Wang Xinyi, Lei Jianyong, Li Zhihui, Yan Lunan
Thyroid and Parathyroid Surgery Center, West China Hospital of Sichuan University, Chengdu, China.
Liver Surgery Center, West China Hospital of Sichuan University, Chengdu, China.
Front Med (Lausanne). 2021 Sep 27;8:651658. doi: 10.3389/fmed.2021.651658. eCollection 2021.
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.
引发显著疾病的冠状病毒，即严重急性呼吸综合征（SARS）、中东呼吸综合征（MERS）和2019冠状病毒病（COVID-19），在基因组组成和致病机制方面表现出显著相似性。尽管冠状病毒作为呼吸道病原体已得到广泛研究，但其对肝胆系统的影响鲜有报道。总体而言，冠状病毒所致肝损伤的表现通常包括白蛋白降低以及转氨酶和胆红素水平升高。已提出多种病理生理假说，包括直接损伤、免疫介导损伤、缺血缺氧、血栓形成和药物肝毒性。已阐明既往存在的肝脏疾病与冠状病毒感染之间的相互作用，即冠状病毒会影响肝脏疾病的发生、严重程度、预后及治疗。用于治疗和预防冠状病毒感染的药物和疫苗也具有肝毒性。目前，建立针对冠状病毒感染与肝病合并症的优化治疗具有重要意义，需要进一步进行安全性测试、动物试验和临床试验。
