COVID-19. Liver damage – visualization features and possible causes

Pathological conditions of various natures are capable of mutual aggravation, significantly affecting the overall burden of the disease, its manifestations and severity. This analytical review is devoted to the interaction between pathogens of socially significant infections human immunodeficiency viruses (HIV), hepatitis C, Mycobacterium tuberculosis and SARS-CoV-2. Foreign and own data covering the issues of syndemia and interference of pathogens are presented. The results of epidemiological analysis in the North-Western Federal District (NWFD) are presented, which demonstrated the absence of a significant impact of the pandemic caused by a new coronavirus infection (COVID-19) on the epidemic incidence of HIV, viral hepatitis C or tuberculosis at the population level, which may be due to various mechanisms of transmission of infections and the required infectious dose of the pathogen. The absence of a negative effect of COVID-19 on mortality rates in HIV infection, viral hepatitis C and tuberculosis in the territories of the NWFD was noted. Special attention is paid to the clinical picture of the combined course of HIV infection, tuberculosis and COVID-19. The data are demonstrated, which allow us to conclude that the worst prognosis and risk of death are patients in the progressive stage of the disease, which is characterized by the presence of opportunistic infections, especially AIDS-indicator conditions, with disseminated tuberculosis and in the cirrhotic stage of viral hepatitis. The significance of severe manifestations of infectious pathology in cases of deterioration of the prognosis of COVID-19 is shown. Based on the experience of two years of the pandemic, the problems contributing to the syndrome of new coronavirus infection and other conditions, as well as the causes of high mortality from COVID-19, which include: limited resources for non-infectious areas of medical care; insufficient funding for planned and high-tech care; a decrease in the volume of primary diagnosis and detection of infectious and non-infectious pathology; delayed and limited research in areas; distraction of specialists from preventive and dispensary work outside of infectious pathology; shortage of medicines and consumables; social instability and deterioration of the well-being of the population, characteristic of pandemics. The role of a personalized approach to patients with concomitant somatic and infectious diseases as a preventive measure for the severe course and complications of COVID-19 is determined.

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Epidemiology and course of infectious diseases during the COVID-19 pandemic. Report 1. HIV infection, hepatitis c and tuberculosis

Belyakov

Боева

Загдын

et al. 2022

Russian Journal of Infection and Immunity

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Factors affecting the development of liver fibrosis in patients who experienced COVID-19

et al. 2023

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The aim of the review is to highlight the main factors affecting the development of liver fibrosis and possible mechanisms of liver damage in patients who have experienced COVID-19. A search was carried out using keywords in the Scopus, Web of Science, and PubMed databases in literary sources of the last three years on factors associated with fibrogenesis in novel coronavirus infection.The review presents the main mechanisms of liver damage in COVID-19: direct effects on hepatocytes and cholangiocytes, hypoxia, and immune-mediated and drug-induced damage. We analyzed the significance of factors affecting fibrosis development in patients with COVID-19: chronic diffuse liver diseases, against which COVID-19 occurs, such as non-alcoholic fatty liver disease, alcohol-associated liver disease, chronic hepatitis B, C, and cirrhosis of the liver.Damage to the liver in coronavirus infection develops by several mechanisms. The development of COVID-19 against the background of diffuse liver pathology of various genesis is associated with progression of these diseases (increased fibrogenesis) and a poorer prognosis.

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Liver X-ray Attenuation in Patients with Novel Coronavirus Infection (Multislice Computed Tomography Study)

Nikogosova

Бердалин

Gubskiy

et al. 2022

Vestn. rentgenol. radiol.

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Objective: to analyze the X-ray liver attenuation values in hospitalized patients with novel coronavirus infection (COVID-19) in relation to the time of disease onset, the severity of pulmonary parenchymal involvement, and the disease outcome.Material and methods. Chest computed tomography (CT) findings in 635 patients hospitalized with COVID-19 were analyzed. CT was performed at various times after the disease onset. The attenuation (CT density) values of the visualized liver upper part were measured by selecting the region of interest on CT images. The extent of the affected lung parenchyma was assessed according to the five-step CT0–4 scale, where CT0 corresponds to the absence of viral pneumonia, CT1 – lung parenchyma involvement less than 25%, CT2 – 25–50% lung volume lesion, CT3 – 50–75% lung volume lesion, CT4 – lung parenchyma involvement more than 75%.Results. In patients with CT0, the liver attenuation was significantly higher than in those with CT1, CT2, CT3, and CT4 (p < 0.01). During the first week of the disease, there was a decrease in liver CT density followed by its increase and return to the initial values (p < 0.0005). The dynamics of liver attenuation in the group of patients who died did not differ significantly from those who survived and recovered (p = 0.107). In the early stage of the disease (0–4 days), the liver attenuation in the group of patients who subsequently died turned out to be significantly lower than in the survivors (p < 0.05).Conclusion. The course of COVID-19 is characterized by a transient decrease in liver CT density. The reduction in liver attenuation does not correlate with the volume of the affected lung parenchyma in patients with CT2–4. The dynamics of liver CT density is not associated with the disease outcome. There is a trend towards more pronounced values of liver attenuation decrease in the early stage of the disease in patients who subsequently died, which requires further research.

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COVID-19. Liver damage – visualization features and possible causes

Cited by 8 publications

References 24 publications

Epidemiology and course of infectious diseases during the COVID-19 pandemic. Report 1. HIV infection, hepatitis c and tuberculosis

Epidemiology and course of infectious diseases during the COVID-19 pandemic. Report 1. HIV infection, hepatitis c and tuberculosis

Factors affecting the development of liver fibrosis in patients who experienced COVID-19

Liver X-ray Attenuation in Patients with Novel Coronavirus Infection (Multislice Computed Tomography Study)

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