4.6 Review

Impact of COVID-19 in individuals with and without pre-existent digestive disorders with a particular focus on elderly patients

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Summary: The COVID-19 pandemic has changed medical priorities, with a significant proportion of patients experiencing hepatic injury, particularly those with severe illness. This review focuses on the pathophysiology of COVID-19 induced liver injury, therapy related liver damage, and the effects of viral infection on preexisting liver diseases. Recommendations include more intensive surveillance and tailored therapeutic approaches for immunocompromised patients, advanced liver disease, hepatocellular carcinoma, and liver transplant patients. Despite limited studies, this overview provides insight on managing liver disease during COVID-19.

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Summary: COVID-19, initially considered a respiratory disease, can have serious systemic consequences involving major organs, including the digestive system. Gastroenterologists need to understand the mechanisms of tissue damage caused by the SARS-CoV-2 virus and the impact of COVID-19 on gastrointestinal emergencies, endoscopy, diagnosis and treatments.

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Summary: This study compared the impact of COVID-19 infection on patients with acute pancreatitis, showing that COVID-19 affects the course, intensive care needs, and mortality of AP patients, particularly when pneumonia is present. New strategies may be necessary for the management of patients with both conditions.

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Cirrhosis and Severe Acute Respiratory Syndrome Coronavirus 2 Infection in US Veterans: Risk of Infection, Hospitalization, Ventilation, and Mortality

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A case-control emergency department-based analysis of acute pancreatitis in Covid-19: Results of the UMC-19-S6

Oscar Miro et al.

Summary: Acute pancreatitis as a presenting form of COVID-19 in the emergency department is rare. Some clinically distinctive characteristics are present compared to other COVID patients; the in-hospital mortality of COVID-AP does not differ significantly from COVID-non-AP, but is higher than non-COVID-AP.

JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES (2021)

Article Medicine, General & Internal

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Merryn Voysey et al.

Summary: The ChAdOx1 nCoV-19 vaccine has been shown to have an acceptable safety profile and effectiveness against symptomatic COVID-19, with higher efficacy observed in the group that received a low dose followed by a standard dose.

LANCET (2021)

Review Gastroenterology & Hepatology

Pathophysiological mechanisms of liver injury in COVID-19

Alexander D. Nardo et al.

Summary: This review discusses the potential mechanisms of hepatic tropism of SARS-CoV-2 and acute, possibly long-term liver injury in COVID-19.

LIVER INTERNATIONAL (2021)

Article Multidisciplinary Sciences

Correlates of protection against SARS-CoV-2 in rhesus macaques

Katherine McMahan et al.

Summary: Adoptive transfer of purified IgG from convalescent macaques protects naive macaques against SARS-CoV-2 infection, and cellular immune responses contribute to protection against rechallenge with SARS-CoV-2. The findings suggest that relatively low antibody titres are sufficient for protection against SARS-CoV-2 in macaques, while higher antibody titres are required for treatment of SARS-CoV-2 infection.

NATURE (2021)

Article Gastroenterology & Hepatology

High lipasemia is frequent in Covid-19 associated acute respiratory distress syndrome

Sebastian Rasch et al.

Summary: A high level of serum lipase activity is a common finding in severe Covid-19 associated ARDS, without typical signs of acute pancreatitis. The elevated lipase activity may be explained by impaired microcirculation in severely ill patients.

PANCREATOLOGY (2021)

Article Medicine, General & Internal

Impact of liver cirrhosis on the clinical outcomes of patients with COVID-19: a nationwide cohort study of Korea

Dongsub Jeon et al.

Summary: The study evaluated the impact of liver cirrhosis on the clinical outcomes of COVID-19 patients using National Health Insurance data in Korea. The results suggest that liver cirrhosis was not independently associated with the development of severe complications, including mortality, in patients with COVID-19, although certain comorbidities may increase the risk. The findings call for further evaluation through large prospective studies.

