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Singh L, Kumar A, Rai M, Basnet B, Rai N, Khanal P, Lai KS, Cheng WH, Asaad AM, Ansari S. Spectrum of COVID-19 induced liver injury: A review report. World J Hepatol 2024; 16:517-536. [PMID: 38689748 PMCID: PMC11056898 DOI: 10.4254/wjh.v16.i4.517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/20/2024] [Accepted: 02/28/2024] [Indexed: 04/24/2024] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic has caused changes in the global health system, causing significant setbacks in healthcare systems worldwide. This pandemic has also shown resilience, flexibility, and creativity in reacting to the tragedy. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection targets most of the respiratory tract, resulting in a severe sickness called acute respiratory distress syndrome that may be fatal in some individuals. Although the lung is the primary organ targeted by COVID-19 viruses, the clinical aspect of the disease is varied and ranges from asymptomatic to respiratory failure. However, due to an unorganized immune response and several affected mechanisms, the liver may also experience liver cell injury, ischemic liver dysfunction, and drug-induced liver injury, which can result in respiratory failure because of the immune system's disordered response and other compromised processes that can end in multisystem organ failure. Patients with liver cirrhosis or those who have impaired immune systems may be more likely than other groups to experience worse results from the SARS-CoV-2 infection. We thus intend to examine the pathogenesis, current therapy, and consequences of liver damage concerning COVID-19.
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Affiliation(s)
- Lokjan Singh
- Department of Microbiology, Karnali Academy of Health Science, Teaching Hospital, Jumla 21200, Karnali, Nepal
| | - Anil Kumar
- Department of Microbiology, Karnali Academy of Health Science, Teaching Hospital, Jumla 21200, Karnali, Nepal
| | - Maya Rai
- Department of Microbiology, Karnali Academy of Health Science, Teaching Hospital, Jumla 21200, Karnali, Nepal
| | - Bibek Basnet
- Health Sciences, Asian College of Advance Studies, Purbanchal University, Satdobato 24122, Lalitpur, Nepal
| | - Nishant Rai
- Department of Biotechnology, Graphic Era (Deemed to be University), Dehradun 248002, Uttarakhand, India
| | - Pukar Khanal
- Department of Pharmacology & Toxicology, KLE College of Pharmacy, Belagavi, KLE Academy of Higher Education and Research, Belagavi 590010, Karnataka, India
| | - Kok-Song Lai
- Division of Health Sciences, Abu Dhabi Women's College, Higher Colleges of Technology, Abu Dhabi 41012, United Arab Emirates
| | - Wan-Hee Cheng
- Health and Life Sciences, INTI International University, Nilai 71800, Malaysia
| | - Ahmed Morad Asaad
- Department of Microbiology, College of Medicine, Zagazig University, Zagazig 44519, Egypt
| | - Shamshul Ansari
- Division of Health Sciences, Abu Dhabi Women's College, Higher Colleges of Technology, Abu Dhabi 41012, United Arab Emirates.
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Michalak A, Lach T, Szczygieł K, Cichoż-Lach H. COVID-19, Possible Hepatic Pathways and Alcohol Abuse-What Do We Know up to 2023? Int J Mol Sci 2024; 25:2212. [PMID: 38396888 PMCID: PMC10888568 DOI: 10.3390/ijms25042212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/25/2024] Open
Abstract
The pandemic period due to coronavirus disease 2019 (COVID-19) revolutionized all possible areas of global health. Significant consequences were also related to diverse extrapulmonary manifestations of this pathology. The liver was found to be a relatively common organ, beyond the respiratory tract, affected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Multiple studies revealed the essential role of chronic liver disease (CLD) in the general outcome of coronavirus infection. Present concerns in this field are related to the direct hepatic consequences caused by COVID-19 and pre-existing liver disorders as risk factors for the severe course of the infection. Which mechanism has a key role in this phenomenon-previously existing hepatic disorder or acute liver failure due to SARS-CoV-2-is still not fully clarified. Alcoholic liver disease (ALD) constitutes another not fully elucidated context of coronavirus infection. Should the toxic effects of ethanol or already developed liver cirrhosis and its consequences be perceived as a causative or triggering factor of hepatic impairment in COVID-19 patients? In the face of these discrepancies, we decided to summarize the role of the liver in the whole picture of coronavirus infection, paying special attention to ALD and focusing on the pathological pathways related to COVID-19, ethanol toxicity and liver cirrhosis.
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Affiliation(s)
- Agata Michalak
- Department of Gastroenterology with Endoscopy Unit, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland;
| | - Tomasz Lach
- Department of Orthopedics and Traumatology, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland;
| | - Karolina Szczygieł
- Clinical Dietetics Unit, Department of Bioanalytics, Medical University of Lublin, Chodźki 7, 20-093 Lublin, Poland;
| | - Halina Cichoż-Lach
- Department of Gastroenterology with Endoscopy Unit, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland;
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3
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Wang Y, Shen M, Li Y, Shao J, Zhang F, Guo M, Zhang Z, Zheng S. COVID-19-associated liver injury: Adding fuel to the flame. Cell Biochem Funct 2023; 41:1076-1092. [PMID: 37947373 DOI: 10.1002/cbf.3883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/19/2023] [Accepted: 10/21/2023] [Indexed: 11/12/2023]
Abstract
COVID-19 is mainly characterized by respiratory disorders and progresses to multiple organ involvement in severe cases. With expansion of COVID-19 and SARS-CoV-2 research, correlative liver injury has been revealed. It is speculated that COVID-19 patients exhibited abnormal liver function, as previously observed in the SARS and MERS pandemics. Furthermore, patients with underlying diseases such as chronic liver disease are more susceptible to SARS-CoV-2 and indicate a poor prognosis accompanied by respiratory symptoms, systemic inflammation, or metabolic diseases. Therefore, COVID-19 has the potential to impair liver function, while individuals with preexisting liver disease suffer from much worse infected conditions. COVID-19 related liver injury may be owing to direct cytopathic effect, immune dysfunction, gut-liver axis interaction, and inappropriate medication use. However, discussions on these issues are infancy. Expanding research have revealed that angiotensin converting enzyme 2 (ACE2) expression mediated the combination of virus and target cells, iron metabolism participated in the virus life cycle and the fate of target cells, and amino acid metabolism regulated immune response in the host cells, which are all closely related to liver health. Further exploration holds great significance in elucidating the pathogenesis, facilitating drug development, and advancing clinical treatment of COVID-19-related liver injury. This article provides a review of the clinical and laboratory hepatic characteristics in COVID-19 patients, describes the etiology and impact of liver injury, and discusses potential pathophysiological mechanisms.
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Affiliation(s)
- Yingqian Wang
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Key Laboratory of Therapeutic Material of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Min Shen
- Institute of Translational Medicine, Medical College, Yangzhou University, Yangzhou, China
| | - Yujia Li
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Key Laboratory of Therapeutic Material of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Jiangjuan Shao
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Key Laboratory of Therapeutic Material of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Feng Zhang
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Key Laboratory of Therapeutic Material of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Mei Guo
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Key Laboratory of Therapeutic Material of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zili Zhang
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Key Laboratory of Therapeutic Material of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Shizhong Zheng
- Jiangsu Key Laboratory for Pharmacology and Safety Evaluation of Chinese Materia Medica, Nanjing University of Chinese Medicine, Nanjing, China
- Jiangsu Key Laboratory of Therapeutic Material of Chinese Medicine, Nanjing University of Chinese Medicine, Nanjing, China
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4
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Naik R, Avula S, Palleti SK, Gummadi J, Ramachandran R, Chandramohan D, Dhillon G, Gill AS, Paiwal K, Shaik B, Balachandran M, Patel B, Gurugubelli S, Mariswamy Arun Kumar AK, Nanjundappa A, Bellamkonda M, Rathi K, Sakhamuri PL, Nassar M, Bali A. From Emergence to Endemicity: A Comprehensive Review of COVID-19. Cureus 2023; 15:e48046. [PMID: 37916248 PMCID: PMC10617653 DOI: 10.7759/cureus.48046] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2023] [Indexed: 11/03/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), later renamed coronavirus disease 2019 (COVID-19), was first identified in Wuhan, China, in early December 2019. Initially, the China office of the World Health Organization was informed of numerous cases of pneumonia of unidentified etiology in Wuhan, Hubei Province at the end of 2019. This would subsequently result in a global pandemic with millions of confirmed cases of COVID-19 and millions of deaths reported to the WHO. We have analyzed most of the data published since the beginning of the pandemic to compile this comprehensive review of SARS-CoV-2. We looked at the core ideas, such as the etiology, epidemiology, pathogenesis, clinical symptoms, diagnostics, histopathologic findings, consequences, therapies, and vaccines. We have also included the long-term effects and myths associated with some therapeutics of COVID-19. This study presents a comprehensive assessment of the SARS-CoV-2 virology, vaccines, medicines, and significant variants identified during the course of the pandemic. Our review article is intended to provide medical practitioners with a better understanding of the fundamental sciences, clinical treatment, and prevention of COVID-19. As of May 2023, this paper contains the most recent data made accessible.
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Affiliation(s)
- Roopa Naik
- Medicine, Geisinger Commonwealth School of Medicine, Scranton, USA
- Internal Medicine/Hospital Medicine, Geisinger Health System, Wilkes Barre, USA
| | - Sreekant Avula
- Diabetes, Endocrinology, and Metabolism, University of Minnesota, Minneapolis, USA
| | - Sujith K Palleti
- Nephrology, Louisiana State University Health Sciences Center, Shreveport, USA
| | - Jyotsna Gummadi
- Internal Medicine, MedStar Franklin Square Medical Center, Baltimore, USA
| | | | | | - Gagandeep Dhillon
- Physician Executive MBA, University of Tennessee, Knoxville, USA
- Internal Medicine, University of Maryland Baltimore Washington Medical Center, Glen Burnie, USA
| | | | - Kapil Paiwal
- Oral & Maxillofacial Pathology, Daswani Dental College & Research Center, Kota, IND
| | - Bushra Shaik
- Internal Medicine, Onslow Memorial Hospital, Jacksonville, USA
| | | | - Bhumika Patel
- Oral Medicine and Radiology, Howard University, Washington, D.C., USA
| | | | | | | | - Mahita Bellamkonda
- Hospital Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, USA
| | - Kanika Rathi
- Internal Medicine, University of Florida, Gainesville, USA
| | | | - Mahmoud Nassar
- Endocrinology, Diabetes, and Metabolism, Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA
| | - Atul Bali
- Internal Medicine/Nephrology, Geisinger Medical Center, Danville, USA
- Internal Medicine/Nephrology, Geisinger Health System, Wilkes-Barre, USA
- Medicine, Geisinger Commonwealth School of Medicine, Scranton, USA
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5
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Aghamohamadi N, Shahba F, Zarezadeh Mehrabadi A, Khorramdelazad H, Karimi M, Falak R, Emameh RZ. Age-dependent immune responses in COVID-19-mediated liver injury: focus on cytokines. Front Endocrinol (Lausanne) 2023; 14:1139692. [PMID: 37654571 PMCID: PMC10465349 DOI: 10.3389/fendo.2023.1139692] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Accepted: 07/21/2023] [Indexed: 09/02/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is potentially pathogenic and causes severe symptoms; in addition to respiratory syndromes, patients might experience other severe conditions such as digestive complications and liver complications injury. The abnormality in the liver is manifested by hepatobiliary dysfunction and enzymatic elevation, which is associated with morbidity and mortality. The direct cytopathic effect, immune dysfunction, cytokine storm, and adverse effects of therapeutic regimens have a crucial role in the severity of liver injury. According to aging and immune system alterations, cytokine patterns may also change in the elderly. Moreover, hyperproduction of cytokines in the inflammatory response to SARS-CoV-2 can lead to multi-organ dysfunction. The mortality rate in elderly patients, particularly those with other comorbidities, is also higher than in adults. Although the pathogenic effect of SARS-CoV-2 on the liver has been widely studied, the impact of age and immune-mediated responses at different ages remain unclear. This review discusses the association between immune system responses in coronavirus disease 2019 (COVID-19) patients of different ages and liver injury, focusing on cytokine alterations.
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Affiliation(s)
- Nazanin Aghamohamadi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Faezeh Shahba
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Zarezadeh Mehrabadi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Khorramdelazad
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
- Department of Immunology, School of Medicine, Rafsanjan University of Medical Sciences, Rafsanjan, Iran
| | - Milad Karimi
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Falak
- Department of Immunology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Reza Zolfaghari Emameh
- Department of Energy and Environmental Biotechnology, National Institute of Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran
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6
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López-Hernández Y, Monárrez-Espino J, López DAG, Zheng J, Borrego JC, Torres-Calzada C, Elizalde-Díaz JP, Mandal R, Berjanskii M, Martínez-Martínez E, López JA, Wishart DS. The plasma metabolome of long COVID patients two years after infection. Sci Rep 2023; 13:12420. [PMID: 37528111 PMCID: PMC10394026 DOI: 10.1038/s41598-023-39049-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 07/19/2023] [Indexed: 08/03/2023] Open
Abstract
One of the major challenges currently faced by global health systems is the prolonged COVID-19 syndrome (also known as "long COVID") which has emerged as a consequence of the SARS-CoV-2 epidemic. It is estimated that at least 30% of patients who have had COVID-19 will develop long COVID. In this study, our goal was to assess the plasma metabolome in a total of 100 samples collected from healthy controls, COVID-19 patients, and long COVID patients recruited in Mexico between 2020 and 2022. A targeted metabolomics approach using a combination of LC-MS/MS and FIA MS/MS was performed to quantify 108 metabolites. IL-17 and leptin were measured in long COVID patients by immunoenzymatic assay. The comparison of paired COVID-19/long COVID-19 samples revealed 53 metabolites that were statistically different. Compared to controls, 27 metabolites remained dysregulated even after two years. Post-COVID-19 patients displayed a heterogeneous metabolic profile. Lactic acid, lactate/pyruvate ratio, ornithine/citrulline ratio, and arginine were identified as the most relevant metabolites for distinguishing patients with more complicated long COVID evolution. Additionally, IL-17 levels were significantly increased in these patients. Mitochondrial dysfunction, redox state imbalance, impaired energy metabolism, and chronic immune dysregulation are likely to be the main hallmarks of long COVID even two years after acute COVID-19 infection.
