Tissue Sentence Context

Table 1. Analysis of context sentence of liver tissue in 729 abstracts.

PMID Senteces
32062957 Routine blood test revealed WBC <4.0×10(9)/L in 8 petients (26.67%) , (4-10) ×10(9)/L in 22 petients (73.33%) , and WBC>4.0×10(9)/L in 4 petients (13.33%) during the disease.Lymphocyte count <1.0×10(9)/L occurred in 12 petients (40%),abnormal liver function in 7 petients (23.33%) ,myocardial damage in 5 petients(16.67%), elevated D-dimer (>0.5mg/l) in 5 patients (16.67%). […] Compared with normal patients, the average exposure times, cumulative exposure time, BMI, Fever time, white blood cell count, liver enzyme, LDH, myoenzyme and D-dimer were significantly increased in severe patients, while the lymphocyte count and albumin levels in peripheral blood were significantly decreased.Chest CT mainly showed patchy shadows and interstitial changes.According to imaging examination, 11 patients (36.67%) showed Unilateral pneumonia and 19 patients (63.33%) showed bilateral pneumonia,4 patients (13.33%) showed bilateral multiple mottling and ground-glass opacity.Compared with the patients infected in the protected period, the proportion of severe infection and bilateral pneumonia were both increased in the patients infected in unprotected period. Conclusion: Medical staffs are at higher risk of infection.Infection rates are associated with contact time, the amount of suction virus. […] Severe patients had BMI increased, heating time prolonged , white blood cell count, lymphocyte count, D-dimer and albumin level significantly changed and were prone to be complicated with liver damage and myocardial damage.Strict protection measures is important to prevent infection for medical workers. 目的: 探讨医务人员新型冠状病毒肺炎(简称新冠肺炎)的临床特征。
32075364 Some patients accompany with liver function damage in addition to the main typical respiratory symptom. […] Here we analyzed the clinical features, susceptible population, potential causes and therapeutic strategies of NCP related liver injury.
32077659 Objective: To explore and analyze the possible mechanism of liver injury in patients with coronavirus disease 2019 (novel coronavirus pneumonia, NCP). Methods: The correlation between ALT, AST and other liver enzyme changes condition and NCP patients’ disease status reported in the literature was comprehensively analyzed. […] ACE2 expression in liver tissue for novel coronavirus was analyzed based on single cell sequencing (GSE115469) data. […] RNA-Seq method was used to analyze Ace2 expression and transcription factors related to its expression in liver tissues at various time-points after hepatectomy in mouse model of acute liver injury with partial hepatectomy. t-test or Spearman rank correlation analysis was used for statistical analysis. Results: ALT and AST were abnormally elevated in some patients with novel coronavirus infection, and the rate and extent of ALT and AST elevation in severe NCP patients were higher than those in non-severe patients. […] Liver tissue results of single cell sequencing and immunohistochemistry showed that ACE2 was only expressed in bile duct epithelial cells of normal liver tissues, and very low in hepatocytes. […] In a mouse model of acute liver injury with partial hepatectomy, Ace2 expression was down-regulated on the first day, but it was elevated up to twice of the normal level on the third day, and returned to normal level on seventh day when the liver recovered and hepatocyte proliferation stopped. […] Whether this phenomenon suggests that the bile duct epithelial cells with positive expression of Ace2 participate in the process of liver regeneration after partial hepatectomy deserves further study. […] In RNA-Seq data, 77 transcription factors were positively correlated with the expression of ACE2 (r > 0.2, FDR < 0.05), which were mainly enriched in the development, differentiation, morphogenesis and cell proliferation of glandular epithelial cells. Conclusion: We assumed that in addition to the over activated inflammatory response in patients with NCP, the up-regulation of ACE2 expression in liver tissue caused by compensatory proliferation of hepatocytes derived from bile duct epithelial cells may also be the possible mechanism of liver tissue injury caused by 2019 novel coronavirus infection. 目的: 探索和分析新型冠状病毒感染肺炎(NCP)患者发生肝损伤的可能机制。
32077660 Objective: To analyze the clinical characteristics of cases of novel coronavirus pneumonia and a preliminary study to explore the relationship between different clinical classification and liver damage. Methods: Consecutively confirmed novel coronavirus infection cases admitted to seven designated hospitals during January 23, 2020 to February 8, 2020 were included. […] ALT, AST, ALB and TBil of the severe or critical subgroups were 60.25 (40.88 ~ 68.90) U/L, 37.00 (20.88 ~ 64.45) U/L, 35.75 (28.68 ~ 42.00) g/L, and 20.50 (11.28 ~ 25.00) mmol/L, respectively. Conclusion: The results of this multicenter retrospective study suggests that novel coronavirus pneumonia combined with liver damage is more likely to be caused by adverse drug reactions and systemic inflammation in severe patients receiving medical treatment. […] Therefore, liver function monitoring and evaluation should be strengthened during the treatment of such patients. 目的: 分析新型冠状病毒肺炎病例的临床特征,初步探讨不同临床分型与肝功能损伤的关系。
32096367 We also isolated alive viral strains from feces, indicating potential infectiousness of feces.Dynamic cytokine detection was necessary to timely identifyingcytokine storms and application of artificial liver blood purification system. […] The artificial liver blood purification system could rapidly remove inflammatory mediators and block cytokine storm.Moreover, it also favoredthe balance of fluid, electrolyte and acid-base and thus improved treatment efficacy in critical illness.
