Liver Injury in COVID-19 Patients

2022 ◽  
pp. 141-158
Author(s):  
Tiziano Balzano ◽  
Omar El Hiba ◽  
Natalia López-González del Rey ◽  
Souad El Amine ◽  
Kamal Smimih
Keyword(s):  
Liver Disease ◽  
Liver Injury ◽  
Severe Acute Respiratory Syndrome ◽  
Respiratory Tract ◽  
Liver Damage ◽  
Rapid Onset ◽  
Test Results ◽  
Direct Injury ◽  
Inflammatory State ◽  
Abnormal Liver Test

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) preferentially infects cells in the respiratory tract, but several studies have also demonstrated low levels of SARS-CoV-2 copies in the liver. The hypothesis that patients with COVID-19 may develop liver dysfunction is supported by findings showing abnormal liver test results in such patients, but the exact mechanisms by which SARS-CoV-2 induces liver damage remain unclear. Liver injury in COVID-19 patients has probably a multifactorial etiology including the rapid onset of a systemic pro-inflammatory state due to viral infection, the use of potentially hepatotoxic drugs, pneumonia-associated hypoxia, and the eventual direct injury of the liver by SARS-CoV-2. This chapter will discuss the potential pathophysiological mechanisms for SARS-CoV-2 hepatic tropism and an overview about the main biochemical and histopathological findings observed in liver from COVID-19 patients. Finally, the effects that this infection can produce in patients with chronic liver disease will be also discussed.

scholarly journals Potential Effects of Coronaviruses on the Liver: An Update

2021 ◽  
Vol 8 ◽  
Author(s):  
Xinyi Wang ◽  
Jianyong Lei ◽  
Zhihui Li ◽  
Lunan Yan
Keyword(s):  
Clinical Trials ◽  
Liver Disease ◽  
Liver Injury ◽  
Severe Acute Respiratory Syndrome ◽  
Respiratory Tract ◽  
Liver Diseases ◽  
Direct Damage ◽  
Animal Trials ◽  
Immune Mediated ◽  
Coronavirus Infection

The coronaviruses that cause notable diseases, namely, severe acute respiratory syndrome (SARS), middle east respiratory syndrome (MERS) and coronavirus disease 2019 (COVID-19), exhibit remarkable similarities in genomic components and pathogenetic mechanisms. Although coronaviruses have widely been studied as respiratory tract pathogens, their effects on the hepatobiliary system have seldom been reported. Overall, the manifestations of liver injury caused by coronaviruses typically involve decreased albumin and elevated aminotransferase and bilirubin levels. Several pathophysiological hypotheses have been proposed, including direct damage, immune-mediated injury, ischemia and hypoxia, thrombosis and drug hepatotoxicity. The interaction between pre-existing liver disease and coronavirus infection has been illustrated, whereby coronaviruses influence the occurrence, severity, prognosis and treatment of liver diseases. Drugs and vaccines used for treating and preventing coronavirus infection also have hepatotoxicity. Currently, the establishment of optimized therapy for coronavirus infection and liver disease comorbidity is of significance, warranting further safety tests, animal trials and clinical trials.

scholarly journals COVID-19 and Liver injury: hepatology perspectives

2020 ◽  
Vol 2 (3) ◽  
pp. 01-04
Author(s):  
Irami Filho
Keyword(s):  
Liver Disease ◽  
Liver Injury ◽  
Severe Acute Respiratory Syndrome ◽  
Angiotensin Converting Enzyme ◽  
Liver Damage ◽  
Clinical Manifestations ◽  
Protein S ◽  
Clinical Syndrome ◽  
Converting Enzyme ◽  
Angiotensin Converting Enzyme 2

SARS-CoV-2, a severe acute respiratory syndrome caused by Coronavirus 2, discovered in 2019 in China, is responsible for the current pandemic declared by the WHO since March 2020. The clinical syndrome caused by Covid-19 has a broad spectrum of severity. The most common clinical manifestations are fever, dry cough, dyspnea, fatigue, and anosmia. The virus binds to receptors for angiotensin-converting enzyme 2 (ECA2) and serine protease TMPRSS2 for protein S initiation, which are expressed not only in the lungs but also in the liver, colonic, esophageal and biliary epithelial cells. In this context, the liver is a potential target for COVID-19 infection. Liver damage occurs during the course and treatment of viral infection in patients with or without previous liver disease. Therefore, the characteristics of liver injury associated with COVID-19 were reviewed based on research related, in the context of the pandemic.

