BACKGROUND There is little evidence about the association of pre-existing hepatitis C infection(HCV)with outcomes in patients with coronavirus disease 2019(COVID-19).AIM To assess the prevalence of history of HCV amon...BACKGROUND There is little evidence about the association of pre-existing hepatitis C infection(HCV)with outcomes in patients with coronavirus disease 2019(COVID-19).AIM To assess the prevalence of history of HCV among patients with COVID-19 and to study the relationship of in-hospital mortality in relation with other predictors of poor outcomes in the presence or absence of COVID-19 induced acute liver injury.METHODS In a retrospective single-center study design,1193 patients with COVID-19 infection were studied.Patients were then classified into those with and without a history of HCV,50(4.1%)and 1157(95.9%)respectively.RESULTS Multivariate cox-regression models showed that age,HCV,D-Dimer,and ferritin were the only predictors of in-hospital mortality.Acute liver injury and fibrosis score(Fib-4 score)were not different between both groups.Multivariate coxregression model for liver profile revealed that aspartate aminotransferase/alanine aminotransferase ratio,Fib-4 score,and HCV were predictors of inhospital mortality.After propensity score matching HCV was the only predictor of mortality in the multivariate cox-regression model.A model including HCV was found to add predictive value to clinical and laboratory parameters.CONCLUSION In patients with COVID-19,history of HCV infection leads to an accentuated severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)virulence,irrespective of baseline comorbidities,admission laboratory variables,or COVID-19-induced liver injury,which may be related to extrahepatic effects of HCV leading to enhanced ACE-2/TMPRSS mechanisms of SARS-CoV-2 viral entry,baseline cytokine-mediated pro-inflammation,and endothelial dysfunction.展开更多
BACKGROUND Hydrogen peroxide is one of the most common household disinfectants worldwide.Hydrogen peroxide has been documented as a rare cause of chemical colitis.CASE SUMMARY We present a case of 31 years old lady wh...BACKGROUND Hydrogen peroxide is one of the most common household disinfectants worldwide.Hydrogen peroxide has been documented as a rare cause of chemical colitis.CASE SUMMARY We present a case of 31 years old lady who presented to our hospital with rectal bleeding and abdominal pain after using hydrogen peroxide vaginal douche as an enema.She underwent colonoscopy which showed findings suggestive of chemical colitis and was managed conservatively.Hydrogen peroxide can induce chemical injury in the colon.Clinical presentation and endoscopic findings of chemical colitis are nonspecific.History taking is an important tool in identifying the underlying etiology.Review of literature showed few case reports,mostly were managed with oral antibiotics and conservative approach.CONCLUSION Chemical colitis is usually managed conservatively.Complications including perforation,stricture and peritonitis may happen and need aggressive treatment accordingly.展开更多
文摘BACKGROUND There is little evidence about the association of pre-existing hepatitis C infection(HCV)with outcomes in patients with coronavirus disease 2019(COVID-19).AIM To assess the prevalence of history of HCV among patients with COVID-19 and to study the relationship of in-hospital mortality in relation with other predictors of poor outcomes in the presence or absence of COVID-19 induced acute liver injury.METHODS In a retrospective single-center study design,1193 patients with COVID-19 infection were studied.Patients were then classified into those with and without a history of HCV,50(4.1%)and 1157(95.9%)respectively.RESULTS Multivariate cox-regression models showed that age,HCV,D-Dimer,and ferritin were the only predictors of in-hospital mortality.Acute liver injury and fibrosis score(Fib-4 score)were not different between both groups.Multivariate coxregression model for liver profile revealed that aspartate aminotransferase/alanine aminotransferase ratio,Fib-4 score,and HCV were predictors of inhospital mortality.After propensity score matching HCV was the only predictor of mortality in the multivariate cox-regression model.A model including HCV was found to add predictive value to clinical and laboratory parameters.CONCLUSION In patients with COVID-19,history of HCV infection leads to an accentuated severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)virulence,irrespective of baseline comorbidities,admission laboratory variables,or COVID-19-induced liver injury,which may be related to extrahepatic effects of HCV leading to enhanced ACE-2/TMPRSS mechanisms of SARS-CoV-2 viral entry,baseline cytokine-mediated pro-inflammation,and endothelial dysfunction.
文摘BACKGROUND Hydrogen peroxide is one of the most common household disinfectants worldwide.Hydrogen peroxide has been documented as a rare cause of chemical colitis.CASE SUMMARY We present a case of 31 years old lady who presented to our hospital with rectal bleeding and abdominal pain after using hydrogen peroxide vaginal douche as an enema.She underwent colonoscopy which showed findings suggestive of chemical colitis and was managed conservatively.Hydrogen peroxide can induce chemical injury in the colon.Clinical presentation and endoscopic findings of chemical colitis are nonspecific.History taking is an important tool in identifying the underlying etiology.Review of literature showed few case reports,mostly were managed with oral antibiotics and conservative approach.CONCLUSION Chemical colitis is usually managed conservatively.Complications including perforation,stricture and peritonitis may happen and need aggressive treatment accordingly.