32105632 Most patients had organ function damage, including 35 (67%) with ARDS, 15 (29%) with acute kidney injury, 12 (23%) with cardiac injury, 15 (29%) with liver dysfunction, and one (2%) with pneumothorax. 37 (71%) patients required mechanical ventilation.
32109279 Only 3 patients (3.75%) showed liver dysfunction. […] The proportion of patients having liver dysfunction and abnormal CT imaging was relatively lower than that of Wuhan.
32118389 Elevation of C-reactive protein (10%, 3/30), erythrocyte sedimentation rate(19%,4/21), procalcitonin(4%,1/28), liver enzyme(22%, 6/27) and muscle enzyme (15%, 4/27) occurred in different proportions.
32120458 The observation indicators included total blood count, C-reactive protein (CRP), arterial blood gas analysis, myocardial injury markers, coagulation function, liver and kidney function, electrolyte, procalcitonin (PCT), B-type natriuretic peptide (BNP), blood lipid, pulmonary CT and pathogen detection. Results: Compared with the general group, the lymphocyte count (0.74×10(9) (0.34×10(9), 0.94×10(9))/L vs.
32125362 Four of the 5 patients treated with lopinavir-ritonavir developed nausea, vomiting, and/or diarrhea, and 3 developed abnormal liver function test results.
32153170 Objective: To understand the clinical characteristics, change of liver function, influencing factors and prognosis in hospitalized patients with coronavirus disease-19 (COVID-19) combined with liver injury. Methods: The general conditions, biochemical indicators of liver, blood clotting mechanism, routine blood test, UGT1A1 * 28 gene polymorphism and other data of 40 cases with COVID-19 admitted to the isolation ward of Tangdu Hospital were retrospectively analyzed. […] The clinical characteristics, influencing factors and prognosis of liver injury in patients with liver injury group and those with normal liver function group were compared. […] Multiple logistic regression analysis was used to analyze the main influencing factors of liver injury. Results: Of the 40 cases, 25 were male (62.5%) and 15 were female (37.5%), aged 22 to 83 (53.87 ± 15.84) years. […] Liver injury was occurred in 22 cases (55%) during the course of the disease. […] Liver function injury was more likely to occur in patients who used many types of drugs and large amounts of hormones (P = 0.002, P = 0.031), and there was no correlation with the TA6TA7 mutation in the UGT1A1 * 28 gene locus. […] Multiple regression analysis showed that the occurrence of liver injury was only related to critical illness. […] The liver function of all patients had recovered within one week after conventional liver protection treatment. Conclusion: COVID-19 combined with liver function injury may be due to the slight elevation of transaminase, mostly around the second week of the disease course. […] Severe patients have a higher proportion of liver injury, and critical type is an independent risk factor for liver injury. 目的: 了解新型冠状病毒肺炎(COVID-19)住院患者合并肝损伤的临床特点、肝功能变化、影响因素及预后。
32154135 Among these 9 pregnant women with confirmed 2019-nCoV infection, onset of clinical symptoms occurred before delivery in 4 cases, on the day of delivery in 2 cases, and after delivery in 3 cases. […] Clinically, the first symptom in the neonates was shortness of breath (n=6), but other initial symptoms such as fever (n=2), thrombocytopenia accompanied by abnormal liver function (n=2), rapid heart rate (n=1), vomiting (n=1), and pneumothorax (n=1) were observed. […] Perinatal 2019-nCoV infection may have adverse effects on newborns, causing problems such as fetal distress, premature labor, respiratory distress, thrombocytopenia accompanied by abnormal liver function, and even death.
32161968 Liver function damage is more frequent in NCOVID-19 than NON-NCOVID-19 patients.
32170806 However, liver injury has also been reported to occur during the course of the disease in severe cases. […] Similarly, previous studies have shown that liver damage was common in the patients infected by the other two highly pathogenic coronavirus - severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV), and associated with the severity of diseases. […] In this review, the characteristics and mechanism of liver injury caused by SARS-CoV, MERS-CoV as well as SARS-CoV-2 infection were summarized, which may provide help for further studies on the liver injury of COVID-19.
32172546 Objective: To investigate the pathological characteristics and the clinical significance of novel coronavirus (2019-nCoV)-infected pneumonia (termed by WHO as corona virus disease 2019, COVID-19). Methods: Minimally invasive autopsies from lung, heart, kidney, spleen, bone marrow, liver, pancreas, stomach, intestine, thyroid and skin were performed on three patients died of novel coronavirus pneumonia in Chongqing, China. […] While the 2019-nCoV is mainly distributed in lung, the infection also involves in the damages of heart, vessels, liver, kidney and other organs.
32188728 We compared the pathogenesis of the DUBmut virus to the wild-type virus and found that the DUBmut-infected mice had a statistically significant reduction (p<0.05) in viral titer in livers and spleens at day 5 post-infection, albeit both wild-type and DUBmut virus infections resulted in similar liver pathology.
32193831 Laboratory findings revealed normal or increased whole blood counts (7/8), increased C-reactive protein, procalcitonin and lactate dehydrogenase (6/8), and abnormal liver function (4/8).
32196707 The laboratory results showed that compared to the normal values, the patients’ lymphocytes were reduced (four [80%] patients), and liver functions alanine aminotransferase and aspartate aminotransferase (two [40%] patients and two [40%] patients) and C-reactive protein (four [80%] patients) were increased when admitted to hospital. […] The main complications for the patients were acute respiratory distress syndrome (one [20%] patients), acute liver injury (three [60%] patients), and diarrhea (two [40%] patients).
