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May 28 | Daily COVID-19 LST Report



Understanding the Pathology

  • Hepatologists summarize the pathophysiology of liver injury in patients with COVID-19, and propose that SARS-CoV-2 may cause cytopathic damage to hepatocytes by inducing cellular stress, cytokine dysregulation, or disrupting essential functions of cholangiocytes expressing angiotensin-2 converting enzyme (ACE2).


  • A link between hypoalbuminemia and COVID-19 was found after a systematic review and meta-analysis of 11 studies conducted by researchers from the University of Toledo.

  • Specifically, weighted mean serum albumin on admission for severe COVID-19 [3.50 g/dL (CI 3.26–3.74 g/dL)] was significantly lower than non-severe COVID-19 [4.05 g/dL (CI 3.82–4.27 g/dL)] (p<0.001). 

  • Based on these results, the authors suggest low serum albumin may aid recognition of severe disease.

  • A positive association (p=0.031) between hyponatremia and severe outcome (ICU admission, ventilation, death) in high-IL-6 patients and increased sodium levels in severe patients with high IL-6 (n=8) 48 hours post-tocilizumab treatment were found in a retrospective analysis of COVID-19 patients (n=29). 

  • Authors suggest a mechanism of IL-6-induced vasopressin release that results in hyponatremia.  

Adjusting Practice

R&D Diagnostics and Therapeutics

  • In an in-silico study, authors determined the most likely configurations in which the S-protein of SARS-CoV-2 binds the angiotensin converting enzyme (ACE) 2 receptor and screened already approved drugs. Results suggest that compounds with hydroxyl groups and monosaccharide moieties may have the highest binding affinities.

  • Cetylpyridinium chloride (a quaternary ammonium compound) causes virus inactivation by lysosomotropic action, suggesting the need of further study of this drug in the form of a mouthwash or nasal spray to combat SARS-CoV-2 at its point of entry.

  • Authors describe methodology used to develop and implement the first COVID-19 convalescent plasma program at the New York Blood Center enterprises and provide recommendations for optimizing future COVID-19 convalescent plasma programs.

Mental Health and Resilience

  • A self-reported questionnaire of healthcare and non-healthcare workers during the peak of infection in Spain found that healthcare workers had increased stress compared to non-healthcare workers, nurses scored higher in all emotional assessments (depression, anxiety, and stress) compared to other health professionals, and trainee-physicians had higher depression scores than their senior colleagues. 

  • The Children’s Hospital at Zhejiang University School of Medicine in Shanghai launched the Children Health Initiative for Children and Adolescents (CHI), an internet-based interactive platform designed to support children and adolescents during the COVID-19 pandemic by promoting physical and mental wellbeing.

Silver Linings


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20200528 The Daily COVID-19 Report
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