What To Know About Liver Disease And Covid
Coronavirus disease 2019 is the illness caused by the SARS-CoV-2 virus. Older adults and people of any age who have serious underlying medical conditions, including people with liver disease, might be at higher risk for severe illness from COVID-19. People with chronic liver disease, including hepatitis B and hepatitis C, may have concerns and questions related to their risk.
Some patients hospitalized for COVID-19 have had increased levels of liver enzymes such as alanine aminotransferase and aspartate aminotransferase . Increased levels of liver enzymes can mean that a persons liver is at least temporarily damaged. People with cirrhosis may be at increased risk of COVID-19. Some studies have shown that people with pre-existing liver disease who were diagnosed with COVID-19 are at higher risk of death than people without pre-existing liver disease.
Adults of any age with certain underlying medical conditions, including people with liver disease , might be at increased risk for severe illness from the virus that causes COVID-19. People might be more likely to have severe disease if their medical conditions are not well controlled. People who are on treatment for hepatitis B or C should continue their treatment unless otherwise directed by their healthcare provider.
If you are a member of any of these groups, contact your healthcare provider to request the hepatitis A vaccine:
What Is Cirrhosis Of The Liver
Cirrhosis is a late-stage liver disease in which healthy liver tissue is replaced with scar tissue and the liver is permanently damaged. Scar tissue keeps your liver from working properly.
Many types of liver diseases and conditions injure healthy liver cells, causing cell death and inflammation. This is followed by cell repair and finally tissue scarring as a result of the repair process.
The scar tissue blocks the flow of blood through the liver and slows the livers ability to process nutrients, hormones, drugs and natural toxins . It also reduces the production of proteins and other substances made by the liver. Cirrhosis eventually keeps the liver from working properly. Late-stage cirrhosis is life-threatening.
What Can I Expect If I Have Cirrhosis
Damage already done to your liver is permanent. But your liver is a large organ. If part of your liver is still working, you might be able to slow the progression of disease, depending on its cause. For instance, if your cirrhosis is caused by alcohol abuse, you need to stop drinking immediately. If you are obese or have diabetes, you will need to lose weight and manage your blood sugar so you can lower the damage caused by fatty liver disease.
You and your healthcare provider or team will work together to determine whats causing your cirrhosis and what complications may have resulted from your cirrhosis and treat them accordingly.
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You Might Have Swollen Lymph Nodes
Your lymph nodes filter substances throughout your body, and are in your neck, armpits, goin and elsewhere. “A locally enlarged lymph node usually refers to immunological activity after vaccination,” reports the Finnish Institute for Health and Welfare. “In particular, vaccines containing live pathogens effectively form antibodies in the lymph nodes closest to the vaccination site. An enlarged lymph node is usually detected within one week of vaccination.While enlarged lymph nodes do not require treatment, they must be monitored.”
Can Cirrhosis Be Reversed
Generally no. If you have been told you have cirrhosis, you have a late-stage liver disease and the damage that is already done is permanent. There are many liver diseases and complications of liver diseases that can lead to cirrhosis. If your liver disease or complication is caught early and successfully managed, it may be possible to slow or stop the progression of disease.
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Do Children Need Protection Against Pneumococcal Disease
Yes. Infants and young children in the United States need to be protected against pneumococcal disease. In fact, they are routinely vaccinated for pneumococcal disease because it is part of the standard infant immunization schedule. Pneumococcal vaccine is also recommended for older children and adolescents with kidney disease, kidney failure, or an organ transplant, even if they received the vaccine as infants. If your child hasn’t been vaccinated, talk to your doctor.
Why Am I At Risk For Pneumococcal Disease
Normally, your body fights off anything that isnt part of itself, like germs and viruses. That system of protection is called your immune system. Having kidney disease and kidney failure can weaken your immune system, making it easier for infections to take hold. In fact, doctors and researchers have found that most infections, like those caused by pneumococcal disease, are worse in people with kidney disease. People with a kidney transplant also have weakened immune systems. This is because antirejection medicines , which protect the body from rejecting the transplanted kidney, suppress the immune system. The good news? Getting vaccinated can help protect against pneumococcal disease.
