Liver and COVID-19: From care of patients with liver diseases to liver injury

Gaspar, Rui; Branco, C.; Macedo, Guilherme

doi:10.4254/wjh.v13.i10.1367

Cited by 10 publications

(8 citation statements)

References 74 publications

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“…This is important since both diabetes and obesity are known risk factors for more serious COVID-19 and also predispose to hepatic steatosis. Liver injury has been previously reported in the acute COVID-19 phase 11,12 and has been associated with worse clinical outcomes in the acute phase. 13,14 Although we cannot exclude residual confounders, our data suggest that there may be persistent ongoing liver injury in the mediumterm in the more severe COVID-19 patients.…”

Section: Discussionmentioning

confidence: 93%

Clinical outcomes at medium-term follow-up of COVID-19

Barbara

Gatt

Xuereb

et al. 2022

Journal of the Royal College of Physicians of Edinburgh

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Background: The long coronavirus disease 2019 (COVID-19) syndrome is defined as persistent physical, cognitive and/or psychological symptoms that continue for more than 12 weeks following the acute illness. Methods: In all, 2,646 patients were randomly selected from all individuals who were diagnosed with COVID-19. They were interviewed so as to assess the persistence of symptoms and health-related quality of life. Blood investigations were also taken. Results: The median (interquartile range (IQR)) age was 44 (31–55) years and 48.6% were males. Five per cent had been hospitalised. Follow-up was for a median of 142 days (IQR: 128–161). Twenty-two per cent of the participants claimed that they were feeling worse than they felt before COVID-19. The most common symptoms were anosmia, ageusia, fatigue, shortness of breath, headaches and myalgia. The Short Form-36 questionnaire revealed that 16.4% felt that they were somewhat worse than in the previous year and that hospitalised patients fared worse in all domains except for role-emotional. New-onset diabetes was similar to the rate of undiagnosed diabetes in the background population. Hospitalised patients had significantly higher liver transaminases, fasting plasma glucose, glycated haemoglobin, uric acid, red cell distribution width, mean platelet volume, triglyceride levels and troponin levels but lower estimated glomerular filtration rate and high-density lipoprotein-cholesterol at follow-up. Discussion: A significant proportion of patients were symptomatic at a median follow-up of 142 days and felt worse than 1 year previously. Hospitalised patients had more biochemical and haematological abnormalities compared to non-hospitalised ones, suggesting ongoing inflammation in subjects who were more severely affected by the disease.

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Section: Discussionmentioning

confidence: 93%

Clinical outcomes at medium-term follow-up of COVID-19

Barbara

Gatt

Xuereb

et al. 2022

Journal of the Royal College of Physicians of Edinburgh

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“…Treatment decision making for HCC should take into account the risk of infection, the availability of medical personnel, and the risk/benefit ratio for a single patient [ 18 ]. In view of preventing SARS-CoV-2 infection in HCC patients, changes in diagnostic and therapeutic algorithms have been proposed, and that was crucial in the management of HCC patients in the pandemic [ 25 ]. Often the main decision was to delay, when possible, the surgical treatment, but the American Association for the Study of Liver Diseases (AASLD) and EASL recommend continuing HCC surveillance and treatment with an acceptable delay of a maximum of two months to reduce the number of patients presenting with HCC not amenable to treatment [ 1 , 26 ].…”

Section: Measures To Reduce the Risk Of Covid-19 In Hcc Patientsmentioning

confidence: 99%

Impact of SARS-CoV-2 Pandemic on the Management of Patients with Hepatocellular Carcinoma

Guarino

Cossiga

Capasso

et al. 2022

JCM

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Worldwide, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) significantly increases mortality and morbidity. The Coronavirus Disease 2019 (COVID-19) outbreak has had a considerable impact on healthcare systems all around the world, having a significant effect on planned patient activity and established care pathways, in order to meet the difficult task of the global pandemic. Patients with hepatocellular carcinoma (HCC) are considered a particularly susceptible population and conceivably at increased risk for severe COVID-19 because of two combined risk factors: chronic advanced liver disease and HCC itself. In these challenging times, it is mandatory to reshape clinical practice in a prompt way to preserve the highest standards of patient care and safety. However, due to the stay-at-home measures instituted to stop the spread of COVID-19, HCC surveillance has incurred a dramatic drop, and care for HCC patients has been rearranged by refining the algorithm for HCC treatment to the COVID-19 pandemic, permitting these patients to be safely managed by identifying those most at risk of neoplastic disease progression.

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“…In fact, the anti-COVID-19 drugs, especially drug-drug or alcohol-drug combinations, cause cellular stress responses and injury to liver cells[ 32 ]. In addition, a direct relationship between the grade of liver injury and severity of the disease has been established[ 33 ]. Elevated liver enzymes appear to be a risk factor for disease progression, even in the absence of underlying liver disease[ 30 ].…”

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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Liver and COVID-19: From care of patients with liver diseases to liver injury

Cited by 10 publications

References 74 publications

Clinical outcomes at medium-term follow-up of COVID-19

Clinical outcomes at medium-term follow-up of COVID-19

Impact of SARS-CoV-2 Pandemic on the Management of Patients with Hepatocellular Carcinoma

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

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