32199615 Although ACE2 is reported to be expressed in lung, liver, stomach, ileum, kidney and colon, its expressing levels are rather low, especially in the lung. […] Consistent with other recent reports, we confirmed that ACE2 was mainly expressed in lung AT2, liver cholangiocyte, colon colonocytes, esophagus keratinocytes, ileum ECs, rectum ECs, stomach epithelial cells, and kidney proximal tubules.
32213556 Among enrolled 651 patients, 74 (11.4%) presented with at least one GI symptom (nausea, vomiting or diarrhoea), average age of 46.14 years, 4-day incubation period and 10.8% had pre-existing liver disease.
32219882 To help understand the advantages and limitations of differential treatments, we provide a timely review and discuss the complications and corresponding major treatments, especially controversial ones such as antiviral therapy (remdesivir, ribavirin, and chloroquine), glucocorticoid therapy, extracorporeal support including an artificial liver system, and extracorporeal membrane oxygenation based on available evidence.
32220017 It may rapidly progress to acute respiratory distress syndrome (ARDS) and result in multiorgan dysfunction or death in some cases.(1,2) Here, we report the case of a patient with hepatocellular carcinoma (HCC) who underwent liver transplantation and experienced COVID-19 infection during the perioperative period.
32222119 All pregnant women did not have an antepartum fever but developed a low-grade fever (37.5℃-38.5℃) within 24 hours after delivery. […] All patients had normal liver and renal function, two patients had elevated plasma levels of the myocardial enzyme. […] All labors smoothly processed, the Apgar scores were 10 points 1 and 5 minutes after delivery, no complications were observed in the newborn. […] It is probable that pregnant women diagnosed with COVID-19 have no fever before delivery.
32233055 Herein we provide the views of a liver transplant surgeon and transplant hepatologist in New York.
32239591 Limited data are available for liver function in COVID-19 patients. […] We aimed to investigate the risk factors related to liver injury in the COVID-19 patients. […] The clinical characteristics of patients with liver injury and without liver injury were compared. […] Males were more likely to have liver injury when infected with COVID-19 (P < .05); compared with patients without liver injury, patients with liver injury had increased levels of white blood cell counts, neutrophils, CRP and CT score (P < .05) and had a longer length of stay (P < .05). […] Logistic regression analyses suggested that the extent of pulmonary lesions on CT was a predictor of liver function damage (P < .05). […] Liver injury is common in non-ICU hospitalized COVID-19 patients. […] Intense monitoring and evaluation of liver function in patients with severe pulmonary imaging lesions should be considered.
32239796 The aim of our study was to investigate the changes of liver function and its clinical significance in COVID-19 patients. […] Liver function and related indexes were analyzed to evaluate its relationship with disease progression in COVID-19 patients. […] Part of the COVID-19 patients presented with varying degrees of abnormality in liver function indexes. […] Most of the liver function indexes in COVID-19 patients were correlated with CRP and NLR, the markers of inflammation. […] Although abnormalities of liver function indexes are common in COVID-19 patients, the impairment of liver function is not a prominent feature of COVID-19, and also may not have serious clinical consequences.
32240670 Common complications included bacterial infection (42.8%), liver enzyme abnormalities (28.7%) and acute respiratory distress syndrome (21.0%).
32243269 Besides typical respiratory symptoms and signs of COVID-19, digestive symptoms and liver injury have been frequently reported during the course of the disease. […] In this review, we summarized the recent studies reporting of gastrointestinal and liver manifestations during the course of COVID-19. […] Attention should also be paid to monitor liver function during the course of COVID-19, especially in patients with higher disease severity.
32243673 Herein we presented the clinical course and outcome of a 50-year-old male post liver transplantation who contracted COVID-19, with subsequent infection of his wife.
32247213 Search terms were, COVID-19, treatment of coronavirus, COVID 19 and following terms; chloroquine, hydroxychloroquine, ibuprofen, ACE-inhibitors or angiotensin receptor blockers, cardiovascular disease, diarrhoea, liver, testis and gastrointestinal disease.
32251805 Multiple organ dysfunction can be observed, the most common organ damage was lung, followed by heart, kidney and liver.
32253172 While patients typically present with fever and a respiratory illness, mounting evidence indicates that patients might also report extra-pulmonary manifestations, including those affecting the liver and gastrointestinal tract.
32267833 The meta-analysis revealed no correlation between increased risk of COVID-19 and liver disease, malignancy, or renal disease.
32270388 The Liver Transplant Society of India (LTSI) has come up with guidelines for transplant centres across the country to deal with liver transplantation during this evolving pandemic of COVID-19 infection. […] The guidelines are applicable to both deceased donor as well as living donor liver transplants.
