Abnormal Liver Function Tests in Patients With COVID‐19: Relevance and Potential Pathogenesis

Bertolini, Anna; Peppel, Ivo P van de; Bodewes, Frank; Moshage, Han; Fantin, Alberto; Farinati, Fabio; Fiorotto, Romina; Jonker, Johan W.; Strazzabosco, Mario; Verkade, Henkjan J.; Peserico, Giulia

doi:10.1002/hep.31480

Cited by 252 publications

(267 citation statements)

References 124 publications

(255 reference statements)

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“…COVID-19 associated liver injury is defined as any liver damage occurring during disease course and treatment of COVID-19 patients, with or without pre-existing liver disease. 4,[34][35][36][37][38][39] This includes a broad spectrum of potential pathomechanisms including direct cytotoxicity from active viral replication of SARS-CoV-2 in the liver, 40,41 immunemediated liver damage due to the severe inflammatory response/ systemic inflammatory response syndrome (SIRS) in COVID-19, 42 hypoxic changes induced by respiratory failure, vascular changes due to coagulopathy, endothelitis or cardiac congestion from right heart failure, drug-induced liver injury and exacerbation of underlying liver disease ( Figure 2). The incidence of elevated liver transaminases (ALT and AST) in COVID-19 patients ranges from 2.5% to 76.3%.…”

Section: The S Pec Trum Of Liver Involvement In Covid -19mentioning

confidence: 99%

“…35 These findings were also obtained in critically ill patients referred to the ICU, suggesting that even in cases of severe respiratory failure during SARS-CoV-2 infection, the adequate oxygen supply to the liver is ensured by compensatory mechanisms. 35,36,39,[149][150][151][152][153][154] of DILI associated with tocilizumab use in a COVID-19 patient has been reported. 62 Tocilizumab undergoes minimal hepatic metabolism, and the most probable etiology for its hepatotoxic effect is the interference with the IL-6 pathway, which plays a key role in hepatic regeneration.…”

Section: Sar S -Cov-2 and Hyp Oxi C Hepatitismentioning

confidence: 99%

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Pathophysiological mechanisms of liver injury in COVID‐19

Nardo

Schneeweiss-Gleixner

Bakail

et al. 2020

Liver International

301

333

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, the outbreak of coronavirus disease 2019 (COVID-19), caused by the novel Severe Acute Respiratory Syndrome (SARS) Coronavirus (CoV) 2 (SARS-CoV-2), has led within a few months to a major global health and economic crisis. As of October 2020, more than 40 million confirmed cases have been reported worldwide, with nearly 1 million deaths, affecting 189 countries. 1 The respiratory tract is considered the main target of SARS-CoV-2 infection and a small subset of infected individuals becomes severely ill and may develop acute respiratory distress syndrome (ARDS) with potentially fatal outcome. 2 More recently, systemic features of the disease with the involvement of organs outside the respiratory tract, including the liver and gastrointestinal tract are receiving increasing attention, indicating that COVID-19 may be considered as a systemic infectious and inflammatory disease. 3-7 Although closely related to other Corona virus (CoV) family members SARS-CoV and MERS-CoV (Middle East Respiratory Syndrome CoV), infections with the new SARS-CoV-2 exhibit a different pathological pattern and the mechanistic link between CoVs-induced molecular pathophysiological changes and clinical manifestations remains incompletely understood.

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Section: The S Pec Trum Of Liver Involvement In Covid -19mentioning

confidence: 99%

Section: Sar S -Cov-2 and Hyp Oxi C Hepatitismentioning

confidence: 99%

Pathophysiological mechanisms of liver injury in COVID‐19

Nardo

Schneeweiss-Gleixner

Bakail

et al. 2020

Liver International

301

333

View full text Add to dashboard Cite

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“…Biomarkers of multisystem organ failure/damage COVID-19 can be associated with liver injury during disease progression and treatment, in patients with or without preexisting liver disease. Elevated values of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and bilirubin, and low albumin and prealbumin concentrations have all been associated with poor outcome [36][37][38] In addition, some drugs used in the treatment of COVID-19 are associated with the development of elevated liver biomarkers [39][40][41]. For this reason, at a minimum, it is recommended to monitor ALT, bilirubin and albumin during treatment of patients with hepatotoxic medications, and in those with pre-existing liver disease.…”

Section: Cardiovascular Biomarkersmentioning

confidence: 99%

IFCC Interim Guidelines on Biochemical/Hematological Monitoring of COVID-19 Patients

Thompson

Bohn

Mancini

et al. 2020

Clinical Chemistry and Laboratory Medicine (CCLM)

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Routine biochemical and hematological tests have been reported to be useful in the stratification and prognostication of pediatric and adult patients with diagnosed coronavirus disease (COVID-19), correlating with poor outcomes such as the need for mechanical ventilation or intensive care, progression to multisystem organ failure, and/or death. While these tests are already well established in most clinical laboratories, there is still debate regarding their clinical value in the management of COVID-19, particularly in pediatrics, as well as the value of composite clinical risk scores in COVID-19 prognostication. This document by the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC) Task Force on COVID-19 provides interim guidance on: (A) clinical indications for testing, (B) recommendations for test selection and interpretation, (C) considerations in test interpretation, and (D) current limitations of biochemical/hematological monitoring of COVID-19 patients. These evidence-based recommendations will provide practical guidance to clinical laboratories worldwide, underscoring the contribution of biochemical and hematological testing to our collective pandemic response.

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“…Hepatic injury is a characteristic clinical feature of COVID-19 and it has been reported in at least one half of patients suffering from the disease [88,89]. Impaired liver function is characterized by elevations of ALT in multiples factors of the upper reference limit [90].…”

Section: Alanine Aminotransferase (Alt)mentioning

confidence: 99%

Preparing for the Storm: Mitigating the Effect of SARS-CoV-2 Induced Hypercytokinemia

Rowaiye¹,

Okpalefe²,

Onuh³

et al. 2020

Preprint

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With increasing fatalities, the COVID-19 pandemic constitutes a formidable global health challenge. The causative agent, SARS-CoV-2 constantly tests the efficacy of the immune system of its victims. The protective ability of the innate immune system as the first responder largely determines the progression of disease and its clinical prognosis. Evidence suggests that mortalities associated with COVID-19 are largely due to hyperinflammation and a dysregulated immune response. Consequently, the degree of the release of pro-inflammatory cytokines such as IL1, IL-6, and TNF alpha remarkably distinguishes between mild and severe cases of COVID-19. The early prediction of a cytokine storm is made possible by several serum chemistry and hematological markers. The prompt use of these markers for laboratory tests, and the aggressive prevention and management of a cytokine release syndrome is critical in determining the level of morbidity and fatality associated with COVID-19. With respect to the SARS-CoV-2 and the host cell, this literature review focuses on the dynamics of the COVID-19 disease highlighting on the pathogenesis, and the markers of Cytokine Storm. It also proffers solutions by critically looking at the current and potential pharmacological agents that are or can be used to mitigate and manage cytokine storms.

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Abnormal Liver Function Tests in Patients With COVID‐19: Relevance and Potential Pathogenesis

Cited by 252 publications

References 124 publications

Pathophysiological mechanisms of liver injury in COVID‐19

Pathophysiological mechanisms of liver injury in COVID‐19

IFCC Interim Guidelines on Biochemical/Hematological Monitoring of COVID-19 Patients

Preparing for the Storm: Mitigating the Effect of SARS-CoV-2 Induced Hypercytokinemia

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