Liver Function in Patients with Long-Term Coronavirus Disease 2019 of up to 20 Months: A Cross-Sectional Study

Lima, Igor Costa de; Menezes, Daniel Carvalho de; Uesugi, Juliana Hiromi Emin; Bichara, Cléa Nazaré Carneiro; Vasconcelos, Pedro Fernando da Costa; Quaresma, Juarez Antônio Simões; Falcão, Luiz Fábio Magno

doi:10.3390/ijerph20075281

Cited by 16 publications

(8 citation statements)

References 30 publications

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“…This liver marker alteration, indicative of hepatocyte damage and systemic inflammation, is evidenced by increased levels of various interleukins and IFN-λ in hospitalized patients [33]. Severe COVID-19 cases, similarly to our findings, show raised AST, ALT, and GGT levels with reduced albumin, although mean albumin remained normal in different studies [34]. AST's role as a liver marker is complex due to its muscle production, especially given that Long COVID-19 patients often face fatigue and muscle weakness [35].…”

Section: Important Findings and Literature Reviewsupporting

confidence: 87%

A Comparative Analysis of Liver Injury Markers in Post-COVID Syndrome among Elderly Patients: A Prospective Study

Bota,

Bratosin,

Bandi

et al. 2024

JCM

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Background: In the wake of the global COVID-19 pandemic, understanding its prolonged impact on vulnerable populations has become a critical area of investigation. This study aimed to elucidate the distinctive post-acute sequelae of SARS-CoV-2 infection (PASC) and liver injury in Romania’s elderly population, hypothesizing unique demographic, clinical, and healthcare factors influencing the manifestation. Methods: A longitudinal design was employed, enrolling COVID-19 patients from the Victor Babes Hospital for Infectious Diseases and Pulmonology in Timisoara, Romania. Participants were stratified into three groups based on age and Long COVID status. The study focused on a variety of demographic, clinical, and biological parameters, including liver function tests, to assess the trajectory and severity of liver injury over six months post discharge. Results: Involving 238 participants, the study revealed a significant increase in the duration of hospitalization for those over 65 (15.8 ± 8.2 days) compared to younger groups (p < 0.001). Notably, elderly Long COVID patients exhibited a marked elevation in liver enzymes post discharge, with median ΔALT and ΔAST of 24.1 U/L and 30.2 U/L, respectively, suggesting ongoing liver injury (p < 0.001). Significant metabolic disruptions were observed, with the ΔFasting glucose showing a substantial median decrease of 21.1 mmol/L in the elderly group (p < 0.001). A pronounced reduction in ΔGGT (16.7 U/L) and ΔLDH (48.7 U/L) was noted, indicating a recovery in liver function and reduced tissue damage (p < 0.001). Coagulation profiles and liver fibrosis risk scores, particularly ΔFIB-4 and ΔAPRI, also significantly improved post discharge, indicating a reduced risk of ongoing liver complications. Conclusion: This study confirms the hypothesis of more severe PASC and liver injury among the elderly Romanian population. Significant improvements post discharge suggest a degree of recovery, yet the persistent alterations in liver enzymes, glucose metabolism, and fibrosis risk scores call for continued monitoring and tailored management strategies.

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Section: Important Findings and Literature Reviewsupporting

confidence: 87%

A Comparative Analysis of Liver Injury Markers in Post-COVID Syndrome among Elderly Patients: A Prospective Study

Bota,

Bratosin,

Bandi

et al. 2024

JCM

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“…Statistical analysis showed that COVID-19 impacted liver function in both male and female patients within the severe category, specifically through elevated alanine transaminase (ALT) and aspartate transaminase (AST) levels. Interestingly, age within this group emerged as a potential contributing factor, with male aged 66-90 exhibiting a greater degree of liver impairment [42]. Bilirubin levels also displayed age-and gender-specific nuances.…”

Section: Discussionmentioning

confidence: 98%

A Biochemical Analysis of Detrimental Effects of COVID-19 Severity on Multiple Organ Systems

Umar,

Tahir,

Shabbir

2023

TSFJB

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To understand the impact of the COVID-19 pandemic on multiple organ system research and review is required. While the primary symptoms of COVID-19 are respiratory distress and lung injury. This study investigates liver and kidney involvement and blood parameter changes among different groups of patients. Understanding these changes is crucial because COVID-19-induced liver and renal injuries, can complicate medication dosing and increase the risk of severe drug reactions. Despite the abundance of literature on COVID-19, information is lacking regarding the prevalence and clinical significance of liver injury, renal injury, and CBC alterations in COVID-19 patients from regions with low mortality and severity rates. This study aims to report and characterize changes in these parameters during the disease, and assess the relationship between them in a cohort of 354 confirmed COVID-19 patients (198 males and 156 females) in Lahore. Chi-square and T-test were used to evaluate the hypothesis. Several parameters showed significant changes, including the RBC count in normal patients, PLT levels in normal patients, ALT levels in normal, moderate, and severe patients, AST level in moderate patients, and Creatinine amount in moderate COVID-19 patients. These results highlight COVID-19's systemic impact on these parameters, enhancing our understanding of disease severity and progression. Furthermore, this knowledge guides clinical management, aiding in the prevention of severe illness and the reduction of serious health issues like renal failure and liver damage.

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“…37 Although there is no universal definition of PCC, its prevalence has been described in up to 45% of COVID-19 patients with unresolved symptoms at 4 months. 38 In a cross-sectional study of 246 patients with long COVID, 39 74 exhibited elevated ALT levels, and 63 exhibited elevated AST levels; among these patients, those who required hospitalization during the acute illness were more likely to have liver enzyme derangements. Bende et al 40 demonstrated increased liver stiffness, viscosity, and steatosis using liver elastography in approximately one-third of patients with persistent COVID-19 symptoms at 3 to 11 weeks.…”

Section: Covid-19 and Liver Injurymentioning

confidence: 99%

COVID-19 and Liver Disease: An Evolving Landscape

Zhu,

Tsai,

Chahal

et al. 2023

Semin Liver Dis

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The COVID-19 pandemic has resulted in significant worldwide morbidity and mortality. In this review, we examine the intricate relationships between COVID-19 and liver diseases. While respiratory manifestations of COVID-19 are well-known, its impact and consequences in patients with liver diseases remain an area of ongoing investigation. COVID-19 can induce liver injury through various mechanisms and is associated with higher mortality in individuals with pre-existing chronic liver disease. Mortality increases with the severity of chronic liver disease and the level of care required. The outcomes in patients with autoimmune hepatitis remain unclear, whereas liver transplant recipients are more likely to experience symptomatic COVID-19 but have comparable outcomes to the general population. Despite suboptimal immunological response, COVID-19 vaccinations are safe and effective in liver disease, although cases of autoimmune-hepatitis-like syndrome have been reported. In conclusion, COVID-19 has significant implications in liver diseases; early recognition and treatments are important for improving patient outcomes.

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Liver Function in Patients with Long-Term Coronavirus Disease 2019 of up to 20 Months: A Cross-Sectional Study

Cited by 16 publications

References 30 publications

A Comparative Analysis of Liver Injury Markers in Post-COVID Syndrome among Elderly Patients: A Prospective Study

A Comparative Analysis of Liver Injury Markers in Post-COVID Syndrome among Elderly Patients: A Prospective Study

A Biochemical Analysis of Detrimental Effects of COVID-19 Severity on Multiple Organ Systems

COVID-19 and Liver Disease: An Evolving Landscape

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