32270660 Objective: To summarize the clinical characteristics and liver biochemical parameters of 324 cases admitted with novel coronavirus pneumonia in Shanghai area. Methods: Clinical data and baseline liver biochemical parameters of 324 cases with novel coronavirus pneumonia admitted to the Shanghai Public Health Clinical Center from January 20, 2020 to February 24, 2020 were retrospectively analyzed. […] The differences in clinical data and baseline liver biochemical parameters of the two groups were described and compared. […] The enumeration data were expressed by frequency and rate, and chi-square test was used. Results: Of the 324 cases with novel coronavirus pneumonia, 26 were severe cases (8%), with median onset of 5 days, 20 cases were HBsAg positive (6.2%), and 70 cases (21.6%) with fatty liver, diagnosed with X-ray computed tomography. […] 1.04, P < 0.01). Conclusion: The baseline liver biochemical parameters of 324 cases with novel coronavirus pneumonia in Shanghai area was comparatively lower and the liverinjury degree was mild, and the bile duct cell damage was rare. 目的: 总结上海地区324例新型冠状病毒肺炎患者入院初肝脏生物化学指标的临床特点。
32274341 Increasing evidence has witnessed the frequent incident liver injury in COVID-19 patients, and it is often manifested as transient elevation of serum aminotransferases; however, the patients seldom have liver failure and obvious intrahepatic cholestasis, unless pre-existing advanced liver disease was present. […] The underlying mechanisms of liver injury in cases of COVID-19 might include psychological stress, systemic inflammation response, drug toxicity, and progression of pre-existing liver diseases. […] However, there is insufficient evidence for SARS-CoV-2 infected hepatocytes or virus-related liver injury in COVID-19 at present. […] The clinical, pathological and laboratory characteristics as well as underlying pathophysiology and etiology of liver injury in COVID-19 remain largely unclear. […] In this review, we highlight these important issues based on the recent developments in the field, for optimizing the management and treatment of liver injury in Chinese patients with COVID-19.
32274342 Cases of liver damage or dysfunction (mainly characterized by moderately elevated serum aspartate aminotransferase levels) have been reported among patients with COVID-19. […] However, it is currently uncertain whether the COVID-19-related liver damage/dysfunction is due mainly to the viral infection per se or other coexisting conditions, such as the use of potentially hepatotoxic drugs and the coexistence of systemic inflammatory response, respiratory distress syndrome-induced hypoxia, and multiple organ dysfunction. […] Based on the current evidence from case reports and case series, this review article focuses on the demographic and clinical characteristics, potential mechanisms, and treatment options for COVID-19-related liver dysfunction. […] This review also describes the geographical and demographic distribution of COVID-19-related liver dysfunction, as well as possible underlying mechanisms linking COVID-19 to liver dysfunction, in order to facilitate future drug development, prevention, and control measures for COVID-19.
32275784 Presently, only about one half of acute care hospitalizations for cirrhosis-related complications result in inpatient specialty care and the current hepatology workforce cannot meet the demand of patients with liver disease nationwide, particularly in less densely populated areas and in community-based practices not affiliated with academic centers. […] Telemedicine, defined as the delivery of health care services at a distance using electronic means for diagnosis and treatment, holds tremendous promise to increase access to broadly specialty care. […] The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Coronavirus Disease 2019 (COVID-19) has, in the short-term, accelerated the growth of telemedicine delivery as a public health and social distancing measure.
32277387 Annually, around 850 liver transplantation is performed in Beijing, China. […] Liver transplant recipients, because of long-term oral immunosuppressant effects, may be more susceptible to 2019-nCoV infection and have a worse prognosis than the general population. […] It is urgent to set up guidelines for the prevention, diagnosis, and treatment of COVID-19 in liver transplant recipients. […] In this article, we reviewed the clinical aspects of 2019-nCoV infection, characteristics of liver transplant recipients, immunosuppressant usage, and potential drug interactions to provide recommendations to clinical staff managing liver transplant recipients during the COVID-19 epidemic.
32277591 Liver injury is common in patients with COVID-19, but little is known about its clinical presentation and severity in the context of liver transplantation.
32278065 ACE2 is expressed furthermore in the upper esophagus, liver, and colon.
32279064 Children with inflammatory bowel disease and post liver transplant patients do not have an increased risk of disease, and should remain on medications they are already on. […] Children with chronic liver disease should continue their medications as usual.
32282972 Following the December 2019 SARS-CoV-2 outbreak in China, France is now fifth in number of deaths worldwide while at the same time hosting one of the biggest European liver transplantation programs.
32282982 Complete suspension of live donor kidney transplantation was reported by 71.8% and live donor liver by 67.7%. […] While complete suspension of deceased donor transplantation was less frequent, some restrictions to deceased donor kidney transplantation were reported by 84.0% and deceased donor liver by 73.3%; more stringent restrictions were associated with higher regional incidence of COVID-19.
32282986 The first patient received liver transplantation due to hepatitis B virus-related hepatocellular carcinoma and was confirmed to have COVID-19 nine days later.
32283325 Some patients with SARS-CoV-2 infection have abnormal liver function. […] We aimed to clarify the features of COVID-19-related liver damage to provide references for clinical treatment. […] Patients were analyzed for clinical features, laboratory parameters (including liver function tests), medications, and length of hospital stay. […] Abnormal liver function was defined as increased levels of alanine and aspartate aminotransferase, gamma glutamyltransferase, alkaline phosphatase, and total bilirubin. […] Fifty-five patients (37.2%) had abnormal liver function at hospital admission; 14.5% of these patients had high fever (14.5%), compared with 4.3% of patients with normal liver function (P=.027). […] Patients with abnormal liver function were more likely to be male, and had higher levels of procalcitonin and C-reactive protein. […] There was no statistical difference between groups in medications taken before hospitalization; a significantly higher proportion of patients with abnormal liver function (57.8%) had received lopinavir/ritonavir after admission compared to patients with normal liver function (31.3%). […] Patients with abnormal liver function had longer mean hospital stays (15.09±4.79 days) than patients with normal liver function (12.76±4.14 days) (P=.021). […] More than one third of patients admitted to the hospital with SARS-CoV-2 infection have abnormal liver function, and this is associated with longer hospital stay. […] A significantly higher proportion of patients with abnormal liver function had received lopinavir/ritonavir after admission; these drugs should be given with caution.