KOREAN JOURNAL OF INTERNAL MEDICINE (2021)

Article Microbiology

Clinical Presentation, Course, and Risk Factors Associated with Mortality in a Severe Outbreak of COVID-19 in Rhode Island, USA, April-June 2020

Eleftheria Atalla et al.

Summary: This study presents a rapidly escalating COVID-19 outbreak among 116 LTCF residents in Rhode Island, with a high mortality rate of 43.2%. Most common comorbidities included hypertension and cardiovascular disease, with a significant portion of residents being asymptomatic or pre-symptomatic. The disease course and symptoms varied, with atypical presentations being common. Further research is needed to understand the factors influencing mortality and symptom variability in LTCF residents.

PATHOGENS (2021)

Article Gastroenterology & Hepatology

SARS-CoV-2 infection in acute pancreatitis increases disease severity and 30-day mortality: COVID PAN collaborative study

Sanjay Pandanaboyana et al.

Summary: Patients with acute pancreatitis and coexistent SARS-CoV-2 infection are at higher risk of developing severe pancreatitis, acute respiratory distress syndrome (ARDS), prolonged hospital stays, and increased 30-day mortality.
Article Pathology

Pathological findings in the postmortem liver of patients with coronavirus disease 2019 (COVID-19)

Chaohui Lisa Zhao et al.

Summary: COVID-19 patients exhibit a variety of pathological manifestations in the liver, including platelet-fibrin microthrombi, steatosis, and histiocytic hyperplasia. Abnormal liver-associated enzymes were observed in 12 cases, with most patients showing elevated D-dimer levels.

HUMAN PATHOLOGY (2021)

Article Gastroenterology & Hepatology

EASL position paper on the use of COVID-19 vaccines in patients with chronic liver diseases, hepatobiliary cancer and liver transplant recipients

Markus Cornberg et al.

Summary: According to a recent estimate by the World Health Organization, the SARS-CoV-2 pandemic has affected nearly 100 million people globally, with patients with chronic liver diseases (CLD) at higher risk of infections. Vaccination against various pathogens, including SARS-CoV-2, is important for these patients, although impaired immune responses may affect the efficacy of immunization. The safety, immunogenicity, and efficacy of SARS-CoV-2 vaccines in patients with CLD, cirrhosis, hepatobiliary cancer, and liver transplant recipients still require further study.

JOURNAL OF HEPATOLOGY (2021)

Article Gastroenterology & Hepatology

Inflammatory bowel disease and risk of severe COVID-19: A nationwide population-based cohort study in Sweden

Jonas F. Ludvigsson et al.

Summary: While individuals with IBD were more likely to be admitted to hospital for COVID-19 than the general population, the risk of severe COVID-19 was not higher.

UNITED EUROPEAN GASTROENTEROLOGY JOURNAL (2021)

Article Gastroenterology & Hepatology

Clinical Outcomes of COVID-19 and Impact on Disease Course in Patients with Inflammatory Bowel Disease

Panu Wetwittayakhlang et al.

Summary: The study showed that the prevalence of COVID-19 infection among patients with IBD was lower compared to the general population in Canada. Severe COVID-19, mortality, and flare of IBD were relatively rare, while a large proportion of patients received COVID-19 vaccination. Older age, comorbidities, active IBD disease, and systemic corticosteroid, but not immunosuppressive or biological therapy, were associated with severe COVID-19 infection.

CANADIAN JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY (2021)

Article Gastroenterology & Hepatology

A “double-hit” damage mechanism can explain self-limited GI bleeding in COVID-19 pneumonia

Lorenzo Dioscoridi et al.

GASTROINTESTINAL ENDOSCOPY (2021)

Article Gastroenterology & Hepatology

Infliximab is associated with attenuated immunogenicity to BNT162b2 and ChAdOx1 nCoV-19 SARS-CoV-2 vaccines in patients with IBD

Nicholas A. Kennedy et al.

