Coronavirus Disease 2019(COVID-19)was first identified in China at the end of 2019.Acute respiratory distress syndrome(ARDS)represents the most common and serious complication of COVID-19.Cytokine storms are a pathoph...Coronavirus Disease 2019(COVID-19)was first identified in China at the end of 2019.Acute respiratory distress syndrome(ARDS)represents the most common and serious complication of COVID-19.Cytokine storms are a pathophysiological feature of COVID-19 and play an important role in distinguishing hyper-inflammatory subphenotypes of ARDS.Accordingly,in this review,we focus on hyper-inflammatory host responses in ARDS that play a critical role in the differentiated development of COVID-19.Furthermore,we discuss inflammationrelated indicators that have the potential to identify hyper-inflammatory subphenotypes of COVID-19,especially for those with a high risk of ARDS.Finally,we explore the possibility of improving the quality of monitoring and treatment of COVID-19 patients and in reducing the incidence of critical illness and mortality via better distinguishing hyper-and hypoinflammatory subphenotypes of COVID-19.展开更多
The coronavirus disease 2019(COVID-19)pandemic imposed arestructuring of global health systems by rethinking spaces used for the care of these patients and the additions of intensive care,infectious diseases and pneum...The coronavirus disease 2019(COVID-19)pandemic imposed arestructuring of global health systems by rethinking spaces used for the care of these patients and the additions of intensive care,infectious diseases and pneumology departments.This paper provides evidence on the presence of severe acute respiratory syndrome coronavirus 2 in hepatocytes and its direct cytopathic activity,as well as the degree of liver damage due to drug toxicity,inflammation and hypoxia in COVID-19.A review of clinical trials has quantified liver damage through both pathology and biochemistry studies.Additionally,we briefly present the results of a study conducted in our clinic on 849 patients admitted for COVID-19 treatment,of which 31 patients had pre-existing chronic liver disease and 388 patients had values above the normal limit for alanine aminotransferase,aspartate aminotransferase,and total bilirubin.It was observed that patients with abnormal liver tests were significantly statistically older,had more comorbidities and had a higher percentage of unfavourable evolution(death or transfer to intensive care).The conclusion of this paper is that the main causes of liver damage are direct viral aggression,coagulation dysfunction and endothelial damage,and patients with impaired liver function develop more severe forms of COVID-19 which requires special care by a multidisciplinary team that includes a hepatologist.展开更多
基金This work was supported by the National Medical Team in Wuhan(from The First Affiliated Hospital of Chongqing Medical University)and Wuhan No.1 Hospital.This article also commemorates the Chinese medical staff who gave their lives in the first-line defense against COVID-19.Finally,we thank Accdon(www.accdon.com)for its linguistic assistance during the preparation of this manuscript.
文摘Coronavirus Disease 2019(COVID-19)was first identified in China at the end of 2019.Acute respiratory distress syndrome(ARDS)represents the most common and serious complication of COVID-19.Cytokine storms are a pathophysiological feature of COVID-19 and play an important role in distinguishing hyper-inflammatory subphenotypes of ARDS.Accordingly,in this review,we focus on hyper-inflammatory host responses in ARDS that play a critical role in the differentiated development of COVID-19.Furthermore,we discuss inflammationrelated indicators that have the potential to identify hyper-inflammatory subphenotypes of COVID-19,especially for those with a high risk of ARDS.Finally,we explore the possibility of improving the quality of monitoring and treatment of COVID-19 patients and in reducing the incidence of critical illness and mortality via better distinguishing hyper-and hypoinflammatory subphenotypes of COVID-19.
文摘The coronavirus disease 2019(COVID-19)pandemic imposed arestructuring of global health systems by rethinking spaces used for the care of these patients and the additions of intensive care,infectious diseases and pneumology departments.This paper provides evidence on the presence of severe acute respiratory syndrome coronavirus 2 in hepatocytes and its direct cytopathic activity,as well as the degree of liver damage due to drug toxicity,inflammation and hypoxia in COVID-19.A review of clinical trials has quantified liver damage through both pathology and biochemistry studies.Additionally,we briefly present the results of a study conducted in our clinic on 849 patients admitted for COVID-19 treatment,of which 31 patients had pre-existing chronic liver disease and 388 patients had values above the normal limit for alanine aminotransferase,aspartate aminotransferase,and total bilirubin.It was observed that patients with abnormal liver tests were significantly statistically older,had more comorbidities and had a higher percentage of unfavourable evolution(death or transfer to intensive care).The conclusion of this paper is that the main causes of liver damage are direct viral aggression,coagulation dysfunction and endothelial damage,and patients with impaired liver function develop more severe forms of COVID-19 which requires special care by a multidisciplinary team that includes a hepatologist.
