Hepatic involvement in COVID‐19 patients: Pathology, pathogenesis, and clinical implications

Li, Yueying; Xiao, Shu Yuan

doi:10.1002/jmv.25973

Cited by 126 publications

(153 citation statements)

References 15 publications

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“…Notably, lymphopenia was commonly observed in COVID-19 studies and patients with lower counts of lymphocyte are more susceptible to fatal outcomes [21]. Second, whether SARS-CoV-2 can directly infect hepatocytes remain undetermined [19,22]. In present study, no significant difference was observed in Ct values on admission or at the peak among liver injury group, abnormal group and normal group.…”

Section: Independent Factors Associated With Severity Of Liver Functionmentioning

confidence: 52%

“…In fact, it may be multifactorial and individualized. First, a hyperinflammatory response to COVID-19 may contribute to liver injury [11,18,19].…”

Section: Independent Factors Associated With Severity Of Liver Functionmentioning

confidence: 99%

“…The pandemic of coronavirus disease 2019 (COVID- 19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), poses an unprecedented threat to public health [1][2][3]. Patients with COVID-19 are frequently associated with pulmonary lesions, however, increasing data revealed that COVID-19 has systemic manifestations affecting multiorgan system including liver injury, myocarditis, thrombosis, and coagulation [4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Course and Risk Factors for Liver Injury of Severe and Critical Patients With COVID-19: A Single-centered, Retrospective, Observational Study

Liu¹,

Du²,

Yang³

et al. 2020

Preprint

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Background: The information regarding the clinical course of COVID-19 patients with liver injury is very limited, especially in severe and critical patients. The objective of this study was to describe the characteristics and clinical course of patients admitted with severe and/or critical SARS-CoV-2 infection in liver function, as well as explore the risk factors that affect liver function in the enrolled COVID-19 patients.Methods: Information on clinical characteristics of 63 severe and critical patients with confirmed COVID-19 were collected and analyzed.Results: The incidence of abnormal aspartate aminotransferase, alanine aminotransferase, and total bilirubin in the critical group was obviously higher than in the severe group (81.48%, 81.49%, 62.67%, and 45.71%, 63.88%, 22.86%, respectively, p＜0.05). The time for liver parameters to reach their peak or trough was approximately 2-3 weeks. No significant difference was observed in cycle threshold values of open reading frame 1ab and nucleocapsid protein gene on admission or at the peak among liver injury group, abnormal group and normal group (p＞0.05). Patients with invasive ventilator, decreased percentage of neutrophil, lymphocyte and monocyte, and SOFA score ≥ 2 (p＜0.05) were the independent factors associated with liver injury.Conclusions: Abnormal liver tests are commonly observed in severe and critical patients with COVID-19. The time of 2-3 weeks after admission should be paid attention to patients with critical COVID-19 in case of the occurrence of liver injury. As independent risk factors for the occurrence of liver injury, regarding decreased ratio of neutrophils, lymphocytes and monocytes, the requirement of invasive ventilator, and SOFA score ≥2 , patients with these abnormal parameters should be of particular concerned during hospitalization.

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Section: Independent Factors Associated With Severity Of Liver Functionmentioning

confidence: 52%

“…In fact, it may be multifactorial and individualized. First, a hyperinflammatory response to COVID-19 may contribute to liver injury [11,18,19].…”

Section: Independent Factors Associated With Severity Of Liver Functionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical Course and Risk Factors for Liver Injury of Severe and Critical Patients With COVID-19: A Single-centered, Retrospective, Observational Study

Liu¹,

Du²,

Yang³

et al. 2020

Preprint

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“…The multivariate analysis revealed that the elevated level of LDH, CTnI, ProBNP were the risk factors for patients with disease progression. Presently, there are three potential mechanisms for this observation: rstly, SARS-CoV-2 binding to ACE2 positive cells mediated direct damage; Secondly, systemic in ammatory response syndrome including cytokine storm, dysregulated immunocytes, and uncontrolled in ammation; Thirdly, exogenous drugs induced organ metabolizing burden, or worsening organ function (45,46). Recently, the coagulation dysfunction has attracted more and more attention among scholars.…”

Section: Risk Factors For Disease Progressionmentioning

confidence: 99%

A Comprehensive Evaluation of Early Predictors of Disease Progression in Patients with COVID-19: A Case Control Study

