SARS-CoV-2 infection and liver involvement

Luo, Mingjia; Ballester, María Pilar; Soffientini, Ugo; Jalan, Rajiv; Mehta, Gautam

doi:10.1007/s12072-022-10364-1

Cited by 39 publications

(48 citation statements)

References 63 publications

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“…The main biochemical abnormality detected is an elevation in aminotransferase levels, often mild, observed in more than 20% of cases, with a subsequent minimal increase in bilirubin levels (10% of patients), while the increase in gamma-glutamyl transferase and alkaline phosphatase is uncommon [ 2 , 5 ]. Liver damage is not responsible for high mortality or severe illness in patients with SARS-CoV-2 infection, but it seems that COVID-19 infection may affect liver disease progression [ 6 ]. The main mechanism is linked to an exaggerated release of inflammatory cytokines and the activation of the inflammasome pathway in target cells, following SARS-CoV-2 infection, mostly in patients with cirrhosis [ 6 ].…”

Section: Risks Of Covid-19 and Serious Illness From Covid-19 In Patie...mentioning

confidence: 99%

“…Liver damage is not responsible for high mortality or severe illness in patients with SARS-CoV-2 infection, but it seems that COVID-19 infection may affect liver disease progression [ 6 ]. The main mechanism is linked to an exaggerated release of inflammatory cytokines and the activation of the inflammasome pathway in target cells, following SARS-CoV-2 infection, mostly in patients with cirrhosis [ 6 ]. In particular, patients with cirrhosis have high overall mortality for COVID-19 (32%), increasing with each Child–Pugh class (patients with CLD without cirrhosis, as well as general population: 8%, Child–Pugh A 19%, Child–Pugh B 35%, Child–Pugh C 51%) [ 7 ].…”

Section: Risks Of Covid-19 and Serious Illness From Covid-19 In Patie...mentioning

confidence: 99%

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Impact of SARS-CoV-2 Pandemic on the Management of Patients with Hepatocellular Carcinoma

Guarino

Cossiga

Capasso

et al. 2022

JCM

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Worldwide, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) significantly increases mortality and morbidity. The Coronavirus Disease 2019 (COVID-19) outbreak has had a considerable impact on healthcare systems all around the world, having a significant effect on planned patient activity and established care pathways, in order to meet the difficult task of the global pandemic. Patients with hepatocellular carcinoma (HCC) are considered a particularly susceptible population and conceivably at increased risk for severe COVID-19 because of two combined risk factors: chronic advanced liver disease and HCC itself. In these challenging times, it is mandatory to reshape clinical practice in a prompt way to preserve the highest standards of patient care and safety. However, due to the stay-at-home measures instituted to stop the spread of COVID-19, HCC surveillance has incurred a dramatic drop, and care for HCC patients has been rearranged by refining the algorithm for HCC treatment to the COVID-19 pandemic, permitting these patients to be safely managed by identifying those most at risk of neoplastic disease progression.

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Section: Risks Of Covid-19 and Serious Illness From Covid-19 In Patie...mentioning

confidence: 99%

Section: Risks Of Covid-19 and Serious Illness From Covid-19 In Patie...mentioning

confidence: 99%

Impact of SARS-CoV-2 Pandemic on the Management of Patients with Hepatocellular Carcinoma

Guarino

Cossiga

Capasso

et al. 2022

JCM

View full text Add to dashboard Cite

show abstract

“…COVID-19 associated liver injury is defined as liver injury directly due to the virus or its treatment in patients with or without preexisting liver damage[ 29 ]. The exact mechanism of liver injury in the presence of SARS-CoV-2 infection is largely unknown[ 30 ]. It has been described that this virus enters the cell through angiotensin converting enzyme 2 (ACE2) receptors, which are abundant in many areas of the body, including cholangiocytes and hepatocytes.…”

Section: Sars-cov-2 Effects On the Livermentioning

confidence: 99%

“…In addition, a direct relationship between the grade of liver injury and severity of the disease has been established[ 33 ]. Elevated liver enzymes appear to be a risk factor for disease progression, even in the absence of underlying liver disease[ 30 ]. Mild aspartate transaminase (AST) elevation is considered an early sign of severe COVID-19, while high alanine transaminase (ALT) levels are considered an independent predictor of prolonged SARS-CoV-2 RNA shedding.…”