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Rheumatoid Arthritis Psoriatic Arthritis And Ankylosing Spondylitis
The recommended subcutaneous dosage of Humira for adult patients with rheumatoid arthritis , psoriatic arthritis , or ankylosing spondylitis is 40 mg administered every other week. Methotrexate , other non-biologic DMARDS, glucocorticoids, nonsteroidal anti-inflammatory drugs , and/or analgesics may be continued during treatment with Humira. In the treatment of RA, some patients not taking concomitant MTX may derive additional benefit from increasing the dosage of Humira to 40 mg every week or 80 mg every other week.
Effects Of Coronavirus Vaccines On The Liver
Vaccines against SARS-CoV-2 will be vital for avoiding the spread of the virus and alleviating social panic, but multiple aspects should be considered to prevent an activated innate inflammatory response, increased incidence of autoimmune diseases, and vaccine-induced liver injury . In general, the development of vaccinations is costly, and it usually takes long time to finish strict animal and clinical trials before approval for public applications . However, under the situation of the COVID-19 outbreak, the medical community is facing tremendous pressure to rapidly develop effective vaccines . In past pandemics such as those involving Ebola, H1N1, SARS, and MERS, vaccine development was unable to be completed owing to the end of the pandemic and the reallocation of scientific funds . Since July 2nd, 2020, there has been 158 vaccine candidates for COVID-19, 135 of which are in the preclinical or the developing stage. Until now, mRNA-1273 , Ad5-nCoV , INO-4800 , LV-SMENP-DC , Pathogen-specific aAPC , and ChAdOx1 have entered the phase II/III clinical trials .
Table 5. The efficacy and current status of COVID vaccines.
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Testing For Elevated Liver Enzymes
A blood test can show elevated liver enzymes. The blood test checks for raised levels of AST and ALT, which are enzymes that the liver releases when it becomes inflamed or damaged.
If a doctor finds that a person has raised AST or ALT levels, they are likely to carry out further tests to determine the underlying cause.
Different ratios of AST to ALT may indicate various underlying causes.
The treatment for elevated liver enzymes will focus on managing the underlying condition causing the increased levels.
The treatments for some common causes of raised AST or ALT levels include:
Does The Vaccine Work
It is estimated that in the first 11 years of the pneumococcal vaccine programme , the vaccine prevented nearly 40,000 cases of invasive pneumococcal disease, and about 2000 deaths.
The original version of the PCV was introduced in 2006. This vaccine protected against seven of the types of bacteria, and resulted in a big reduction in the number of cases of pneumococcal disease in babies caused by these seven types. However, there was an increase in the number of cases caused by other types of pneumococcal bacteria. Six strains in particular were identified as causing most of the new cases of pneumococcal disease.
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More Information On Side Effects
Reactions listed under possible side effects or adverse events on vaccine product information sheets may not all be directly linked to the vaccine. See Vaccine side effects and adverse reactions for more information on why this is the case.
If you are concerned about any reactions that occur after vaccination, consult your doctor. In the UK you can report suspected vaccine side effects to the Medicines and Healthcare products Regulatory Agency through the Yellow Card Scheme . See more information on the Yellow Card scheme and monitoring of vaccine safety.
People With Health Problems And The Pneumococcal Vaccine
The PPV vaccine is available on the NHS for children and adults aged from 2 to 64 years old who are at a higher risk of developing a pneumococcal infection than the general population.
This is generally the same people who are eligible for annual flu vaccination.
You’re considered to be at a higher risk of a pneumococcal infection if you have:
- a suppressed immune system caused by a health condition, such as HIV
- a suppressed immune system caused by medicines, such as chemotherapy or steroid tablets
- a cochlear implant Action on Hearing Loss has more information about cochlear implants
- had a leak of cerebrospinal fluid this could be the result of an accident or surgery
Adults and children who are severely immunocompromised usually have a single dose of PCV followed by PPV.