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Affiliation(s)
- Yamilé López-Hernández
- CONAHCyT-Metabolomics and Proteomics Laboratory, Academic Unit of Biological Sciences, Autonomous University of Zacatecas, 98000, Zacatecas, Mexico.
| | - Joel Monárrez-Espino
- Department of Health Research, Christus Muguerza del Parque Hospital - University of Monterrey, 31125, Chihuahua, Mexico
| | | | - Jiamin Zheng
- The Metabolomics Innovation Centre, University of Alberta, Edmonton, AB, T6G 1C9, Canada
| | - Juan Carlos Borrego
- Departamento de Epidemiología, Hospital General de Zona #1 "Emilio Varela Luján", Instituto Mexicano del Seguro Social, Zacatecas, 98000, México
| | | | - José Pedro Elizalde-Díaz
- Laboratory of Cell Communication & Extracellular Vesicles, Division of Basic Science, Instituto Nacional de Medicina Genómica, 14610, Ciudad de México, Mexico
| | - Rupasri Mandal
- The Metabolomics Innovation Centre, University of Alberta, Edmonton, AB, T6G 1C9, Canada
| | - Mark Berjanskii
- The Metabolomics Innovation Centre, University of Alberta, Edmonton, AB, T6G 1C9, Canada
| | - Eduardo Martínez-Martínez
- Laboratory of Cell Communication & Extracellular Vesicles, Division of Basic Science, Instituto Nacional de Medicina Genómica, 14610, Ciudad de México, Mexico
| | - Jesús Adrián López
- MicroRNAs and Cancer Laboratory, Academic Unit of Biological Sciences, Autonomous University of Zacatecas, 98000, Zacatecas, Mexico
| | - David S Wishart
- The Metabolomics Innovation Centre, University of Alberta, Edmonton, AB, T6G 1C9, Canada.
- Department of Biological Sciences, University of Alberta, Edmonton, AB, T6G 1C9, Canada.
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7
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Seyoum F. Mechanisms of severe acute respiratory syndrome coronavirus-2 induced liver damage and alteration of some liver biomarkers: A review. Medicine (Baltimore) 2023; 102:e33517. [PMID: 37171303 PMCID: PMC10174413 DOI: 10.1097/md.0000000000033517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023] Open
Abstract
The most serious problem for people suffering from severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection is liver damage. The liver is a frequently affected organ due to the metabolizing and detoxifying functions of several endogenous and exogenous molecules. In COVID-19-affected individuals, even moderate loss of hepatic function could dramatically affect the therapeutic efficacy of antiviral drugs metabolized in the liver. The clear mechanism of hepatocellular damage from SARS-CoV-2 infection is not fully understood. The main objective of this review is to identify potential mechanisms of SARS-2 induced liver damage, treatment outcomes in SARS-CoV-2-infected patients, and future direction. Electronic databases including Web of Science, Google Scholar, MEDLINE, Scopus, and Cochrane library were used to systematically search without limitation of publication date and status. Observational, retrospective cohort, prospective case-control, cohort studies, cross-sectional studies, or clinical trials were included. Liver damage in coronavirus patients is characterized by histopathological changes and abnormal elevation of some liver function tests. These abnormalities include elevation of Alanine aminotransferase, Aspartate aminotransferase, Gamma-glutamyl transferase, Alkaline phosphatase, and Serum bilirubin levels. Histopathological changes of the liver might consist of complete or partial thrombosis of the portal and sinusoidal vessels, portal tract fibrosis, and focally markedly enlarged and fibrotic hepatocytes. Understanding the fundamental molecular and immunological processes of COVID-19-related liver injury is essential for the selection of appropriate drugs and the logical development of successful treatment.
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Affiliation(s)
- Fikadu Seyoum
- Department of Medical Biochemistry, College of Medicine and Health Sciences, Ambo University, Addis Ababa, Ethiopia
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8
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Roshanshad R, Roshanshad A, Fereidooni R, Hosseini-Bensenjan M. COVID-19 and liver injury: Pathophysiology, risk factors, outcome and management in special populations. World J Hepatol 2023; 15:441-459. [PMID: 37206656 PMCID: PMC10190688 DOI: 10.4254/wjh.v15.i4.441] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 02/05/2023] [Accepted: 03/20/2023] [Indexed: 04/20/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 is an ongoing health concern. In addition to affecting the respiratory system, COVID-19 can potentially damage other systems in the body, leading to extra-pulmonary manifestations. Hepatic manifestations are among the common consequences of COVID-19. Although the precise mechanism of liver injury is still questionable, several mechanisms have been hypothesized, including direct viral effect, cytokine storm, hypoxic-ischemic injury, hypoxia-reperfusion injury, ferroptosis, and hepatotoxic medications. Risk factors of COVID-19-induced liver injury include severe COVID-19 infection, male gender, advanced age, obesity, and underlying diseases. The presentations of liver involvement comprise abnormalities in liver enzymes and radiologic findings, which can be utilized to predict the prognosis. Increased gamma-glutamyltransferase, aspartate aminotransferase, and alanine aminotransferase levels with hypoalbuminemia can indicate severe liver injury and anticipate the need for intensive care units’ hospitalization. In imaging, a lower liver-to-spleen ratio and liver computed tomography attenuation may indicate a more severe illness. Furthermore, chronic liver disease patients are at a higher risk for severe disease and death from COVID-19. Nonalcoholic fatty liver disease had the highest risk of advanced COVID-19 disease and death, followed by metabolic-associated fatty liver disease and cirrhosis. In addition to COVID-19-induced liver injury, the pandemic has also altered the epidemiology and pattern of some hepatic diseases, such as alcoholic liver disease and hepatitis B. Therefore, it warrants special vigilance and awareness by healthcare professionals to screen and treat COVID-19-associated liver injury accordingly.
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Affiliation(s)
- Romina Roshanshad
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz 7184731443, Iran
| | | | - Reza Fereidooni
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz 7134814336, Iran
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9
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Sadeghi Dousari A, Hosseininasab SS, Sadeghi Dousari F, Fuladvandi M, Satarzadeh N. The impact of COVID-19 on liver injury in various age. World J Virol 2023; 12:91-99. [PMID: 37033149 PMCID: PMC10075051 DOI: 10.5501/wjv.v12.i2.91] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 10/14/2022] [Accepted: 01/04/2023] [Indexed: 03/21/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) disease was first detected in December 2019 in Wuhan, China. This disease is currently one of the most important global health problems. The novel coronavirus COVID-19 is a respiratory illness, that has caused a deadly pandemic that is spreading rapidly around the world. It is not only a respiratory system virus that causes severe lung disease, but also a systemic disease agent that can affect all systems. People with COVID-19 disease usually have respiratory signs, however, the liver disorder is not an uncommon presentation. In addition, many studies around the world have revealed that the liver is injured to various degrees in patients with severe acute respiratory syndrome coronavirus 2 disease. This review mainly focuses on the impact of COVID-19 on Liver Injury at various ages.
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Affiliation(s)
- Amin Sadeghi Dousari
- Department of Microbiology, Jiroft University of Medical Sciences, Jiroft 7861634204, Iran
| | | | | | - Masoumeh Fuladvandi
- Department of Nursing, Aligoudarz School of Nursing, Lorestan University of Medical Sciences, Khorramabad 6813833946, Iran
| | - Naghmeh Satarzadeh
- Department of Pharmaceutical Biotechnology, Kerman University of Medical Sciences, Kerman 7616913555, Iran
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10
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Liptak P, Nosakova L, Rosolanka R, Skladany L, Banovcin P. Acute-on-chronic liver failure in patients with severe acute respiratory syndrome coronavirus 2 infection. World J Hepatol 2023; 15:41-51. [PMID: 36744167 PMCID: PMC9896507 DOI: 10.4254/wjh.v15.i1.41] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/03/2022] [Accepted: 11/29/2022] [Indexed: 01/16/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had a significant impact on the lives of millions of people, especially those with other concomitant diseases, such as chronic liver diseases. To date, seven coronaviruses have been identified to infect humans. The main site of pathological action of these viruses is lung tissue. However, a substantial number of studies have proven that SARS-CoV-2 shows affinity towards several organs, including the gastrointestinal tract and the liver. The current state of evidence points to several proposed mechanisms of liver injury in patients with COVID-19 and their combination. Liver impairment is considered to be the result of the direct effect of the virus on the hepatic tissue cells, a systemic reaction consisting of inflammation, hypoxia and cytokine storm, drug-induced liver injury, with the possible contribution of a perturbed gut-liver axis. Reactivation of chronic hepatic disease could be another factor for liver impairment in patients with SARS-CoV-2 infection. Acute-on-chronic liver failure (ACLF) is a relatively new syndrome that occurs in 10%–30% of all hospitalized patients with chronic liver disease. It is crucial to recognize high-risk patients due to the increased morbidity and mortality in these cases. Several published studies have reported virus infection as a trigger factor for ACLF. However, to date, there are few relevant studies describing the presence of ACLF in patients with acute SARS-CoV-2 infection. In this minireview we summarize the current state of knowledge regarding the relation between ACLF and acute SARS-CoV-2 infection.
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Affiliation(s)
- Peter Liptak
- Clinic of Internal Medicine-Gastroenterology, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University, Martin 03601, Slovakia
| | - Lenka Nosakova
- Clinic of Internal Medicine-Gastroenterology, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University, Martin 03601, Slovakia
| | - Robert Rosolanka
- Clinic of Infectology and Travel Medicine, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University, Martin 03601, Slovakia
| | - Lubomir Skladany
- Department of Internal Medicine II, Division Hepatology, Gastroenterology and Liver Transplantation, FD Roosevelt University Hospital of Slovak Medical University, Banska Bystrica 97517, Slovakia
| | - Peter Banovcin
- Clinic of Internal Medicine-Gastroenterology, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University, Martin 03601, Slovakia
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11
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Hepatic Disorders and COVID-19: From Pathophysiology to Treatment Strategy. Can J Gastroenterol Hepatol 2022; 2022:4291758. [PMID: 36531832 PMCID: PMC9754839 DOI: 10.1155/2022/4291758] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Revised: 10/31/2022] [Accepted: 11/12/2022] [Indexed: 12/13/2022] Open
Abstract
Following the SARS-CoV-2 outbreak and the subsequent development of the COVID-19 pandemic, organs such as the lungs, kidneys, liver, heart, and brain have been identified as priority organs. Liver diseases are considered a risk factor for high mortality from the COVID-19 pandemic. Besides, liver damage has been demonstrated in a substantial proportion of patients with COVID-19, especially those with severe clinical symptoms. Furthermore, antiviral medications, immunosuppressive drugs after liver transplantation, pre-existing hepatic diseases, and chronic liver diseases such as cirrhosis have also been implicated in SARS-CoV-2-induced liver injury. As a result, some precautions have been taken to prevent, monitor the virus, and avoid immunocompromised and susceptible individuals, such as liver and kidney transplant recipients, from being infected with SARS-CoV-2, thereby avoiding an increase in mortality. The purpose of this review was to examine the impairment caused by SARS-CoV-2 infection and the impact of drugs used during the pandemic on the mortality range and therefore the possibility of preventive measures in patients with liver disease.
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Hanif FM, Majid Z, Ahmed S, Luck NH, Mubarak M. Hepatic manifestations of coronavirus disease 2019 infection: Clinical and laboratory perspective. World J Virol 2022; 11:453-466. [PMID: 36483109 PMCID: PMC9724207 DOI: 10.5501/wjv.v11.i6.453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 10/17/2022] [Accepted: 11/07/2022] [Indexed: 11/23/2022] Open
Abstract
The novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, has become a global challenge of unprecedented nature since December 2019. Although most patients with COVID-19 exhibit mild clinical manifestations and upper respiratory tract involvement, in approximately 5%-10% of patients, the disease is severe and involves multiple organs, leading to multi-organ dysfunction and failure. The liver and gastrointestinal tract are also frequently involved in COVID-19. In the context of liver involvement in patients with COVID-19, many key aspects need to be addressed in both native and transplanted organs. This review focuses on the clinical presentations and laboratory abnormalities of liver function tests in patients with COVID-19 with no prior liver disease, patients with pre-existing liver diseases and liver transplant recipients. A brief overview of the history of COVID-19 and etiopathogenesis of the liver injury will also be described as a prelude to better understanding the above aspects.
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Affiliation(s)
- Farina M Hanif
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Zain Majid
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Shoaib Ahmed
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Nasir H Luck
- Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
| | - Muhammed Mubarak
- Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
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Goyal R, Gautam RK, Chopra H, Dubey AK, Singla RK, Rayan RA, Kamal MA. Comparative highlights on MERS-CoV, SARS-CoV-1, SARS-CoV-2, and NEO-CoV. EXCLI JOURNAL 2022; 21:1245-1272. [PMID: 36483910 PMCID: PMC9727256 DOI: 10.17179/excli2022-5355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/20/2022] [Accepted: 09/23/2022] [Indexed: 01/25/2023]
Abstract
The severe acute respiratory syndrome (SARS-CoV, now SARS-CoV-1), middle east respiratory syndrome (MERS-CoV), Neo-CoV, and 2019 novel coronavirus (SARS-CoV-2/COVID-19) are the most notable coronaviruses, infecting the number of people worldwide by targeting the respiratory system. All these viruses are of zoonotic origin, predominantly from bats which are one of the natural reservoir hosts for coronaviruses. Thus, the major goal of our review article is to compare and contrast the characteristics and attributes of these coronaviruses. The SARS-CoV-1, MERS-CoV, and COVID-19 have many viral similarities due to their classification, they are not genetically related. COVID-19 shares approximately 79 % of its genome with SARS-CoV-1 and about 50 % with MERS-CoV. The shared receptor protein, ACE2 exhibit the most striking genetic similarities between SARS-CoV-1 and SARS-CoV-2. SARS-CoV primarily replicates in the epithelial cells of the respiratory system, but it may also affect macrophages, monocytes, activated T cells, and dendritic cells. MERS-CoV not only infects and replicates inside the epithelial and immune cells, but it may lyse them too, which is one of the common reasons for MERS's higher mortality rate. The details of infections caused by SARS-CoV-2 and lytic replication mechanisms in host cells are currently mysterious. In this review article, we will discuss the comparative highlights of SARS-CoV-1, MERS-CoV, SARS-CoV-2, and Neo-CoV, concerning their structural features, morphological characteristics, sources of virus origin and their evolutionary transitions, infection mechanism, computational study approaches, pathogenesis and their severity towards several diseases, possible therapeutic approaches, and preventive measures.
