Aslan Abdullah Tarik, Yasemin Balaban Hatice
Department of Internal Medicine, Hacettepe University School of Medicine, Ankara, Turkey.
Department of Gastroenterology, Hacettepe University School of Medicine, Ankara, Turkey.
Hepatol Forum. 2021 Sep 15;2(3):122-127. doi: 10.14744/hf.2021.2021.0020. eCollection 2021 Sep.
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative pathogen of coronavirus disease 2019 (COVID-19), is highly contagious and has a variety of clinical manifestations, including liver injury. There have been a few reports indicating acute-on chronic liver failure among COVID-19 patients, however, patients with COVID-19-related liver injury are generally asymptomatic and present with a mild to moderate elevation in serum hepatic enzymes. Severe COVID-19 patients have high rates of liver injury with poorer outcomes. The pattern of abnormalities in liver biochemical indicators may be hepatocellular, cholestatic, or mixed. Although the pathogenesis of hepatic injury is not yet completely understood, causes of liver damage include systemic inflammatory response syndrome, ischemia-reperfusion injury, side effects of medications, and underlying chronic liver disease. While viral RNA has been detected in hepatocytes, it remains unknown if the coronavirus has the capacity to cause cytopathic effects in hepatic tissue. Additionally, it is important to remember that the current upheaval to daily life and access to healthcare caused by the COVID-19 pandemic has had a significant and negative effect on other patients with chronic liver disease. The objective of this review was to summarize the current literature on COVID-19-related hepatic injury with an examination of clinical features, potential pathogenesis, and histopathological findings of this entity.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）是2019冠状病毒病（COVID-19）的致病病原体，具有高度传染性，有多种临床表现，包括肝损伤。已有一些报告指出COVID-19患者中存在慢加急性肝衰竭，然而，COVID-19相关肝损伤患者通常无症状，血清肝酶轻度至中度升高。重症COVID-19患者肝损伤发生率高，预后较差。肝脏生化指标异常模式可能为肝细胞性、胆汁淤积性或混合性。虽然肝损伤的发病机制尚未完全明确，但肝损伤的原因包括全身炎症反应综合征、缺血再灌注损伤、药物副作用和潜在的慢性肝病。虽然在肝细胞中检测到了病毒RNA，但冠状病毒是否有能力在肝组织中引起细胞病变效应仍不清楚。此外，必须记住，COVID-19大流行对日常生活和医疗保健获取造成的当前动荡，已对其他慢性肝病患者产生了重大负面影响。本综述的目的是总结关于COVID-19相关肝损伤的当前文献，审视该疾病的临床特征、潜在发病机制和组织病理学发现。