Drugs and liver damage

2010 ◽  
pp. 2527-2537
Author(s):  
J. Neuberger
Keyword(s):  
Liver Disease ◽  
Liver Injury ◽  
Pulmonary Tuberculosis ◽  
Liver Damage ◽  
Case History ◽  
Genetic Component ◽  
Drug Induced ◽  
Drug Induced Liver Injury ◽  
Almost All

Case History—A 22 yr old man, being treated for pulmonary tuberculosis, now presenting with confusion and jaundice. Drug-induced liver injury (DILI) is relatively uncommon but can very rarely be fatal. Almost all patterns of liver disease can be induced by drugs, and some drugs may be associated with more than one type of reaction. Some cases of DILI have a genetic component. Most cases present with jaundice and/or hepatitis....

scholarly journals Implications of Liver Injury in Risk-Stratification and Management of Patients with COVID-19

2020 ◽  
Author(s):  
Jiaofang Shao ◽  
Yuan Liang ◽  
Yan Li ◽  
Rong Ding ◽  
Mengyan Zhu ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Injury ◽  
Expression Profiles ◽  
Gene Expression Profiles ◽  
Cell Types ◽  
Test Results ◽  
Severity Of Disease ◽  
Liver Injuries ◽  
Laboratory Test Results ◽  
Score Model

Abstract BackgroundInfection with SARS-CoV-2 has been associated with liver dysfunction, aggravation of liver burden, and liver injury. This study aimed to assess the effects of liver injuries on the clinical outcomes of patients with COVID-19.MethodsA total of 1,564 patients with severe or critical COVID-19 from Huoshenshan Hospital, Wuhan, were enrolled. Chronic liver disease (CLD) was confirmed by consensus diagnostic criteria. Laboratory test results were compared between different groups. scRNA-seq data and bulk gene expression profiles were used to identify cell types associated with liver injury.ResultsA total of 10.98% of patients with severe or critical COVID-19 developed liver injury after admission that was associated with significantly higher rates of mortality (21.74%, p<0.001) and intensive care unit admission (26.71%, p<0.001). A pre-existing CLD was not associated with a higher risk. However, fatty liver disease and cirrhosis were associated with higher risks, supported by evidences from single cell and bulk transcriptome analysis that showed more TMPRSS2+ cells in these tissues. By generating a model, we were able to predict the risk and severity of liver injury during hospitalization.ConclusionWe demonstrate that liver injury occurring during therapy in patients with COVID-19 is significantly associated with the severity of disease and mortality, but the presence of CLD is not associated. We provide a risk-score model that can predict whether patients with COVID-19 will develop liver injury or proceed to higher risk stages during subsequent hospitalizations. These findings may prove beneficial for the clinical management of patients infected with SARS-CoV-2.

Hepatology

2012 ◽  
Author(s):  
John J. Poterucha
Keyword(s):  
Liver Disease ◽  
Cost Effective ◽  
Biliary Cirrhosis ◽  
Test Results ◽  
Liver Test ◽  
Effective Manner ◽  
Chief Complaints ◽  
History Of ◽  
Abnormal Liver Test ◽  
Cholestatic Diseases

