a timely and safety sample submission.More than 11,000 nasopharyngeal specimens were collected by eight nurses,with an average of 1,375 specimen swab collections each nurse,and no one was infected.

Extracorporeal Membrane Oxygenation Therapy for Critically Ill Coronavirus Disease 2019 Patients in Wuhan,China:A Retrospective Multicenter Cohort Study

Currently,little in-depth evidence is known about the application of extracorporeal membrane oxygenation(ECMO)therapy in coronavirus disease 2019(COVID-19)patients.This retrospective multicenter cohort study included patients with COVID-19 at 7 designated hospitals in Wuhan,China.The patients were followed up until June 30,2020.Univariate and multivariate logistic regression analyses were performed to identify the risk factors associated with unsuccessful ECMO weaning.Propensity score matching was used to match patients who received veno-venous ECMO with those who received invasive mechanical ventilation(IMV)-only therapy.Of 88 patients receiving ECMO therapy,27 and 61 patients were and were not successfully weaned from ECMO,respectively.Additionally,15,15,and 65 patients were further weaned from IMV,discharged from hospital,or died during hospitalization,respectively.In the multivariate logistic regression analysis,a lymphocyte count≤0.5×10^(9)/L and D-dimer concentration>4×the upper limit of normal level at ICU admission,a peak PaCO_(2)>60 mmHg at 24 h before ECMO initiation,and no tracheotomy performed during the ICU stay were independently associated with lower odds of ECMO weaning.In the propensity scorematched analysis,a mixed-effect Cox model detected a lower hazard ratio for 120-day all-cause mortality after ICU admission during hospitalization in the ECMO group.The presence of lymphocytopenia,higher D-dimer concentrations at ICU admission and hypercapnia before ECMO initiation could help to identify patients with a poor prognosis.Tracheotomy could facilitate weaning from ECMO.ECMO relative to IMV-only therapy was associated with improved outcomes in critically ill COVID-19 patients.

Myocardial injury is associated with higher mortality in patients with coronavirus disease 2019:a meta-analysis

In December 2019,coronavirus disease 2019(COVID-19)caused by a novel coronavirus(SARS-CoV-2)broke out in Wuhan,China,and has spread widely all over the world,reaching the pandemic level.[1]According to the latest WHO report,693,224 cases of COVID-19 were confirmed globally as of March 30,2020,with more than 33,000 deaths.[2]Because COVID-19 is highly contagious and harmful,it is crucial to determine the predictors of severe infection and death for risk stratification and guiding clinical treatment and intervention.

Coronavirus disease 2019 (COVID-19) and global mental health

The mental health effects of the coronavirus disease 2019(COVID-19)pandemic may shape population health for many years to come.Failure to address the mental health issues stemming from the pandemic is likely to prolong its impact.The COVID-19 pandemic has created a significant global challenge and,in lower-income countries,even a disruption of mental health services.Given our experience with previous pandemics,the present COVID-19 crisis can be expected to cause psychological trauma,and steps are needed to address this issue proactively.Policies focusing on the long-term mental health consequences of COVID-19 may equal the importance of those currently seeking to mitigate its physical effects.The implications of the GOVID-19 pandemic for mental health call for a greater focus on the needs of those with mental disorders and on mental health issues affecting health care workers and the general public.Timely preventive and therapeutic mental health care is essential in addressing the psychosocial needs of populations exposed to the pandemic.In addition to specialist care,"task-shifting"and digital technologies may provide cost-effective means of providing mental health care in lower-income countries worldwide as well as in higher-income countries with mental health services overwhelmed by the effects of the COVID-19 pandemic.In view of the ever-increasing pressure on global health systems resulting from the COVID-19 pandemic,adopting and adapting"task-shifting",i.e.,the delegation of psychotherapeutic interventions to trained non-specialists,as an element of the provision of mental health services,is overdue.Digital technologies can be used to enhance social support and facilitate resilience to the detrimental mental health effects of the pandemic;they may also offer an efficient and cost-effective way to provide easy access to mentalhealth care.