Summary: Infliximab treatment in patients with inflammatory bowel disease results in attenuated serological responses to a single dose of the SARS-CoV-2 vaccine. Delayed second dosing should be avoided in these patients, as vaccination after SARS-CoV-2 infection or a second dose leads to seroconversion in most individuals.
Article Gastroenterology & Hepatology

Prognosis of French COVID-19 patients with chronic liver disease: A national retrospective cohort study for 2020

Vincent Mallet et al.

Summary: Chronic liver disease was found to increase the risk of COVID-19-related death in France in 2020. Therapeutic effort limitation may have contributed to the excess mortality in French residents with a liver-related complication or an alcohol use disorder.

JOURNAL OF HEPATOLOGY (2021)

Article Gastroenterology & Hepatology

Acute pancreatitis in COVID-19 patients: true risk?

Margo C. Bulthuis et al.

Summary: This study investigated the incidence and clinical impact of acute pancreatitis in 433 COVID-19 patients admitted to two Dutch university hospitals. Results showed that COVID-19-related acute pancreatitis is rare and has little clinical impact, suggesting it may not require specific screening.

SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY (2021)

Article Gastroenterology & Hepatology

Adverse Events After SARS-CoV-2 mRNA Vaccination Among Patients With Inflammatory Bowel Disease

Gregory J. Botwin et al.

Summary: Patients with immune-mediated inflammatory diseases like IBD who are on immunosuppressive and biologic therapies were largely excluded from COVID-19 mRNA vaccine trials. A study on 246 adults with IBD found that adverse events after mRNA vaccination were similar to the general population. Adverse events were more common in younger patients and those with previous COVID-19, but less common in individuals receiving advanced therapies with biologics or small-molecule inhibitors.

AMERICAN JOURNAL OF GASTROENTEROLOGY (2021)

Article Gastroenterology & Hepatology

Acute Necrotizing Pancreatitis and Coronavirus Disease-2019 (COVID-19)

Ulas Aday et al.

Summary: Acute necrotizing pancreatitis caused by COVID-19 is rare, and the mechanisms involved remain controversial.

KOREAN JOURNAL OF GASTROENTEROLOGY (2021)

Article

Crohn’s and Colitis Canada’s 2021 Impact of COVID-19 and Inflammatory Bowel Disease in Canada: Seniors With IBD

Charles N Bernstein et al.

Journal of the Canadian Association of Gastroenterology (2021)

Article Gastroenterology & Hepatology

Outcomes of SARS-CoV-2 Infection in Patients With Chronic Liver Disease and Cirrhosis: A National COVID Cohort Collaborative Study

Jin Ge et al.

Summary: The study used an electronic health record database to describe outcomes of SARS-CoV-2 infection in patients with chronic liver disease and cirrhosis, finding that patients with cirrhosis infected with SARS-CoV-2 had an increased risk of mortality.

GASTROENTEROLOGY (2021)

Article Medicine, General & Internal

Pancreatic damage in COVID-19: Why? How?

Ferhat Bacaksiz et al.

Summary: Elevated levels of pancreatic enzymes in COVID-19 infections are associated with the severity of COVID-19 infection and hemodynamic instability. Just like other organs, the pancreas can be affected by severe COVID-19 infection. Elevated amylase levels were significantly associated with the severity of COVID-19, as well as comorbidities such as diabetes mellitus, kidney failure, liver damage, hypotension, and sepsis.

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE (2021)

Article Gastroenterology & Hepatology

Analysis of antibody responses after COVID-19 vaccination in liver transplant recipients and those with chronic liver diseases

Paul J. Thuluvath et al.

Summary: The study found that 61% of liver transplant recipients and 24% of patients with liver disease had poor antibody responses after receiving the SARS-CoV-2 vaccine. Immunocompromised status, vaccination with a single dose of Johnson & Johnson vaccine, and use of 2 or more immunosuppressive medications were associated with poor immune responses.

