Sivandzadeh Gholam Reza, Askari Hassan, Safarpour Ali Reza, Ejtehadi Fardad, Raeis-Abdollahi Ehsan, Vaez Lari Armaghan, Abazari Mohammad Foad, Tarkesh Firoozeh, Bagheri Lankarani Kamran
Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz 7193635899, Iran.
Department of Medical Sciences, Qom Medical Branch, Islamic Azad University, Qom 1417613151, Iran.
World J Clin Cases. 2021 Aug 6;9(22):6178-6200. doi: 10.12998/wjcc.v9.i22.6178.
It is hypothesized that liver impairment caused by coronavirus disease 2019 (COVID-19) infection might play a central role in severe clinical presentations. Liver injury is closely associated with severe disease and, even with antiviral drugs, have a poor prognosis in COVID-19 patients. In addition to the common hepatobiliary disorders caused by COVID-19, patients with pre-existing liver diseases demand special considerations during the current pandemic. Thus, it is vital that upon clinical presentation, patients with concurrent pre-existing liver disease associated with metabolic dysfunction and COVID-19 be managed properly to prevent liver failure. Careful monitoring and early detection of liver damage through biomarkers after hospitalization for COVID-19 is underscored in all cases, particularly in those with pre-existing metabolic liver injury. The purpose of this study was to determine most recent evidence regarding causality, potential risk factors, and challenges, therapeutic options, and management of COVID-19 infection in vulnerable patients with pre-existing liver injury. This review aims to highlight the current frontier of COVID-19 infection and liver injury and the direction of liver injury in these patients.
据推测,2019冠状病毒病(COVID-19)感染所致的肝功能损害可能在严重临床表现中起核心作用。肝损伤与重症疾病密切相关,并且在COVID-19患者中,即便使用抗病毒药物,预后也较差。除了COVID-19引起的常见肝胆疾病外,患有既往肝病的患者在当前大流行期间需要特殊考虑。因此,至关重要的是,对于同时患有与代谢功能障碍相关的既往肝病和COVID-19的患者,在临床表现时要进行妥善管理,以预防肝衰竭。在所有情况下,尤其是在那些有既往代谢性肝损伤的患者中,强调在COVID-19住院后通过生物标志物仔细监测和早期发现肝损伤。本研究的目的是确定有关因果关系、潜在危险因素和挑战、治疗选择以及对有既往肝损伤的易感患者进行COVID-19感染管理的最新证据。本综述旨在突出COVID-19感染和肝损伤的当前前沿以及这些患者肝损伤的方向。
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