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Affiliation(s)
- Rajat Goyal
- MM College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana-Ambala, Haryana, India,MM School of Pharmacy, Maharishi Markandeshwar University, Sadopur-Ambala, India
| | - Rupesh K. Gautam
- Department of Pharmacology, Indore Institute of Pharmacy, Rau, Indore, India-453331,*To whom correspondence should be addressed: Rupesh K. Gautam, Department of Pharmacology, Indore Institute of Pharmacy, IIST Campus, Opposite IIM Indore, Rau-Pithampur Road, Indore – 453331 (M.P.), India; Tel.: +91 9413654324, E-mail:
| | - Hitesh Chopra
- Chitkara College of Pharmacy, Chitkara University, Punjab, India-140401
| | | | - Rajeev K. Singla
- Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China,School of Pharmaceutical Sciences, Lovely Professional University, Phagwara, Punjab-144411, India
| | - Rehab A. Rayan
- Department of Epidemiology, High Institute of Public Health, Alexandria University, 5422031, Egypt
| | - Mohammad Amjad Kamal
- Institutes for Systems Genetics, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, Sichuan, China,King Fahd Medical Research Center, King Abdulaziz University, Saudi Arabia,Department of Pharmacy, Faculty of Allied Health Sciences, Daffodil International University, Bangladesh,Enzymoics, 7 Peterlee Place, Hebersham NSW 2770; Novel Global Community Educational Foundation, Australia
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14
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Alnamshan MM. Potential histopathological and immunological effects of SARS-CoV-2 on the liver. BRAZ J BIOL 2022; 82:e262008. [PMID: 36074418 DOI: 10.1590/1519-6984.262008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/05/2022] [Indexed: 12/15/2022] Open
Abstract
The coronavirus disease outbreak of 2019 (COVID-19) poses a serious threat to public health worldwide. Lung injury is the most common complication of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. However, other organs, including the liver, can also be affected. Currently, there is limited evidence that liver impairment is associated with severe SARS-CoV-2 infection. Clinicians will need to determine whether liver injury is caused by an underlying liver condition, COVID-19 therapy, the virus directly, or immune-mediated inflammation or represents a complicated disease course in the context of COVID-19. To address the scarcity of data on histopathological changes and immunological effects on the liver with COVID-19 positivity, we analyze and summarize recent findings. We searched PubMed, Medline, Google Scholar, Science Direct, Scopus, and Web of Science databases up to December 1, 2021, identifying published studies with the search terms "Histopathology in COVID-19," "COVID-19," "Pathological changes in liver in COVID-19," "Liver pathology in COVID-19," "immunological effects in liver in COVID-19," and "SARS-CoV-2." This concise review will aid clinicians and researchers in better understanding the tissue histopathology and immunological consequences of SARS-CoV-2 on the liver, enabling improved care planning and avoiding future dangers.
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Affiliation(s)
- M M Alnamshan
- Imam Abdulrahman Bin Faisal University, College of Science, Department of Biology, Dammam, Saudi Arabia
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15
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Yu Y, Li X, Wan T. Effects of Hepatitis B Virus Infection on Patients with COVID-19: A Meta-Analysis. Dig Dis Sci 2022; 68:1615-1631. [PMID: 36085229 PMCID: PMC9462612 DOI: 10.1007/s10620-022-07687-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2022] [Accepted: 08/29/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND The COVID-19 pandemic has brought new problems to patients infected with hepatitis B virus (HBV). AIM We aim to know the effects of HBV infection on patients with COVID-19. METHODS We searched PubMed, Embase, and Web of Science for data and utilized Stata 14.0 software for this meta-analysis with a random-effects model. This paper was conducted in alignment with the preferred reporting items for systematic review and meta-analysis (PRISMA) guideline. RESULTS In total, 37,696 patients were divided into two groups: 2591 COVID-19 patients infected with HBV in the experimental group and 35,105 COVID-19 patients not infected with HBV in the control group. Our study showed that the in-hospital mortality of the experimental group was significant higher than that of the control group (OR = 2.04, 95% CI 1.49-2.79). We also found that COVID-19 patients infected with HBV were more likely to develop severe disease (OR = 1.90, 95% CI 1.32-2.73) than COVID-19 patients not infected with HBV. Upon measuring alanine aminotransferase (SMD = 0.62, 95% CI 0.25-0.98), aspartate aminotransferase (SMD = 0.60, 95% CI 0.30-0.91), total bilirubin (SMD = 0.45, 95% CI 0.23-0.67), direct bilirubin (SMD = 0.36, 95% CI 0.24-0.47), lactate dehydrogenase (SMD = 0.32, 95% CI 0.18-0.47), we found that HBV infection led to significantly higher laboratory results in COVID-19 patients. CONCLUSION COVID-19 patients infected with HBV should receive more attention, and special attention should be given to various liver function indices during treatment.
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Affiliation(s)
- Yang Yu
- Department of Hepatobiliary and Pancreatic Surgery, China-Japan Union Hospital of Jilin University, Changchun, 130033, Jilin Province, China
| | - Xingzhao Li
- Department of Ultrasound, China-Japan Union Hospital of Jilin University, Changchun, 130033, Jilin Province, China
| | - Taihu Wan
- Department of Radiology, China-Japan Union Hospital of Jilin University, Changchun, 130033, Jilin Province, China.
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16
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Ahmadi I, Afifipour A, Sakhaee F, Zamani MS, Mirzaei Gheinari F, Anvari E, Fateh A. Impact of interferon-induced transmembrane protein 3 gene rs12252 polymorphism on COVID-19 mortality. Cytokine 2022; 157:155957. [PMID: 35792282 PMCID: PMC9250290 DOI: 10.1016/j.cyto.2022.155957] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/26/2022] [Accepted: 06/28/2022] [Indexed: 01/08/2023]
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17
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Probiotics in the Management of Mental and Gastrointestinal Post-COVID Symptomes. J Clin Med 2022; 11:jcm11175155. [PMID: 36079082 PMCID: PMC9457065 DOI: 10.3390/jcm11175155] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Revised: 08/17/2022] [Accepted: 08/29/2022] [Indexed: 01/30/2023] Open
Abstract
Patients with “post-COVID” syndrome manifest with a variety of signs and symptoms that continue/develop after acute COVID-19. Among the most common are gastrointestinal (GI) and mental symptoms. The reason for symptom occurrence lies in the SARS-CoV-2 capability of binding to exact receptors, among other angiotensin converting enzyme 2 (ACE2) receptors in gastrointestinal lining and neuropilin-1 (NRP-1) in the nervous system, which leads to loss of gastrointestinal and blood-brain barriers integrity and function. The data are mounting that SARS-CoV-2 can trigger systemic inflammation and lead to disruption of gut-brain axis (GBA) and the development of disorders of gut brain interaction (DGBIs). Functional dyspepsia (FD) and irritable bowel syndrome (IBS) are the most common DGBIs syndromes. On the other hand, emotional disorders have also been demonstrated as DGBIs. Currently, there are no official recommendations or recommended procedures for the use of probiotics in patients with COVID-19. However, it can be assumed that many doctors, pharmacists, and patients will want to use a probiotic in the treatment of this disease. In such cases, strains with documented activity should be used. There is a constant need to plan and conduct new trials on the role of probiotics and verify their clinical efficacy for counteracting the negative consequences of COVID-19 pandemic. Quality control is another important but often neglected aspect in trials utilizing probiotics in various clinical entities. It determines the safety and efficacy of probiotics, which is of utmost importance in patients with post-acute COVID-19 syndrome.
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18
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Mercado-Gómez M, Prieto-Fernández E, Goikoetxea-Usandizaga N, Vila-Vecilla L, Azkargorta M, Bravo M, Serrano-Maciá M, Egia-Mendikute L, Rodríguez-Agudo R, Lachiondo-Ortega S, Lee SY, Eguileor Giné A, Gil-Pitarch C, González-Recio I, Simón J, Petrov P, Jover R, Martínez-Cruz LA, Ereño-Orbea J, Delgado TC, Elortza F, Jiménez-Barbero J, Nogueiras R, Prevot V, Palazon A, Martínez-Chantar ML. The spike of SARS-CoV-2 promotes metabolic rewiring in hepatocytes. Commun Biol 2022; 5:827. [PMID: 35978143 PMCID: PMC9383691 DOI: 10.1038/s42003-022-03789-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 08/02/2022] [Indexed: 01/08/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes a multi-organ damage that includes hepatic dysfunction, which has been observed in over 50% of COVID-19 patients. Liver injury in COVID-19 could be attributed to the cytopathic effects, exacerbated immune responses or treatment-associated drug toxicity. Herein we demonstrate that hepatocytes are susceptible to infection in different models: primary hepatocytes derived from humanized angiotensin-converting enzyme-2 mice (hACE2) and primary human hepatocytes. Pseudotyped viral particles expressing the full-length spike of SARS-CoV-2 and recombinant receptor binding domain (RBD) bind to ACE2 expressed by hepatocytes, promoting metabolic reprogramming towards glycolysis but also impaired mitochondrial activity. Human and hACE2 primary hepatocytes, where steatosis and inflammation were induced by methionine and choline deprivation, are more vulnerable to infection. Inhibition of the renin-angiotensin system increases the susceptibility of primary hepatocytes to infection with pseudotyped viral particles. Metformin, a common therapeutic option for hyperglycemia in type 2 diabetes patients known to partially attenuate fatty liver, reduces the infection of human and hACE2 hepatocytes. In summary, we provide evidence that hepatocytes are amenable to infection with SARS-CoV-2 pseudovirus, and we propose that metformin could be a therapeutic option to attenuate infection by SARS-CoV-2 in patients with fatty liver. SARS-CoV-2 pseudovirus infects human hepatocytes leading to metabolic reprogramming towards glycolysis and impaired mitochondrial activity, and metformin can reduce infection under steatotic conditions.
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Affiliation(s)
- Maria Mercado-Gómez
- Liver Disease Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain
| | - Endika Prieto-Fernández
- Cancer Immunology and Immunotherapy Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain
| | - Naroa Goikoetxea-Usandizaga
- Liver Disease Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain
| | - Laura Vila-Vecilla
- Cancer Immunology and Immunotherapy Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain
| | - Mikel Azkargorta
- Proteomics Platform, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), ProteoRedISCIII, 48160, Derio, Bizkaia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Miren Bravo
- Liver Disease Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain
| | - Marina Serrano-Maciá
- Liver Disease Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain
| | - Leire Egia-Mendikute
- Cancer Immunology and Immunotherapy Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain
| | - Rubén Rodríguez-Agudo
- Liver Disease Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain
| | - Sofia Lachiondo-Ortega
- Liver Disease Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain
| | - So Young Lee
- Cancer Immunology and Immunotherapy Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain
| | - Alvaro Eguileor Giné
- Liver Disease Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain
| | - Clàudia Gil-Pitarch
- Liver Disease Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain
| | - Irene González-Recio
- Liver Disease Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain
| | - Jorge Simón
- Liver Disease Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Petar Petrov
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28029, Madrid, Spain.,Experimental Hepatology Joint Research Unit, IIS Hospital La Fe, Valencia, Spain
| | - Ramiro Jover
- Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28029, Madrid, Spain.,Experimental Hepatology Joint Research Unit, IIS Hospital La Fe, Valencia, Spain.,Dep. Biochemistry and Molecular Biology, University of Valencia, Valencia, Spain
| | - Luis Alfonso Martínez-Cruz
- Liver Disease Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain
| | - June Ereño-Orbea
- Chemical Glycobiology Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain.,Ikerbasque, Basque Foundation for Science, Bilbao, Spain.,Department of Organic Chemistry, University of the Basque Country, UPV/EHU, 48940, Leioa, Spain
| | - Teresa Cardoso Delgado
- Liver Disease Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain
| | - Felix Elortza
- Proteomics Platform, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), ProteoRedISCIII, 48160, Derio, Bizkaia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28029, Madrid, Spain
| | - Jesús Jiménez-Barbero
- Chemical Glycobiology Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain.,Ikerbasque, Basque Foundation for Science, Bilbao, Spain.,Department of Organic Chemistry, University of the Basque Country, UPV/EHU, 48940, Leioa, Spain.,Centro de Investigación Biomédica En Red de Enfermedades Respiratorias (CIBERES), 28029, Madrid, Spain
| | - Ruben Nogueiras
- Department of Physiology, Center for Research in Molecular Medicine and Chronic Diseases (CIMUS), University of Santiago de Compostela-Instituto de Investigación Sanitaria, CIBER Fisiopatología de a Obesidad y Nutrición (CIBERobn), Galician Agency of Innovation (GAIN), Xunta de Galicia, 15782, Santiago de Compostela, Spain
| | - Vincent Prevot
- Univ. Lille, Inserm, CHU Lille, Development and Plasticity of the Neuroendocrine Brain Lab, UMR-S1172 INSERM, DISTALZ, EGID, Lille, France
| | - Asis Palazon
- Cancer Immunology and Immunotherapy Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain. .,Ikerbasque, Basque Foundation for Science, Bilbao, Spain.
| | - María L Martínez-Chantar
- Liver Disease Lab, CIC bioGUNE, Basque Research and Technology Alliance (BRTA), 48160, Derio, Bizkaia, Spain. .,Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBERehd), Instituto de Salud Carlos III, 28029, Madrid, Spain.
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Gorący A, Rosik J, Szostak B, Ustianowski Ł, Ustianowska K, Gorący J. Human Cell Organelles in SARS-CoV-2 Infection: An Up-to-Date Overview. Viruses 2022; 14:v14051092. [PMID: 35632833 PMCID: PMC9144443 DOI: 10.3390/v14051092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 05/10/2022] [Accepted: 05/17/2022] [Indexed: 12/10/2022] Open
Abstract
Since the end of 2019, the whole world has been struggling with the life-threatening pandemic amongst all age groups and geographic areas caused by Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2). The Coronavirus Disease 2019 (COVID-19) pandemic, which has led to more than 468 million cases and over 6 million deaths reported worldwide (as of 20 March 2022), is one of the greatest threats to human health in history. Meanwhile, the lack of specific and irresistible treatment modalities provoked concentrated efforts in scientists around the world. Various mechanisms of cell entry and cellular dysfunction were initially proclaimed. Especially, mitochondria and cell membrane are crucial for the course of infection. The SARS-CoV-2 invasion depends on angiotensin converting enzyme 2 (ACE2), transmembrane serine protease 2 (TMPRSS2), and cluster of differentiation 147 (CD147), expressed on host cells. Moreover, in this narrative review, we aim to discuss other cell organelles targeted by SARS-CoV-2. Lastly, we briefly summarize the studies on various drugs.
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Affiliation(s)
- Anna Gorący
- Independent Laboratory of Invasive Cardiology, Pomeranian Medical University, 70-204 Szczecin, Poland; (A.G.); (J.G.)
- Department of Clinical and Molecular Biochemistry, Pomeranian Medical University, 70-204 Szczecin, Poland
| | - Jakub Rosik
- Independent Laboratory of Invasive Cardiology, Pomeranian Medical University, 70-204 Szczecin, Poland; (A.G.); (J.G.)
- Department of Physiology, Pomeranian Medical University, 70-204 Szczecin, Poland; (B.S.); (Ł.U.); (K.U.)
- Department of Chemistry, The University of Chicago, Chicago, IL 60637, USA
- Correspondence:
| | - Bartosz Szostak
- Department of Physiology, Pomeranian Medical University, 70-204 Szczecin, Poland; (B.S.); (Ł.U.); (K.U.)
| | - Łukasz Ustianowski
- Department of Physiology, Pomeranian Medical University, 70-204 Szczecin, Poland; (B.S.); (Ł.U.); (K.U.)
| | - Klaudia Ustianowska
- Department of Physiology, Pomeranian Medical University, 70-204 Szczecin, Poland; (B.S.); (Ł.U.); (K.U.)
| | - Jarosław Gorący
- Independent Laboratory of Invasive Cardiology, Pomeranian Medical University, 70-204 Szczecin, Poland; (A.G.); (J.G.)
