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Article ; Online: Endoscopic Management of Complex Colorectal Polyps

Rupinder Mann / Mahesh Gajendran / Chandraprakash Umapathy / Abhilash Perisetti / Hemant Goyal / Shreyas Saligram / Juan Echavarria

Frontiers in Medicine, Vol

Current Insights and Future Trends

2022 Volume 8

Abstract: Most colorectal cancers arise from adenomatous polyps and sessile serrated lesions. Screening colonoscopy and therapeutic polypectomy can potentially reduce colorectal cancer burden by early detection and removal of these polyps, thus decreasing ... ...

Abstract	Most colorectal cancers arise from adenomatous polyps and sessile serrated lesions. Screening colonoscopy and therapeutic polypectomy can potentially reduce colorectal cancer burden by early detection and removal of these polyps, thus decreasing colorectal cancer incidence and mortality. Most endoscopists are skilled in detecting and removing the vast majority of polyps endoscopically during a routine colonoscopy. Polyps can be considered “complex” based on size, location, morphology, underlying scar tissue, which are not amenable to removal by conventional endoscopic polypectomy techniques. They are technically more challenging to resect and carry an increased risk of complications. Most of these polyps were used to be managed by surgical intervention in the past. Rapid advancement in endoscopic resection techniques has led to a decreasing role of surgery in managing these complex polyps. These endoscopic resection techniques do require an expert in the field and advanced equipment to perform the procedure. In this review, we discuss various advanced endoscopic techniques for the management of complex polyps.
Keywords	colorectal polyp ; colorectal cancer ; endoscopic mucosal resection ; endoscopic submucosal dissection ; colonoscopy ; Medicine (General) ; R5-920
Subject code	571
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Efficacy and Safety of Robotic Dor Fundoplication on Severe Gastroesophageal Reflux Disease in Patients With Scleroderma

Priyadarshini Loganathan MD / Mahesh Gajendran MD / Brian Davis MD / Richard McCallum MD

Journal of Investigative Medicine High Impact Case Reports, Vol

2021 Volume 9

Abstract: Systemic sclerosis (SSc) is a disease that affects the gastrointestinal tract resulting in its atrophy and fibrosis of smooth muscles. Approximately 80% of SSc patients develop both gastroesophageal reflux disease (GERD) and dysphagia. The nocturnal GERD ...

Abstract	Systemic sclerosis (SSc) is a disease that affects the gastrointestinal tract resulting in its atrophy and fibrosis of smooth muscles. Approximately 80% of SSc patients develop both gastroesophageal reflux disease (GERD) and dysphagia. The nocturnal GERD can cause regurgitation and aspiration, which can further aggravate the pulmonary fibrosis from SSc. Also, their dysphagia is further worsened by performing standard Nissen fundoplication. Therefore, we aimed to investigate whether Dor fundoplication (a 180° anterior wrap) can reduce nocturnal heartburn and regurgitation without worsening dysphagia in patients with SSc and severe GERD. Five SSc patients with drug-refractory severe GERD underwent a Dor fundoplication procedure with a median follow-up of 2 years (range: 1-5 years). In all 5 patients, the preoperative high-resolution manometry showed significant impairment of esophageal motility. Patients were interviewed postoperatively to assess for nocturnal and diurnal GERD symptoms, treatment response, the status of dysphagia, and adverse effects of surgery. The average age of 5 patients was 50 years and all were females. Four of the 5 patients (80%) reported 90% improvement in both diurnal and nocturnal GERD symptoms since surgery, with no nocturnal reflux, heartburn, or regurgitation, and reports to sleep at night without requiring any more pillows or wedges. About 50% of patients reported a decrease in their proton pump inhibitor dosage after surgery compared to before surgery. No surgical complication was reported and specifically, no worsening of dysphagia. The Dor fundoplication performed for refractory GERD in SSc patients substantially decreases heartburn and regurgitation, primarily nocturnal, without affecting dysphagia, thus improving the quality of life.
Keywords	Medicine (General) ; R5-920 ; Pathology ; RB1-214
Subject code	610
Language	English
Publishing date	2021-10-01T00:00:00Z
Publisher	SAGE Publishing
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Advanced Endoscopic Imaging and Interventions in GERD

Rupinder Mann / Mahesh Gajendran / Abhilash Perisetti / Hemant Goyal / Shreyas Saligram / Chandraprakash Umapathy

Frontiers in Medicine, Vol

An Update and Future Directions

2021 Volume 8

Abstract: Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases encountered in primary care and gastroenterology clinics. Most cases of GERD can be diagnosed based on clinical presentation and risk factors; however, some ... ...

