8 Recent reports on COVID-19, GI: Liver transplantation, malnutrition, vaccine response
Healio Gastroenterology presents the following reports on recent news in COVID-19.
These stories include research on liver transplantation, hepatitis B, GI symptoms that persist in patients post-COVID infection and more.
Mortality increases among liver transplantation recipients with COVID-19
Liver transplant candidates with decompensated cirrhosis who were infected with COVID-19 had increased mortality during the first and second waves of the pandemic, according to data published in Gut.
“Increased mortality in [liver transplantation (LT)] candidates with COVID-19 (32.7%), reaching 45% in those with decompensated cirrhosis (DC) and Lab-MELD score of [15 or greater] was observed with no significant difference between first and second waves of the pandemic,” Luca Saverio Belli, from the department of hepatology and gastroenterology, ASST Grande Ospedale Metropolitano Niguarda, Milano, Italy, and colleagues wrote. “Respiratory failure was the major cause of death. The dismal prognosis of patients with DC supports the adoption of strict preventive measures and the urgent testing of vaccination efficacy in this population. Prior SARS-CoV-2 symptomatic infection did not affect early post-transplant survival (96%).” READ MORE.
Malnutrition persistent in patients with COVID-19 at 3- and 6-months post-infection
For patients with COVID-19, at 3- and 6-months, malnutrition was the most persistent gastrointestinal sequalae, according to a study published in Clinical Gastroenterology and Hepatology.
“It’s overall reassuring that most GI symptoms, for patients who presented with severe COVID-19, resolve within 3 to 6 months,” Arvind Trindade, MD, FASGE, director of endoscopy, Long Island Jewish Medical Center, Northwell Health System in New York, told Healio Gastroenterology. “Inability to gain weight in patients diagnosed with COVID and malnutrition is a lingering symptom that deserves more attention. These patients should follow up with a nutritionist. Future research needs to identify the mechanism of why these patients are unable to gain weight. In addition, we will be looking at 1-year follow up data to determine if this resolves within this time span.” READ MORE.
Hepatitis B does not link to increased risk for liver injury, death in COVID-19
Chronic hepatitis B virus, whether current or past, was not associated with increased incidence of acute liver injury or death among patients with COVID-19, according to research presented at the International Liver Congress.
“There is emerging evidence that demonstrates the impact of HBV infection on COVID-19 patients. A recently published report described 105 COVID-19 patients, who also suffered from chronic HBV, showed elevated alanine aminotransferase and aspartate aminotransferase occurred in 21% and 28% of the patients, respectively,” Terry Cheuk-Fung Yip, PhD, The Chinese University of Hong Kong, said. “However, the impact of HBV infection on COVID-19 remains unclear as non-chronic HBV patients were not included as control in the previous studies. Also, the impact of past exposure to HBV remains unknown.” READ MORE.
VIDEO: Telemedicine shaped future of health care during COVID-19
In this video exclusive, Maria T. Abreu, MD, AGAF, Stephen B. Hanauer, MD, and Carol Burke, MD, leaders in the field of gastroenterology, discussed how COVID-19 impacted them professionally and personally.
Abreu, division chief of gastroenterology at University of Miami Health System, won the Lifetime Disrupter award in 2020, one of several Disruptive Innovator awards given by Healio Gastroenterology to physicians pushing the status quo toward the betterment of gastroenterology and liver diseases. Hanauer, from the Digestive Health Center Northwestern University Feinberg School of Medicine, won the award in 2019 and Burke, from Cleveland Clinic, won in 2018. READ MORE.
Age, fibrosis, immune suppression link to less COVID vaccine response
A study from Israel, where vaccination for COVID reached most of the population older than 16 years, showed older patients, post-transplant patients and those with advanced liver disease produced less immune response to the Pfizer COVID-19 vaccine.
“We had the chance to vaccinate until now almost 96% of the adult population who were 16 and above and just a week ago, we started to vaccinate the young people between the ages of 12 years and 16 years,” Rifaat Safadi, MD, director of the liver institute at the Hadassah-Hebrew University Hospital in Israel, said during a press conference. “I wondered if this was affecting our liver patients.” READ MORE.
Patients hospitalized during COVID-19 have higher rates of alcohol dependency
A higher proportion of patients hospitalized during the COVID-19 pandemic were alcohol-dependent, according to results presented at the International Liver Congress.
“The COVID-19 pandemic has presented significant challenges to health care services. Hospitals have reported a twofold increase in admissions due to alcohol-related liver disease; patients are sicker and higher numbers are requiring high dependency care,” Mohsan Subhani, Nottingham University Hospitals NHS Trust, wrote. “More representative data on the impact of COVID-19 on alcohol use disorder (AUD) among hospitalized patients is lacking.” READ MORE.
Those with fatty liver at 5 times greater risk for death from COVID
Patients with metabolic-associated fatty liver disease or higher transaminases who were then diagnosed with COVID-19 were more likely to die, according to a presenter at the International Liver Congress
“We have to consider that conditions with metabolic dysregulation such as MAFLD and obesity that are characterized by low grade chronic inflammation could overlap with the acute inflammatory state caused by COVID 19 infection resulting in an immune system dysregulation with excessive release of inflammatory mediators and a cytokine storm that could lead to more severe condition for COVID 19 even to multiple organ failures,” Martín Uriel Vázquez Medina, MD, of the Escuela Superior de Medicina, said during a press conference. READ MORE.
Chronic liver disease, alcohol use disorders contribute to mortality, disease burden in COVID-19
Independent risk factors for COVID-19 mortality included chronic liver disease and alcohol use disorders, which also contributed to disease burden in 2020, according to a presenter at the International Liver Congress.
“Our study has exposed health inequities in our country,” Vincent Mallet, MD, senior physician and professor, hepatology unit, Cochin University, Paris, France, said during his presentation. “We think that a strong message should come from our society to profit from these lessons from this catastrophic disorder and leverage new policies to improve outcomes of our patients including patients with advanced liver disease and patients with alcohol use disorders.” READ MORE.
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