Section: Sars-cov-2 Effects On the Livermentioning

confidence: 99%

Alcohol use disorder and liver injury related to the COVID-19 pandemic

Marano¹,

Traversi²,

Gaetani³

et al. 2022

World J Hepatol

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Alcohol use disorder is a complex and heterogeneous phenomenon that can be studied from several points of view by focusing on its different components. Alcohol is a hepatotoxin whose metabolism creates profound alterations within the hepatocyte. The liver is the central organ in the metabolism of alcohol, a process that also involves other organs and tissues such as the brain, heart and muscles, but the most relevant organ is the liver. The anatomopathological alterations in the liver associated with the prolonged use of alcohol range from the simple accumulation of neutral fats in the hepatocytes, to cirrhosis and hepatocellular carcinoma. Alcohol abuse frequently leads to liver disease such as steatosis, steatohepatitis, fibrosis, cirrhosis, and tumors. Following the spread of coronavirus disease 2019 (COVID-19), there was an increase in alcohol consumption, probably linked to the months of lockdown and smart working. It is known that social isolation leads to a considerable increase in stress, and it is also recognized that high levels of stress can result in an increase in alcohol intake. Cirrhotic patients or subjects with liver cancer are immunocompromised, so they may be more exposed to COVID-19 infection with a worse prognosis. This review focuses on the fact that the COVID-19 pandemic has made the emergence of alcohol-induced liver damage a major medical and social problem.

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“…[3][4][5][6] While the impact of COVID-19 on the liver remains unclear, a considerable proportion of patients with elevated liver enzyme have been reported. [6][7][8] Some studies found a mild [1-2 times the upper limit of normal (ULN)] increase in transaminases, while severe liver injury has also been reported. 3,9,10 However, information related to the clinical course of COVID-19 patients with liver injury is very limited, especially in severe and critical patients.…”

Section: Introductionmentioning

confidence: 99%

Clinical Course and Risk Factors for Liver Injury of Severe and Critical Patients with COVID-19

Du¹,

Yang²,

Li³

et al. 2022

IDR

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Introduction Information regarding the clinical course of COVID-19 patients with liver injury is very limited, especially in severe and critical patients. The objective of this study was to describe the characteristics and clinical course of liver function in patients admitted with severe and/or critical SARS-CoV-2 infection, as well as explore the risk factors that affect liver function in the enrolled COVID-19 patients. Methods Information on clinical characteristics of 63 severe and critical patients with confirmed COVID-19 was collected. Data on patients’ demographics, laboratory characteristics, laboratory examination, SARS-CoV-2 RNA results and liver test parameters were acquired and analyzed. Results The incidence of abnormal aspartate aminotransferase, alanine aminotransferase, and total bilirubin in the critical group was significantly higher than in the severe group (respectively 81.48%, 81.49%, 62.67%, and 45.71%, 63.88%, 22.86%, p < 0.05). The time for liver function parameters to reach their extremes was approximately 2–3 weeks after admission. The independent factors associated with liver injury were patients with invasive ventilators, decreased percentages of neutrophils, lymphocytes and monocytes, and sequential organ failure assessment (SOFA) score ≥2 (p < 0.05). Conclusion Abnormal liver tests are commonly observed in severe and critical patients with COVID-19. Severe patients infected by SARS-CoV-2 should be closely observed and monitored the liver function parameters, particularly when they present with independent risk factors for liver injury.

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SARS-CoV-2 infection and liver involvement

Cited by 39 publications

References 63 publications

Impact of SARS-CoV-2 Pandemic on the Management of Patients with Hepatocellular Carcinoma

Impact of SARS-CoV-2 Pandemic on the Management of Patients with Hepatocellular Carcinoma

Alcohol use disorder and liver injury related to the COVID-19 pandemic

Clinical Course and Risk Factors for Liver Injury of Severe and Critical Patients with COVID-19

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