Liver injury in COVID-19: The hepatic aspect of the respiratory syndrome — what we know so far

Anirvan, Prajna; Bharali, Pankaj; Gogoi, Mrinal; Thuluvath, Paul J.; Singh, Shivaram Prasad

doi:10.4254/wjh.v12.i12.1182

Cited by 23 publications

(28 citation statements)

References 68 publications

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“…ACE2 expression is substantially increased in diabetic patients treated with ACE inhibitors and angiotensin II type I receptor blockers. It was therefore speculated that upregulation of ACE2 in various organs, such as the lungs and liver, may not only promote SARS-CoV-2 infection, but also raises the risk of developing the extreme and fatal disease [12].…”

Section: Discussionmentioning

confidence: 99%

Liver function test abnormalities in COVID-19 patients and factors affecting them – a retrospective study

Abdelrahman¹,

Abdel-Baset²,

Younis³

et al. 2021

ceh

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Aim of the study: We aimed to study liver function test abnormalities in our COVID-19 patients and factors affecting them and to evaluate whether liver function test abnormalities are related to the severity of COVID-19. Material and methods: Our retrospective study included 118 patients who were SARS-CoV-2 positive. Their median age was 40 years. Fifty percent were male. Clinical and biochemical data were collected from patient records during the period from the start of June 2020 to the end of July 2020. Liver function test abnormalities included: alanine aminotransferase (ALT) > 40 U/l, aspartate aminotransferase (AST) > 40 U/l, serum albumin < 3.5 mg/dl, total bilirubin > 1.2 mg/dl, and international normalized ratio (INR) > 1.2. Results: Forty-four percent of COVID-19 patients had liver function test (LFT) abnormalities. In patients with severe SARS-CoV-2, AST, total bilirubin and INR levels were significantly higher than in patients with the nonsevere disease. Levels of hemoglobin, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum ferritin, D-dimer, and serum glucose were significantly higher in SARS-CoV-2 patients with LFT abnormalities than those with normal liver function. Conclusions: LFT abnormalities are very common in SARS-CoV2 positive patients, especially those with the severe form. Levels of ESR, CRP, serum ferritin, and D-dimer were higher in COVID-19 patients with LFT abnormalities than those with normal LFT. High serum ferritin levels might be potential risk factors for LFT abnormalities.

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Section: Discussionmentioning

confidence: 99%

Liver function test abnormalities in COVID-19 patients and factors affecting them – a retrospective study

Abdelrahman¹,

Abdel-Baset²,

Younis³

et al. 2021

ceh

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“…24 Liver injury in COVID-19 is also associated with disease severity. 25 It is characterised by increased transminases, with increase of AST dominating over ALT. 5 In our study, AST tended to be higher in the ethnic minority population than in the white population, while ALT did not show any difference between the two groups.…”

Section: Discussionmentioning

confidence: 99%

Biochemical abnormalities in COVID-19: a comparison of white versus ethnic minority populations in the UK

et al. 2021

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AimsPublic Health England has identified that in COVID-19, death rates among ethnic minorities far exceeds that of the white population. While the increase in ethnic minorities is likely to be multifactorial, to date, no studies have looked to see whether values for routine clinical biochemistry parameters differ between ethnic minority and white individuals.MethodsBaseline biochemical data for 22 common tests from 311 SARS-CoV-2 positive patients presenting to hospital in April 2020 in whom ethnicity data were available was retrospectively collected and evaluated. Data comparisons between ethnic minority and white groups were made for all patient data and for the subset of patients subsequently admitted to intensive care.ResultsWhen all patient data were considered, the ethnic minority population had statistically significant higher concentrations of C reactive protein (CRP), aspartate aminotransferase and gamma-glutamyl transferase, while troponin T was higher in the white group. A greater proportion of ethnic minority patients were subsequently admitted to intensive care, but when the presenting biochemistry of this subset of patients was compared, no significant differences were observed between ethnic minority and white groups.ConclusionOur data show for the first time that routine biochemistry at hospital presentation in COVID-19 differs between ethnic minority and white groups. Among the markers identified, CRP was significantly higher in the ethnic minority group pointing towards an increased tendency for severe inflammation in this group.

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“…In addition to treating the respiratory syndrome in COVID-19, liver function tests (LFTs) should be done and all factors known to cause or predispose to liver injury should be investigated while managing the patient[ 58 ]. In patients with mild liver test abnormalities of one or two times the ULN, close observation and flow-up is necessary.…”

Section: Managementmentioning

confidence: 99%

Impact of COVID-19 on liver

Chang

Chen

et al. 2021

WJCC

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The incidence of liver injury after coronavirus disease 2019 (COVID-19) infection ranged from 15%-53%. The mechanism includes direct viral cytopathic effect, cytokinesis, and treatment drug-induced liver injury. The symptoms include nausea, vomiting, diarrhea, and loss of appetite. The laboratory results include increased liver enzyme levels, decreased monocyte count, and longer prothrombin time. The most common imaging findings are hepatomegaly on ultrasound, ground-glass opacity on chest computed tomography (CT), and liver hypodensity and pericholecystic fat stranding on abdominal CT. Patients may also have different presentations and poor outcomes of different liver diseases concomitant with COVID-19 infection. Liver function test (LFT) results should be monitored, and all factors known to cause or predispose liver injury should be investigated while managing the patients. The risks of transfer to an intensive care unit, need for mechanical ventilator support, and acute kidney injury is higher in COVID-19 patients with than without abnormal LFTs. Increased mortality and length of hospital stay are both observed.

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Liver injury in COVID-19: The hepatic aspect of the respiratory syndrome — what we know so far

Cited by 23 publications

References 68 publications

Liver function test abnormalities in COVID-19 patients and factors affecting them – a retrospective study

Liver function test abnormalities in COVID-19 patients and factors affecting them – a retrospective study

Biochemical abnormalities in COVID-19: a comparison of white versus ethnic minority populations in the UK

Impact of COVID-19 on liver

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