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20
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Harouachi A, Bouhout T, Hadj Kacem H, Serji B, Berkhli H, Madani H, EL Harroudi T. Acute hepatitis with portal and mesenteric vein thrombosis revealing SARS-CoV-2 infection: Case report and literature review. Ann Med Surg (Lond) 2022; 77:103706. [PMID: 35531429 PMCID: PMC9060732 DOI: 10.1016/j.amsu.2022.103706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 04/25/2022] [Accepted: 04/26/2022] [Indexed: 11/06/2022] Open
Abstract
Novel coronavirus disease 2019 (COVID-19) is a single-stranded RNA virus identified for the first time in Wuhan, China, and it unfurls quickly worldwide. The corona virus 2019 is a systemic disease which develops a prothrombotic environment, and has an extensive spectrum of clinical presentations in the gastrointestinal and hepatobiliary systems. Ischemic hepatitis (hypoxic hepatitis) is one potential mechanism behind lessened perfusion of the liver. The portal and mesenteric vein thrombosis are extremely rare complications and unusual main manifestations of COVID-19. We report the case of a patient presented acute hepatitis with portal and mesenteric vein thrombosis revealing a SARS-CoV-2 infection. In addition, we discuss the most characteristic elements of the Impact of COVID-19 on liver Injury, and the mechanisms of this damage and the formation of thrombus in portal and mesenteric vein.
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Affiliation(s)
- Abdelhakim Harouachi
- Surgical Oncology Department, Regional Oncology Center, Mohammed VI University Hospital, Oujda, Morocco
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda, Morocco
| | - Tariq Bouhout
- Surgical Oncology Department, Regional Oncology Center, Mohammed VI University Hospital, Oujda, Morocco
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda, Morocco
| | - Hanane Hadj Kacem
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda, Morocco
- Department of Radiology, Regional Oncology Center, Mohammed VI University Hospital, Oujda, Morocco
| | - Badr Serji
- Surgical Oncology Department, Regional Oncology Center, Mohammed VI University Hospital, Oujda, Morocco
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda, Morocco
| | - Hayat Berkhli
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda, Morocco
- Department of Intensive Care Unit, Regional Oncology Center, Mohammed VI University Hospital, Oujda, Morocco
| | - Hamid Madani
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda, Morocco
- Department of Intensive Care Unit, Regional Oncology Center, Mohammed VI University Hospital, Oujda, Morocco
| | - Tijani EL Harroudi
- Surgical Oncology Department, Regional Oncology Center, Mohammed VI University Hospital, Oujda, Morocco
- Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda, Morocco
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21
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Kariyawasam JC, Jayarajah U, Abeysuriya V, Riza R, Seneviratne SL. Involvement of the Liver in COVID-19: A Systematic Review. Am J Trop Med Hyg 2022; 106:1026-1041. [PMID: 35203056 PMCID: PMC8991364 DOI: 10.4269/ajtmh.21-1240] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Accepted: 01/16/2022] [Indexed: 01/11/2023] Open
Abstract
COVID-19, a respiratory viral infection, has affected 388 million individuals worldwide as of the February 4, 2022. In this review, we have outlined the important liver manifestations of COVID-19 and discussed the possible underlying pathophysiological mechanisms and their diagnosis and management. Factors that may contribute to hepatic involvement in COVID-19 include direct viral cytopathic effects, exaggerated immune responses/systemic inflammatory response syndrome, hypoxia-induced changes, vascular changes due to coagulopathy, endothelitis, cardiac congestion from right heart failure, and drug-induced liver injury. The majority of COVID-19-associated liver symptoms are mild and self-limiting. Thus management is generally supportive. Liver function tests and abdominal imaging are the primary investigations done in relation to liver involvement in COVID-19 patients. However, imaging findings are nonspecific. Severe acute respiratory syndrome coronavirus 2 RNA has been found in liver biopsies. However, there is limited place for liver biopsy in the clinical context, as it does not influence management. Although, the management is supportive in the majority of patients without previous liver disease, special emphasis is needed in those with nonalcoholic fatty liver disease, cirrhosis, hepatocellular carcinoma, hepatitis B and C infections, and alcoholic liver disease, and in liver transplant recipients.
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Affiliation(s)
| | - Umesh Jayarajah
- Postgraduate Institute of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Visula Abeysuriya
- Nawaloka Hospital Research and Education Foundation, Nawaloka Hospitals, Colombo, Sri Lanka
| | - Rishdha Riza
- Colombo South Teaching Hospital, Colombo, Sri Lanka
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22
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Fataftah JZ, Tayyem R, Qandeel H, Baydoun HA, Al Manasra ARA, Tahboub A, Al-Dwairy SY, Al-Mousa A. The Effect of COVID 19 on Liver Parenchyma Detected and measured by CT scan Hounsfield Units. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2022; 27:26. [PMID: 35419067 PMCID: PMC8995305 DOI: 10.4103/jrms.jrms_1228_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 03/28/2021] [Accepted: 06/23/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND COVID 19 may affect organs other than lungs, including liver, leading to parenchymal changes. These changes are best assessed by unenhanced computed tomography (CT). We aim to investigate the effect of COVID 19 on liver parenchyma by measuring the attenuation in CT scan Hounsfield unit (HU). MATERIALS AND METHODS A cohort of patients, who tested COVID 19 polymerase chain reaction positive, were enrolled and divided into two groups: fatty liver (FL) group (HU ≤ 40) and nonfatty liver (NFL) group (HU > 40) according to liver parenchyma attenuation measurements by high resolution noncontrast CT scan. The CT scan was performed on admission and on follow up (10-14 days later). Liver enzyme tests were submitted on admission and follow up. RESULTS Three hundred and two patients were enrolled. Liver HU increased significantly from 48.9 on admission to 53.4 on follow up CT scan (P<0.001) in all patients. This increase was more significant in the FL group (increased from 31.9 to 42.9 [P =0.018]) Liver enzymes were abnormal in 22.6% of the full cohort. However, there was no significant change in liver enzymes between the admission and follow up in both groups. CONCLUSION The use of unenhanced CT scan for assessment of liver parenchymal represents an objective and noninvasive method. The significant changes in parenchymal HU are not always accompanied by significant changes in liver enzymes. Increased HU values caused by COVID 19 may be due to either a decrease in the fat or an increase in the fibrosis in the liver.
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Affiliation(s)
| | - Raed Tayyem
- Department of Surgery, Hashemite University, Zarqa, Jordan
| | | | | | | | - Ahmad Tahboub
- Department of Radiology, Hashemite University, Zarqa, Jordan
| | | | - Alaa Al-Mousa
- Department of Neurosurgery, Hashemite University, Zarqa, Jordan
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Laboratory Profile of COVID-19 Patients with Hepatitis C-Related Liver Cirrhosis. J Clin Med 2022; 11:jcm11030652. [PMID: 35160114 PMCID: PMC8836842 DOI: 10.3390/jcm11030652] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/14/2022] [Accepted: 01/26/2022] [Indexed: 12/12/2022] Open
Abstract
Patients with cirrhosis are known to have multiple comorbidities and impaired organ system functioning due to alterations caused by chronic liver failure. In the past two years, since the COVID-19 pandemic started, several studies have described the affinity of SARS-CoV-2 with the liver and biliary cells. Considering hepatitis C as a significant independent factor for cirrhosis in Romania, this research was built on the premises that this certain group of patients is susceptible to alterations of their serum parameters that are yet to be described, which might be useful in the management of COVID-19 in these individuals. A retrospective cohort study was developed at a tertiary hospital for infectious disease in Romania, which included a total of 242 patients with hepatitis C cirrhosis across two years, out of which 46 patients were infected with SARS-CoV-2. Stratification by patient weight and COVID-19 status identified several important laboratory serum tests as predictors for acute-on-chronic liver failure and risk for intensive care unit admission. Thus, white blood cell count, lymphocyte count, ferritin, hypoglycemia, prothrombin time, and HCV viral load were independent risk factors for ACLF in patients with COVID-19. High PT, creatinine, BUN, and HCV viral load were the strongest predictors for ICU admission. Inflammatory markers and parameters of gas exchange were also observed as risk factors for ACLF and ICU admission, including procalcitonin, CRP, IL-6, and D-dimers. Our study questions and confirms the health impact of COVID-19 on patients with cirrhosis and whether their laboratory profile significantly changes due to SARS-CoV-2 infection.
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Mohammed SA, Eid KM, Anyiam FE, Wadaaallah H, Muhamed MAM, Morsi MH, Dahman NBH. Liver injury with COVID-19: laboratory and histopathological outcome-systematic review and meta-analysis. EGYPTIAN LIVER JOURNAL 2022; 12:9. [PMID: 35096428 PMCID: PMC8781706 DOI: 10.1186/s43066-022-00171-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Accepted: 01/02/2022] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The novel coronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has been predominantly linked to respiratory distress syndrome, but hepatic injury has also been reported. The mechanism of liver injury is poorly understood.This review aimed to systematically review the current data through laboratory tests and liver tissue pathology to ascertain the correlation of liver involvement in SARS-CoV-2 infection patients. METHODS The PubMed, Scopus, Science Direct, and Web of Science databases were searched systematically. We included peer-reviewed published papers available online as clinical cases, cohort studies, and retrospective studies, for both in vitro and in vivo human studies. Independent extraction of the data was done by two independent authors. RESULTS A total of 15 articles were finally included in the systematic review process and meta-analysis after exclusion of studies that did not meet the eligibility criteria, summarized in a PRISMA flow diagram.The meta-analysis showed that patients with underlying abnormal liver function and/or histopathological finding had a statistically significant 8.08 times higher odds of severe COVID-19 outcomes when data from the individual studies were pooled (OR 8.08; 95% CI,3.43, 19.03; p = 0.00001). Five of these studies showed histopathological changes on autopsy from cases with severe COVID-19, and in four of these five studies, the histopathology was associated with a history of abnormal liver function after affection with COVID-19. SHORT CONCLUSION The study observed that the severity of COVID-19 was associated with more patients with aberrant liver function tests.
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Affiliation(s)
| | - Khalid M Eid
- Faculty of Pharmacy, Al-Azhar University, Assiut Branch, Assiut, Egypt
| | - Felix Emeka Anyiam
- Centre for Health and Development, University of Port Harcourt, Port Harcourt, Nigeria
| | - Hazem Wadaaallah
- Biomedical Physics Department, Faculty of Science, Helwan University, Cairo, Egypt
| | | | - Maha Hosni Morsi
- Misr University for Science and Technology, 6th of October City, Egypt
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25
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Liver Injury in Patients with COVID-19 without Underlying Liver Disease. J Clin Med 2022; 11:jcm11020308. [PMID: 35054003 PMCID: PMC8778101 DOI: 10.3390/jcm11020308] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/20/2021] [Accepted: 12/31/2021] [Indexed: 02/06/2023] Open
Abstract
SARS-CoV-2 shows a high affinity for the ACE-2 receptor, present on the epithelial cells of the upper and lower respiratory tract, within the intestine, kidneys, heart, testes, biliary epithelium, and-where it is particularly challenging-on vascular endothelial cells. Liver involvement is a rare manifestation of COVID-19. MATERIAL AND METHODS We reviewed 450 patients admitted due to the fact of SARS-CoV-2 infection (COVID-19) including 88 with liver injury. Based on medical history and previous laboratory test results, we excluded cases of underlying liver disease. The analysis involved a clinical course of COVID-19 in patients without underlying liver disease as well as the type and course of liver injury. RESULTS Signs and symptoms of liver injury were present in 20% of patients, mostly presenting as a mixed-type pattern of injury with less common cases of standalone hepatocellular (parenchymal) or cholestatic injury. The liver injury symptoms resolved at the end of inpatient treatment in 20% of cases. Sixteen patients died with no cases where liver injury would be deemed a cause of death. CONCLUSIONS (1) Liver injury secondary to COVID-19 was mild, and in in 20%, the signs and symptoms of liver injury resolved by the end of hospitalization. (2) It seems that liver injury in patients with COVID-19 was not associated with a higher risk of mortality. (3) The underlying mechanism of liver injury as well as its sequelae are not fully known. Therefore, caution and further monitoring are advised, especially in patients whose liver function tests have not returned to normal values.
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26
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Pazgan-Simon M, Kucharska M, Górka-Dynysiewicz J, Simon K. Impact of SARS CoV-2 /COVID-19 infection on the course of advanced chronic liver disease and hepatocellular carcinoma. Pharmacol Rep 2022; 74:1306-1314. [PMID: 36394820 PMCID: PMC9669525 DOI: 10.1007/s43440-022-00434-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 11/07/2022] [Accepted: 11/08/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND About 20% of patients infected with SARS-CoV-2 develop COVID-19-the disease that has dominated health care in the last two years. The course of COVID-19 in patients with advanced liver disease tends to be severe, patients also suffer from a higher risk of complications and death. The primary object of this study was to assess the risk and causes of death in patients with cirrhosis and hepatocellular carcinoma (HCC). MATERIALS AND METHODS From a group of 4,314 patients hospitalized at Jerzy Gromkowski Regional Specialist Hospital in Wroclaw (Poland) due to SARS-CoV-2/COVID-19 infection between March 15, 2020, and January 31, 2022, we selected a cohort of 31 patients with liver cirrhosis (12 women and 19 men) and 7 patients with HCC developed on the cirrhotic liver (1 woman, 6 men). The control group included 123 patients without liver disease. In the entire cohort, we analyzed the course of COVID-19 infection, baseline oxygen demand, liver function (assessed using the CTP-Child-Turoctte-Pugh score and MELD-Model of End-Stage Liver Disease scales), length of hospitalization, development of acute-on-chronic liver failure, and deaths. RESULTS The mean age of the patients was 56.6 years in the liver cirrhosis group, 63.3 years for patients with (HCC) hepatocellular carcinoma, and 64 years in the control group. Time of hospitalization averaged 15.52 days and 11.14 days for patients with liver cirrhosis and liver cancer, respectively. For the control group, the average duration of the hospital stay was 11.61 days. With respect to baseline liver function assessed using the CTP score, in the cirrhosis group 10 patients were CTP class A, 19 patients were class B and 9 patients were class C. The cancer group included 3 patients with class A, 2 patients with class B, and 2 patients with class C. In the studied cohort, 22 patients had a baseline MELD score < 12 points, and in 15 patients was > 12. In the HCC group, it was, respectively, CTP A:3, B: 2, C: 2, and MELD < 12: 3, ≥12: 4 people. Most of these patients presented with a progression of liver disease. Fifteen patients died, including 12 with cirrhosis and 3 with HCC, accounting for 39.47% in the entire cohort, 39% in the cirrhotic group and 43% in the HCC group, and 13 in the control group (10.6%), There was a clear statistical difference between the mortality rate in the group with liver disease and in the control group. CONCLUSIONS Infection with SARS-CoV-2/COVID-19 in patients with cirrhosis and HCC tends to have a more severe course and leads to exacerbation of the liver disease. The most common cause of death in the analyzed cohort infected with SARS-CoV-2/COVID-19 was the progression of liver disease, complicated by liver failure.
