Context: Within only 30 days after the first announcement of infection with "SARS-CoV-2" in Wuhan, it spread to more than 20 countries and become a pandemic by WHO as a "high alarming level of infection" with 136,343 involved cases all over the world. Methods: To uncover more about the probable gastrointestinal transmission and its clinical manifestations, we reviewed all research publications with keywords including: "COVID-19", "SARS-CoV-2", "Coronavirus", "outbreak", "ARAS-CoV" in Medline, Scopus, Google Scholar as well as all news in social media about "novel COVID-19 pandemic". Out of 40 recent publications, 10 articles were studied by 2 authors. Results: Although the SARS-CoV-2 tends to infect respiratory epithelial cells through the respiratory tracts, recent investigations detected the virus in the stool specimen, raising the question of the fecal-oral transmission route. Different studies showed that almost all gastrointestinal signs and symptoms were seen in elderly patients (more than 65 years old). including anorexia (40%), nonspecific abdominal pains (8%), diarrhea (10%) and nausea and Vomiting in about 8% of patients. Anorexia and generalized abdominal pain suffer many treated cases even 10-20 days after negative blood tests (like CRP, lymphopenia) and negative PCR of respiratory samples. The main reason for this prolonged anorexia and abdominal pain may be due to the long persistence of COVID-19 in the gastrointestinal tracts after primary treatment. Conclusions: Comparing to SARS, patients with COVID-19 showed less diarrhea, nausea, vomiting and/or abdominal discomfort before respiratory symptoms. Feces as a potential contagious source of Viral RNA can last even after viral clearance in the respiratory tract. We strongly recommend all cured patients of COVID-19 to disinfect and clean their toilets until 17-20 days after negative blood tests and solving their respiratory disorders. Gastrointestinal manifestations have seen in all men while no women referred with GI signs.

Peginterferon alpha-2a in combination with weight-based ribavirin has SVR rate of 51% for genotype 1 and 71% for genotype non-1 infections in haemophilia patients. Age<24, BMI<25, viral load<600 000 IU/ml and genotype non-1 are the major determinants of SVR achievement in these patients.

ContextOccult HCV infection (OCI) is defined as the presence of HCV-RNA in hepatocytes and the absence of HCV in the serum according to usual tests. We aimed to define OCI and provide information about the currently available diagnostic methods. Then we focus on specific groups that are at high risk of OCI and finally investigate immune responses to OCI and the available treatment approaches.Evidence AcquisitionPubMed, Scopus and Google Scholar were comprehensively searched with combination of following keywords: “occult”, “hepatitis C virus” and “occult HCV infection”. The definition of OCI, diagnostic methods, specific groups that are at high risk and available treatment approaches were extract from literature. An analysis of available articles on OCI also was done based on Scopus search results.ResultsOCI has been reported in several high-risk groups, especially in hemodialysis patients and subjects with cryptogenic liver disease. Furthermore, some studies have proposed a specific immune response for OCI in comparison with chronic hepatitis C (CHC).ConclusionsWith a clinical history of approximately 11 years, occult HCV infection can be considered an occult type of CHC. Evidences suggest that considering OCI in these high-risk groups seems to be necessary. We suggest that alternative diagnostic tests should be applied and that there is a need for the participation of all countries to determine the epidemiology of this type of HCV infection. Additionally, evaluating OCI in blood transfusion centers and in patients who receive large amounts of blood and clotting factors, such as patients with hemophilia, should be performed in future projects.

BackgroundCapillary hemangiomas of spinal nerve root, mostly affecting the cauda equina, are extremely rare.Case presentationA 20-year old man was presented with back pain, radiculopathy, and urogenital symptoms. Magnetic resonance images revealed an intradural extramedullary mass, isointense in T1-weighted and hyperintense in T2-weighted images, with noticeable post injection enhancement. The clinical and radiological findings simulated neurinoma.However, a pinkish lesion was removed surgically and histopathological examination revealed lobules of capillary vessels separated by fibrous tissue, suggesting capillary hemangioma.ConclusionAlthough rare and sometimes indistinguishable from more common lesion, capillary hemangioma should be in differential diagnosis of any enhancing intradural extramedullary mass at the level of cauda equina or conus medullaris.