JOURNAL OF HEPATOLOGY (2021)

Review Gastroenterology & Hepatology

COVID-19 and the liver: A 2021 update

Catherine W. Spearman et al.

Summary: COVID-19 is a respiratory illness caused by the novel coronavirus SARS-CoV-2, with extrapulmonary manifestations involving multiple organ systems. This review focuses on the pathophysiology of COVID-19, specifically looking at liver injury, its impact on chronic liver disease, management during the pandemic, and long-term effects on CLD.

LIVER INTERNATIONAL (2021)

Article Multidisciplinary Sciences

Age-related immune response heterogeneity to SARS-CoV-2 vaccine BNT162b2

Dami A. Collier et al.

Summary: Elderly individuals, especially those above eighty, show lower immune responses and neutralization abilities against variants of concern after the first vaccine dose, but this improves after the second dose. They have higher frequencies of spike-specific memory B cells but reduced somatic hypermutation of class-switched cells. Production of interferon-gamma and interleukin-2 by SARS-CoV-2 spike-specific T cells is lower in older participants, predominantly by CD4 T cells.

NATURE (2021)

Review Pharmacology & Pharmacy

Drug-Induced Liver Disturbance During the Treatment of COVID-19

Guanghua Zhai et al.

Summary: The outbreak of SARS-CoV-2 in Wuhan at the end of 2019 led to the naming of the infectious disease as COVID-19 by the World Health Organization. Research indicates that SARS-CoV-2 patients may experience liver disturbances, but the impact of COVID-19 treatment drugs on liver function remains controversial. Evaluating the potential liver damage caused by various drugs is crucial for guiding clinical practice.

FRONTIERS IN PHARMACOLOGY (2021)

Review Gastroenterology & Hepatology

COVID-19 in gastroenterology: Where are we now? Current evidence on the impact of COVID-19 in gastroenterology

Fernando Magro et al.

Summary: The COVID-19 pandemic has significantly impacted gastroenterology patients and healthcare systems, forcing them to adapt to new measures to ensure continuous medical care. Evaluating the impact of the pandemic on this field is crucial for improving service quality and anticipating future practices and policies.

UNITED EUROPEAN GASTROENTEROLOGY JOURNAL (2021)

Article Immunology

Pancreatic Injury after COVID-19 Vaccine-A Case Report

Artur Cieslewicz et al.

Summary: The COVID-19 pandemic has resulted in over 3 million deaths worldwide, with genetically engineered vaccines playing a critical role in controlling the outbreak. While clinical trials have confirmed the safety and efficacy of these vaccines, new infrequent adverse effects have emerged with increasing numbers of vaccinated individuals. This report highlights the importance of closely monitoring patients experiencing abdominal pain post-vaccination for potential complications like acute pancreatic injury.

VACCINES (2021)

Article Surgery

Prognosis Evaluation for Patients with Abdominal Trauma Using Usual Biological Parameters

Daniel Ion et al.

Summary: The study developed a scoring system using biological parameters to predict mortality in patients with abdominal trauma. By analyzing biochemical parameters and ROC curves, cutoff values related to mortality were established, leading to a predictive score correlated with ISS and NISS.

CHIRURGIA (2021)

Review Gastroenterology & Hepatology

The elderly IBD patient in the modern era: changing paradigms in risk stratification and therapeutic management

Simon J. Hong et al.

Summary: The incidence and prevalence of inflammatory bowel disease (IBD) are increasing in the elderly population. Patients with elderly onset IBD have distinct clinical characteristics, disease phenotypes, and natural histories compared to those who develop the disease at a younger age. While genetics play a smaller role in disease pathogenesis, biological changes associated with aging have a greater impact on disease outcomes. With a wider range of treatment options available, it is crucial to examine the efficacy and safety of these agents in elderly IBD patients due to their unique characteristics.