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Affiliation(s)
- Monika Pazgan-Simon
- I Department of Infectious Diseases, Jerzy Gromkowski Regional Specialist Hospital, ul Koszarowa 5, 51-149 Wrocław, Poland ,grid.4495.c0000 0001 1090 049XDepartment of Infectious Diseases and Hepatology, Wroclaw Medical University, Wrocław, Poland
| | - Marta Kucharska
- I Department of Infectious Diseases, Jerzy Gromkowski Regional Specialist Hospital, ul Koszarowa 5, 51-149 Wrocław, Poland ,grid.4495.c0000 0001 1090 049XDepartment of Infectious Diseases and Hepatology, Wroclaw Medical University, Wrocław, Poland
| | - Joanna Górka-Dynysiewicz
- grid.4495.c0000 0001 1090 049XDepartment of Pharmaceutical Biochemistry, Wroclaw Medical University, Wrocław, Poland
| | - Krzysztof Simon
- I Department of Infectious Diseases, Jerzy Gromkowski Regional Specialist Hospital, ul Koszarowa 5, 51-149 Wrocław, Poland ,grid.4495.c0000 0001 1090 049XDepartment of Infectious Diseases and Hepatology, Wroclaw Medical University, Wrocław, Poland
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27
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Zhao W, Zhang X, Zhu F, Jiang X. Dynamic Changes of Liver Function Indexes in Patients with Different Clinical Types of COVID-19. Int J Gen Med 2022; 15:877-884. [PMID: 35115814 PMCID: PMC8801727 DOI: 10.2147/ijgm.s347291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 01/13/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Wei Zhao
- Department of Respiratory and Critical Care Medicine, Wuxi Fifth People’s Hospital, Wuxi, 214000, People’s Republic of China
| | - Xiaoqing Zhang
- Department of Respiratory and Critical Care Medicine, Wuxi Fifth People’s Hospital, Wuxi, 214000, People’s Republic of China
| | - Feng Zhu
- Department of Respiratory and Critical Care Medicine, Wuxi Fifth People’s Hospital, Wuxi, 214000, People’s Republic of China
- Correspondence: Feng Zhu; Xiufeng Jiang, Department of Respiratory and Critical Care Medicine, Wuxi Fifth People’s Hospital, Wuxi, 214000, People’s Republic of China, Tel +86-13914135026; +86-13013630369, Email ;
| | - Xiufeng Jiang
- Department of Respiratory and Critical Care Medicine, Wuxi Fifth People’s Hospital, Wuxi, 214000, People’s Republic of China
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28
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Elhiny R, Al-Jumaili AA, Yawuz MJ. OUP accepted manuscript. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2022; 30:404-413. [PMID: 35881153 PMCID: PMC9384593 DOI: 10.1093/ijpp/riac026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2021] [Accepted: 04/04/2022] [Indexed: 11/13/2022]
Abstract
Objectives Methods Key findings Conclusion
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Affiliation(s)
- Rehab Elhiny
- Clinical Pharmacy Department, Faculty of Pharmacy, Minia University, Minia, Egypt
| | - Ali Azeez Al-Jumaili
- Correspondence: Ali Azeez Al-Jumaili, University of Baghdad College of Pharmacy, Bab Al Muadham, Baghdad 10047, Iraq; The University of Iowa, Iowa City, IA, USA; and UC Davis School of Medicine/PHS Department, USA.
| | - Mohammed Jamal Yawuz
- Clinical Pharmacy Department, College of Pharmacy, University of Baghdad, Baghdad, Iraq
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29
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Adouani I, Bendaoud T, Belaaliat H, Teniou W, Keriou F, Djabi F. Different routine laboratory tests in assessment of COVID–19: A case–control study. JOURNAL OF ACUTE DISEASE 2022. [DOI: 10.4103/2221-6189.355311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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30
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Kayaaslan B, Guner R. COVID-19 and the liver: A brief and core review. World J Hepatol 2021; 13:2013-2023. [PMID: 35070005 PMCID: PMC8727220 DOI: 10.4254/wjh.v13.i12.2013] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/23/2021] [Accepted: 10/27/2021] [Indexed: 02/06/2023] Open
Abstract
Coronavirus disease 2019 has a wide range of clinical spectrum from asymptomatic infection to severe infection resulting in death within a short time. Currently, it is known that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) does not only cause a respiratory tract infection but a more complicated disease that can lead to multiple system involvement including the liver. Herein, we evaluate the epidemiology, the impact of liver injury/ dysfunction on disease prognosis, the pathophysiological mechanisms and management of liver injury. More than one-fourth of the patients have abnormal liver function tests, mostly a mild-to-moderate liver dysfunction. Liver injury is significantly associated with a poor clinical outcome. Direct cytotoxic effect of SARS-CoV-2, the immune response (“cytokine storm”), the complications related to the disease, and drugs used in the treatments are the pathophysiological mechanisms responsible for liver injury. However, the exact mechanism is not yet clearly explained. The binding of SARS-CoV-2 to the angiotensin-converting enzyme 2 receptors and entering the hepatocyte and cholangiocytes can cause cytotoxic effects on the liver. Excessive immune response has an important role in disease progression and causes acute respiratory distress syndrome and multi-organ failures accompanied by liver injury. Treatment drugs, particularly lopinavir/ritonavir, remdesivir and antibiotics are a frequent reason for liver injury. The possible reasons should be meticulously investigated and resolved.
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Affiliation(s)
- Bircan Kayaaslan
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara 06800, Turkey
| | - Rahmet Guner
- Department of Infectious Disease and Clinical Microbiology, Ankara City Hospital, Ankara Yildirim Beyazit University, Ankara 06800, Turkey
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Pranata R, Huang I, Lim MA, Yonas E, Vania R, Lukito AA, Nasution SA, Siswanto BB, Kuswardhani RAT. Elevated De Ritis Ratio Is Associated With Poor Prognosis in COVID-19: A Systematic Review and Meta-Analysis. Front Med (Lausanne) 2021; 8:676581. [PMID: 35004709 PMCID: PMC8729881 DOI: 10.3389/fmed.2021.676581] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 11/22/2021] [Indexed: 01/08/2023] Open
Abstract
Objective: This meta-analysis aims to assess whether elevated De Ritis ratio is associated with poor prognosis in patients with coronavirus 2019 (COVID-19). Methods: A systematic literature search was performed using PubMed, Embase, and EuropePMC databases up until September 17, 2021. De Ritis ratio is also known as Aspartate aminotransferase/alanine transaminase (AST/ALT) ratio. The main outcome was poor prognosis, a composite of mortality, severity, the need for ICU care, and intubation. The effect measure was odds ratios (ORs) and mean differences. We generated sensitivity and specificity, negative and positive likelihood ratio (NLR and PLR), diagnostic odds ratio (DOR), and area under curve (AUC). Results: There were eight studies with 4,606 patients. De Ritis ratio was elevated in 44% of the patients. Patients with poor prognosis have higher De Ritis ratio [mean difference 0.41 (0.31, 0.50), p < 0.001; I 2: 81.0%] and subgroup analysis showed that non-survivors also have higher De Ritis Ratio [mean difference 0.47 (0.46, 0.48), p < 0.001; I 2: 0%]. Elevated De Ritis ratio was associated with poor prognosis [OR 3.28 (2.39, 4.52), p < 0.001; I 2: 35.8%]. It has a sensitivity of 55% (36-73), specificity of 71% (52-85), PLR 1.9, NLR.63, DOR of 3 (2-4), and AUC of.67 (0.63-0.71). The posterior probability of poor prognosis was 38% if De Ritis is elevated, while 17% if De Ritis is not elevated. Conclusion: Elevated De Ritis ratio is associated with poor prognosis in patients with COVID-19. Systematic Review Registration: PROSPERO ID: CRD42020216634.
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Affiliation(s)
- Raymond Pranata
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
| | - Ian Huang
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
- Faculty of Medicine, Department of Internal Medicine, Hasan Sadikin General Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | | | - Emir Yonas
- Faculty of Medicine, Universitas YARSI, Jakarta, Indonesia
| | - Rachel Vania
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
- Faculty of Medicine, Division of Plastic, Reconstructive, and Aesthetic, Department of Surgery, Sanglah General Hospital, Udayana University, Jimbaran, Indonesia
| | - Antonia Anna Lukito
- Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Indonesia
- Department of Cardiology and Vascular Medicine, Siloam Hospitals Lippo Village, Tangerang, Indonesia
| | - Sally Aman Nasution
- Faculty of Medicine, Division of Cardiology, Department of Internal Medicine, Universitas Indonesia/Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Bambang Budi Siswanto
- Faculty of Medicine, Department of Cardiology and Vascular Medicine, National Cardiovascular Center Harapan Kita, Universitas Indonesia, Jakarta, Indonesia
| | - Raden A. Tuty Kuswardhani
- Faculty of Medicine, Division of Geriatrics, Department of Internal Medicine, Sanglah Teaching Hospital, Udayana University, Denpasar, Indonesia
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Das KM, Singh R, Al Dossari K, Subramanya S, Ojha SK, AlMansoori T, Alkoteesh JA. Chest radiographic score and lactate dehydrogenase are independent risk factors linked to mortality in Middle East Respiratory Syndrome Coronavirus (MERS-CoV) patients. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2021. [PMCID: PMC8491180 DOI: 10.1186/s43055-021-00635-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Background Despite the dominance of Covid-19 in the current situation, MERS-CoV is found infrequently in the Middle East. When coupled with the chest radiographic score, serum biochemical parameters may be utilized to assess serum biochemical changes in individuals with different degrees of MERS-CoV infection and to predict death. The purpose of this study was to examine the association between increased LDH levels and severe MERS-CoV outcomes utilizing ventilation days and an elevated chest radiographic score. Results Fifty-seven patients were included in the retrospective cohort. The mean age was 44.9 ± 13.5 years, while the range was between 12 and 73 years. With an average age of 53.3 ± 16.5 years, 18 of 57 (31.6%) patients were classified as deceased. The deceased group showed a substantially greater amount of LDH than the recovery group (280.18 ± 150.79 vs. 1241.72 ± 1327.77, p = 0.007). A cut-off value of > 512 LDH was established with a C-statistic of 0.96 (95% CI 0.92–1.00) and was 94% sensitive and 93% specific for mortality. Multivariate cox regression analysis revealed that loge (LDH) (adjusted HR: 9.91, 95% CI: 2.44–40.3, p = 0.001) and chest radiographic score (adjusted HR: 1.24, 95% CI: 1.05–1.47, p = 0.01) were risk factors for mortality, whereas ventilation days were a protective factor (adjusted HR: 0.84, 95% CI: 0.76–0.93, p = 0.001). Conclusion According to our results, blood LDH levels of > 512 had a 94% sensitivity and 93% specificity for predicting in-hospital mortality in patients infected with MERS-CoV. The chest radiographic score of 11.34 ± 5.4 was the risk factor for the mortality (adjusted Hazard ratio HR: 1.24, 95% CI: 1.05–1.47, p = 0.01). Thus, threshold may aid in the identification of individuals with MERS-CoV infection who die in hospital.
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Kukla M, Menżyk T, Dembiński M, Winiarski M, Garlicki A, Bociąga-Jasik M, Skonieczna M, Hudy D, Maziarz B, Kusnierz-Cabala B, Skladany L, Grgurevic I, Wójcik-Bugajska M, Grodzicki T, Stygar D, Rogula T. Anti-inflammatory adipokines: chemerin, vaspin, omentin concentrations and SARS-CoV-2 outcomes. Sci Rep 2021; 11:21514. [PMID: 34728695 PMCID: PMC8563971 DOI: 10.1038/s41598-021-00928-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 10/11/2021] [Indexed: 12/15/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is associated with systemic inflammation. A wide range of adipokines activities suggests they influence pathogenesis and infection course. The aim was to assess concentrations of chemerin, omentin, and vaspin among COVID-19 patients with an emphasis on adipokines relationship with COVID-19 severity, concomitant metabolic abnormalities and liver dysfunction. Serum chemerin, omentin and vaspin concentrations were measured in serum collected from 70 COVID-19 patients at the moment of admission to hospital, before any treatment was applied and 20 healthy controls. Serum chemerin and omentin concentrations were significantly decreased in COVID-19 patients compared to healthy volunteers (271.0 vs. 373.0 ng/ml; p < 0.001 and 482.1 vs. 814.3 ng/ml; p = 0.01, respectively). There were no correlations of analyzed adipokines with COVID-19 severity based on the presence of pneumonia, dyspnea, or necessity of Intensive Care Unit hospitalization (ICU). Liver test abnormalities did not influence adipokines levels. Elevated GGT activity was associated with ICU admission, presence of pneumonia and elevated concentrations of CRP, ferritin and interleukin 6. Chemerin and omentin depletion in COVID-19 patients suggests that this adipokines deficiency play influential role in disease pathogenesis. However, there was no relationship between lower adipokines level and frequency of COVID-19 symptoms as well as disease severity. The only predictive factor which could predispose to a more severe COVID-19 course, including the presence of pneumonia and ICU hospitalization, was GGT activity.