Abstract	Gastroesophageal reflux disease (GERD) is one of the most common gastrointestinal diseases encountered in primary care and gastroenterology clinics. Most cases of GERD can be diagnosed based on clinical presentation and risk factors; however, some patients present with atypical symptoms, which can make diagnosis difficult. An esophagogastroduodenoscopy can be used to assist in diagnosis of GERD, though only half of these patients have visible endoscopic findings on standard white light endoscopy. This led to the development of new advanced endoscopic techniques that enhanced the diagnosis of GERD and related complications like squamous cell dysplasia, Barrett's esophagus, and early esophageal adenocarcinoma. This is conducted by improved detection of subtle irregularities in the mucosa and vascular structures through optical biopsies in real-time. Management of GERD includes lifestyle modifications, pharmacological therapy, endoscopic and surgical intervention. Minimally invasive endoscopic intervention can be an option in selected patients with small hiatal hernia and without complications of GERD. These endoscopic interventions include endoscopic fundoplication, endoscopic mucosal resection techniques, ablative techniques, creating mechanical barriers, and suturing and stapling devices. As these new advanced endoscopic techniques are emerging, data surrounding the indications, advantages and disadvantages of these techniques need a thorough understanding.
Keywords	gastroesophageal reflux disease (GERD) ; endoscopic reflux therapy ; narrow band imaging (NBI) ; endoscopy ; Barrett's esophagus (BE) ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2021-11-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Red Blood Cell Distribution Width in Hospitalized COVID-19 Patients

Preethi Ramachandran / Mahesh Gajendran / Abhilash Perisetti / Karim Osama Elkholy / Abhishek Chakraborti / Giuseppe Lippi / Hemant Goyal

Frontiers in Medicine, Vol

2022 Volume 8

Abstract: Introduction: Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is causing dramatic morbidity and mortality worldwide. The Red Blood Cell Distribution Width (RDW) has been strongly associated ... ...

Abstract	Introduction: Coronavirus disease-2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), is causing dramatic morbidity and mortality worldwide. The Red Blood Cell Distribution Width (RDW) has been strongly associated with increased morbidity and mortality in multiple diseases.Objective: To assess if elevated RDW is associated with unfavorable outcomes in hospitalized COVID-19.Methods: We retrospectively studied clinical outcomes of hospitalized COVID-19 patients for their RDW values. In-hospital mortality was defined as primary outcome, while septic shock, need for mechanical ventilation, and length of stay (LOS) were secondary outcomes.Results: A total of 294 COVID-19 patients were finally studied. Overall prevalence of increased RDW was 49.7% (146/294). RDW was associated with increased risk of in-hospital mortality (aOR, 4.6; 95%CI, 1.5-14.6) and septic shock (aOR, 4.6; 95%CI, 1.4-15.1) after adjusting for anemia, ferritin, lactate, and absolute lymphocyte count. The association remained unchanged even after adjusting for other clinical confounders such as age, sex, body mass index, coronary artery disease, hypertension, diabetes mellitus, and chronic obstructive pulmonary disease. No association was found instead with mechanical ventilation and median LOS.Conclusion: Elevated RDW in hospitalized COVID-19 patients is associated with a significantly increased risk of mortality and septic shock.
Keywords	COVID-19 ; Red cell distribution width (RDW) ; SARS-CoV-2 ; septic shock ; mortality ; length of stay ; Medicine (General) ; R5-920
Language	English
Publishing date	2022-01-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Addition of Tocilizumab to the Standard of Care Reduces Mortality in Severe COVID-19

Umesha Boregowda / Abhilash Perisetti / Arpitha Nanjappa / Mahesh Gajendran / Gurusaravanan Kutti Sridharan / Hemant Goyal

Frontiers in Medicine, Vol

A Systematic Review and Meta-Analysis

2020 Volume 7

Abstract: Introduction: Tocilizumab (TCZ) is an anti-interleukin-6 antibody that has been used for the treatment of severe coronavirus disease 2019 (COVID-19). However, concrete evidence of its benefit in reducing mortality in severe COVID-19 is lacking. Therefore, ...