32286245 Biomarkers of inflammation, cardiac and muscle injury, liver and kidney function and coagulation measures were also significantly elevated in patients with both severe and fatal COVID-19.
32287140 Patients with digestive symptoms had higher mean liver enzyme levels, lower monocyte count, longer prothrombin time, and received more antimicrobial treatment than those without digestive symptoms. […] Moreover, these patients have a longer time from onset to admission, evidence of longer coagulation, and higher liver enzyme levels.
32289115 It remains unclear at this point to what extent chronic liver diseases should be considered as risk factors, due to a shortage of appropriate studies. […] However, patients with advanced liver disease and those after liver transplantation represent vulnerable patient cohorts with an increased risk of infection and/or a severe course of COVID-19. […] In addition, the current pandemic requires unusual allocation of healthcare resources which may negatively impact the care of patients with chronic liver disease that continue to require medical attention.
32291399 To gain knowledge about the pathology that may contribute to disease progression and fatality, we performed postmortem needle core biopsies of lung, liver, and heart in four patients who died of COVID-19 pneumonia. […] The liver exhibits mild lobular infiltration by small lymphocytes, and centrilobular sinusoidal dilation. […] Changes in the liver and heart are likely secondary or related to the underlying diseases.
32293716 About 37.2% of patients with elevated D-dimer, 25.9% of patients with leukopenia, along with abnormal levels of liver function (29%) and renal function (25.5%).
32293741 There were 91 death cases who developed different complications including acute respiratory distress syndrome (ARDS) (73/91), myocardial injury (31/91), liver injury (15/91), renal insufficiency (14/91), multiple organ dysfunction syndrome (MODS) (14/91) and pneumothorax (1/91). […] The main complications of deceased patients with COVID-19 were ARDS, myocardial injury, liver injury, renal insufficiency and MODS.
32294285 The authors found that abnormalities of liver function tests are common in COVID-19 patients, but the clinically significant liver dysfunction in COVID-19 was not a prominent feature of this illness and also may not have serious clinical consequences.
32295322 The changes in peripheral blood cells were mainly lymphonpenia (83 cases, 55%) and eosinophilia (95 cases, 63%), The lymphocyte count of the severe and critically ill patients was more significantly reduced, and some patients had increased myocardial enzymes, mainly LDH (47 cases, 31%), and a few patients had liver function damage, mainly manifested in ALT and AST.
32297089 Patients on VKA hospitalized with SARS-CoV-2 show high instability of PT INR due to the variability of vitamin K metabolism, diet, fasting, co-medications, liver impairment, and heart failure.
32297985 At discharge, 7/184 (4%) patients had a mild cough while their other symptoms had disappeared, and the proportion of patients with abnormal liver function and with increased leucocytes, neutrophils or erythrocyte sedimentation rate among the 184 patients were close to those at admission.
32298273 Meanwhile, ACE2 was also expressed in specific cell types of human fetal heart, liver and lung, but not in kidney.
32298473 The goals of this document are to provide data on what is currently known about COVID-19, and how it may impact hepatologists and liver transplant providers and their patients. […] Our aim is to provide a template for the development of clinical recommendations and policies to mitigate the impact of the COVID-19 pandemic on liver patients and healthcare providers.
32298767 Recent data on the coronavirus disease 2019 (COVID-19) outbreak caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has begun to shine light on the impact of the disease on the liver. […] But no studies to date have systematically described liver test abnormalities in patients with COVID-19. […] We evaluated the clinical characteristics of COVID-19 in patients with abnormal liver test results. […] Information on clinical features of patients with abnormal liver tests were collected for analysis. […] Of 417 patients with COVID-19, 318 (76.3%) had abnormal liver test results and 90 (21.5%) had liver injury during hospitalization. […] The presence of abnormal liver tests became more pronounced during hospitalization within 2 weeks, with 49 (23.4%), 31 (14.8%), 24 (11.5%) and 51 (24.4%) patients having alanine aminotransferase, aspartate aminotransferase, total bilirubin and gamma-glutamyl transferase levels elevated to more than 3× the upper limit of normal, respectively. […] Patients with abnormal liver tests of hepatocellular type or mixed type at admission had higher odds of progressing to severe disease (odds ratios [ORs] 2.73; 95% CI 1.19-6.3, and 4.44, 95% CI 1.93-10.23, respectively). […] The use of lopinavir/ritonavir was also found to lead to increased odds of liver injury (OR from 4.44 to 5.03, both p <0.01). […] Patients with abnormal liver tests were at higher risk of progressing to severe disease. […] The detrimental effects on liver injury mainly related to certain medications used during hospitalization, which should be monitored and evaluated frequently. […] Data on liver tests in patients with COVID-19 are scarce. […] We observed a high prevalence of liver test abnormalities and liver injury in 417 patients with COVID-19 admitted to our referral center, and the prevalence increased substantially during hospitalization. […] The presence of abnormal liver tests and liver injury were associated with the progression to severe pneumonia. […] The detrimental effects on liver injury were related to certain medications used during hospitalization, which warrants frequent monitoring and evaluation for these patients.
