Objective: Treatment options for nonhospitalized patients with coronavirus disease 2019 (COVID-19) to reducemorbidity, mortality, and spread of the disease are an urgent global need The over-the-counter histamine-2 receptorantagonist famotidine is a putative therapy for COVID-19 We quantitively assessed longitudinal changes in patient-reported outcome measures in nonhospitalized patients with COVID-19 who self-administered high-dose famotidineorally Design: Patients were enrolled consecutively after signing written informed consent Data on demographics, COVID-19 diagnosis, famotidine use, drug related side-effects, temperature measurements, oxygen saturations, and symptom scores were obtained using questionnaires and telephone interviews Based on an NIH-endorsedProtocol to research Patient Experience of COVID-19, we collected longitudinal severity scores of five symptoms(cough, shortness of breath, fatigue, headaches, and anosmia) and general unwellness on a 4-point ordinal scalemodeled on performance status scoring All data are reported at the patient level Longitudinal combined normalizedsymptom scores were statistically compared Results: Ten consecutive patients with COVID-19 who self-administered high-dose oral famotidine were identified The most frequently used famotidine regimen was 80mg three times daily (n=6) for a median of 11 days (range: 5 to21 days) Famotidine was well tolerated All patients reported marked improvements of disease-related symptomsafter starting famotidine The combined symptom score improved significantly within 24 hours of starting famotidineand peripheral oxygen saturation (n=2), and device recorded activity (n=1) increased Conclusions: The results of this case series suggest that high-dose oral famotidine is well tolerated and associated with improved patient reported outcomes in nonhospitalized patients with COVID-19 A blinded outpatient trial isplanned The findings may be transferable and relevant to the treatment of patients with cancer and COVID-19

Famotidine use and quantitativesymptom tracking for COVID-19 in nonhospitalizedpatients: A case series

Research of the etiological structure of acute hepatitis of unknown origin has allowed verifying the hepatitis E at 5,6% cases, DNA EBV was found out at 2,8% cases and 2,8% of patients had RNA HGV in blood. The data of the anamnesis and a clinical and laboratory picture does not allow excluding at 31% of patients a drug-induced liver injury.

https://cyberleninka.ru/article/n/lekarstvennye-porazheniya-pecheni-v-strukture-ostrogo-gepatita-neutochnennoy-etiologii.pdf

Лекарственные поражения печени в структуре острого гепатита неуточненной этиологии

With a new coronavirus infection (COVID-19), gastroenterological symptoms are often detected, which is due to both the damage to the digestive organs by the SARS-CoV-2 coronavirus and the exacerbation of chronic diseases, as well as aggressive multicomponent therapy. The severity of gastroenterological manifestations, primarily impaired liver function, is associated with a more severe and complicated course of COVID-19 infection. Numerous mechanisms of damage to the digestive organs in COVID-19 have been identified: direct damage by the virus due to resuscitation and multicomponent therapy, impaired central and peripheral nervous regulation, immunothrombotic syndrome, virus persistence in the gastrointestinal tract, induction of autoimmune reactions by the virus, humoral disorders (changes in serotonin levels, bradykinin, activation of mast cells). Violation of the microbial-tissue complex of the intestine and the permeability of the intestinal barrier, induced by the SARS-CoV-2 virus, ensures the formation and progression of chronic systemic inflammation, cytokine aggression, insulin resistance, endothelial dysfunction, which affect the severity of the infection. Therapy for patients with COVID-19 should include therapeutic approaches aimed at correcting disorders of the intestinal microbiota, intestinal barrier permeability, and relief of gastroenterological manifestations

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Diseases of the digestive organs and covid-19

Liver dysfunction is common with COVID-19 infection, and the prevalence is higher in men as well as in the elderly. Manifestations of liver damage such as high aspartate aminotransferase and alanine aminotransferase activity, increased bilirubin levels, low albumin levels, and prolonged prothrombin time are associated with severe COVID-19 infection. Mortality in patients with diffuse liver diseases without cirrhosis with COVID-19 infection was 12 %, in the presence of liver cirrhosis up to 40%, decompensated liver cirrhosis up to 4363%. The mechanisms of liver damage in COVID-19 include direct hepatotoxicity and indirect liver damage (due to systemic inflammation with impaired immunity, sepsis, hypoxia, ischemia, coagulopathy, endotheliitis, right ventricular failure, worsening of the course of existing liver diseases, drug liver damage). Treatment of patients with diffuse liver diseases includes lifestyle and nutritional modification, the use of hepatoprotective drugs, and means of correcting the intestinal barrier (bibliography: 30 refs).

/pdf/features-of-management-of-patients-with-liver-diseases-in-56ehembvsj.pdf

Features of management of patients with liver diseases in the conditions of the COVID-19 pandemic

Summary Post- COVID syndrome refers to the long-term consequences of a new coronavirus infection COVID-19, which includes a set of symptoms that develop or persist after COVID-19. Symptoms of gastrointestinal disorders in post- COVID syndrome, due to chronic infl ammation, the consequences of organ damage, prolonged hospitalization, social isolation, and other causes, can be persistent and require a multidisciplinary approach. The presented clinical practice guidelines consider the main preventive and therapeutic and diagnostic approaches to the management of patients with gastroenterological manifestations of postCOVID syndrome. The Guidelines were approved by the 17th National Congress of Internal Medicine and the 25th Congress of Gastroenterological Scientifi c Society of Russia.

/pdf/gastrointestinal-disorders-in-post-covid-syndrome-clinical-2kfpiqc8.pdf

Gastrointestinal disorders in post-COVID syndrome. Clinical guidelines

The presented clinical practice guidelines of the Gastroenterological Scientiﬁc Society of Russia (GSSR), diagnostic, and therapeutic approaches for patients with digestive diseases during the COVID-19 pandemic. The guidelines were approved by the XXIII Congress of the GSSR and the 22nd International Slavonic-Baltic Scientiﬁ c Forum “St. Petersburg - Gastro-2020 ON-LINE” (St. Petersburg, June 11, 2020). The presented clinical practice guidelines of the Russian Scientiﬁc Medical Society of Internal Medicine (RSMSIM) and the Gastroenterological Scientiﬁc Society of Russia (GSSR), diagnostic, and therapeutic approaches for patients with digestive diseases during the COVID-19 pandemic. The recommendations were approved at the XV National Congress of Internal Medicine, XXIII Congress of NOGR on the basis of the 1st edition, adopted at the 22nd International Slavic- Baltic Scientiﬁc Forum “St. Petersburg - Gastro-2020 ON-LINE”.

/pdf/management-of-patients-with-digestive-diseases-during-the-4ofs4e2zup.pdf

Management of patients with digestive diseases during the COVID-19 pandemic. Clinical practice guidelines by the Russian scientific medical society of internal medicine (RSMSIM) and the Gastroenterological Scientific Society of Russia (2nd edition)

V. V. A. Ratnikov

Papers

Management of patients with digestive diseases during the COVID-19 pandemic. Clinical practice guidelines by the Russian scientific medical society of internal medicine (RSMSIM) and the Gastroenterological Scientific Society of Russia (2nd edition)