Tang

Liu

et al. 2020

Preprint

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Background: The 2019 coronavirus disease (COVID-19) has become an unprecedented public health crisis with nearly 16 million confirmed cases and 630,000 deaths worldwide. Methods: We retrospectively investigated the demographic, clinical, laboratory, radiological and treatment data of COVID-19 patients consecutively enrolled from January 18 to May 15, 2020, in Taihe and Jinzhou central hospital. Results: Of all 197 patients, the median age was 66.5 years (IQR 7-76), and 120 (60.9%) patients were males. We identified 88 (44.7%) of 197 COVID-19 patients as the disease progression (aggravation) cases. The aggravation cases tend to have more medical comorbidity: hypertension (34.1%), diabetes (30.7%), and presented with dyspnea (34.1%), neutrophilia (60.2%), and lymphocytopenia (73.9%), compared with those without. And the patients with disease progression showed significantly higher level of Fibrinogen (Fbg), D-dimer, IL-6, C-reactive protein (CRP), procalcitonin (PCT), and serum ferritin, and were more prone to develop organ damage in the liver, kidney, and heart (P<0.05). Multivariable regression showed that advanced age, comorbidities, lymphopenia, and elevated level of Fbg, lactate dehydrogenase (LDH), Cardiac troponin (CTnI), IL-6, serum ferritin were the significant predictors of disease progression. Further, we investigated antibody responses to SARS-CoV-2 and found that the levels of IgM and IgG were significantly higher in the disease progression cases compared to non-progression cases from 3 weeks after symptom onset. In addition, the disease progression group tended to peak later and has a more vigorous IgM/IgG response against SARS-CoV-2. Further, we performed Kaplan-Meier analysis and found that 61.6% of patients had not experienced ICU transfer or survival from hospital within 25 days from admission.Conclusions: Investigating the potential factors of advanced age, comorbidities and elevated level of IL-6, serum ferritin and Kaplan-Meier analysis enables early identification and management of patients with poor prognosis. Detection of the dynamic antibody may offer vital clinical information during the course of SARS-CoV-2 and provide prognostic value for patients infection.

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“…In Spain, the health authorities' guidelines for making decisions on the workers' vulnerability due to COVID-19 infection effects, have been based on the assessment of personal aspects: age [9]; pregnancy [10] [11] and the morbidities that have had an impact throughout the different phases of the pandemic [12]: diabetes, arterial hypertension [13] [14], obesity [15] [16], cancer, cardiovascular disease [17] [18], chronic lung disease [19], chronic liver disease [20] [21] and immunosuppression [22]; the risk of exposure to COVID-19 in the workplace (particularly in the health [23], social care sector [24], and in contact with the public).…”

Section: Introductionmentioning

confidence: 99%

Proposed Occupational Vulnerability Index COVID-19

Vicente-Herrero¹,

Torre²,

Balsa³

et al. 2020

ODEM

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Introduction: Vulnerable is someone who can be hurt or receive injury, physically or morally. The work environment appears as one of the dimensions in which social vulnerability develops and social and occupational vulnerability is defined. The literature does not include an assessment of quantified occupational vulnerability as it already exists in the case of social vulnerability. The aim of this paper is to identify and quantify the variables included in the Protocol for the Assessment of Vulnerability to COVID-19 in such a way that the result can be quantified and allows for a predictive effect on the degree of vulnerability. Methodology: The starting point is the design of a protocol proposal that includes 29 variables. Data is collected from a sample of 420 workers, quantifying the results according to each variable, the overall scores for each group of aspects assessed and, finally, the total score that estimates the degree of vulnerability according to established ranges. Results: Variables that have the highest coefficient and, therefore, the greatest weight in the probability of reaching a group of high or medium vulnerability are cardiovascular disease, cancer, and coagulation alteration. The weight of the labour aspects due to inadequate working conditions stands out. Conclusions: The results obtained with this protocol allow us to make a quantified assessment of labour vulnerability to COVID-19

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Hepatic involvement in COVID‐19 patients: Pathology, pathogenesis, and clinical implications

Cited by 126 publications

References 15 publications

Clinical Course and Risk Factors for Liver Injury of Severe and Critical Patients With COVID-19: A Single-centered, Retrospective, Observational Study

Clinical Course and Risk Factors for Liver Injury of Severe and Critical Patients With COVID-19: A Single-centered, Retrospective, Observational Study

A Comprehensive Evaluation of Early Predictors of Disease Progression in Patients with COVID-19: A Case Control Study

Proposed Occupational Vulnerability Index COVID-19

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