Feng Gong, Zheng Kenneth I, Yan Qin-Qin, Rios Rafael S, Targher Giovanni, Byrne Christopher D, Poucke Sven Van, Liu Wen-Yue, Zheng Ming-Hua
Xi'an Medical University, Xi'an, China.
NAFLD Research Center, Department of Hepatology, the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
J Clin Transl Hepatol. 2020 Mar 28;8(1):18-24. doi: 10.14218/JCTH.2020.00018. Epub 2020 Mar 30.
The outbreak of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has attracted increasing worldwide attention. Cases of liver damage or dysfunction (mainly characterized by moderately elevated serum aspartate aminotransferase levels) have been reported among patients with COVID-19. However, it is currently uncertain whether the COVID-19-related liver damage/dysfunction is due mainly to the viral infection per se or other coexisting conditions, such as the use of potentially hepatotoxic drugs and the coexistence of systemic inflammatory response, respiratory distress syndrome-induced hypoxia, and multiple organ dysfunction. Based on the current evidence from case reports and case series, this review article focuses on the demographic and clinical characteristics, potential mechanisms, and treatment options for COVID-19-related liver dysfunction. This review also describes the geographical and demographic distribution of COVID-19-related liver dysfunction, as well as possible underlying mechanisms linking COVID-19 to liver dysfunction, in order to facilitate future drug development, prevention, and control measures for COVID-19.
由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引起的2019冠状病毒病(COVID-19)疫情已引起全球越来越多的关注。COVID-19患者中已报告出现肝损伤或功能障碍病例(主要表现为血清天冬氨酸氨基转移酶水平中度升高)。然而,目前尚不确定COVID-19相关的肝损伤/功能障碍主要是由于病毒感染本身,还是其他并存情况,如使用潜在肝毒性药物以及全身炎症反应、呼吸窘迫综合征引起的缺氧和多器官功能障碍的并存。基于目前病例报告和病例系列的证据,这篇综述文章重点关注COVID-19相关肝功能障碍的人口统计学和临床特征、潜在机制及治疗选择。本综述还描述了COVID-19相关肝功能障碍的地理和人口分布,以及将COVID-19与肝功能障碍联系起来的可能潜在机制,以便为未来COVID-19的药物研发、预防和控制措施提供便利。