Endocrine impact in infections including COVID-19

Endocrine damage in infectious diseases (bacterial, viral) has been proven for a long time, confirming the disruption of the functions of most endocrine glands via the hypothalamic-pituitary-glandular axis. Endocrine activity takes place in tandem with the activity of the immune system. They inter-condition and influence each other, any change in one sector influencing the other (positively or negatively). Severe (critical), bacterial or viral infections go through the stage of SEPSIS, the background of which is the disruption (disorganization) of the host’s response to the infection. The mechanisms by which the endocrine glands are affected are multiple (direct, immunologically mediated, thrombotic) leading to multiple, morphological and functional lesions. The recovery of these injuries takes place over time, and permanent sequelae are possible. The recent pandemic caused by SARS-CoV-2, through the ways of manifestation and evolution of the diseases, justifies the interest regarding the endocrine damage in the SARS-CoV-2 infection, both in the acute and post-acute phase (long COVID evolves with symptoms, some newly appeared, which are also present in non-COVID endocrinopathies). Material. The arguments regarding the endocrine damage were extracted from the publications mentioned at the end of the work as bibliographic titles. The results highlight the endocrine damage in infections, especially in severe ones - and the impact on the immediate and late evolution of the illnesses. Conclusions. In order to understand the pathogenic, physio-pathological and clinical aspects of an infection, attention must be paid to the state of the endocrine system in correlation with the immune system, especially in patients receiving shorter or longer corticosteroid therapy

Infecţia cu virusul hepatitic E

Cluj-Napoca, Români

Acute Viral Hepatitis A – Clinical, Laboratory and Epidemiological Characteristics

Background and Aims: Infection with hepatitis A virus is still one of the most common causes of hepatitis worldwide. The clinical manifestation of acute hepatitis A (AHA) in adults can vary greatly, ranging from asymptomatic infection to severe and fulminant hepatitis. The aim of this study was to describe the demographic, clinical characteristics, laboratory features and hospital outcome of adult patients with AHA over a consecutive period of 4 years within an area from Eastern European country. Methods: Two hundred and two adult patients diagnosed with AHA were retrospective, observational and analytic analized over a period of 4 years. Based on prothrombin time less than 50, the study group was stratified in medium (79.2%) and severe forms (20.8%). We investigated the clinical, laboratory and epidemiological features. Statistical analysis were applied to compare the medium and severe forms of AHA. Results: Most patients (72.7%) were younger than 40 years. The main symptoms included: dyspepsia (72.07%), jaundice (86.63%), asteno-adynamia (86.72%), and flu-like symptoms (53.46%). The hemorrhagic cutaneous-mucous manifestations (6.93%) associated with the severe forms of AHA (OR =12.19, 95%CI -3.59 - 41.3, p =0.001). We found statistically significant differences for PT (p <0.001), INR (p <0.001), TQ (p <0.001), ALAT (p <0.001), ASAT (p <0.001), ALP (p <0.001) and platelets (p =0.009) between severe and medium AHA forms. We found that TQ, INR, ALAT and ASAT have the highest diagnostic values, statistically significant (p <0.05 ) for severe AHA forms with AUC (0.99, 0.99, 0.72, 0.70) at values of sensitivity (95%, 90.5%, 89%, 95%) and specificity (98%, 99%, 88%,94%). Conclusions Medium severity AHA forms were found in most of the study group patients (79.2%). The severe AHA forms were associated with hemorrhagic cutaneous-mucous manifestations (OR =12.19, p =0.001). The univariate analysis proved a negatively statistically significant correlation between IP and ALAT, ASAT. The present study revealed that TQ, INR and ALAT have the highest diagnostic values and are statistically significant for severe AHA forms

Usefulness of Presepsin (sCD14-ST) in diagnosis of Infective Endocarditis - preliminary results of an observational study / Utilitatea presepsinului (sCD14-ST) în Endocardita Infecțioasă –rezultate preliminare ale unui studiu observațional

Introducere: Presepsinul sau subtipul formei solubile a CD14 (s CD14-ST), a fost propus ca si biomarker nou în diagnosticul sepsisului. Scopul acestui studiu este de a testa utilitatea presepsinului in diagnosticul endocarditei infecțioase (EI)