32301155 We report our preliminary experience with 18 SOT (kidney [44.4%], liver [33.3%], and heart [22.2%]) recipients diagnosed with COVID-19 by March 23, 2020 at a tertiary-care center at Madrid.
32302212 We present a case of COVID-19 hepatitis in a living donor liver allograft recipient whose donor subsequently tested positive for COVID-19. […] She recovered well, with improving liver function tests for 4 days. […] Liver function tests increased approximately 5-fold. […] Liver biopsy showed moderate acute hepatitis with prominent clusters of apoptotic hepatocytes and associated cellular debris.
32302459 The laboratory derangements may be reminiscent of HELLP (hemolysis, elevated liver enzymes, low platelet count) syndrome, and thus knowledge of the COVID-19 relationship is paramount for appropriate diagnosis and management. […] These investigations in SARS-CoV-2-positive pregnant women are vital, as their derangement may signal a more severe COVID-19 infection, and may warrant pre-emptive admission and consideration of delivery to achieve maternal stabilization.
32306657 Heterogeneity between studies was significant; however, subgroup and sensitivity analysis had failed to identify clear sources of heterogeneity. Conclusion: Fever, cough and liver dysfunction are the main clinical manifestations of this disease and the mortality rate is low. 目的: 自2019年12月首次报道新型冠状病毒肺炎以来,该传染病已迅速发生于全国各地及海外多个国家。
32314698 Considering the significantly increased use of HCQ during the COVID-19 pandemic, this case alerts us to the potential for HCQ to be associated with hepatotoxicity and the need to monitor liver function during HCQ therapy.
32316719 Real-time PCR was performed to quantify ACE2 and TMPRSS2 gene expression in conjunctiva, cornea, lacrimal gland, iris, lens, retina, lung, heart, kidney, and liver from male mice.
32318325 Among the 19 cases, there were 16 (84.2%) cases in which the total number of lymphocytes decreased, 12 cases (63%) had reduced liver function, and 11 cases (58%) had deviant results for fibrinogen (FIB) and D-dimer, in particular, the D-dimer level was significantly higher in the non-survivors compared with the survivors.
32324898 Our results showed that the prevalence of ADRs was 37.8% in the patients, which was predominated by drug-induced gastrointestinal disorders and liver system disorders (23.0% vs.
32327904 Mild to moderate elevation of the liver enzymes are also common, although no case of acute liver failure has been reported so far. […] Many of the medications used for treatment of COVID-19 can also be associated with GI symptoms or liver injury and can be included in the differential diagnosis in these patients.
32329563 At present, there is scarce information regarding the global prevalence of chronic liver disease in individuals with coronavirus disease 2019 (COVID-19) disease, which is becoming a global pandemic. […] The aim of this study was to assess the overall prevalence of chronic liver disease among patients with COVID-19 disease by meta-analysing data in observational studies and to investigate the relationship between liver damage and COVID-19 disease. […] The overall prevalence of chronic liver disease at baseline was 3% (95% CI 2%-4%; I2 = 29.1%). […] Individuals with severe COVID-19 disease had relevant alterations of liver enzymes and coagulative profile, probably due to the innate immune response against the virus. […] Further studies are needed to better investigate the causes of liver injury in patients with COVID-19 disease and the effect of treatment for COVID-19 on the liver.
32329589 Some of the patients may have long-term impairment and dysfunctions, including pulmonary fibrosis, heart, liver, kidney, nerve and immune system.
32330343 Forty-six were kidney recipients, 17 lung, 13 liver, 9 heart, and 5 dual-organ transplants.
32330351 In January 2020, Novel Coronavirus Disease 2019 (COVID-19) resulted in a global pandemic, creating uncertainty toward the management of liver transplantation (LT) programs. […] There has been a drastic decrease in liver donors.
32330356 We report four cases of COVID-19 in solid organ transplant recipients including recipients of kidney, liver, lung, and heart transplants.
32333581 In the stage of an imminent organ failure with significantly reduced kidney and liver function, CEUS can be used to show a narrowing of the organ-supplying arteries, as well as a delayed capillary filling of vessels near the capsule, a regional reduced parenchymal perfusion or an inflammatory hyperemia with capillary hypercirculation.
32335426 Coronavirus disease 2019 (COVID-19) is highly contagious, mainly causing inflammatory lesions in the lungs, and can also cause damage to the intestine and liver.
32336007 Dipeptidyl peptidase 4 (DPP4), also known as cluster of differentiation 26 (CD26), is a serine exopeptidase expressed ubiquitously in several tissues, including but not limited to lung, kidney, liver, gut, and immune cells.
32338017 The gastrointestinal tract and the liver are affected by SARS-CoV-2, especially in patients with immunosuppressive therapies. […] Patients with liver transplantation should be followed closely.
32338224 Of note, CD209L or liver/lymph node special intercellular adhesion molecule-3-grabbing non-integrin (SIGN) and dendritic cell (DC)-SIGN are alternative receptors for SARS-CoV but with lower affinity [7]. […] In all these experimental models, RES led to an increase of ACE2 with reduction of organ damage, such as liver steatosis and aorta media thickness and decrease of adipose tissue mass, respectively.
32341229 Many countries, including SA, have imposed major restrictions on travel, and everyday life, and the implications of these necessary changes are being felt in liver transplant (LT) centers in SA. […] Therefore, the Saudi Association for the Study of Liver Diseases and Transplantation (SASLT) established an urgent task force to launch a statement that can be utilized by LT centers as a guidance in the management of patients with advanced liver disease from the time of LT listing to the post-operative care of transplanted patients.