The evaluation of patients who have abnormal liver test results includes many clinical factors: the chief complaints of the patient, patient age, risk factors for liver disease, personal or family history of liver disease, medications, and physical examination findings. Because of these many factors, designing a standard algorithm for the evaluation of abnormal liver test results is difficult and often inefficient. Nevertheless, with basic information, abnormalities can be evaluated in an efficient, cost-effective manner. Diseases that predominantly affect the biliary system are called cholestatic diseases. They can affect the microscopic ducts (eg, primary biliary cirrhosis) or the large bile ducts (eg, pancreatic cancer causing obstruction of the common bile duct), or both (eg, primary sclerosing cholangitis).

scholarly journals Direct or Collateral Liver Damage in SARS-CoV-2–Infected Patients

2020 ◽  
Vol 40 (03) ◽  
pp. 321-330
Author(s):  
Maria J. Lizardo-Thiebaud ◽  
Eduardo Cervantes-Alvarez ◽  
Nathaly Limon-de la Rosa ◽  
Farid Tejeda-Dominguez ◽  
Mildred Palacios-Jimenez ◽  
...  
Keyword(s):  
Liver Disease ◽  
Liver Injury ◽  
Liver Damage ◽  
Cytopathic Effect ◽  
Liver Enzymes ◽  
Collateral Damage ◽  
Viral Response ◽  
Immune Mediated ◽  
Vascular Congestion ◽  
Elevated Liver Enzymes

AbstractLiver injury can result from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with more than one-third of COVID-19 patients exhibiting elevated liver enzymes. Microvesicular steatosis, inflammation, vascular congestion, and thrombosis in the liver have been described in autopsy samples from COVID-19 patients. Several factors, including direct cytopathic effect of the virus, immune-mediated collateral damage, or an exacerbation of preexisting liver disease may contribute to liver pathology in COVID-19. Due to its immunological functions, the liver is an organ likely to participate in the viral response against SARS-CoV-2 and this may predispose it to injury. A better understanding of the mechanism contributing to liver injury is needed to develop and implement early measures to prevent serious liver damage in patients suffering from COVID-19. This review summarizes current reports of SARS-CoV-2 with an emphasis on how direct infection and subsequent severe inflammatory response may contribute to liver injury in patients with and without preexisting liver disease.

scholarly journals Liver Disease - A Concern in SARS-COV2 Infection

2020 ◽  
Author(s):  
Prosenjit Mondal ◽  
Surbhi Dogra
Keyword(s):  
Liver Disease ◽  
Liver Injury ◽  
Severe Acute Respiratory Syndrome ◽  
Liver Function ◽  
Poor Prognosis ◽  
Clinical Characteristics ◽  
Hepatic Injury ◽  
Clinical Symptoms ◽  
Cardiac Diseases ◽  
Global Pandemic

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of coronavirus disease (COVID-19) that has resulted in a global pandemic. The clinical symptoms of the disease vary from mild illness to acute respiratory issues. Older age, diabetes, cardiac diseases predict poor prognosis in COVID-19 patients. Various reports mention the incidence of liver injury with transient elevations in the levels of aminotransferases (liver function enzymes). The clinical characteristics, etiology and underlying pathophysiological mechanisms associated with liver damage in SARS-CoV2 infected patients need to be explored. This review highlights the severity of the hepatic injury in COVID-19.

Hepatic Disorders

2016 ◽  
pp. 251-270
Author(s):  
William Sanchez ◽  
John J. Poterucha
Keyword(s):  
Risk Factors ◽  
Liver Disease ◽  
Family History ◽  
Physical Examination ◽  
Cost Effective ◽  
Test Results ◽  
Liver Test ◽  
Effective Manner ◽  
History Of ◽  
Abnormal Liver Test

The evaluation of patients who have abnormal liver test results includes many clinical factors: the patient’s symptoms, age, risk factors for liver disease, personal or family history of liver disease, medications, and physical examination findings. A standard algorithm can aid in evaluating abnormal liver test results in an efficient, cost-effective manner.

