COVID-19 and comorbidities of hepatic diseases in a global perspective

Abstract

The worldwide outbreak of coronavirus disease 2019 (COVID-19) has challenged the priorities of healthcare system in terms of different clinical management and infection transmission, particularly those related to hepatic-disease comorbidities. Epidemiological data evidenced that COVID-19 patients with altered liver function because of hepatitis infection and cholestasis have an adverse prognosis and experience worse health outcomes. COVID-19-associated liver injury is correlated with various liver diseases following a severe acute respiratory syndrome-coronavirus type 2 (SARS-CoV-2) infection that can progress during the treatment of COVID-19 patients with or without pre-existing liver disease. SARS-CoV-2 can induce liver injury in a number of ways including direct cytopathic effect of the virus on cholangiocytes/hepatocytes, immune-mediated damage, hypoxia, and sepsis. Indeed, immediate cytopathogenic effects of SARS-CoV-2 via its potential target, the angiotensin-converting enzyme-2 receptor, which is highly expressed in hepatocytes and cholangiocytes, renders the liver as an extra-respiratory organ with increased susceptibility to pathological outcomes. But, underlying COVID-19-linked liver disease pathogenesis with abnormal liver function tests (LFTs) is incompletely understood. Hence, we collated COVID-19-associated liver injuries with increased LFTs at the nexus of pre-existing liver diseases and COVID-19, and defining a plausible pathophysiological triad of COVID-19, hepatocellular damage, and liver disease. This review summarizes recent findings of the exacerbating role of COVID-19 in pre-existing liver disease and vice versa as well as international guidelines of clinical care, management, and treatment recommendations for COVID-19 patients with liver disease.

Spatial Variability of COVID-19 Hospitalization in the Silesian Region, Poland

“…Obtained results are in line with the opinion that patients with diabetes, chronic obstructive pulmonary disease, cardiovascular diseases, hypertension, malignancies, and other comorbidities could develop a life-threatening situation [ 30 ]. Current published data confirmed that COVID-19 plays an exacerbating role in the worsening of health status in patients with pre-existing liver diseases [ 31 ]. Moreover, the mean value of the age of deceased patients in Silesian hospitals was close to 75 years which was comparably similar to those observed in other studies [ 32 , 33 , 34 , 35 , 36 ].…”

Abnormal liver function tests in patients with COVID-19

“…Некоторые публикации сообщают, что наличие НАЖБП также влияло на течение COVID-19. Так, пациенты с НАЖБП демонстрировали более быстрое прогрессирование заболевания и более длительное время выделения вируса по сравнению с пациентами без НАЖБП [13,18].…”

“…Анализ динамики уровня трансаминаз на фоне гепатопротективной терапии показал, что на 30-й день болезни у 67% пациентов произошла нормализация уровня АЛТ и у 76% -АСТ. Данный вопрос скудно освещен в литературе и требует дальнейшего изучения [12,13].…”

Direct, indirect, post-infection damages induced by coronavirus in the human body: an overview

“…The information indirectly conveys that the survivors from critical situations might recover with uncertain internal organ damages manifest as post-COVID [10,12,20]. The host conditions such as senility, comorbidities, concurrent or previous infections, antimicrobial resistance, personal habits such as tobacco, alcohol and food choices, obesity, and medicines used for comorbidities, impact the viral pathogenesis and treatment choices during emergencies [9,[21][22][23]. The recovered patients with mentioned conditions burden a lifetime due to the post-COVID compromised functions of the affected organs [24,25].…”