THERAPEUTIC ADVANCES IN GASTROENTEROLOGY (2021)

Article Gastroenterology & Hepatology

Acute pancreatitis in a patient with COVID-19: a case report

Chiranjeevi Gadiparthi et al.

Summary: This article reports a case of a COVID-19 patient with AP, hypothesizing a causal relationship with SARS-CoV-2 and suggesting that the presence of ACE 2 receptors in the pancreas or direct viral involvement may be related to AP in COVID-19. While there appears to be an association between diabetes and AP, data on the etiological role of diabetes in causing AP is limited.

TRANSLATIONAL GASTROENTEROLOGY AND HEPATOLOGY (2021)

Article Geriatrics & Gerontology

Impact of immunosuppressants on SARS-CoV-2 infection in elderly patients with inflammatory bowel disease

Margalida Calafat et al.

Summary: This study investigated the incidence and severity of COVID-19 in elderly patients with inflammatory bowel disease, and found that the incidence of COVID-19 was similar among elderly IBD patients regardless of the use of immunosuppressants, compared to the background population.

AGING CLINICAL AND EXPERIMENTAL RESEARCH (2021)

Letter Surgery

Raised serum amylase in patients with COVID-19 may not be associated with pancreatitis

J. R. Stephens et al.

Summary: A high incidence of pancreatitis has been reported in COVID-19 patients, but elevated serum amylase levels in critically ill patients do not necessarily indicate acute pancreatitis or clinically significant pancreatic injury.

BRITISH JOURNAL OF SURGERY (2021)

Article Medicine, General & Internal

COVID-19 risk, disparities and outcomes in patients with chronic liver disease in the United States

QuanQiu Wang et al.

Summary: Patients with chronic liver disease, especially those with chronic non-alcoholic liver disease and non-alcoholic cirrhosis, are at significantly increased risk for COVID-19. African Americans with chronic liver disease are twice as likely to develop COVID-19 compared to Caucasians. COVID-19 patients with chronic liver disease have a higher death rate and hospitalization rate than those without liver disease.

ECLINICALMEDICINE (2021)

Article Medicine, General & Internal

Acute Pancreatitis: A Possible Side Effect of COVID-19 Vaccine

Om Parkash et al.

Summary: This case report highlights a 96-year-old female who developed acute pancreatitis shortly after receiving the Pfizer-BioNTech COVID-19 vaccine. The goal is to raise awareness in the medical literature about potential emerging side effects of the vaccine, including self-resolving uncomplicated acute pancreatitis.

CUREUS JOURNAL OF MEDICAL SCIENCE (2021)

Article Gastroenterology & Hepatology

Liver Injury in Patients Hospitalized with Coronavirus Disease 2019 Correlates with Hyperinflammatory Response and Elevated Interleukin-6

Ben L. Da et al.

Summary: A study found that the risk of liver injury in patients with severe/critical COVID-19 is associated with an exaggerated hyperinflammatory response (cytokine storm), manifested by elevated levels of CRP, LDH, ferritin, and IL-6. The liver injury group had a longer length of stay in the hospital and more severe disease despite having less diabetes and chronic kidney disease.

HEPATOLOGY COMMUNICATIONS (2021)

Article Gastroenterology & Hepatology

Clinical Characteristics of 195 Cases of COVID-19 with Gastrointestinal Symptoms

Ting Zhan et al.

Summary: The study found that about half of COVID-19 patients exhibit gastrointestinal symptoms, with a higher likelihood of concomitant vascular and digestive system diseases, and clinical manifestations such as fever, dyspnea, and insomnia in the GI symptom group.

TURKISH JOURNAL OF GASTROENTEROLOGY (2021)

Review Cell Biology

Why does COVID-19 disproportionately affect older people?

Amber L. Mueller et al.

AGING-US (2020)

Letter Emergency Medicine

Acute Olfactory Loss Is Specific for COVID-19 at the Emergency Department

Andy J. Chua et al.