Abstract	Introduction: Tocilizumab (TCZ) is an anti-interleukin-6 antibody that has been used for the treatment of severe coronavirus disease 2019 (COVID-19). However, concrete evidence of its benefit in reducing mortality in severe COVID-19 is lacking. Therefore, we performed a systematic review and meta-analysis of relevant studies that compared the efficacy of TCZ in severe COVID-19 vs. standard of care (SOC) alone.Methods: A literature search for studies that compared “tocilizumab” and “standard of care” in the treatment of COVID-19 was done using major online databases from December 2019 to June 14, 2020. Search words “Tocilizumab,” “anti-interleukin-6 antibody,” and “COVID-19” or “coronavirus 2019” in various combinations were used. Articles in the form of abstracts, letters without original data, case reports, and reviews were excluded. Data were gathered on an Excel sheet, and statistical analysis was performed using Review Manager 5.3.Results: Sixteen studies were eligible from 693 initial studies, including 3,641 patients (64% males). There were 13 retrospective studies and three prospective studies. There were 2,488 patients in the SOC group (61.7%) and 1,153 patients (68.7%) in the TCZ group. The death rate in the TCZ group, 22.4% (258/1,153), was lower than in the SOC group, 26.21% (652/2,488) [pooled odds ratio 0.57 (95% CI 0.36–0.92), p = 0.02]. There was a significant heterogeneity (inconsistency index = 80%) among the included studies.Conclusion: The addition of TCZ to the SOC might reduce mortality in severe COVID-19. More extensive randomized clinical trials are needed to validate these findings.
Keywords	tocilizumab (IL-6 inhibitor) ; COVID-19 ; coronavirus (2019-nCoV) ; SARS-C0V-2 infection ; tocilizumab ; tocilizumab (TCZ) ; Medicine (General) ; R5-920 ; covid19
Subject code	610
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Clinical Characteristics, Diagnosis, and Treatment of Major Coronavirus Outbreaks

Rupinder Mann / Abhilash Perisetti / Mahesh Gajendran / Zainab Gandhi / Chandraprakash Umapathy / Hemant Goyal

Frontiers in Medicine, Vol

2020 Volume 7

Abstract: Human coronavirus infections have been known to cause mild respiratory illness. It changed in the last two decades as three global outbreaks by coronaviruses led to significant mortality and morbidity. SARS CoV-1 led to the first epidemic of the twenty ... ...

Abstract	Human coronavirus infections have been known to cause mild respiratory illness. It changed in the last two decades as three global outbreaks by coronaviruses led to significant mortality and morbidity. SARS CoV-1 led to the first epidemic of the twenty first century due to coronavirus. SARS COV-1 infection had a broad array of symptoms with respiratory and gastrointestinal as most frequent. The last known case was reported in 2004. Middle East respiratory syndrome coronavirus (MERS-CoV) led to the second outbreak in 2012, and case fatality was much higher than SARS. MERS-CoV has a wide array of clinical presentations from mild, moderate to severe, and some patients end up with acute respiratory distress syndrome (ARDS). The third and recent outbreak by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) started in December 2019, which lead to a global pandemic. Patients with SARS-CoV2 infection can be asymptomatic or have a range of symptoms with fever, cough, and shortness of breath being most common. Reverse transcriptase-Polymerase chain reaction (RT-PCR) is a diagnostic test of choice for SARS CoV-1, MERS-CoV, and SARS CoV-2 infections. This review aims to discuss epidemiological, clinical features, diagnosis, and management of human coronaviruses with a focus on SARS CoV-1, MERS-CoV, and SARS CoV-2.
Keywords	COVID-19 ; MERS ; SARS ; SARS-CoV-2 ; clinical ; Medicine (General) ; R5-920
Subject code	610
Language	English
Publishing date	2020-11-01T00:00:00Z
Publisher	Frontiers Media S.A.
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Audio / Video ; Online: Image_1_Addition of Tocilizumab to the Standard of Care Reduces Mortality in Severe COVID-19