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Affiliation(s)
- Michał Kukla
- Department of Internal Medicine and Geriatrics, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland.,Department of Endoscopy, University Hospital in Kraków, Cracow, Poland
| | - Tomasz Menżyk
- Department of Internal Medicine, Gastroenterology and Acute Intoxication, Regional Hospital, Tarnów, Poland
| | - Marcin Dembiński
- Department of Endoscopy, University Hospital in Kraków, Cracow, Poland.,2nd Department of General Surgery, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Marek Winiarski
- Department of Endoscopy, University Hospital in Kraków, Cracow, Poland.,2nd Department of General Surgery, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Aleksander Garlicki
- Chair of Gastroenterology, Hepatology and Infectious Diseases, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Monika Bociąga-Jasik
- Chair of Gastroenterology, Hepatology and Infectious Diseases, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Magdalena Skonieczna
- Department of Systems Biology and Engineering, Silesian University of Technology, 44-100, Gliwice, Poland.,Biotechnology Centre, Silesian University of Technology, 44-100, Gliwice, Poland
| | - Dorota Hudy
- Department of Systems Biology and Engineering, Silesian University of Technology, 44-100, Gliwice, Poland.,Biotechnology Centre, Silesian University of Technology, 44-100, Gliwice, Poland
| | - Barbara Maziarz
- Chair of Clinical BioChemistry, Department of Diagnostics, Faculty of Medicine, Jagiellonian University Medical College, 31-501, Cracow, Poland
| | - Beata Kusnierz-Cabala
- Chair of Clinical BioChemistry, Department of Diagnostics, Faculty of Medicine, Jagiellonian University Medical College, 31-501, Cracow, Poland
| | - Lubomir Skladany
- Department of Internal Medicine and HEGITO (Hepatology, Gastroenterology and Liver Transplantation), F.D. Roosevelt University Hospital, Banska Bystrica, Slovakia
| | - Ivica Grgurevic
- Zagreb University School of Medicine, Šalata ul. 2, 10000, Zagreb, Croatia.,Division for Liver Diseases, Department of Gastroenterology, Dubrava University Hospital, Zagreb, Croatia
| | - Małgorzata Wójcik-Bugajska
- Department of Internal Medicine and Geriatrics, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Tomasz Grodzicki
- Department of Internal Medicine and Geriatrics, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
| | - Dominika Stygar
- Department of Physiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, 40-055, Katowice, Poland.
| | - Tomasz Rogula
- Case Western Reserve University School of Medicine, Cleveland, OH, USA.,1st Department of General Surgery, Faculty of Medicine, Jagiellonian University Medical College, Cracow, Poland
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Yoo HW, Jin HY, Yon DK, Effenberger M, Shin YH, Kim SY, Yang JM, Kim MS, Koyanagi A, Jacob L, Smith L, Yoo IK, Shin JI, Lee SW. Non-alcoholic Fatty Liver Disease and COVID-19 Susceptibility and Outcomes: a Korean Nationwide Cohort. J Korean Med Sci 2021; 36:e291. [PMID: 34697932 PMCID: PMC8546310 DOI: 10.3346/jkms.2021.36.e291] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 10/05/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Evidence for the association between underlying non-alcoholic fatty liver disease (NAFLD), the risk of testing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive, and the clinical consequences of coronavirus disease 2019 (COVID-19) is controversial and scarce. We aimed to investigate the association between the presence of NAFLD and the risk of SARS-CoV-2 infectivity and COVID-19-related outcomes. METHODS We used the population-based, nationwide cohort in South Korea linked with the general health examination records between January 1, 2018 and July 30, 2020. Data for 212,768 adults older than 20 years who underwent SARS-CoV-2 testing from January 1 to May 30, 2020, were obtained. The presence of NAFLDs was defined using three definitions, namely hepatic steatosis index (HSI), fatty liver index (FLI), and claims-based definition. The outcomes were SARS-CoV-2 test positive, COVID-19 severe illness, and related death. RESULTS Among 74,244 adults who completed the general health examination, there were 2,251 (3.0%) who were SARS-CoV-2 positive, 438 (0.6%) with severe COVID-19 illness, and 45 (0.06%) COVID-19-related deaths. After exposure-driven propensity score matching, patients with pre-existing HSI-NAFLD, FLI-NAFLD, or claims-based NAFLD had an 11-23% increased risk of SARS-CoV-2 infection (HSI-NAFLD 95% confidence interval [CI], 1-28%; FLI-NAFLD 95% CI, 2-27%; and claims-based NAFLD 95% CI, 2-31%) and a 35-41% increased risk of severe COVID-19 illness (HSI-NAFLD 95% CI, 8-83%; FLI-NAFLD 95% CI, 5-71%; and claims-based NAFLD 95% CI, 1-92%). These associations are more evident as liver fibrosis advanced (based on the BARD scoring system). Similar patterns were observed in several sensitivity analyses including the full-unmatched cohort. CONCLUSION Patients with pre-existing NAFLDs have a higher likelihood of testing SARS-CoV-2 positive and severe COVID-19 illness; this association was more evident in patients with NAFLD with advanced fibrosis. Our results suggest that extra attention should be given to the management of patients with NAFLD during the COVID-19 pandemic.
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Affiliation(s)
- Hae Won Yoo
- Division of Gastroenterology and Hepatology, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Hyun Young Jin
- Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea
| | - Dong Keon Yon
- Department of Pediatrics, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
| | - Maria Effenberger
- Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, Innsbruck, Austria
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Korea
| | - So Young Kim
- Department of Otorhinolaryngology-Head & Neck Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Jee Myung Yang
- Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Min Seo Kim
- Genomics and Digital Health, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Korea
- Korea University College of Medicine, Seoul, Korea
| | - Ai Koyanagi
- Catalan Institution for Research and Advanced Studies (ICREA), Pg. Lluis Companys, Barcelona, Spain
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - In Kyung Yoo
- Department of Gastroenterology, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
| | - Seung Won Lee
- Department of Data Science, Sejong University College of Software Convergence, Seoul, Korea.
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35
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Kukla M, Menżyk T, Dembiński M, Winiarski M, Garlicki A, Bociąga-Jasik M, Skonieczna M, Hudy D, Maziarz B, Kuśnierz-Cabala B, Kapusta M, Skladany L, Grgurevic I, Mikolasevic I, Filipec-Kanizaj T, Wójcik-Bugajska M, Grodzicki T, Rogula T, Stygar D. Fetuin-A Deficiency but Not Pentraxin 3, FGF-21, or Irisin, Predisposes to More Serious COVID-19 Course. Biomolecules 2021; 11:biom11101422. [PMID: 34680053 PMCID: PMC8533535 DOI: 10.3390/biom11101422] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 09/19/2021] [Accepted: 09/22/2021] [Indexed: 02/07/2023] Open
Abstract
Analysis of liver biopsy specimens showed that SARS-CoV-2 might have led to liver damage. This study aimed to evaluate the role of selected hepatokines and myokines in the development and progression of COVID-19. Seventy patients with laboratory-confirmed COVID-19 and 20 healthy volunteers were enrolled in the study. Irisin, pentraxin 3, fetuin-A, and FGF-21 serum concentrations and biochemical parameters were assessed using an immunoenzymatic method with commercially available enzyme immunoassay (EIA) or enzyme-linked immunosorbent assay (ELISA) kits. Serum fetuin-A concentrations were significantly decreased in COVID-19 patients compared to healthy volunteers. The serum concentration of FGF-21 was significantly increased in obese COVID-19 patients compared to overweight ones. Moreover, the FGF-21 level was higher in COVID-19 patients diagnosed with metabolic syndrome than in patients without metabolic syndrome. PTX3 concentration was higher in COVID-19 patients with higher HOMA-IR values than those with lower HOMA-IR values. COVID-19 patients with HOMA-IR ≤ 3 and >3 had significantly lower fetuin-A levels than the control group. Irisin concentration was significantly decreased in the HOMA-IR ≤ 3 COVID-19 subgroup when comparing with the control group. Lower levels of fetuin-A observed in COVID-19 patients despite higher HOMA-IR, CRP, and ferritin levels, pneumonia, patients requiring ICU care suggests that fetuin-A deficiency predisposes to more severe COVID-19 course. Upregulated pentraxin 3 may be used as a potential predictor of COVID-19 severity.
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Affiliation(s)
- Michał Kukla
- Department of Internal Medicine and Geriatrics, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2, 30-688 Kraków, Poland; (M.K.); (M.W.-B.); (T.G.)
- Department of Endoscopy, University Hospital in Kraków, Jakubowskiego 2, 30-688 Kraków, Poland; (M.D.); (M.W.)
| | - Tomasz Menżyk
- Department of Internal Medicine, Gastroenterology and Acute Intoxication, Regional Hospital, Lwowska 178A, 33-100 Tarnów, Poland;
| | - Marcin Dembiński
- Department of Endoscopy, University Hospital in Kraków, Jakubowskiego 2, 30-688 Kraków, Poland; (M.D.); (M.W.)
- 2nd Department of General Surgery, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2, 30-688 Kraków, Poland
| | - Marek Winiarski
- Department of Endoscopy, University Hospital in Kraków, Jakubowskiego 2, 30-688 Kraków, Poland; (M.D.); (M.W.)
- 2nd Department of General Surgery, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2, 30-688 Kraków, Poland
| | - Aleksander Garlicki
- Chair of Gastroenterology, Hepatology and Infectious Diseases, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2, 30-688 Kraków, Poland; (A.G.); (M.B.-J.)
| | - Monika Bociąga-Jasik
- Chair of Gastroenterology, Hepatology and Infectious Diseases, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2, 30-688 Kraków, Poland; (A.G.); (M.B.-J.)
| | - Magdalena Skonieczna
- Department of Systems Biology and Engineering, Silesian University of Technology, Akademicka 16, 44-100 Gliwice, Poland; (M.S.); (D.H.)
- Biotechnology Centre, Silesian University of Technology, Krzywoustego 8, 44-100 Gliwice, Poland
| | - Dorota Hudy
- Department of Systems Biology and Engineering, Silesian University of Technology, Akademicka 16, 44-100 Gliwice, Poland; (M.S.); (D.H.)
- Biotechnology Centre, Silesian University of Technology, Krzywoustego 8, 44-100 Gliwice, Poland
| | - Barbara Maziarz
- Department of Diagnostics, Chair of Clinical Biochemistry, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2, 30-688 Kraków, Poland; (B.M.); (B.K.-C.); (M.K.)
| | - Beata Kuśnierz-Cabala
- Department of Diagnostics, Chair of Clinical Biochemistry, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2, 30-688 Kraków, Poland; (B.M.); (B.K.-C.); (M.K.)
| | - Maria Kapusta
- Department of Diagnostics, Chair of Clinical Biochemistry, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2, 30-688 Kraków, Poland; (B.M.); (B.K.-C.); (M.K.)
| | - Lubomir Skladany
- Department of Internal Medicine and HEGITO (Hepatology, Gastroenterology and Liver Transplantation), F.D. Roosevelt University Hospital, Nam. l. Svobodu 1, 975 17 Banska Bystrica, Slovakia;
| | - Ivica Grgurevic
- School of Medicine, Zagreb University, Šalata ul. 2, 10000 Zagreb, Croatia; (I.G.); (T.F.-K.)
- Division for Liver Diseases, Department of Gastroenterology, Dubrava University Hospital, Avenija Gojka Šuška 6, 10000 Zagreb, Croatia
| | - Ivana Mikolasevic
- Department of Gastroenterology, Clinical Hospital Center Rijeka, Krešimirova ul. 42, 51000 Rijeka, Croatia;
| | - Tajana Filipec-Kanizaj
- School of Medicine, Zagreb University, Šalata ul. 2, 10000 Zagreb, Croatia; (I.G.); (T.F.-K.)
| | - Małgorzata Wójcik-Bugajska
- Department of Internal Medicine and Geriatrics, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2, 30-688 Kraków, Poland; (M.K.); (M.W.-B.); (T.G.)
| | - Tomasz Grodzicki
- Department of Internal Medicine and Geriatrics, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2, 30-688 Kraków, Poland; (M.K.); (M.W.-B.); (T.G.)
| | - Tomasz Rogula
- 1st Department of General Surgery, Faculty of Medicine, Jagiellonian University Medical College, Jakubowskiego 2, 30-688 Kraków, Poland;
- Health Education Campus, Case Western Reserve University School of Medicine, 9501 Euclid Ave, Cleveland, OH 44106, USA
| | - Dominika Stygar
- Department of Physiology, School of Medicine with the Division of Dentistry in Zabrze, Medical University of Silesia, Poniatowskiego 15, 40-055 Katowice, Poland
- Correspondence: or ; Tel.: +48-32-272-2362
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Wang X, Lei J, Li Z, Yan L. Potential Effects of Coronaviruses on the Liver: An Update. Front Med (Lausanne) 2021; 8:651658. [PMID: 34646834 PMCID: PMC8502894 DOI: 10.3389/fmed.2021.651658] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 07/22/2021] [Indexed: 02/06/2023] Open
Abstract
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.
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Affiliation(s)
- Xinyi Wang
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu, China
- Liver Surgery Center, West China Hospital of Sichuan University, Chengdu, China
| | - Jianyong Lei
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu, China
- Liver Surgery Center, West China Hospital of Sichuan University, Chengdu, China
| | - Zhihui Li
- Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu, China
- Liver Surgery Center, West China Hospital of Sichuan University, Chengdu, China
| | - Lunan Yan
- Liver Surgery Center, West China Hospital of Sichuan University, Chengdu, China
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37
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Koulaouzidis G, Charisopoulou D, Kukla M, Marlicz W, Rydzewska G, Koulaouzidis A, Skonieczna-Żydecka K. Association of non-alcoholic fatty liver disease with coronary artery calcification progression: a systematic review and meta-analysis. PRZEGLAD GASTROENTEROLOGICZNY 2021; 16:196-206. [PMID: 34584580 PMCID: PMC8456760 DOI: 10.5114/pg.2021.109063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 08/31/2021] [Indexed: 12/12/2022]
Abstract
INTRODUCTION Non-alcoholic fatty liver disease (NAFLD) is the most common chronic liver disease, which is estimated to affect 20-30% of the adult population in Europe. Several studies have shown an association of NAFLD with multiple cardiovascular risk factors such as abdominal obesity, atherogenic dyslipidaemia, hypertension, insulin resistance, and impaired glucose tolerance. Atherosclerosis is a chronic, progressive, inflammatory disease, which begins early in life and follows a long asymptomatic phase. Coronary artery calcification (CAC) is the radiological confirmation of the presence of atherosclerotic coronary artery disease. The predictive value of CAC for future cardiac events is well established. Also, the progression of CAC is strongly associated with the development of cardiovascular events. AIM To assess the association of NAFLD with the progression of subclinical atherosclerotic activity, reflected as the dynamic changes in CAC score over time. MATERIAL AND METHODS The databases PubMed/Medline/Embase from inception until 31 December 2020 were searched for observational studies investigating NAFLD and CAC progression in adults. RESULTS In total, 5 studies were included, 4 of which, including 10,060 patients, provided data regarding the association of NAFLD with the progression of CAC. The analysis showed that NAFLD is associated with significant odds of progression of CAC; OR = 1.5, 95% CI: 1.34-1.68, p = 0.001. No publication bias was detected (Egger's test p = 0.6). Meta-regression analyses proved that OR toward CAC progression is not significantly influenced by the time of follow-up (coefficient = 0.0083, Z = 1.14, p = 0.25). CONCLUSIONS NAFLD increases the risk toward CAC progression over time.