Coronavirus disease 2019 (COVID-19) pandemic: how countries shouldbuild more resilient health systems for preparedness and response

Objective: A resilient health system plays a crucial role in pandemic preparedness and response. Althoughthe World Health Organization (WHO) has required all states parties to strengthen core capacities to respondto public health emergencies under the International Health Regulations (2005), the actions of most countriesto combating coronavirus disease 2019 (COVID-19) has showed that they are not well-prepared. This crosssectionalstudy aimed to examine the health system resilience of selected countries and analyze their strategiesand measures in response to the COVID-19 pandemic.Methods: This study selected five countries including the Iran, Japan, Republic of Korea (South Korea), the U.K.,and the U.S., based on the severity of the national epidemic, the geographical location, and the developmentlevel. Cumulative number of death cases derived from WHO COVID-19 dashboard was used to measure theseverity of the impact of the pandemic in each country;WHO State Parties Self-Assessment Annual Reporting (SPAR)Scores and Global Health Security (GHS) Index were applied to measure the national health system resilience;and research articles and press materials were summarized to identify the strategies and measures adopted bycountries during response to COVID-19. This study applied the resilient health systems framework to analyzehealth system resilience in the selected countries from five dimensions, including awareness, diversity, selfregulation,integration and adaptation.Results: The SPAR Scores and GHS Index of the four developed countries, Japan, South Korea, the U.K. and theU.S. were above the global and regional averages;the SPAR Scores of Iran were above the global average whilethe GHI Index lain below the global average. In terms of response strategies, Japan, the U.K. and the U.S. investedmore health resources in the treatment of severe patients, while South Korea and Iran had adopted a strategyof extensive testing and identification of suspected patients. In terms of specific measures, all the five countriesadopted measures such as restrictions on entry and international travel, closure of schools and industries,lockdown and quarantine. Nevertheless, the effectiveness of implementing these measures varied acrosscountries, based on the response strategies.Conclusion: Although SPAR Scores and GHS Index have evaluated the national core capacities for preparednessand response, the actions to cope with the COVID-19 pandemic has revealed the fact that most countries stilldo not build resilient health systems in response to public health emergencies. Health system strengtheningand health security efforts should be pursued in tandem, as part of the same mutually reinforcing approach todeveloping resilient health systems.

Armarium facilitating angina management post myocardial infarction concomitant with coronavirus disease 2019

The outbreak and spread of coronavirus disease 2019(COVID-19)are not only a disaster of people’s life and health over the world,[1–3]but also the challenge for medical practitioner in clinical management.Owing to many diagnostic instruments are not suitable or convenient to use any more in contagious ward considering the risk of cross infections,such as traditional stethoscope or electrocardiogram(ECG).In this scenarios,wireless and digital equipment are optimal choices for epidemic management in order to exert rapid diagnosis and disease evaluation.Herein,we reported a case of the patient suffering both COVID-19 and myocardial infarction,for which the tele-ECG and wireless stethoscope facilitated the accurate diagnosis and instant management.

Management of neurosurgical patients during coronavirus disease 2019 pandemics:The Ljubljana,Slovenia experience

The novel coronavirus disease 2019(COVID-19)is an emerging disease,caused by severe acute respiratory syndrome coronavirus-2.It bears unique biological characteristics,clinical symptoms and imaging manifestations,therefore presenting an important and urgent threat to global health.As a result,a new public health crisis arose,threatening the world with the spread of the 2019 novel coronavirus.Despite the maximal worldwide public health responses aimed at containing the disease and delaying its spread,many countries have been confronted with a critical care crisis,and even more,countries will almost certainly follow.In Slovenia,the COVID-19 has struck the health system immensely and among all the specialities,neurosurgery has also been experiencing difficulties in the service,not only in regular,elective surgeries but especially during emergencies.The management of these neurosurgical patients has become more difficult than ever.We describe our protocol in the management of neurosurgical patients in the University Medical Centre Ljubljana,Slovenia and how neurosurgical pathology was tackled during the pandemics.