ANNALS OF EMERGENCY MEDICINE (2020)

Review Gastroenterology & Hepatology

Diarrhea During COVID-19 Infection: Pathogenesis, Epidemiology, Prevention, and Management

Ferdinando D'Amico et al.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2020)

Letter Gastroenterology & Hepatology

ACE2 Expression in Pancreas May Cause Pancreatic Damage After SARS-CoV-2 Infection

Furong Liu et al.

CLINICAL GASTROENTEROLOGY AND HEPATOLOGY (2020)

Editorial Material Gastroenterology & Hepatology

Pancreatic Injury Patterns in Patients With Coronavirus Disease 19 Pneumonia

Fan Wang et al.

GASTROENTEROLOGY (2020)

Article Gastroenterology & Hepatology

Outcomes of COVID-19 in 79 patients with IBD in Italy: an IG-IBD study

Cristina Bezzio et al.

Article Gastroenterology & Hepatology

Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection

Lu Lin et al.

Article Gastroenterology & Hepatology

Acute Liver Injury in COVID-19: Prevalence and Association with Clinical Outcomes in a Large US Cohort

Meaghan M. Phipps et al.

HEPATOLOGY (2020)

Article Critical Care Medicine

Pathological findings of COVID-19 associated with acute respiratory distress syndrome

Zhe Xu et al.

LANCET RESPIRATORY MEDICINE (2020)

Article Gastroenterology & Hepatology

COVID-19: Abnormal liver function tests

Qingxian Cai et al.

JOURNAL OF HEPATOLOGY (2020)

Letter Gastroenterology & Hepatology

Non-alcoholic fatty liver diseases in patients with COVID-19: A retrospective study

Dong Ji et al.

JOURNAL OF HEPATOLOGY (2020)

Article Geriatrics & Gerontology

Clinical Characteristics and Outcomes of Older Patients with Coronavirus Disease 2019 (COVID-19) in Wuhan, China: A Single-Centered, Retrospective Study

TieLong Chen et al.

JOURNALS OF GERONTOLOGY SERIES A-BIOLOGICAL SCIENCES AND MEDICAL SCIENCES (2020)

Letter Medicine, General & Internal

COVID-19: consider cytokine storm syndromes and immunosuppression

Puja Mehta et al.

LANCET (2020)

Review Biochemistry & Molecular Biology

COVID-19: The first documented coronavirus pandemic in history

Yen-Chin Liu et al.

BIOMEDICAL JOURNAL (2020)

Letter Gastroenterology & Hepatology

SARS-CoV2 RNA detection in a pancreatic pseudocyst sample

T. Schepis et al.

PANCREATOLOGY (2020)

Article Cell Biology

COVID-19 induced liver function abnormality associates with age

Shasha Li et al.

AGING-US (2020)

Review Gastroenterology & Hepatology

Systematic review with meta-analysis: liver manifestations and outcomes in COVID-19

Anand V. Kulkarni et al.

ALIMENTARY PHARMACOLOGY & THERAPEUTICS (2020)

Article Gastroenterology & Hepatology

Lipase Elevation in Patients With COVID-19

Julia McNabb-Baltar et al.

AMERICAN JOURNAL OF GASTROENTEROLOGY (2020)

Article Biochemistry & Molecular Biology

SARS-CoV-2 receptor ACE2 gene expression in small intestine correlates with age

Raphael N. Vuille-dit-Bille et al.

AMINO ACIDS (2020)

Article Infectious Diseases

Characteristics and predictors of death among 4035 consecutively hospitalized patients with COVID-19 in Spain

Juan Berenguer et al.

CLINICAL MICROBIOLOGY AND INFECTION (2020)

Editorial Material Public, Environmental & Occupational Health

Drug-Induced Liver Injury and COVID-19 Infection: The Rules Remain the Same

Alexandre Olry et al.

DRUG SAFETY (2020)

Editorial Material Gastroenterology & Hepatology

Clinical Outcomes of Acute Pancreatitis in Patients With Coronavirus Disease 2019

Ahmed Dirweesh et al.