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Affiliation(s)
- George Koulaouzidis
- Department of Biochemical Sciences, Pomeranian Medical University, Szczecin, Poland
| | - Dafni Charisopoulou
- Amalia Children’s Hospital, Radboud University Medical Centre, Nijmegen, Netherlands
- Academic Centre for Congenital Heart Disease, Netherlands
| | - Michał Kukla
- Department of Internal Medicine and Geriatrics, Faculty of Medicine, Jagiellonian University Medical College, Krakow, Poland
- Department of Endoscopy, University Hospital, Krakow, Poland
| | - Wojciech Marlicz
- Department of Gastroenterology, Pomeranian Medical University, Szczecin, Poland
- Endoklinika, The Centre for Digestive Diseases, Szczecin, Poland
| | - Grażyna Rydzewska
- Clinical Department of Internal Medicine and Gastroenterology with Inflammatory Bowel Disease Unit, Central Clinical Hospital of the Ministry of the Inferior and Administration, Warsaw, Poland
- Collegium Medicum, Jan Kochanowski University, Kielce, Poland
| | - Anastasios Koulaouzidis
- Department of Social Medicine and Public Health, Pomeranian Medical University, Szczecin, Poland
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38
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Caterino M, Costanzo M, Fedele R, Cevenini A, Gelzo M, Di Minno A, Andolfo I, Capasso M, Russo R, Annunziata A, Calabrese C, Fiorentino G, D’Abbraccio M, Dell’Isola C, Fusco FM, Parrella R, Fabbrocini G, Gentile I, Castaldo G, Ruoppolo M. The Serum Metabolome of Moderate and Severe COVID-19 Patients Reflects Possible Liver Alterations Involving Carbon and Nitrogen Metabolism. Int J Mol Sci 2021; 22:ijms22179548. [PMID: 34502454 PMCID: PMC8431319 DOI: 10.3390/ijms22179548] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/17/2021] [Accepted: 08/30/2021] [Indexed: 12/15/2022] Open
Abstract
COVID-19 is a global threat that has spread since the end of 2019, causing severe clinical sequelae and deaths, in the context of a world pandemic. The infection of the highly pathogenetic and infectious SARS-CoV-2 coronavirus has been proven to exert systemic effects impacting the metabolism. Yet, the metabolic pathways involved in the pathophysiology and progression of COVID-19 are still unclear. Here, we present the results of a mass spectrometry-based targeted metabolomic analysis on a cohort of 52 hospitalized COVID-19 patients, classified according to disease severity as mild, moderate, and severe. Our analysis defines a clear signature of COVID-19 that includes increased serum levels of lactic acid in all the forms of the disease. Pathway analysis revealed dysregulation of energy production and amino acid metabolism. Globally, the variations found in the serum metabolome of COVID-19 patients may reflect a more complex systemic perturbation induced by SARS-CoV-2, possibly affecting carbon and nitrogen liver metabolism.
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Affiliation(s)
- Marianna Caterino
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Napoli, Italy; (M.C.); (M.C.); (R.F.); (A.C.); (M.G.); (A.D.M.); (I.A.); (M.C.); (R.R.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Scuola di Medicina e Chirurgia, Università degli Studi di Napoli “Federico II”, 80131 Napoli, Italy
| | - Michele Costanzo
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Napoli, Italy; (M.C.); (M.C.); (R.F.); (A.C.); (M.G.); (A.D.M.); (I.A.); (M.C.); (R.R.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Scuola di Medicina e Chirurgia, Università degli Studi di Napoli “Federico II”, 80131 Napoli, Italy
| | - Roberta Fedele
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Napoli, Italy; (M.C.); (M.C.); (R.F.); (A.C.); (M.G.); (A.D.M.); (I.A.); (M.C.); (R.R.)
| | - Armando Cevenini
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Napoli, Italy; (M.C.); (M.C.); (R.F.); (A.C.); (M.G.); (A.D.M.); (I.A.); (M.C.); (R.R.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Scuola di Medicina e Chirurgia, Università degli Studi di Napoli “Federico II”, 80131 Napoli, Italy
| | - Monica Gelzo
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Napoli, Italy; (M.C.); (M.C.); (R.F.); (A.C.); (M.G.); (A.D.M.); (I.A.); (M.C.); (R.R.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Scuola di Medicina e Chirurgia, Università degli Studi di Napoli “Federico II”, 80131 Napoli, Italy
| | - Alessandro Di Minno
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Napoli, Italy; (M.C.); (M.C.); (R.F.); (A.C.); (M.G.); (A.D.M.); (I.A.); (M.C.); (R.R.)
- Dipartimento di Farmacia, Università Degli Studi di Napoli “Federico II”, 80131 Napoli, Italy
| | - Immacolata Andolfo
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Napoli, Italy; (M.C.); (M.C.); (R.F.); (A.C.); (M.G.); (A.D.M.); (I.A.); (M.C.); (R.R.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Scuola di Medicina e Chirurgia, Università degli Studi di Napoli “Federico II”, 80131 Napoli, Italy
| | - Mario Capasso
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Napoli, Italy; (M.C.); (M.C.); (R.F.); (A.C.); (M.G.); (A.D.M.); (I.A.); (M.C.); (R.R.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Scuola di Medicina e Chirurgia, Università degli Studi di Napoli “Federico II”, 80131 Napoli, Italy
| | - Roberta Russo
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Napoli, Italy; (M.C.); (M.C.); (R.F.); (A.C.); (M.G.); (A.D.M.); (I.A.); (M.C.); (R.R.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Scuola di Medicina e Chirurgia, Università degli Studi di Napoli “Federico II”, 80131 Napoli, Italy
| | - Anna Annunziata
- Fisiopatologia e Riabilitazione Respiratoria-1 Utsir COVID, Azienda Ospedaliera Specialistica dei Colli-Napoli, 80137 Napoli, Italy; (A.A.); (G.F.)
| | - Cecilia Calabrese
- Dipartimento di Scienze Mediche Traslazionali, Università degli Studi della Campania “Luigi Vanvitelli”, 81100 Napoli, Italy;
| | - Giuseppe Fiorentino
- Fisiopatologia e Riabilitazione Respiratoria-1 Utsir COVID, Azienda Ospedaliera Specialistica dei Colli-Napoli, 80137 Napoli, Italy; (A.A.); (G.F.)
| | - Maurizio D’Abbraccio
- COVID Unit—Azienda Ospedaliera Specialistica dei Colli—Napoli, Dipartimento di Malattie Infettive ed Urgenze Infettivologiche, 80137 Napoli, Italy; (M.D.); (C.D.); (F.M.F.); (R.P.)
| | - Chiara Dell’Isola
- COVID Unit—Azienda Ospedaliera Specialistica dei Colli—Napoli, Dipartimento di Malattie Infettive ed Urgenze Infettivologiche, 80137 Napoli, Italy; (M.D.); (C.D.); (F.M.F.); (R.P.)
| | - Francesco Maria Fusco
- COVID Unit—Azienda Ospedaliera Specialistica dei Colli—Napoli, Dipartimento di Malattie Infettive ed Urgenze Infettivologiche, 80137 Napoli, Italy; (M.D.); (C.D.); (F.M.F.); (R.P.)
| | - Roberto Parrella
- COVID Unit—Azienda Ospedaliera Specialistica dei Colli—Napoli, Dipartimento di Malattie Infettive ed Urgenze Infettivologiche, 80137 Napoli, Italy; (M.D.); (C.D.); (F.M.F.); (R.P.)
| | - Gabriella Fabbrocini
- Dipartimento di Medicina Clinica e Chirurgica, Università degli Studi di Napoli “Federico II”, 80131 Napoli, Italy; (G.F.); (I.G.)
| | - Ivan Gentile
- Dipartimento di Medicina Clinica e Chirurgica, Università degli Studi di Napoli “Federico II”, 80131 Napoli, Italy; (G.F.); (I.G.)
| | - Giuseppe Castaldo
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Napoli, Italy; (M.C.); (M.C.); (R.F.); (A.C.); (M.G.); (A.D.M.); (I.A.); (M.C.); (R.R.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Scuola di Medicina e Chirurgia, Università degli Studi di Napoli “Federico II”, 80131 Napoli, Italy
- Correspondence: (G.C.); (M.R.); Tel.: +39-081-373-7850 (M.R.)
| | - Margherita Ruoppolo
- CEINGE-Biotecnologie Avanzate s.c.ar.l., 80145 Napoli, Italy; (M.C.); (M.C.); (R.F.); (A.C.); (M.G.); (A.D.M.); (I.A.); (M.C.); (R.R.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Scuola di Medicina e Chirurgia, Università degli Studi di Napoli “Federico II”, 80131 Napoli, Italy
- Correspondence: (G.C.); (M.R.); Tel.: +39-081-373-7850 (M.R.)
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Lopes LR. Functional and tissue enrichment analyses suggest that SARS-CoV-2 infection affects host metabolism and catabolism mediated by interference on host proteins. Braz J Microbiol 2021; 52:1151-1159. [PMID: 33956332 PMCID: PMC8099703 DOI: 10.1007/s42770-021-00497-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/08/2021] [Indexed: 12/24/2022] Open
Abstract
Infection by SARS-CoV-2, the causative agent of COVID-19, is critically connected with host metabolism. Through functional enrichment analysis, the present study aims to evaluate the biological processes involving host proteins interfered by SARS-CoV-2 to verify the potential metabolic impact of the infection. Furthermore, tissue enrichment analyses and differential gene expression of host proteins were applied to understand the interference by SARS-CoV-2 on tissue levels. Results based on functional and tissue-specific enrichment analyses, presented in this study, suggest that SARS-CoV-2, mediated interference on host proteins, can affect the metabolism and catabolism of molecular building blocks and control intracellular mechanisms, including gene expression in metabolism-related organs, to support viral demands. Thus, SARS-CoV-2 can broadly affect the host metabolism and catabolism at tissue and physiological levels contributing to a more severe disease.
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Affiliation(s)
- Luciano Rodrigo Lopes
- Bioinformatics and Bio-Data Science Division, Health Informatics Department, Universidade Federal de São Paulo-UNIFESP, Rua Botucatu 862 - Prédio Leal Prado (térreo), São Paulo, SP, CEP: 04023-062, Brazil.
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Pre-Existing HBV and HCV Infections Do Not Affect COVID-19-Related Outcomes: An Observational Retrospective Study. HEPATITIS MONTHLY 2021. [DOI: 10.5812/hepatmon.116986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
Abstract
Background: A better understanding of the interaction between SARS-CoV-2 infection and HBV or HCV hepatitis is very important. Objectives: We aimed to determine the prevalence and the impact of pre-existing HBV and HCV infections in patients with COVID-19. Methods: We conducted a retrospective study and included all the subjects positive for SARS-CoV-2 from March to May 2020. We evaluated the prevalence of chronic HBV and HCV infections and performed a matched cohort analysis to compare COVID-19-related outcomes between patients with and without infections due to HBV or HCV. Results: Among 606 subjects, 12 cases (2%) had positive HBsAg, and 6 cases (0.99%) presented detectable HCV RNA. We recognized 80 individuals positive for SARS-CoV-2 with negative markers for HBV and HCV suitable for the matched analysis. No statistical differences in mechanical ventilation support and mortality rates were found (P = 0.27 and P = 0.80, respectively). Moreover, although not statistically different, individuals with viral hepatitis were more likely to be admitted to the Intensive Care Unit in comparison to those without HBV or HCV infections (29% vs. 15%). The median time of virus clearance was 27.5 days, with no difference between the two groups. Conclusions: In our cohort, the pre-existing viral liver infection did not have any impact on the clinical and virological evolution of COVID-19.
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Qu J, Zhu HH, Huang XJ, He GF, Liu JY, Huang JJ, Chen Y, Qu Q, Wu YL, Chen XY, Lu Q. Abnormal Indexes of Liver and Kidney Injury Markers Predict Severity in COVID-19 Patients. Infect Drug Resist 2021; 14:3029-3040. [PMID: 34408447 PMCID: PMC8364353 DOI: 10.2147/idr.s321915] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 07/21/2021] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND SARS-CoV-2 can damage not only the lungs but also the liver and kidney. Most critically ill patients with coronavirus disease 2019 (COVID-19) have liver and kidney dysfunction. We aim to investigate the levels of liver and kidney function indexes in mild and severe COVID-19 patients and their capability to predict the severity of the disease. METHODS The characteristics and laboratory indexes were compared between patients with different conditions. We applied binary logistic regression to find the independent risk factors of severe patients. Receiver operating characteristic (ROC) analysis was used to predict the severity of COVID-19 using the liver and kidney function indexes. RESULTS This study enrolled 266 COVID-19 patients, including 235 mild patients and 31 severe patients. Compared with mild patients, severe patients had lower albumin (ALB) and higher alanine aminotransferase (ALT), aspartate aminotransferase (AST), and urea nitrogen (BUN) (all p<0.001). Binary logistic regression analysis also identified ALB [OR=0.273 (0.079-0.947), p=0.041] and ALT [OR=2.680 (1.036-6.934), p=0.042] as independent factors of severe COVID-19 patients. Combining ALB, ALT, BUN, and LDH exhibited the area under ROC at 0.914, with a sensitivity of 86.7% and specificity of 83.0%. CONCLUSION COVID-19 patients, especially severe patients, have damage to liver and kidney function. ALT, AST, LDH, and BUN could be independent factors for predicting the severity of COVID-19. Combining the ALB, ALT, BUN, and LDH could predict the transition from mild to severe in COVID-19 patients.
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Affiliation(s)
- Jian Qu
- Department of Pharmacy, the Second Xiangya Hospital, Central South University; Institute of Clinical Pharmacy, Central South University, Changsha, 410011, People’s Republic of China
| | - Hai-Hong Zhu
- Department of Pharmacy, the Second Xiangya Hospital, Central South University; Institute of Clinical Pharmacy, Central South University, Changsha, 410011, People’s Republic of China
| | - Xue-Jian Huang
- Department of Pharmacy, the Second Xiangya Hospital, Central South University; Institute of Clinical Pharmacy, Central South University, Changsha, 410011, People’s Republic of China
| | - Ge-Fei He
- Department of Pharmacy, The First Hospital of Changsha, Changsha, 410005, People’s Republic of China
| | - Ji-Yang Liu
- Department of Pharmacy, The First Hospital of Changsha, Changsha, 410005, People’s Republic of China
| | - Juan-Juan Huang
- Department of Pharmacy, The First Hospital of Changsha, Changsha, 410005, People’s Republic of China
| | - Ying Chen
- Department of Pharmacy, Wuhan University, Renmin Hospital, Wuhan, 430060, People’s Republic of China
| | - Qiang Qu
- Department of Pharmacy, Xiangya Hospital, Central South University, Changsha, 410007, People’s Republic of China
| | - Ya-Li Wu
- Department of Pharmacy, Hunan Provincial Maternal and Child Health Care Hospital, Changsha, 410000, People’s Republic of China
| | - Xiang-Yu Chen
- Department of Radiology, the Second Xiangya Hospital, Central South University, Changsha, 410011, People’s Republic of China
| | - Qiong Lu
- Department of Pharmacy, the Second Xiangya Hospital, Central South University; Institute of Clinical Pharmacy, Central South University, Changsha, 410011, People’s Republic of China
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Ngiam JN, Chew N, Tham SM, Lim ZY, Li TYW, Cen S, Tambyah PA, Santosa A, Muthiah M, Sia CH, Cross GB. Elevated liver enzymes in hospitalized patients with COVID-19 in Singapore. Medicine (Baltimore) 2021; 100:e26719. [PMID: 34397705 PMCID: PMC8322538 DOI: 10.1097/md.0000000000026719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 07/08/2021] [Indexed: 01/04/2023] Open
Abstract
Liver dysfunction in patients with COVID-19 (coronavirus disease 2019) has been described. However, it is not clear if the presence of abnormal liver function tests at presentation was related to underlying undiagnosed liver disease, or a result of the viral infection.We retrospectively examined the first 554 consecutive polymerase chain reaction positive SARS-CoV-2 patients admitted from February 2020 to April 2020 to our academic medical centre. We reviewed their clinical data, chest radiography and laboratory studies obtained within 24 hour of admission.Despite similar hemodynamic parameters, we found significant aspartate transaminase elevation (64 ± 141 vs 35 ± 23 U/L, P < .001) in those with pneumonia compared to those without. Elevated liver enzymes were seen in 102 patients (18.4%). They presented with higher temperatures (38.5 ± 0.9 vs 37.5 ± 0.8 degC, P = .011), higher total white cell counts (6.95 ± 2.29 vs 6.39 ± 2.19 x109/L, P = .021), serum ferritin (240 ± 274 vs 165 ± 198 ng/ml, P = .002) and lactate dehydrogenase (632 ± 912 vs 389 ± 107 U/L, P < .001). These patients were more likely to require intensive care (6.9% vs 2.7% P = .036) and mechanical ventilation (5.9% vs 2.2%, P = .046). Migrant workers from dormitories had a higher rate of baseline liver function test abnormalities (88/425 vs 14/129, P = .01), which were more likely to persist at the time of discharge.Despite relatively mild COVID-19 disease, there was a significant prevalence of liver dysfunction, particularly amongst migrant workers. Elevated liver enzymes were associated with more severe disease, despite similar haemodynamic characteristics. Future studies should explore whether pre-existing liver disease may predispose to more severe COVID-19 disease.
