COVID-19 Severity and Mortality Among Chronic Liver Disease Patients: A Systematic Review and Meta-Analysis

Nagarajan, Ramya; Krishnamoorthy, Yuvaraj; Rajaa, Sathish; Hariharan, Vishnu Shankar

doi:10.5888/pcd19.210228

Cited by 55 publications

(47 citation statements)

References 60 publications

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“…Krishnan et al [ 30 ] found that CLD patients with elevated AST and tBIL levels had a significantly higher risk fora more severe COVID-19 disease course and also reported that ALD was the most important factor associated with the need for mechanical ventilation. A systematic review including 40 studies, mainly from China, reported that CLD was significantly associated with COVID-19 severity and mortality[ 55 ]. The risk of getting more severe COVID-19 was 2.44 times higher among patients with CLD compared to those without CLD, and the presence of NAFLD was the most strongly associated with higher COVID-19 severity, followed by MAFLD and cirrhosis.…”

Section: Covid-19 In Patients With Pre-existing Liver Diseasementioning

confidence: 99%

Outcomes of COVID-19 among patients with liver disease

Vujčić¹

2023

World J Gastroenterol

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Coronavirus disease 2019 (COVID-19) is primarily a respiratory disease with multi-organ involvement, including impaired liver function. It has been noticed that a significant proportion of COVID-19 patients have liver dysfunction, especially those with a more severe disease course. The coronavirus causes direct damage to the liver using the angiotensin-converting enzyme 2, a cell-surface receptor for cellular entry, that is expressed in the liver. According to previous research, liver enzyme abnormalities were observed in a considerable proportion of COVID-19 patients, and elevated liver transaminases were found in about 20% of these patients, alkaline phosphatase in 6.1%, and gamma-glutamyl transferase in 21.1%. COVID-19 might trigger a deterioration of liver function in patients with pre-existing chronic liver diseases (CLDs) and also in those without previous liver disorders. The majority of COVID-19 patients who develop liver injury are men, the elderly, and those with a higher body mass index. Compared to the general population, COVID-19 is associated with significant morbidity and mortality in patients with liver disease (cirrhosis and liver transplantation recipients). However, some studies indicate that CLDs have a lesser role in determining patient progression towards higher disease severity.

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Section: Covid-19 In Patients With Pre-existing Liver Diseasementioning

confidence: 99%

Outcomes of COVID-19 among patients with liver disease

Vujčić¹

2023

World J Gastroenterol

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“…Many studies have shown that hospitalized COVID-19 patients with CLD have an acute rise in liver enzymes, which results in a severe condition requiring mechanical ventilation and even leading to death. There are other plausible pathogeneses in patients with cirrhosis who have a worse disease course and even death following COVID-19, such as excess systemic inflammation, intestinal dysbiosis, cirrhosis-induced immune dysfunction, and coagulopathies[ 36 ].…”

Section: Sars-cov-2 Effects On the Livermentioning

confidence: 99%

Alcohol use disorder and liver injury related to the COVID-19 pandemic

Marano¹,

Traversi²,

Gaetani³

et al. 2022

World J Hepatol

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Alcohol use disorder is a complex and heterogeneous phenomenon that can be studied from several points of view by focusing on its different components. Alcohol is a hepatotoxin whose metabolism creates profound alterations within the hepatocyte. The liver is the central organ in the metabolism of alcohol, a process that also involves other organs and tissues such as the brain, heart and muscles, but the most relevant organ is the liver. The anatomopathological alterations in the liver associated with the prolonged use of alcohol range from the simple accumulation of neutral fats in the hepatocytes, to cirrhosis and hepatocellular carcinoma. Alcohol abuse frequently leads to liver disease such as steatosis, steatohepatitis, fibrosis, cirrhosis, and tumors. Following the spread of coronavirus disease 2019 (COVID-19), there was an increase in alcohol consumption, probably linked to the months of lockdown and smart working. It is known that social isolation leads to a considerable increase in stress, and it is also recognized that high levels of stress can result in an increase in alcohol intake. Cirrhotic patients or subjects with liver cancer are immunocompromised, so they may be more exposed to COVID-19 infection with a worse prognosis. This review focuses on the fact that the COVID-19 pandemic has made the emergence of alcohol-induced liver damage a major medical and social problem.

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“…A meta-analysis that focused on the outcome of COVID-19 infection in cirrhotic and non-cirrhotic patients included 40 studies with more than 900,000 participants. This showed that the COVID-19-cirrhosis association had an increased risk for severity (OR = 2.44; 95% CI, 1.89–3.16) and death (OR = 2.35; 95% CI, 1.85–3.00) [ 52 ].…”

Section: Covid-19 and Cirrhosismentioning

confidence: 99%

Risk of New-Onset Liver Injuries Due to COVID-19 in Preexisting Hepatic Conditions—Review of the Literature

Bucurica

Radu²,

Bucurica³

et al. 2022

Medicina

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacted the world and caused the 2019 coronavirus disease (COVID-19) pandemic. The clinical manifestations of the virus can vary from patient to patient, depending on their respective immune system and comorbidities. SARS-CoV-2 can affect patients through two mechanisms: directly by targeting specific receptors or by systemic mechanisms. We reviewed data in the latest literature in order to discuss and determine the risk of new-onset liver injuries due to COVID-19 in preexisting hepatic conditions. The particular expression of angiotensin-converting enzyme 2 (ACE2) receptors is an additional risk factor for patients with liver disease. COVID-19 causes more severe forms in patients with non-alcoholic fatty liver disease (NAFLD), increases the risk of cirrhosis decompensation, and doubles the mortality for these patients. The coinfection SARS-CoV-2—viral hepatitis B or C might have different outcomes depending on the stage of the liver disease. Furthermore, the immunosuppressant treatment administered for COVID-19 might reactivate the hepatic virus. The high affinity of SARS-CoV-2 spike proteins for cholangiocytes results in a particular type of secondary sclerosing cholangitis. The impact of COVID-19 infection on chronic liver disease patients is significant, especially in cirrhosis, influencing the prognosis and outcome of these patients.

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COVID-19 Severity and Mortality Among Chronic Liver Disease Patients: A Systematic Review and Meta-Analysis

Cited by 55 publications

References 60 publications

Outcomes of COVID-19 among patients with liver disease

Outcomes of COVID-19 among patients with liver disease

Alcohol use disorder and liver injury related to the COVID-19 pandemic

Risk of New-Onset Liver Injuries Due to COVID-19 in Preexisting Hepatic Conditions—Review of the Literature

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