COVID-19 infection and liver injury: Clinical features, biomarkers, potential mechanisms, treatment, and management challenges

Sivandzadeh, Gholam Reza; Askari, Hasan; Safarpour, Ali Reza; Ejtehadi, Fardad; Raeis-Abdollahi, Ehsan; Lari, Armaghan Vaez; Abazari, Mohammad Foad; Tarkesh, Firoozeh; Lankarani, Kamran Bagheri

doi:10.12998/wjcc.v9.i22.6178

Cited by 27 publications

(46 citation statements)

References 178 publications

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“…Moreover, younger age and elevated interleukin (IL)-6 or ferritin level have recently been defined as the strongest predictors of liver injury [123]. Of note, liver injury symptoms may appear even without respiratory symptoms, and persistent liver damage may advance over the patient's entire lifetime [124].…”

Section: Zinc In the Prevention Of Covid-19-related Liver Injurymentioning

confidence: 99%

Zinc as a Drug for Wilson’s Disease, Non-Alcoholic Liver Disease and COVID-19-Related Liver Injury

et al. 2021

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Zinc is the second most abundant trace element in the human body, and it plays a fundamental role in human physiology, being an integral component of hundreds of enzymes and transcription factors. The discovery that zinc atoms may compete with copper for their absorption in the gastrointestinal tract let to introduce zinc in the therapy of Wilson’s disease, a congenital disorder of copper metabolism characterized by a systemic copper storage. Nowadays, zinc salts are considered one of the best therapeutic approach in patients affected by Wilson’s disease. On the basis of the similarities, at histological level, between Wilson’s disease and non-alcoholic liver disease, zinc has been successfully introduced in the therapy of non-alcoholic liver disease, with positive effects both on insulin resistance and oxidative stress. Recently, zinc deficiency has been indicated as a possible factor responsible for the susceptibility of elderly patients to undergo infection by SARS-CoV-2, the coronavirus responsible for the COVID-19 pandemic. Here, we present the data correlating zinc deficiency with the insurgence and progression of Covid-19 with low zinc levels associated with severe disease states. Finally, the relevance of zinc supplementation in aged people at risk for SARS-CoV-2 is underlined, with the aim that the zinc-based drug, classically used in the treatment of copper overload, might be recorded as one of the tools reducing the mortality of COVID-19, particularly in elderly people.

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Section: Zinc In the Prevention Of Covid-19-related Liver Injurymentioning

confidence: 99%

Zinc as a Drug for Wilson’s Disease, Non-Alcoholic Liver Disease and COVID-19-Related Liver Injury

et al. 2021

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“…Liver impairment has been documented to be induced by COVID-19 ( Sivandzadeh et al., 2021 ), and scientific evidence of liver tropism with SARS-CoV-2 has been established, including molecular mechanisms ( Wanner et al., 2022 ; Osborn et al., 2022 ). The high affinity of SARS-CoV-2 to the liver supports an existing working hypothesis ( UK Health Security Agency, 2022a ), suspecting an abnormal host response to adenovirus due to priming caused by a previous infection with SARS-CoV-2.…”

Section: Discussionmentioning

confidence: 99%

High population burden of Omicron variant (B.1.1.529) is associated with the emergence of severe hepatitis of unknown etiology in children

Nishiura¹,

Jung²,

Hayashi³

2022

International Journal of Infectious Diseases

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“…Our study also showed that even severe patients did not have significantly increased bilirubin levels, and they showed lower albumin levels. Sivandzadeh et al 32 proposed that decreased serum albumin synthesis, increased catabolism, and nutritional problems are the possible causes of hypoalbuminemia in patients with severe COVID-19 and liver injury, which has been proved to be a predictor of mortality in COVID-19 patients with liver injury. 33 SARS-CoV-2 infection is often associated with different degrees of abnormal liver function indexes.…”

Section: Discussionmentioning

confidence: 99%

Dynamic Changes of Liver Function Indexes in Patients with Different Clinical Types of COVID-19

W¹,

Zhang²,

Zhu³

2022

IJGM

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Background To investigate the liver function indexes and dynamic changes in patients with different clinical types of new coronavirus pneumonia (COVID-19). Methods A retrospective analysis of 170 COVID-19 patients hospitalized in the Wuxi Fifth People’s Hospital was divided into asymptomatic group (13 cases), mild-common group (142 cases) and seriously-critically ill group (15 cases), the clinical data and liver function indexes of the three groups were compared. Results A total of 170 patients included 94 males and 76 females, with an average age of 44.7 ± 17.8 years. Seriously-critically ill group was older, and the proportion of patients with diabetes and liver injury at admission was also higher. As the hospitalization time increased, the changes of alanine aminotransferase (ALT) levels in asymptomatic group and mild-common group were not significant (all P > 0.05), while the ALT levels of seriously-critically ill group showed a curve that first flattened and then decreased (degree of freedom: 1.809, P = 0.002). Compared with the mild-common group, the daily decrease of ALT was 1.220U/L more in the seriously-critically ill group (P<0.001). The aspartate aminotransferase (AST) in asymptomatic group and seriously-critically ill group did not decrease significantly (all P > 0.05), while the AST in mild-common group decreased significantly (regression coefficient: −10.507, P = 0.008). There was no significant difference in AST changes between the three groups (P = 0.250–0.904). Conclusion Liver injury is common in COVID-19 patients, especially for severe patients; the dynamic change pattern of liver function indicators may be helpful to judge liver injury and evaluate treatment effects in patients with different clinical types.

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COVID-19 infection and liver injury: Clinical features, biomarkers, potential mechanisms, treatment, and management challenges

Cited by 27 publications

References 178 publications

Zinc as a Drug for Wilson’s Disease, Non-Alcoholic Liver Disease and COVID-19-Related Liver Injury

Zinc as a Drug for Wilson’s Disease, Non-Alcoholic Liver Disease and COVID-19-Related Liver Injury

High population burden of Omicron variant (B.1.1.529) is associated with the emergence of severe hepatitis of unknown etiology in children

Dynamic Changes of Liver Function Indexes in Patients with Different Clinical Types of COVID-19

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