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Affiliation(s)
| | - Nicholas Chew
- Department of Cardiology, National University Heart Centre Singapore, Singapore
| | - Sai Meng Tham
- Division of Infectious Diseases, National University Health System, Singapore
| | - Zhen Yu Lim
- Department of Medicine, National University Health System, Singapore
| | - Tony Yi-Wei Li
- Department of Medicine, National University Health System, Singapore
| | - Shuyun Cen
- Department of Medicine, National University Health System, Singapore
| | - Paul Anantharajah Tambyah
- Division of Infectious Diseases, National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Infectious Diseases Translational Research Programme, Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Amelia Santosa
- Division of Rheumatology, National University Health System, Singapore
| | - Mark Muthiah
- Division of Rheumatology, National University Health System, Singapore
- Division of Gastroenterology and Hepatology, National University Health System, Singapore
| | - Ching-Hui Sia
- Department of Cardiology, National University Heart Centre Singapore, Singapore
- Division of Rheumatology, National University Health System, Singapore
| | - Gail Brenda Cross
- Division of Infectious Diseases, National University Health System, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Mohamed DZ, Ghoneim MES, Abu-Risha SES, Abdelsalam RA, Farag MA. Gastrointestinal and hepatic diseases during the COVID-19 pandemic: Manifestations, mechanism and management. World J Gastroenterol 2021; 27:4504-4535. [PMID: 34366621 PMCID: PMC8326263 DOI: 10.3748/wjg.v27.i28.4504] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 02/12/2021] [Accepted: 06/07/2021] [Indexed: 02/06/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is considered the causative pathogen of coronavirus disease 2019 (COVID-19) and has become an international danger to human health. Although respiratory transmission and symptoms are still the essential manifestations of COVID-19, the digestive system could be an unconventional or supplementary route for COVID-19 to be transmitted and manifested, most likely due to the presence of angiotensin-converting enzyme 2 (ACE2) in the gastrointestinal tract. In addition, SARS-CoV-2 can trigger hepatic injury via direct binding to the ACE2 receptor in cholangiocytes, antibody-dependent enhancement of infection, systemic inflammatory response syndrome, inflammatory cytokine storms, ischemia/reperfusion injury, and adverse events of treatment drugs. Gastrointestinal symptoms, including anorexia, nausea, vomiting, and diarrhea, which are unusual in patients with COVID-19, and some digestive signs may occur without other respiratory symptoms. Furthermore, SARS-CoV-2 can be found in infected patients' stool, demonstrating the likelihood of transmission through the fecal-oral route. In addition, liver function should be monitored during COVID-19, particularly in more severe cases. This review summarizes the evidence for extra-pulmonary manifestations, mechanisms, and management of COVID-19, particularly those related to the gastrointestinal tract and liver.
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Affiliation(s)
- Dina Zakaria Mohamed
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tanta University, Tanta 31511, Egypt
| | - Mai El-Sayed Ghoneim
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, University of Sadat City, Menoufia 32632, Egypt
| | - Sally El-Sayed Abu-Risha
- Department of Pharmacology and Toxicology, Faculty of Pharmacy, Tanta University, Tanta 31511, Egypt
| | - Ramy Ahmed Abdelsalam
- Department of Pathology, Faculty of Medicine, Mansoura University, Mansoura 35511, Egypt
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Vuppalanchi V, Gelow K, Green K, Vuppalanchi R, Lammert C. Behaviors, symptoms, and outcomes of North American patients with autoimmune hepatitis during the COVID-19 pandemic. J Investig Med 2021; 69:1426-1433. [PMID: 34315800 PMCID: PMC8318716 DOI: 10.1136/jim-2021-001871] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2021] [Indexed: 02/06/2023]
Abstract
The management of patients with autoimmune hepatitis (AIH) in the era of SARS-CoV-2 is challenging given minimal published clinical data. We used a large cohort of patients with AIH across the USA to investigate the differences in known risk factors for severe SARS-CoV-2 and AIH characteristics among patients who experienced symptoms consistent with COVID-19 illness versus those who did not. Additionally, we explored the effect of living through the SARS-CoV-2 pandemic on the extrahepatic symptoms and behaviors of patients with AIH. An invitation to complete a COVID-19-specific questionnaire was publicized in well-established social media cohorts of patients with AIH. Eligibility criteria were age ≥18 years, US residency, and an AIH diagnosis by a physician. A total of 420 individuals were eligible for the study. Symptoms consistent with COVID-19 were reported in 11% (n=48) with 3 patients requiring hospitalizations. Body mass index (BMI) >40 kg/m2 (23% vs 10%, p=0.01) and exposure to house (33% vs 3%, p=0.0001) or work (38% vs 17%, p=0.02) contacts with COVID-19 were factors found higher in those with symptoms. Cirrhosis or steroid use or immunosuppression was not significantly different between symptomatic and non-symptomatic groups. Worsening fatigue (45% vs 30%, p=0.06), anxiety (89% vs 70%, p=0.08), and itch (40% vs 18%, p=0.03) were more common among those reporting COVID-19 symptoms compared with those without. BMI >40 kg/m2 and exposure to contacts with COVID-19 illness but not cirrhosis or immunosuppression were associated with increased risk of COVID-19 illness in patients with AIH.
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Affiliation(s)
- Vahin Vuppalanchi
- Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kayla Gelow
- Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Kelsey Green
- Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Raj Vuppalanchi
- Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Craig Lammert
- Gastroenterology and Hepatology, Indiana University School of Medicine, Indianapolis, Indiana, USA
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McGrowder DA, Miller F, Anderson Cross M, Anderson-Jackson L, Bryan S, Dilworth L. Abnormal Liver Biochemistry Tests and Acute Liver Injury in COVID-19 Patients: Current Evidence and Potential Pathogenesis. Diseases 2021; 9:diseases9030050. [PMID: 34287285 PMCID: PMC8293258 DOI: 10.3390/diseases9030050] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Revised: 06/16/2021] [Accepted: 06/24/2021] [Indexed: 02/07/2023] Open
Abstract
Globally, millions of persons have contracted the coronavirus disease 2019 (COVID-19) over the past several months, resulting in significant mortality. Health care systems are negatively impacted including the care of individuals with cancers and other chronic diseases such as chronic active hepatitis, cirrhosis and hepatocellular carcinoma. There are various probable pathogenic mechanisms that have been presented to account for liver injury in COVID-19 patients such as hepatotoxicity cause by therapeutic drugs, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of the bile duct cells and hepatocytes, hypoxia and systemic inflammatory response. Liver biochemistry tests such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) are deranged in COVID-19 patients with liver injury. Hepatocellular damage results in the elevation of serum AST and ALT levels in early onset disease while a cholestatic pattern that develops as the disease progress causes higher levels of ALP, GGT, direct and total bilirubin. These liver biochemistry tests are prognostic markers of disease severity and should be carefully monitored in COVID-19 patients. We conducted a systematic review of abnormal liver biochemistry tests in COVID-19 and the possible pathogenesis involved. Significant findings regarding the severity, hepatocellular pattern, incidence and related clinical outcomes in COVID-19 patients are highlighted.
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Affiliation(s)
- Donovan A. McGrowder
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (L.A.-J.); (L.D.)
- Correspondence:
| | - Fabian Miller
- Department of Physical Education, Faculty of Education, The Mico University College, 1A Marescaux Road, Kingston 5, Jamaica;
- Department of Biotechnology, Faculty of Science and Technology, The University of the West Indies, Kingston 7, Jamaica
| | - Melisa Anderson Cross
- School of Allied Health and Wellness, College of Health Sciences, University of Technology, Kingston 7, Jamaica;
| | - Lennox Anderson-Jackson
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (L.A.-J.); (L.D.)
| | - Sophia Bryan
- Department of Basic Medical Sciences, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica;
| | - Lowell Dilworth
- Department of Pathology, Faculty of Medical Sciences, The University of the West Indies, Kingston 7, Jamaica; (L.A.-J.); (L.D.)
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Hsieh JYC, Chin TT. An emerging entity after pandemic: Post-coronavirus disease 2019 syndrome and associated medical complications. SAGE Open Med 2021; 9:20503121211023631. [PMID: 34178339 PMCID: PMC8202311 DOI: 10.1177/20503121211023631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 03/08/2021] [Indexed: 01/08/2023] Open
Abstract
The coronavirus disease 2019 is a devastating illness that has infected millions of people since the beginning of year 2020, through its multi-systemic manifestations that range widely in severity. Because current knowledge on the types and severities of medical illnesses encountered by patients who recovered from coronavirus disease 2019 is limited, it remains unknown whether these illnesses are direct sequelae of coronavirus disease 2019 infection or unrelated coincidences. In this article, we summarize the evidence currently available on post-coronavirus disease 2019 medical complications and propose directions for studying the long-term complications of coronavirus disease 2019 in the future.
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Affiliation(s)
| | - Tan Tze Chin
- Department of Internal Medicine, Singapore General Hospital, Singapore
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47
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Jayaweera D. Overview of COVID-19 and the Liver. Gastroenterol Hepatol (N Y) 2021; 17:275-277. [PMID: 34776801 PMCID: PMC8576842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
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48
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Bzeizi K, Abdulla M, Mohammed N, Alqamish J, Jamshidi N, Broering D. Effect of COVID-19 on liver abnormalities: a systematic review and meta-analysis. Sci Rep 2021; 11:10599. [PMID: 34012016 PMCID: PMC8134580 DOI: 10.1038/s41598-021-89513-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 04/13/2021] [Indexed: 02/06/2023] Open
Abstract
Emerging evidence suggest association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with the development of many liver abnormalities. The overarching aim of this study was therefore to assess the available evidence on the clinical effects of SARS-CoV-2 on the profiles of liver chemistries and coagulation in COVID-19 diagnosed patients. We considered all study designs including epidemiological and observational that reported liver function test abnormalities in patients confirmed with SARS-CoV-2 infection. Medline, Embase databases and Google Scholar as well as relevant reviews were searched to identify appropriate studies from inception to 31st of August 2020. We calculated the pooled mean with 95% confidence intervals (95% CI) through a random-effect model meta-analysis. A total of 35 studies with 10,692 participants were considered for the review from which 23 studies with sufficient quantitative data were included in the meta-analysis. The pooled mean for liver enzymes and coagulation parameters did not significantly change in patients diagnosed with COVID-19 and remained within normal range. Notwithstanding potential bias from confounding factors in interpretation of data in this review, findings from the observational studies and case reports suggest that COVID-19 does not appear to have a significant impact on the transaminases or total bilirubin levels of patients with confirmed SARS-CoV-2 infection. Further controlled studies and larger sample size observational studies are needed with adequate reporting of other liver function parameters are warranted.
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Affiliation(s)
- Khalid Bzeizi
- Department of Liver & Small Bowel Transplantation & Hepatobiliary-Pancreatic Surgery, King Faisal Specialist Hospital & Research Center, P.O. Box 3354, Riyadh, 11211, Saudi Arabia.
| | - Maheeba Abdulla
- Internal Medicine Department, Salmaniya Medical Complex, Manama, Bahrain
| | - Nafeesa Mohammed
- Internal Medicine Department, Salmaniya Medical Complex, Manama, Bahrain
| | | | - Negar Jamshidi
- School of Science, RMIT University, Melbourne, VIC, 3000, Australia
| | - Dieter Broering
- Organ Transplant Center & Department of Surgery, King Faisal Specialist Hospital & Research Centre (Gen. Org) MBC 96, AlFaisal University, P.O. Box 3354, Riyadh, 11211, Saudi Arabia
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Covichem: A biochemical severity risk score of COVID-19 upon hospital admission. PLoS One 2021; 16:e0250956. [PMID: 33956870 PMCID: PMC8101934 DOI: 10.1371/journal.pone.0250956] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 04/17/2021] [Indexed: 12/20/2022] Open
Abstract
Clinical and laboratory predictors of COVID-19 severity are now well described and combined to propose mortality or severity scores. However, they all necessitate saturable equipment such as scanners, or procedures difficult to implement such as blood gas measures. To provide an easy and fast COVID-19 severity risk score upon hospital admission, and keeping in mind the above limits, we sought for a scoring system needing limited invasive data such as a simple blood test and co-morbidity assessment by anamnesis. A retrospective study of 303 patients (203 from Bordeaux University hospital and an external independent cohort of 100 patients from Paris Pitié-Salpêtrière hospital) collected clinical and biochemical parameters at admission. Using stepwise model selection by Akaike Information Criterion (AIC), we built the severity score Covichem. Among 26 tested variables, 7: obesity, cardiovascular conditions, plasma sodium, albumin, ferritin, LDH and CK were the independent predictors of severity used in Covichem (accuracy 0.87, AUROC 0.91). Accuracy was 0.92 in the external validation cohort (89% sensitivity and 95% specificity). Covichem score could be useful as a rapid, costless and easy to implement severity assessment tool during acute COVID-19 pandemic waves.
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50
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Zamani F, Mansoorian M, Pishgar E, Sahraei R, Rahimian N, Alibeik N. Successful liver transplant in a patient with acute cholestatic liver failure due to COVID-19 infection: A case report. JOURNAL OF LIVER TRANSPLANTATION 2021; 2:100007. [PMID: 38620662 PMCID: PMC8061622 DOI: 10.1016/j.liver.2021.100007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/06/2021] [Accepted: 04/10/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Farhad Zamani
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical science, Tehran, Iran
| | - Mohsenreza Mansoorian
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical science, Tehran, Iran
| | - Elham Pishgar
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical science, Tehran, Iran
| | - Roghaye Sahraei
- Gastrointestinal and Liver Diseases Research Center, Iran University of Medical science, Tehran, Iran
| | - Neda Rahimian
- Endocrine Research Center, Institute of Endocrinology and Metabolism, Iran University of Medical Sciences (IUMS), Tehran, Iran
| | - Nazanin Alibeik
- Firoozgar Hospital, Iran University of Medical Sciences (IUMS), Tehran, Iran
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