Umesha Boregowda / Abhilash Perisetti / Arpitha Nanjappa / Mahesh Gajendran / Gurusaravanan Kutti Sridharan / Hemant Goyal

A Systematic Review and Meta-Analysis.JPEG

2020

Abstract	Introduction: Tocilizumab (TCZ) is an anti-interleukin-6 antibody that has been used for the treatment of severe coronavirus disease 2019 (COVID-19). However, concrete evidence of its benefit in reducing mortality in severe COVID-19 is lacking. Therefore, we performed a systematic review and meta-analysis of relevant studies that compared the efficacy of TCZ in severe COVID-19 vs. standard of care (SOC) alone. Methods: A literature search for studies that compared “tocilizumab” and “standard of care” in the treatment of COVID-19 was done using major online databases from December 2019 to June 14, 2020. Search words “Tocilizumab,” “anti-interleukin-6 antibody,” and “COVID-19” or “coronavirus 2019” in various combinations were used. Articles in the form of abstracts, letters without original data, case reports, and reviews were excluded. Data were gathered on an Excel sheet, and statistical analysis was performed using Review Manager 5.3. Results: Sixteen studies were eligible from 693 initial studies, including 3,641 patients (64% males). There were 13 retrospective studies and three prospective studies. There were 2,488 patients in the SOC group (61.7%) and 1,153 patients (68.7%) in the TCZ group. The death rate in the TCZ group, 22.4% (258/1,153), was lower than in the SOC group, 26.21% (652/2,488) [pooled odds ratio 0.57 (95% CI 0.36–0.92), p = 0.02]. There was a significant heterogeneity (inconsistency index = 80%) among the included studies. Conclusion: The addition of TCZ to the SOC might reduce mortality in severe COVID-19. More extensive randomized clinical trials are needed to validate these findings.
Keywords	Dermatology ; Emergency Medicine ; Gastroenterology and Hepatology ; Geriatrics and Gerontology ; Intensive Care ; Medical Genetics (excl. Cancer Genetics) ; Nephrology and Urology ; Nuclear Medicine ; Orthopaedics ; Otorhinolaryngology ; Pathology (excl. Oral Pathology) ; Radiology and Organ Imaging ; Foetal Development and Medicine ; Obstetrics and Gynaecology ; Family Care ; Primary Health Care ; Medical and Health Sciences not elsewhere classified ; tocilizumab (IL-6 inhibitor) ; COVID-19 ; coronavirus (2019-nCoV) ; SARS-C0V-2 infection ; tocilizumab ; tocilizumab (TCZ) ; covid19
Subject code	610
Publishing date	2020-10-02T04:38:45Z
Publishing country	uk
Document type	Audio / Video ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Audio / Video ; Online: Image_5_Serum Activity of Liver Enzymes Is Associated With Higher Mortality in COVID-19

Umesha Boregowda / Mark M. Aloysius / Abhilash Perisetti / Mahesh Gajendran / Pardeep Bansal / Hemant Goyal

A Systematic Review and Meta-Analysis.TIFF

2020

Abstract: Background: Abnormal liver chemistries are common findings in patients with COVID-19. It is unclear whether abnormal liver chemistries can predict the severity of COVID-19. Therefore, we compared the serum liver chemistries such as hepatic transaminases, ...

