Liver injury in COVID-19 patients with non-alcoholic fatty liver disease: an update

Miranda, Cesare; Garlatti, Elena; Porto, Andrea Da; Rinaldo, Elena; Grazioli, Silvia; Zanette, Giorgio; Tonizzo, Maurizio

doi:10.5114/amsad/160950

Cited by 9 publications

(4 citation statements)

References 100 publications

(116 reference statements)

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“…However, limited data—especially histological ones—are currently available. There is evidence correlating COVID-19 to Non-Alcoholic Fatty Liver Disease (NAFLD) via pathogenetic mechanisms including cytokine storm and additional multifactorial events [ 31 , 32 ]. In addition, clinical data suggest a prothrombotic state in patients with NAFLD due to its metabolic characteristics, although the complex biochemical pathways involved are not yet fully understood [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

Liver Damage and Impaired Coagulation in COVID-19 Patients: A Case Series

Abenavoli,

Aquila,

Sacco

et al. 2023

Diseases

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The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has generated an unprecedented challenge for healthcare systems worldwide. Currently, the scientific community wonders if liver injury in patients suffering from severe forms is a direct consequence of the virus or secondary manifestations of systemic inflammation. The liver plays an essential role in the development of the inflammatory storm typical of this disease, and its involvement is associated with worse clinical outcomes and a higher risk of morbidity and mortality from Coronavirus disease 2019 (COVID-19). Methods: Ten patients suffering from severe COVID-19 disease who died between January 2020 and December 2021 were included in the present analysis. These subjects underwent a post mortem examination with a focused evaluation of the hepatic injury. Also, several laboratory parameters have been evaluated, with a primary focus on prothrombin time, partial thromboplastin time, fibrinogen, antithrombin III, and D-dimers to detect coagulative changes. Results: The main cause of death was represented by pulmonary thromboembolism events (50%). The analysis of coagulation laboratory parameters and liver biomarkers revealed a statistically significant rise in aPTT and ALP, and a decrease in albumin, when comparing the blood value at admission and death. We also found high levels of D-dimers in most of the subjects at the time of hospitalization. Interestingly, the post mortem analysis of the liver showed ample morphologic variability, with several disease features. In detail, the liver histology revealed the following: the presence of a variable degree of micro- and macrovacuolar steatosis, inflammation (also, hepato-cholangitis), and variable fibrosis. Of mention, we were also able to detect organized fibrinous material. Conclusions: Our results indicate that in subjects with a severe form of COVID-19, liver disease is related to changes in coagulative and fibrinolytic pathways. In particular, we noted low fibrinogen levels and high D-dimer levels with histological liver findings. Our data suggest that fibrinogen and D-dimers may be used as prognostic markers to detect the severity of liver disease in patients with COVID-19. Finally, we underline the crucial role of coagulation balance in subjects with severe forms of COVID-19.

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Section: Discussionmentioning

confidence: 99%

Liver Damage and Impaired Coagulation in COVID-19 Patients: A Case Series

Abenavoli,

Aquila,

Sacco

et al. 2023

Diseases

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“…37 Although several studies have highlighted the role of MASLD in the progression of COVID-19, there is still no evidence that MASLD will affect its prognosis. 38 The situation is further complicated by the fact that people with MASLD are likely to have significant co-morbidities, for example diabetes and cardiovascular disease, which might themselves adversely affect the outcome of COVID-19. Furthermore, other mechanisms such as an increased susceptibility to infections, impaired immune responses, and an increased risk of coagulation could enhance the risk of severe COVID-19 in people with MASLD.…”

Section: Metabolic Dysfunction-associated Steatotic Liver Disease (Ma...mentioning

confidence: 99%

“… 37 Although several studies have highlighted the role of MASLD in the progression of COVID-19, there is still no evidence that MASLD will affect its prognosis. 38 …”

Section: Effects Of the Pandemic On Patients With Liver Diseasementioning

confidence: 99%

COVID-19 and the Liver: A Complex and Evolving Picture

Taylor-Robinson,

Morgan

2023

HMER

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Although the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily attacks the respiratory system, other organs, such as the liver, are also affected. In this overview, the effects of SARS-CoV-2 infection on the liver in both healthy people and in those with pre-existing liver disease are documented; the relationship between coronavirus disease 19 (COVID-19) vaccination and liver injury is examined; the mechanism of SARS-CoV-2-associated liver injury is explored; and the long-term consequences of COVID-19 are delineated, both in people with and without pre-existing liver disease.

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“…It is known that people with chronic diseases have a more severe course of COVID-19, in particular those with obesity, diabetes, and meta bolic syndrome. Liver steatosis, which is often diagnosed in patients with obesity and diabetes mellitus, has been recognized as an independent predictor of COVID-19 severity [1][2][3].…”

Section: Introductionmentioning

confidence: 99%

Serum levels of neurokinin B in patients with non-alcoholic fatty liver disease and intestinal lesions after COVID-19

Sirchak,

Stehura

2023

GASTRO

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Background. The study of neuropeptides, including substance P, neurokinins, may reveal possible mechanisms of the progression of gastrointestinal lesions with the formation of motility disorders in patients with coronavirus disease 2019 (COVID-19), especially in metabolically associated diseases such as non-alcoholic fatty liver disease (NAFLD), obesity, type 2 diabetes mellitus. Aim of the research: to determine the peculiarities of changes in serum neurokinin B (NK-B) levels in patients with NAFLD after COVID-19. Materials and methods. The study included 104 patients with NAFLD and intestinal lesions at the outpatient stage of follow-up after COVID-19 (they formed the main group of those being treated (group I)). Group II (comparison one) included 78 patients with NAFLD who did not have neither COVID-19, nor complaints indicating intestinal lesions. All examined patients were tested for NK-B levels in blood serum. Results. Complaints indicating intestinal lesions in patients with NAFLD after COVID-19 were more often manifested by changes in the act of defecation, namely constipation was diagnosed in 51.0 % of cases (р < 0.001), a tendency to diarrhea — in 26.9 %, and in 22.1 % of patients in group I, constipation followed by diarrhea was diagnosed. Among NAFLD patients, a significant increase in serum NK-B levels with minimal deviations from the norm was found in group II (1.1-fold; р < 0.05), while in group I, significant deviations from the norm were diagnosed (3.0-fold; р < 0.001). The lowest levels of NK-B were detected in intestinal damage manifested by constipation. In patients with diarrhea in NAFLD after COVID-19, the level of NK-B was maximal and 6.2 times (р < 0.001) higher than that of the control group. Conclusions. Among patients with NAFLD, intestinal damage after COVID-19 is more often manifested by constipation (in 51.0 % of cases). In patients with NAFLD after COVID-19, changes in the level of neurokinin B in the blood serum were found, with its minimum in constipation ((0.173 ± 0.009) pg/ml; р < 0.01), and maximum values in patients with diarrhea (an increase to (1.782 ± 0.023) pg/ml; р < 0.001).

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Liver injury in COVID-19 patients with non-alcoholic fatty liver disease: an update

Cited by 9 publications

References 100 publications

Liver Damage and Impaired Coagulation in COVID-19 Patients: A Case Series

Liver Damage and Impaired Coagulation in COVID-19 Patients: A Case Series

COVID-19 and the Liver: A Complex and Evolving Picture

Serum levels of neurokinin B in patients with non-alcoholic fatty liver disease and intestinal lesions after COVID-19

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