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Hepatitis B Virus Reactivation
Use of TNF blockers, including Humira, may increase the risk of reactivation of hepatitis B virus in patients who are chronic carriers of this virus. In some instances, HBV reactivation occurring in conjunction with TNF blocker therapy has been fatal. The majority of these reports have occurred in patients concomitantly receiving other medications that suppress the immune system, which may also contribute to HBV reactivation. Evaluate patients at risk for HBV infection for prior evidence of HBV infection before initiating TNF blocker therapy. Exercise caution in prescribing TNF blockers for patients identified as carriers of HBV. Adequate data are not available on the safety or efficacy of treating patients who are carriers of HBV with anti-viral therapy in conjunction with TNF blocker therapy to prevent HBV reactivation. For patients who are carriers of HBV and require treatment with TNF blockers, closely monitor such patients for clinical and laboratory signs of active HBV infection throughout therapy and for several months following termination of therapy. In patients who develop HBV reactivation, stop Humira and initiate effective anti-viral therapy with appropriate supportive treatment. The safety of resuming TNF blocker therapy after HBV reactivation is controlled is not known. Therefore, exercise caution when considering resumption of Humira therapy in this situation and monitor patients closely.
What Is Pneumococcal Disease
Pneumococcal disease is caused by a specific type of bacterium called Streptococcus pneumoniae. Its most common in children, but can also cause significant complications in older adults or people with chronic conditions.
The pneumococcal bacterium is contagious, which means that it can be passed from one person to another. This typically happens through direct contact with respiratory secretions like saliva or mucus.
Developing a pneumococcal infection can lead to a variety of conditions, some of which can be life threatening. Conditions caused by pneumococcal infections include:
Vaccination against a pneumococcal infection helps prevent you or your child from becoming sick from pneumococcal diseases. It also aids in preventing these diseases from spreading within your community.
Vaccination cant always prevent all cases of pneumococcal disease. Nevertheless, according to the , even just 1 dose can help protect against a variety of pneumococcal infections.
There are two vaccines available for pneumococcal disease:
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What Are The Side Effects Of The Pneumococcal Vaccine
After receiving the pneumococcal vaccine, children commonly will have pain or swelling where the shot is given and occasionally low-grade fever. About 1 of every 100 children will develop a high fever.
Side effects from the polysaccharide version used in adults include tenderness and redness at the injection site, and about 1 of every 100 people will get a fever and experience muscle aches.
Booster Doses Of Pneumococcal Vaccine
If you’re at increased risk of a pneumococcal infection, you’ll be given a single dose of the PPV vaccine.
But if your spleen does not work properly or you have a chronic kidney condition, you may need booster doses of PPV every 5 years.
This is because your levels of antibodies against the infection decrease over time.
Your GP surgery will advise you on whether you’ll need a booster dose.
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Who Should Not Get The Vaccine
People should not get the vaccine if they have had a life threatening allergic reaction to a previous dose.
Additionally, a person should not undergo vaccination if they have had an allergic reaction to medication containing diphtheria toxoid or an earlier form of the pneumonia vaccination .
Lastly, people who are sick or have allergic reactions to any of the ingredients of the vaccine should talk to a doctor before getting the shot.
A pneumonia shot will not reduce pneumonia. However, it helps prevent invasive pneumococcal diseases, such as meningitis, endocarditis, empyema, and bacteremia, which is when bacteria enter the bloodstream.
Noninvasive pneumococcal disease includes sinusitis.
There are two types of pneumonia shots available. Which type a person gets depends on their age, whether or not they smoke, and the presence of any underlying medical conditions.
The two types are:
- Pneumococcal conjugate vaccine : Healthcare providers recommend this vaccine for young children, people with certain underlying conditions, and some people over the age of 65 years.
- Pneumococcal polysaccharide vaccine : Healthcare providers recommend this vaccine for anyone over 65 years of age, people with certain underlying conditions, and people who smoke.
