The Impact of Coronavirus Disease 2019 (COVID-19) on Liver Injury in China: A Systematic Review and Meta-analysis

Zhao, Xin; Lei, Zehua; Gao, Fengwei; Xie, Qingyun; Jang, Kangyi; Wu, Jianping; Fu, Jinqiang; Du, Bo; Wang, Zhixu

doi:10.1101/2020.05.03.20089557

Cited by 8 publications

(18 citation statements)

References 51 publications

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“…Currently, the pathological impact of COVID-19 on the liver is still largely unknown. 19 , 20 In our current study, we found that 51.7% of patients on admission had abnormal liver function. Previous investigations have proposed that COVID-19 triggers hepatic injury by inducing viral hepatitis.…”

Section: Discussionsupporting

confidence: 48%

The clinical implication of gamma-glutamyl transpeptidase in COVID-19

Liu

Yang

et al. 2021

Liver Research

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Background and aim Coronavirus disease 2019 (COVID-19) is a life-threatening disease that predominantly causes respiratory failure. The impact of COVID-19 on other organs remains elusive. Herein, we aimed to investigate the effects of COVID-19 on the hepatobiliary system. Methods In the current study, we obtained the clinical records and laboratory results from 66 laboratory-confirmed patients with COVID-19 at the Wuhan Tongji Hospital between 10 February 2020 and 28 February 2020. The detailed clinical features and laboratory findings were collected for analysis. Bioinformatics analysis was conducted to evaluate the correlation between gamma-glutamyl transferase (GGT) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) entry receptor angiotensin-converting enzyme 2 (ACE2). Results In this cohort, 30 (51.7%) patients had abnormal liver function on admission, which was associated with disease severity and enriched in the male and diabetic patients. The elevated levels of direct bilirubin ( P = 0.029) and GGT ( P = 0.004) were common in patients with severe pneumonia when compared with those with mild pneumonia. In addition, elevated levels of GGT ( P = 0.003) and aspartate aminotransferase (AST) ( P = 0.007) were positively associated with longer hospital stay. The expression of ACE2 was closely associated with GGT in various human tissues because they shared the common transcriptional regulator hepatic nuclear factor-1β (HNF1B). Conclusions Increased GGT levels were common in severe cases and elevated GGT levels were positively associated with prolonged hospital stay and disease severity. Due to the consistent expression with ACE2, GGT is a potent biomarker indicating the susceptibility of SARS-CoV-2 infection.

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Section: Discussionsupporting

confidence: 48%

The clinical implication of gamma-glutamyl transpeptidase in COVID-19

Liu

Yang

et al. 2021

Liver Research

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“…2 3 Most patients with COVID-19 have dyspnoea as the main clinical manifestation, and some cases may be complicated by heart, kidney, circulatory, liver, nerve and other multisystem injuries. [4][5][6][7][8] These patients may eventually die of diffuse alveolar injury and progressive respiratory failure. The cytokine storm syndrome involved in the pathogenesis of acute respiratory distress syndrome and organ failure during SARS-CoV infection seems to be related to a massive inflammatory reaction.…”

Section: Introductionmentioning

confidence: 99%

Risk factors and prognosis for COVID-19-induced acute kidney injury: a meta-analysis

et al. 2020

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ObjectiveTo analyse the incidence, risk factors and impact of acute kidney injury (AKI) on the prognosis of patients with COVID-19.DesignMeta-analysis.Data sourcesPubMed, Embase, CNKI and MedRxiv of Systematic Reviews from 1 January 2020 to 15 May 2020.Study selectionStudies examining the following demographics and outcomes were included: patients’ age; sex; incidence of and risk factors for AKI and their impact on prognosis; COVID-19 disease type and incidence of continuous renal replacement therapy (CRRT) administration during COVID-19 infection.ResultsA total of 79 research articles, including 49 692 patients with COVID-19, met the systemic evaluation criteria. The mortality rate and incidence of AKI in patients with COVID-19 in China were significantly lower than those in patients with COVID-19 outside China. A significantly higher proportion of patients with COVID-19 from North America were aged ≥65 years and also developed AKI. European patients with COVID-19 had significantly higher mortality and a higher CRRT rate than patients from other regions. Further analysis of the risk factors for COVID-19 combined with AKI showed that age ≥60 years and severe COVID-19 were independent risk factors for AKI, with an OR of 3.53, 95% CI (2.92–4.25) and an OR of 6.07, 95% CI (2.53–14.58), respectively. The CRRT rate in patients with severe COVID-19 was significantly higher than in patients with non-severe COVID-19, with an OR of 6.60, 95% CI (2.83–15.39). The risk of death in patients with COVID-19 and AKI was significantly increased, with an OR of 11.05, 95% CI (9.13–13.36).ConclusionAKI was a common and serious complication of COVID-19. Older age and having severe COVID-19 were independent risk factors for AKI. The risk of in-hospital death was significantly increased in patients with COVID-19 complicated by AKI.

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“…19 infection compared to patients with milder symptoms (OR 2.07) (7). However, severe liver injury, defined as ALT or AST >3-fold or g-GT, ALP and bilirubin >2-fold above normal, during COVID-19 rarely occurs (10)(11)(12).…”

Section: Accepted Manuscriptmentioning

confidence: 99%

Liver, NAFLD and COVID-19

Hoffmann¹,

Gerber²,

Cavelti-Weder³

et al. 2022

Horm Metab Res

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Coronavirus disease 2019 (COVID-19) is characterized by a wide clinical spectrum that includes abnormalities in liver function indicative of liver damage. Conversely, people with liver diseases are at higher risk of severe COVID-19. In the current review, we summarize first the epidemiologic evidence describing the bidirectional relationship between COVID-19 and liver function/liver diseases. Additionally, we present the most frequent histologic findings as well as the most important direct and indirect mechanisms supporting a COVID-19 mediated liver injury. Furthermore, we focus on the most frequent liver disease in the general population, non-alcoholic or metabolic-associated fatty liver disease (NAFLD/MAFLD), and describe how COVID-19 may affect NAFLD/MAFLD development and progression and conversely how NAFLD/MAFLD may further aggravate a COVID-19 infection. Finally, we present the long-term consequences of the pandemic on the development and management of NAFLD.

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The Impact of Coronavirus Disease 2019 (COVID-19) on Liver Injury in China: A Systematic Review and Meta-analysis

Cited by 8 publications

References 51 publications

The clinical implication of gamma-glutamyl transpeptidase in COVID-19

The clinical implication of gamma-glutamyl transpeptidase in COVID-19

Risk factors and prognosis for COVID-19-induced acute kidney injury: a meta-analysis

Liver, NAFLD and COVID-19

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