Abstract	Background: Abnormal liver chemistries are common findings in patients with COVID-19. It is unclear whether abnormal liver chemistries can predict the severity of COVID-19. Therefore, we compared the serum liver chemistries such as hepatic transaminases, total bilirubin, albumin, and prothrombin time to evaluate whether they can predict severity and mortality in COVID-19. Methods: An electronic search was performed on PubMed/Medline, EMBASE, and Google Scholar for studies comparing liver chemistries in severe and mild COVID-19. The literature search was performed using keywords “COVID-19,” “Liver,” Aspartate Aminotransferase (AST),” and “Alanine Aminotransferase (ALT),” “AST,” and “ALT,” in various combinations of “AND/OR” from December 1, 2019, till May 8, 2020. The pooled weighted mean difference (WMD) and 95% confidence interval (CI) were calculated for each component of liver chemistries. Results: Twenty-two studies were eligible, with 3,256 patients (54.57% males). Seventeen studies compared liver chemistries for severe vs. mild COVID-19, whereas five studies compared liver chemistries in survival vs. non-survival groups. The pooled WMD of AST and ALT in severe vs. mild COVID-19 were 12.23 (95% CI; 8.07, 16.39; p < 0.01) and 8.07 (95% CI 2.55, 11.91; p < 0.01), respectively. The pooled WMD for AST in survivors vs. non-survivors analysis was 8.82 (n = 789; 95% CI; 2.27, 15.37; p < 0.01) and that of ALT was 4.70 (n = 340; 95% CI 0.04,9.35; p = 0.05). Conclusion: Our meta-analysis shows that deranged liver chemistries may indicate severe COVID-19 and could also predict mortality. Larger studies are needed to evaluate the relationship between derangement in liver chemistries and mortality in COVID-19.
Keywords	Dermatology ; Emergency Medicine ; Gastroenterology and Hepatology ; Geriatrics and Gerontology ; Intensive Care ; Medical Genetics (excl. Cancer Genetics) ; Nephrology and Urology ; Nuclear Medicine ; Orthopaedics ; Otorhinolaryngology ; Pathology (excl. Oral Pathology) ; Radiology and Organ Imaging ; Foetal Development and Medicine ; Obstetrics and Gynaecology ; Family Care ; Primary Health Care ; Medical and Health Sciences not elsewhere classified ; COVID-19 ; coronavirus ; liver tests ; liver chemistries ; LFT ; SARS-CoV-2 ; covid19
Subject code	610
Publishing date	2020-07-22T04:15:13Z
Publishing country	uk
Document type	Audio / Video ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Audio / Video ; Online: Image_6_Serum Activity of Liver Enzymes Is Associated With Higher Mortality in COVID-19

Umesha Boregowda / Mark M. Aloysius / Abhilash Perisetti / Mahesh Gajendran / Pardeep Bansal / Hemant Goyal

A Systematic Review and Meta-Analysis.TIFF

2020

Abstract	Background: Abnormal liver chemistries are common findings in patients with COVID-19. It is unclear whether abnormal liver chemistries can predict the severity of COVID-19. Therefore, we compared the serum liver chemistries such as hepatic transaminases, total bilirubin, albumin, and prothrombin time to evaluate whether they can predict severity and mortality in COVID-19. Methods: An electronic search was performed on PubMed/Medline, EMBASE, and Google Scholar for studies comparing liver chemistries in severe and mild COVID-19. The literature search was performed using keywords “COVID-19,” “Liver,” Aspartate Aminotransferase (AST),” and “Alanine Aminotransferase (ALT),” “AST,” and “ALT,” in various combinations of “AND/OR” from December 1, 2019, till May 8, 2020. The pooled weighted mean difference (WMD) and 95% confidence interval (CI) were calculated for each component of liver chemistries. Results: Twenty-two studies were eligible, with 3,256 patients (54.57% males). Seventeen studies compared liver chemistries for severe vs. mild COVID-19, whereas five studies compared liver chemistries in survival vs. non-survival groups. The pooled WMD of AST and ALT in severe vs. mild COVID-19 were 12.23 (95% CI; 8.07, 16.39; p < 0.01) and 8.07 (95% CI 2.55, 11.91; p < 0.01), respectively. The pooled WMD for AST in survivors vs. non-survivors analysis was 8.82 (n = 789; 95% CI; 2.27, 15.37; p < 0.01) and that of ALT was 4.70 (n = 340; 95% CI 0.04,9.35; p = 0.05). Conclusion: Our meta-analysis shows that deranged liver chemistries may indicate severe COVID-19 and could also predict mortality. Larger studies are needed to evaluate the relationship between derangement in liver chemistries and mortality in COVID-19.
Keywords	Dermatology ; Emergency Medicine ; Gastroenterology and Hepatology ; Geriatrics and Gerontology ; Intensive Care ; Medical Genetics (excl. Cancer Genetics) ; Nephrology and Urology ; Nuclear Medicine ; Orthopaedics ; Otorhinolaryngology ; Pathology (excl. Oral Pathology) ; Radiology and Organ Imaging ; Foetal Development and Medicine ; Obstetrics and Gynaecology ; Family Care ; Primary Health Care ; Medical and Health Sciences not elsewhere classified ; COVID-19 ; coronavirus ; liver tests ; liver chemistries ; LFT ; SARS-CoV-2 ; covid19
Subject code	610
Publishing date	2020-07-22T04:15:13Z
Publishing country	uk
Document type	Audio / Video ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Audio / Video ; Online: Image_7_Serum Activity of Liver Enzymes Is Associated With Higher Mortality in COVID-19