GASTROENTEROLOGY (2020)

Editorial Material Medicine, General & Internal

Acute pancreatitis in a 61-year-old man with COVID-19

Shay Brikman et al.

CANADIAN MEDICAL ASSOCIATION JOURNAL (2020)

Letter Gastroenterology & Hepatology

Liver injury in remdesivir-treated COVID-19 patients

Rosa Zampino et al.

HEPATOLOGY INTERNATIONAL (2020)

Article Gastroenterology & Hepatology

Marked Elevation of Lipase in COVID-19 Disease: A Cohort Study

Usman Barlass et al.

Clinical and Translational Gastroenterology (2020)

Review Medicine, General & Internal

Pathophysiology, Transmission, Diagnosis, and Treatment of Coronavirus Disease 2019 (COVID-19) A Review

W. Joost Wiersinga et al.

JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (2020)

Article Gastroenterology & Hepatology

High rates of 30-day mortality in patients with cirrhosis and COVID-19

Massimo Iavarone et al.

JOURNAL OF HEPATOLOGY (2020)

Article Gastroenterology & Hepatology

Epidemiology and the Impact of Therapies on the Outcome of COVID-19 in Patients With Inflammatory Bowel Disease

Alfredo Papa et al.

AMERICAN JOURNAL OF GASTROENTEROLOGY (2020)

Article Gastroenterology & Hepatology

Metabolic-associated fatty liver disease is associated with severity of COVID-19

Yu-Jie Zhou et al.

LIVER INTERNATIONAL (2020)

Article Infectious Diseases

SARS-CoV-2 leading to acute pancreatitis: an unusual presentation

Amanda Mandarino Alves et al.

BRAZILIAN JOURNAL OF INFECTIOUS DISEASES (2020)

Review Biochemistry & Molecular Biology

Extrapulmonary manifestations of COVID-19

Aakriti Gupta et al.

NATURE MEDICINE (2020)

Editorial Material Gastroenterology & Hepatology

COVID-19 presenting as acute pancreatitis: Lessons from a patient in Iran

Sedighe Karimzadeh et al.

PANCREATOLOGY (2020)

Article Geriatrics & Gerontology

COVID-19 in Older Adults: A Series of 76 Patients Aged 85 Years and Older with COVID-19

Agathe Vrillon et al.

JOURNAL OF THE AMERICAN GERIATRICS SOCIETY (2020)

Review Gastroenterology & Hepatology

Coronavirus disease 2019 and the pancreas

Jayanta Samanta et al.

PANCREATOLOGY (2020)

Article Geriatrics & Gerontology

The Clinical Characteristics of Acute Pancreatitis in Gerontal Patients: A Retrospective Study

Bingjun Yu et al.

CLINICAL INTERVENTIONS IN AGING (2020)

Review Medicine, Research & Experimental

Age-related susceptibility to coronavirus infections: role of impaired and dysregulated host immunity

Rudragouda Channappanavar et al.

JOURNAL OF CLINICAL INVESTIGATION (2020)

Article Medicine, General & Internal

Clinical manifestation and disease progression in COVID-19 infection

Ping-Hsing Tsai et al.

Journal of the Chinese Medical Association (2020)

Review Medical Laboratory Technology

Gastrointestinal symptoms associated with COVID-19: impact on the gut microbiome

Sonia Villapol

TRANSLATIONAL RESEARCH (2020)

Article Medicine, General & Internal

Coronavirus disease-19 (COVID-19) associated with acute necrotising pancreatitis (ANP)

Naren K. Kumaran et al.

BMJ CASE REPORTS (2020)

Letter Gastroenterology & Hepatology

A Case of COVID-19-Induced Acute Pancreatitis

Matthew H. Meyers et al.

PANCREAS (2020)

Letter Gastroenterology & Hepatology

Acute Pancreatitis During COVID-19 Pneumonia

Takayuki Shinohara et al.