scholarly journals Iron-Induced Liver Injury: A Critical Reappraisal

2019 ◽  
Vol 20 (9) ◽  
pp. 2132 ◽  
Author(s):  
Steven A. Bloomer ◽  
Kyle E. Brown
Keyword(s):  
Liver Disease ◽  
Animal Models ◽  
Liver Injury ◽  
Iron Overload ◽  
Liver Damage ◽  
Human Liver ◽  
Hereditary Hemochromatosis ◽  
Hepatitis C Infection ◽  
Nonalcoholic Fatty Liver ◽  
Hepatocyte Necrosis

Iron is implicated in the pathogenesis of a number of human liver diseases. Hereditary hemochromatosis is the classical example of a liver disease caused by iron, but iron is commonly believed to contribute to the progression of other forms of chronic liver disease such as hepatitis C infection and nonalcoholic fatty liver disease. In this review, we present data from cell culture experiments, animal models, and clinical studies that address the hepatotoxicity of iron. These data demonstrate that iron overload is only weakly fibrogenic in animal models and rarely causes serious liver damage in humans, calling into question the concept that iron overload is an important cause of hepatotoxicity. In situations where iron is pathogenic, iron-induced liver damage may be potentiated by coexisting inflammation, with the resulting hepatocyte necrosis an important factor driving the fibrogenic response. Based on the foregoing evidence that iron is less hepatotoxic than is generally assumed, claims that assign a causal role to iron in liver injury in either animal models or human liver disease should be carefully evaluated.

scholarly journals 6-O-galloylsalidroside, an active ingredient from Acer tegmentosum, ameliorates alcoholic steatosis and liver injury in a mouse model of chronic ethanol consumption

2019 ◽  
Author(s):  
Young Han Kim ◽  
Dong-Cheol Woo ◽  
Moonjin Ra ◽  
Sangmi Jung ◽  
Su Jung Ham ◽  
...  
Keyword(s):  
Liver Disease ◽  
Magnetic Resonance ◽  
Alcohol Consumption ◽  
Liver Injury ◽  
Fatty Liver ◽  
Liver Damage ◽  
Active Ingredient ◽  
Alcoholic Fatty Liver ◽  
Fat Accumulation ◽  
Hepatocellular Damage

AbstractWe previously reported that Acer tegmentosum extract, which is traditionally used to treat liver disease in Korea, may help reduce fat accumulation, improve liver metabolism, and suppress inflammation in alcoholic liver disease. The active ingredient was found to be 6-O-galloylsalidroside, which was isolated from the methanol extract of A. tegmentosum. We hypothesized that 6-O-galloylsalidroside extracted from A. tegmentosum may help protect from liver damage and attenuate hepatic fat accumulation associated with chronic alcohol consumption. In the present study, we aimed to investigate whether 6-O-galloylsalidroside can regulate alcoholic fatty liver and liver injury in mice. For this purpose, mice were fed with Lieber-DeCarli 5% ethanol diet for 11 days to induce steatosis and liver injury. Oral 6-O-galloylsalidroside was administered once a day for 11 days. Intrahepatic lipid accumulation caused by alcohol consumption was measured using in vivo 1H magnetic resonance imaging. Hepatic steatosis was observed histologically in tissue samples stained with hematoxylin and eosin, as well as Oil Red O. The serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were measured, as well as the triglyceride content in liver homogenates. On magnetic resonance spectroscopy, 6-O-galloylsalidroside appeared to alleviate alcohol-induced steatosis, which was reflected in decreased hepatic and serum triglyceride levels despite ethanol feeding. Furthermore, 6-O-galloylsalidroside treatment was associated with decreased RNA expression of Cd36, which plays an important role in the development of alcoholic steatosis through the hepatic de novo lipogenesis pathway. Furthermore, treatment with 6-O-galloylsalidroside inhibited the expression of cytochrome P4502E1 and attenuated hepatocellular damage, reflected in reduced ALT and AST levels. These findings suggest that 6-O-galloylsalidroside extracted from A. tegmentosum might serve as a bioactive agent for treating alcoholic fatty liver and liver damage.

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