According to the
- roughly 8 in 10 babies from invasive pneumococcal disease
- 45 in 100 adults 65 years or older against pneumococcal pneumonia
- 75 in 100 adults 65 years or older against invasive pneumococcal disease
How Can I Prevent Cirrhosis Of The Liver
Food and drink issues:
- Don’t abuse alcohol. If you do drink alcohol, limit how much you drink and how often. If you drink more than two drinks a day if you are a man or more than one if you are a woman, you are increasing your risk. A drink is a glass of wine or a 12-ounce can of beer or a 1.5 ounce serving of hard liquor. If you have liver disease, you should not drink alcohol at all.
- Eat a well-balanced, low-fat diet, such as the Mediterranean diet. A well-balanced healthy diet consists of fruits, vegetables, lean proteins and whole grains.
- Dont eat raw seafood, especially oysters and clams. These foods can contain a bacteria that can cause serious illness.
- Cut back on the amount of salt in your diet. Use other seasonings to flavor your foods.
Healthy body habits:
- Maintain a healthy weight. Excess body fat can damage your liver. Ask your healthcare provider for a weight loss plan if you are overweight.
- Exercise regularly.
- See your healthcare provider regularly for check-ups. Follow medical recommendations to control obesity, diabetes, hypertension and cholesterol and high triglycerides.
- Quit smoking if you smoke.
Healthy liver practices:
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More Information About The Vaccine
The PCV is a conjugate vaccine . Sugars are taken from the capsule around the pneumococcal bacteria and joined to a non-toxic diphtheria protein called CRM197. The protein helps to stimulate the immune system in a broader way to respond well to the vaccine. This gives a better immune response in individuals of all ages.
In recent years, there have been several changes to the pneumococcal vaccination schedule in the UK:
- 2002: a pneumococcal conjugate vaccine protecting against 7 types of pnemococcal bacteria was recommended forimmunisation of babies and children in at-risk groups under the age of two years
- 2003: pneumococcal polysaccharide immunisation was recommended for all people aged 65 and over
- 2004: PCV7 was extended to at-risk babies and children under five years of age
- 2006: PCV7 was added to the routine childhood immunisation programme
- 2010: a pneumococcal conjugate vaccine protecting against 13 types of pnemococcal bacteria replaced PCV7.
Is There A Cure For Cirrhosis Of The Liver
No, there is no cure for cirrhosis. The damage already done to your liver is permanent. However, depending on the underlying cause of your cirrhosis, there may be actions you can take to keep your cirrhosis from getting worse. These actions include:
- Stop drinking alcohol.
- Treat chronic hepatitis .
- Avoid medications that stress the liver.
- Eat a healthy, well-balanced, low-fat diet, such as the Mediterranean diet.
Follow other tips listed under the Prevention section in this article.
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Liver Plays Role In Pneumonia Sepsis Susceptibility
- Boston University Medical Center
- New evidence highlights the importance of the liver in immunity against bacterial pneumonia. The study is the first of its kind to directly show such a link between liver-produced molecules and pneumonia susceptibility during sepsis.
New evidence highlights the importance of the liver in immunity against bacterial pneumonia. The study is the first of its kind to directly show such a link between liver-produced molecules and pneumonia susceptibility during sepsis.
Led by researchers at Boston University School of Medicine , the study appears in the journal Infection and Immunity.
Pneumonia, according to the World Health Organization, is the leading infectious cause of death in children worldwide, taking more than 900,000 lives of children under the age of 5 in 2013 alone. Pneumonia, in both children and adults, is frequently associated with sepsis, which is the body’s own inflammatory reaction to becoming infected.
While it may be too early to immediately speculate on the applications of these findings, the authors believe that liver activity may serve as a previously unappreciated window into pneumonia defense/susceptibility. “A better understanding of how these distinct organs collaborate to mount immune responses has important clinical implications for patients with or at risk for pneumonia and sepsis. The idea that non-lung tissue could be targeted for treatments of lung disease is compelling,” added Quinton.