32341519 Moreover, kidney injury was the second-most common organ affected by COVID-19 followed by heart and liver.
32345072 COVID-19 patients with heart, liver and kidneycomorbidity, compared to patients without related comorbidities, were more likely to have cardiac injuries [9.1%(3/33) vs 2.2%(4/179), P = 0.043], liver injuries [13.0%(3/23) vs 3.2%(6/189), P = 0.027], kidney injury [54.5%(6/11) vs 2.0%(4/201), P < 0.001], and higher risk of mortality [Heart-comorbidity: 6.1%(2/33) vs 0.6%(1/179), P = 0.014; Liver-comorbidity: 8.7%(2/23) vs 0.5%(1/189), P = 0.002; Kidney-comorbidity: 27.3%(3/11) vs 1.0%(2/201), P < 0.001. […] Mortality was higher in patients with more severe Grade of organ injuries [Heart-injury: P = 0.044; Liver-injury: P = 0.020; Kidney-injury: P = 0.030].Conclusion: Male, older, co-existing of heart, liver, and kidney comorbidities, especially those with severe Grade organ injuries, had a poor prognosis after SARS-CoV-2 infection.
32345226 Importantly, we found liver, kidney, digestive tract, and heart injuries in COVID-19 cases besides respiratory problems.
32345362 ACE2 showed medium expression levels in the lungs, colon, liver, bladder, and adrenal gland.
32348050 The current epidemic of SARS-CoV-2 infection poses new challenges in the management of patients with gastrointestinal or liver disease.
32349198 In this paper, we aim to provide professional guidance to clinicians who are managing patients with chronic liver disease during the current coronavirus disease 2019 (COVID-19) pandemic in Singapore. […] We reviewed and summarised the available relevant published data on liver disease in COVID-19 and the advisory statements that were issued by major professional bodies, such as the American Association for the Study of Liver Diseases and European Association for the Study of the Liver, contextualising the recommendations to our local situation.
32352224 Zhang et al. showed that COVID-19 affected patients’ present liver biochemistry abnormalities, including elevation of aminotransferases, gamma-glutamyl transferase, and alkaline phosphatase 1 . […] Hence, several possible clinical scenarios in the setting of liver diseases have been postulated. […] First, patients with chronic liver disease may be more vulnerable to the severe clinical consequences of COVID-19, including oxygen desaturation and hypoxemia due to severe pneumonia or the cytokine storm 1;2 . […] Second, liver biochemistry abnormalities are the consequence of drug toxicity.
32354369 Other medication was also given to him in combination for anti-inflammation, intestinal microbial regulation, phlegm elimination, liver protection and pulmonary fibrosis prevention purposes.
32356641 Gastroenterologists and members of other medical specialties should also remember that the current epidemiological situation has changed diagnostic and therapeutic algorithms in the management of several gastrointestinal and liver disorders.
32359177 We reported the distributional and temporal patterns of liver injury indicators in these patients and determined their associated factors and death risk. […] Longitudinal liver function tests were retrospectively analyzed and correlated with the risk factors and death. […] Liver injury dynamic patterns differed in alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TBIL). […] AST abnormality was associated with the highest mortality risk compared to other indicators of liver injury during hospitalization. […] Common factors associated with elevated liver injury indicators were lymphocyte count decrease, neutrophil count increase, and male gender. […] CONCLUSION: The dynamic patterns of liver injury indicators and their potential risk factors may provide an important explanation for the COVID-19-associated liver injury. […] Because elevated liver injury indicators, particularly AST, are strongly associated with the mortality risk, our study indicates that these parameters should be monitored during hospitalization.
32359188 During the coronavirus outbreak in China, our center performed 16 organ transplants (10 kidney, 4 liver and 2 lung transplants, from January 24 to March 11, 2020) harvested from deceased donors. […] Our approaches aiming to interrupt the spread of coronavirus within the transplantation wards were successful and allowed us to maintain the transplantation program for deceased liver, kidney and lung recipients.
32359210 We report the clinical course and management of a liver transplant recipient on hemodialysis, who presented with COVID-19 pneumonia, and despite completing a 5-day course of hydroxychloroquine, later developed marked inflammatory manifestations with rapid improvement after administration of off-label, single-dose tocilizumab.
32360055 This document, written by the French Association for the Study of the Liver (AFEF) board, aims to provide information to physicians involved in the care of patients with liver disease during the Coronavirus disease (COVID-19) epidemic.
32360479 After CVVHDF, not only cytokines were reduced, but also liver function and cardiac function significantly improved.
32361911 Being infected by SARS-CoV-2 may cause damage to multiple organs in patients, such as the lung, liver and heart.
32362392 Liver and kidney insufficiency was seen in 5 and 6 recipients, respectively.
32362732 Although it mainly causes respiratory symptoms, respiratory failure and death due to multiorgan failure, there is evolving evidence to suggest gastrointestinal (GI) and liver involvement by this virus. […] Owing to this, health-care professionals taking care of GI and liver diseases are also at an increased risk of getting exposed. […] Hence, there is a need for protocols to be prepared to guide the handling of COVID-19 patients by the GI and liver specialists, as well as to manage the pre-existing GI and liver diseases during the ongoing pandemic. […] We present here the guidelines prepared jointly by the three Indian professional bodies in the field of GI diseases, namely the Society of Gastrointestinal Endoscopy of India, Indian Society of Gastroenterology, and Indian National Association for the Study of the Liver.