PANCREAS (2020)

Article Medicine, General & Internal

Acute pancreatitis in a COVID-19 patient: An unusual presentation

Goutam Kumar Acherjya et al.

CLINICAL CASE REPORTS (2020)

Letter Gastroenterology & Hepatology

COVID-19 and intestinal inflammation: Role of fecal calprotectin

Veronica Ojetti et al.

DIGESTIVE AND LIVER DISEASE (2020)

Letter Gastroenterology & Hepatology

Pathogenesis of Liver Injury in Coronavirus Disease 2019

Pramod Kumar et al.

JOURNAL OF CLINICAL AND EXPERIMENTAL HEPATOLOGY (2020)

Review Medicine, General & Internal

Prevalence, Mechanisms, and Implications of Gastrointestinal Symptoms in COVID-19

Abhilash Perisetti et al.

FRONTIERS IN MEDICINE (2020)

Review Gastroenterology & Hepatology

Care of patients with liver disease during the COVID-19 pandemic: EASL-ESCMID position paper

Tobias Boettler et al.

JHEP REPORTS (2020)

Review Critical Care Medicine

Anticoagulation in COVID - 19: An Update

Nishant R. Tiwari et al.

JOURNAL OF CRITICAL CARE MEDICINE (2020)

Article Gastroenterology & Hepatology

Tocilizumab and liver injury in patients with COVID-19

Gaetano Serviddio et al.

THERAPEUTIC ADVANCES IN GASTROENTEROLOGY (2020)

Review Gastroenterology & Hepatology

Covid-19 and the management of patients with inflammatory bowel disease: a practical decalogue for the post-pandemic phase

Alfredo Papa et al.

THERAPEUTIC ADVANCES IN GASTROENTEROLOGY (2020)

Article Gastroenterology & Hepatology

Acute pancreatitis in elderly patients: a single-center retrospective evaluation of clinical outcomes

Giuseppe Quero et al.

SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY (2019)

Article Gastroenterology & Hepatology

Update on the effect of age on acute pancreatitis morbidity: a retrospective, single-center study

Banu Kara et al.

GASTROENTEROLOGY REVIEW-PRZEGLAD GASTROENTEROLOGICZNY (2018)

Review Gastroenterology & Hepatology

Idiopathic recurrent acute pancreatitis

Nalini M. Guda et al.

LANCET GASTROENTEROLOGY & HEPATOLOGY (2018)

Review Gastroenterology & Hepatology

European Crohn's and Colitis Organisation Topical Review on IBD in the Elderly

Andreas Sturm et al.

JOURNAL OF CROHNS & COLITIS (2017)

Review Gastroenterology & Hepatology

Immune Dysfunction in Cirrhosis

Mohd Talha Noor et al.

JOURNAL OF CLINICAL AND TRANSLATIONAL HEPATOLOGY (2017)

Review Pharmacology & Pharmacy

The role of vagal neurocircuits in the regulation of nausea and vomiting

Tanja Babic et al.

EUROPEAN JOURNAL OF PHARMACOLOGY (2014)

Article Multidisciplinary Sciences

ACE2 links amino acid malnutrition to microbial ecology and intestinal inflammation

Tatsuo Hashimoto et al.

NATURE (2012)

Review Critical Care Medicine

Acute Respiratory Failure Complicating Advanced Liver Disease

Marcin Karcz et al.

SEMINARS IN RESPIRATORY AND CRITICAL CARE MEDICINE (2012)

Review Biotechnology & Applied Microbiology

Vaccination in the elderly

Evelyna Derhovanessian et al.

MICROBIAL BIOTECHNOLOGY (2012)

Article Gastroenterology & Hepatology

Severe acute pancreatitis in the elderly: Etiology and clinical characteristics

Ming-Jun Xin et al.

WORLD JOURNAL OF GASTROENTEROLOGY (2008)