Features of Liver Injury in COVID-19 Pathophysiological, Biological and Clinical Particularities
The outbreak of the coronavirus pandemic in March 2020 has caused unprecedented pressure on public health and healthcare. The spectrum of COVID-19 onset is large, from mild cases with minor symptoms to severe forms with multi-organ dysfunction and death. In COVID-19, multiple organ damage has been d...
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| Format: | Article |
| Language: | English |
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MDPI AG
2023-04-01
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| Series: | Gastroenterology Insights |
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| Online Access: | https://www.mdpi.com/2036-7422/14/2/12 |
| _version_ | 1797594629669912576 |
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| author | Cristina Maria Marginean Eliza Cinteza Corina Maria Vasile Mihaela Popescu Viorel Biciusca Anca Oana Docea Radu Mitrut Marian Sorin Popescu Paul Mitrut |
| author_facet | Cristina Maria Marginean Eliza Cinteza Corina Maria Vasile Mihaela Popescu Viorel Biciusca Anca Oana Docea Radu Mitrut Marian Sorin Popescu Paul Mitrut |
| author_sort | Cristina Maria Marginean |
| collection | DOAJ |
| description | The outbreak of the coronavirus pandemic in March 2020 has caused unprecedented pressure on public health and healthcare. The spectrum of COVID-19 onset is large, from mild cases with minor symptoms to severe forms with multi-organ dysfunction and death. In COVID-19, multiple organ damage has been described, including lung damage, acute kidney injury, liver damage, stroke, cardiovascular and digestive tract disorders. The aspects of liver injury are different, sometimes presenting with only a slight increase in liver enzymes, but sometimes with severe liver injury, leading to acute liver failure requiring liver transplantation. In patients with chronic liver disease, especially liver cirrhosis, immune dysfunction can increase the risk of infection. Immune dysfunction has a multifactorial physiopathological mechanism, implying a complement system and macrophage activation, lymphocyte and neutrophil activity dysfunction, and intestinal dysbiosis. This review aims to evaluate the most relevant studies published in the last years related to the etiopathogenetic, biochemical, and histological aspects of liver injury in patients diagnosed with COVID-19. Liver damage is more evident in patients with underlying chronic liver disease, with a significantly higher risk of developing severe outcomes of COVID-19 and death. Systemic inflammation, coagulation disorders, endothelial damage, and immune dysfunction explain the pathogenic mechanisms involved in impaired liver function. Although various mechanisms of action of SARS-CoV-2 on the liver cell have been studied, the impact of the direct viral effect on hepatocytes is not yet established. |
| first_indexed | 2024-03-11T02:26:00Z |
| format | Article |
| id | doaj.art-0955c9229a3d406d8ec87493dd33d731 |
| institution | Directory Open Access Journal |
| issn | 2036-7414 2036-7422 |
| language | English |
| last_indexed | 2024-03-11T02:26:00Z |
| publishDate | 2023-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Gastroenterology Insights |
| spelling | doaj.art-0955c9229a3d406d8ec87493dd33d7312023-11-18T10:31:38ZengMDPI AGGastroenterology Insights2036-74142036-74222023-04-0114215616910.3390/gastroent14020012Features of Liver Injury in COVID-19 Pathophysiological, Biological and Clinical ParticularitiesCristina Maria Marginean0Eliza Cinteza1Corina Maria Vasile2Mihaela Popescu3Viorel Biciusca4Anca Oana Docea5Radu Mitrut6Marian Sorin Popescu7Paul Mitrut8Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaPediatrics Department, University of Medicine and Pharmacy “Carol Davila”, 020021 Bucharest, RomaniaDepartment of Pediatric Cardiology, “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, RomaniaDepartment of Endocrinology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Toxicology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Cardiology, University and Emergency Hospital, 050098 Bucharest, RomaniaPh.D. School Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaDepartment of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, RomaniaThe outbreak of the coronavirus pandemic in March 2020 has caused unprecedented pressure on public health and healthcare. The spectrum of COVID-19 onset is large, from mild cases with minor symptoms to severe forms with multi-organ dysfunction and death. In COVID-19, multiple organ damage has been described, including lung damage, acute kidney injury, liver damage, stroke, cardiovascular and digestive tract disorders. The aspects of liver injury are different, sometimes presenting with only a slight increase in liver enzymes, but sometimes with severe liver injury, leading to acute liver failure requiring liver transplantation. In patients with chronic liver disease, especially liver cirrhosis, immune dysfunction can increase the risk of infection. Immune dysfunction has a multifactorial physiopathological mechanism, implying a complement system and macrophage activation, lymphocyte and neutrophil activity dysfunction, and intestinal dysbiosis. This review aims to evaluate the most relevant studies published in the last years related to the etiopathogenetic, biochemical, and histological aspects of liver injury in patients diagnosed with COVID-19. Liver damage is more evident in patients with underlying chronic liver disease, with a significantly higher risk of developing severe outcomes of COVID-19 and death. Systemic inflammation, coagulation disorders, endothelial damage, and immune dysfunction explain the pathogenic mechanisms involved in impaired liver function. Although various mechanisms of action of SARS-CoV-2 on the liver cell have been studied, the impact of the direct viral effect on hepatocytes is not yet established.https://www.mdpi.com/2036-7422/14/2/12COVID-19liver injuryliver enzymesSARS-CoV-2hepatic lesions |
| spellingShingle | Cristina Maria Marginean Eliza Cinteza Corina Maria Vasile Mihaela Popescu Viorel Biciusca Anca Oana Docea Radu Mitrut Marian Sorin Popescu Paul Mitrut Features of Liver Injury in COVID-19 Pathophysiological, Biological and Clinical Particularities Gastroenterology Insights COVID-19 liver injury liver enzymes SARS-CoV-2 hepatic lesions |
| title | Features of Liver Injury in COVID-19 Pathophysiological, Biological and Clinical Particularities |
| title_full | Features of Liver Injury in COVID-19 Pathophysiological, Biological and Clinical Particularities |
| title_fullStr | Features of Liver Injury in COVID-19 Pathophysiological, Biological and Clinical Particularities |
| title_full_unstemmed | Features of Liver Injury in COVID-19 Pathophysiological, Biological and Clinical Particularities |
| title_short | Features of Liver Injury in COVID-19 Pathophysiological, Biological and Clinical Particularities |
| title_sort | features of liver injury in covid 19 pathophysiological biological and clinical particularities |
| topic | COVID-19 liver injury liver enzymes SARS-CoV-2 hepatic lesions |
| url | https://www.mdpi.com/2036-7422/14/2/12 |
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