Umesha Boregowda / Mark M. Aloysius / Abhilash Perisetti / Mahesh Gajendran / Pardeep Bansal / Hemant Goyal

A Systematic Review and Meta-Analysis.TIFF

2020

Abstract	Background: Abnormal liver chemistries are common findings in patients with COVID-19. It is unclear whether abnormal liver chemistries can predict the severity of COVID-19. Therefore, we compared the serum liver chemistries such as hepatic transaminases, total bilirubin, albumin, and prothrombin time to evaluate whether they can predict severity and mortality in COVID-19. Methods: An electronic search was performed on PubMed/Medline, EMBASE, and Google Scholar for studies comparing liver chemistries in severe and mild COVID-19. The literature search was performed using keywords “COVID-19,” “Liver,” Aspartate Aminotransferase (AST),” and “Alanine Aminotransferase (ALT),” “AST,” and “ALT,” in various combinations of “AND/OR” from December 1, 2019, till May 8, 2020. The pooled weighted mean difference (WMD) and 95% confidence interval (CI) were calculated for each component of liver chemistries. Results: Twenty-two studies were eligible, with 3,256 patients (54.57% males). Seventeen studies compared liver chemistries for severe vs. mild COVID-19, whereas five studies compared liver chemistries in survival vs. non-survival groups. The pooled WMD of AST and ALT in severe vs. mild COVID-19 were 12.23 (95% CI; 8.07, 16.39; p < 0.01) and 8.07 (95% CI 2.55, 11.91; p < 0.01), respectively. The pooled WMD for AST in survivors vs. non-survivors analysis was 8.82 (n = 789; 95% CI; 2.27, 15.37; p < 0.01) and that of ALT was 4.70 (n = 340; 95% CI 0.04,9.35; p = 0.05). Conclusion: Our meta-analysis shows that deranged liver chemistries may indicate severe COVID-19 and could also predict mortality. Larger studies are needed to evaluate the relationship between derangement in liver chemistries and mortality in COVID-19.
Keywords	Dermatology ; Emergency Medicine ; Gastroenterology and Hepatology ; Geriatrics and Gerontology ; Intensive Care ; Medical Genetics (excl. Cancer Genetics) ; Nephrology and Urology ; Nuclear Medicine ; Orthopaedics ; Otorhinolaryngology ; Pathology (excl. Oral Pathology) ; Radiology and Organ Imaging ; Foetal Development and Medicine ; Obstetrics and Gynaecology ; Family Care ; Primary Health Care ; Medical and Health Sciences not elsewhere classified ; COVID-19 ; coronavirus ; liver tests ; liver chemistries ; LFT ; SARS-CoV-2 ; covid19
Subject code	610
Publishing date	2020-07-22T04:15:13Z
Publishing country	uk
Document type	Audio / Video ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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