Taneva Gergana, Dimitrov Dimitar, Velikova Tsvetelina
Department of Gastroenterology, Sveta Sofia Hospital, Sofia 1618, Bulgaria.
Department of Clinical Immunology, University Hospital Lozenetz, Sofia 1407, Bulgaria.
World J Hepatol. 2021 Dec 27;13(12):2005-2012. doi: 10.4254/wjh.v13.i12.2005.
Liver damage in severe acute respiratory coronavirus 2 infection occurs in patients with or without preexisting liver disorders, posing a significant complication and mortality risk. During coronavirus disease 2019 (COVID-19), abnormal liver function is typically observed. However, liver injury may occur because of the treatment as well. Ischemia, cytokine storm, and hypoxia were identified as the three major factors contributing to liver damage during COVID-19. Indeed, raised liver enzymes during hospitalizations may be attributed to medications used, as well as sepsis and shock. As a result, the proportion of hospitalized patients afflicted with COVID-19 and pathological liver biomarkers varies from 14% to 53%. Aminotransferases and bilirubin are found most often elevated. Usually, increased gamma-glutamyltransferase, alkaline phosphatase, and decreased serum albumin levels are demonstrated. Additionally, although there is no specific treatment for COVID-19, many of the drugs used to treat the infection are hepatotoxic. In this mini-review, we focus on how liver dysfunction can be one of the features associated with the COVID-19 cytokine storm. Furthermore, data show that liver injury can be an independent predictor of severe COVID-19, the need for hospitalization, and death.
严重急性呼吸综合征冠状病毒2感染中的肝损伤在有或无既往肝脏疾病的患者中均会发生，构成了重大并发症和死亡风险。在2019冠状病毒病（COVID-19）期间，通常会观察到肝功能异常。然而，肝损伤也可能因治疗而发生。缺血、细胞因子风暴和缺氧被确定为COVID-19期间导致肝损伤的三大因素。事实上，住院期间肝酶升高可能归因于所使用的药物，以及脓毒症和休克。因此，患有COVID-19且有肝脏病理生物标志物的住院患者比例在14%至53%之间。氨基转移酶和胆红素最常被发现升高。通常还会表现出γ-谷氨酰转移酶、碱性磷酸酶升高以及血清白蛋白水平降低。此外，尽管尚无针对COVID-19的特异性治疗方法，但许多用于治疗该感染的药物具有肝毒性。在本综述中，我们重点关注肝功能障碍如何成为与COVID-19细胞因子风暴相关的特征之一。此外，数据表明肝损伤可能是重症COVID-19、住院需求和死亡的独立预测因素。
