Acute Liver Failure and Acute-on-Chronic Liver Failure in COVID-19 Era

Sasaki, Reina; Ishii, Tomotaka; Abe, Hayato; Ogawa, Masahiro; Enomoto, Hirayuki

doi:10.3390/jcm11144249

Cited by 5 publications

(3 citation statements)

References 26 publications

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“…Because of liver cirrhosis-related altered immune system functioning, characterized by the micro-inflammatory response within the liver and affecting gut permeability with a tendency towards immune tolerance depression for hepatocytes presenting with oncogenic features, severe acute respiratory syndrome (SARS) from SARS-CoV-2 infection has a higher prevalence in patients with liver cirrhosis [ 71 ]. High SARS incidence in cirrhotic patients significantly correlates with the development of consensual liver damage (namely, acute-on-chronic liver failure) [ 72 ]. The latter is mainly related to hypoxic stress and/or sepsis development [ 73 ].…”

Section: Resultsmentioning

confidence: 99%

Liver Damage and COVID-19: At Least a “Two-Hit” Story in Systematic Review

Montori

Baroni

Santori³

et al. 2023

CIMB

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COVID-19 pandemic waves have hit on our lives with pulmonary and, also, gastrointestinal symptoms. The latter also includes acute liver damage linked to direct SARS-CoV-2 action and/or drug-induced (DILI) in the frame of pre-existing chronic liver disease. We aimed to review literature data regarding liver damage during COVID-19. We conducted a systematic search on the main medical databases for original articles, reviews, meta-analyses, randomized clinical trials and case series using the following keywords and acronyms and their associations: liver disease, COVID-19, acute liver damage, drug-induced liver injury, antivirals. Acute liver damage due to SARS-CoV-2 infection is common among COVID-19 patients and is generally self-limiting. However, chronic hepatic diseases, such as metabolic-associated fatty liver disease (MAFLD), are associated with a less favorable prognosis, especially when alkaline phosphatases show a significant rise. Pathophysiology of COVID-19 liver damage is multifaceted and helps understand differences in liver derangement among patients. Thus, early recognition, monitoring and treatment of liver damage are crucial in these patients. In the frame of a not-ending pandemic sustained by SARS-CoV-2, it is crucial to recognize acute hepatic decompensation due to the virus and/or drugs used for COVID-19 treatment.

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Section: Resultsmentioning

confidence: 99%

Liver Damage and COVID-19: At Least a “Two-Hit” Story in Systematic Review

Montori

Baroni

Santori³

et al. 2023

CIMB

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show abstract

“…The coronavirus causes direct liver injury using the angiotensin converting enzyme 2 receptor for cellular entry, which is expressed mainly in the cholangiocytes and less frequently in the hepatocytes[ 21 ]. Certain hepatotoxic medications, such as antibiotics (macrolides, quinolones), antivirals (ribavirin), steroids, and other drugs used to treat patients with COVID-19, are connected with drug-induced liver injury and were found in 10.9% of COVID-19 patients[ 22 - 24 ]. However, in COVID-19 patients, liver damage is primarily secondary to ischemic, hypercoagulable, and hyperinflammatory states, which are independent predictors of death rather than liver injury per se[ 21 ].…”

Section: Liver Injury In Coronavirus Infected Patientsmentioning

confidence: 99%

“…The prognosis of the COVID-19 infection depends primarily on the patients’ characteristics, present comorbidities, severity of clinical symptoms, laboratory parameters, and imaging features[ 34 ] (Figure 1 ). Liver injury occurs in patients with or without pre-existing liver disorders[ 24 ]. The incidence of liver injury manifesting as abnormal levels of liver enzymes ranges from 14.8% to 53.0%[ 18 ].…”

Section: Prognostic Factors In Covid-19 Patients With Liver Diseasementioning

confidence: 99%

Outcomes of COVID-19 among patients with liver disease

Vujčić¹

2023

World J Gastroenterol

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Coronavirus disease 2019 (COVID-19) is primarily a respiratory disease with multi-organ involvement, including impaired liver function. It has been noticed that a significant proportion of COVID-19 patients have liver dysfunction, especially those with a more severe disease course. The coronavirus causes direct damage to the liver using the angiotensin-converting enzyme 2, a cell-surface receptor for cellular entry, that is expressed in the liver. According to previous research, liver enzyme abnormalities were observed in a considerable proportion of COVID-19 patients, and elevated liver transaminases were found in about 20% of these patients, alkaline phosphatase in 6.1%, and gamma-glutamyl transferase in 21.1%. COVID-19 might trigger a deterioration of liver function in patients with pre-existing chronic liver diseases (CLDs) and also in those without previous liver disorders. The majority of COVID-19 patients who develop liver injury are men, the elderly, and those with a higher body mass index. Compared to the general population, COVID-19 is associated with significant morbidity and mortality in patients with liver disease (cirrhosis and liver transplantation recipients). However, some studies indicate that CLDs have a lesser role in determining patient progression towards higher disease severity.

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Overview of acute liver failure in India

Acharya

2024

Indian J Gastroenterol

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Acute Liver Failure and Acute-on-Chronic Liver Failure in COVID-19 Era

Abstract: Acute liver failure (ALF) and acute-on-chronic liver failure (ACLF), respectively, occur in patients with normal liver and patients with chronic liver diseases, including cirrhosis [...]

Cited by 5 publications

References 26 publications

Liver Damage and COVID-19: At Least a “Two-Hit” Story in Systematic Review

Liver Damage and COVID-19: At Least a “Two-Hit” Story in Systematic Review

Outcomes of COVID-19 among patients with liver disease

Overview of acute liver failure in India

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