32364677 A liver and kidney transplant patient with SARS-CoV-2 pneumonia without respiratory failure was treated in a clinical multimodal strategy consisting of symptomatic support therapy, immunosuppression reduction, use of anti-coronavirus drugs and heparin leading to a progressive improvement of patient symptoms till discharge.
32367837 In addition, some patients were reported to have liver injury. […] In this article, we review gastrointestinal and liver aspects of COVID-19. […] In addition, we provide general gastroenterologists with guidance on the management of patients with gastrointestinal and liver disorders from COVID-19.
32368531 To penetrate the body, Severe acute respiratory syndrome coronavirus 2 uses ACE2 receptors, which are present not only in respiratory epithelium but also in gastrointestinal mucosa and liver cholangiocytes. […] The liver damage seems to show a multifactorial origin. […] In 14%-53% of COVID-19 cases, there is an alteration of the indices of liver cytolysis and is more frequently observed in severe forms of COVID-19, especially during hospitalization.
32369204 In addition, the pre-existing chronic liver disease exacerbated during COVID-19, and COVID-19-related hyperinflammatory reactions may contribute to liver injury as well.
32369209 Complications were observed in 29(55.8%) patients, such as liver injury (19, 36.5%), acute respiratory distress syndrome (ARDS) (9, 17.3%), sepsis (8, 15.4%), myocardial injury (8, 15.4%), renal insufficiency (4, 7.7%), and multiple organ dysfunction syndrome (MODS) (3, 5.8%).11(21.2%) cancer patients died.
32369251 The COVID-19 pandemic, caused by the SARS-CoV-2 virus, has been devastating to health care delivery in many parts of the US and has had a significant impact on organ transplantation. […] With shelter-in-place orders, outpatient clinics transitioned to telemedicine, and the threat of hospitals being overrun with COVID-19 patients, liver transplant programs have been faced with the challenge of balancing patient and staff safety while operating in a resource limited environment.
32369624 Relevant to liver disease, patients with alcohol use disorder (AUD) and alcohol-associated liver disease (ALD) may be amongst the populations that are the most severely impacted. […] The reasons for this include being at a higher risk of severe COVID-19 infection due to a depressed immune system and high-risk underlying comorbidities, the injurious effect of COVID-19 on the liver, the inability to attend regular visits with providers, diversion of hospital resources, and social isolation leading to psychological decompensation and increased drinking or relapse. […] Liver transplantation (LT) centers should adapt to the pandemic by considering leniency to some LT candidates with ALD who cannot access appropriate alcohol treatment due to the current situation.
32369658 Elevated liver enzymes have been reported during the course of disease and appear to be common. […] We present a 56-year-old woman with a history of decompensated alcoholic cirrhosis who presented with abdominal pain, fever and diarrhoea and was found to have acute on chronic liver failure secondary to SARS-CoV-2 infection.
32371463 Lymphopaenia was observed in about 47.6% of the infected patients, along with abnormal levels of myocardial enzymes (49.4%) and liver function (26.4%).
32374815 In all patients, SARS-CoV-2 RNA was detected in the lung at high concentrations; viremia in 6 of 10 and 5 of 12 patients demonstrated high viral RNA titers in the liver, kidney, or heart.
32377638 Specifically, preexisting chronic conditions such as hypertension, cardiovascular disease, chronic kidney disease, and diabetes are strongly associated with an increased risk of developing severe COVID-19; surprisingly, however, we found no correlation between chronic liver disease and increased disease severity.
32378325 Liver Transplant Programs in Italy have faced a sequela of management and clinical decision-making problems due to the high incidence in some regions of the country of severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2). […] The Italian Society for Organ Transplantation (SITO) and the Board of Liver Transplant Program Directors issued a survey to assess the initial impact of this pandemic event on the routine activity of 22 Italian Liver Transplant Programs. […] Transplant Programs reduced their outpatient activity both in terms of pre-transplant evaluation (68% of the centers) and transplant recipient follow-up (100%); a reduction in transplant activity was observed in the first two weeks of March only in the north-central macro area (23 LTs vs 39 in 2018 and 60 in 2019); overall, SARS-CoV-2 infection was registered for 24 liver transplant recipients and 37 health care providers in liver transplant units. […] In the perspective of the increasing magnitude of the epidemic, more data will be required to define appropriate strategies for the increasingly complex management of liver transplant patients.
32380209 The isolate I0305/19 exhibited broader tropisms in different tissues, including tracheas, lungs, bursa of Fabricius, spleen, liver, kidneys, proventriculus, small intestines, large intestines, cecum, and cecal tonsils.
32382358 We discuss the potential contribution of two traditional oral antidiabetic agents, metformin and pioglitazone, to the improvement of liver injury in COVID-19.
32386019 Laboratory examination showed no abnormality in all the patients except for slight increase in CRP in 2 patients and mild abnormal liver function index in 1 patient.
32386444 During COVID-19 outbreak, we have to deal with the post-immunosuppression COVID-19 increased risk, a burden less prominent in the case of liver and heart transplant candidates, who eventually will die if not transplanted.
32386449 However, liver damage has also been considered to occur in severe cases. […] Current meta-analysis of retrospective studies was done to summarize available findings on the association between liver injury and severity of COVID-19 infection. […] The incidence of liver injury, as assessed by serum analysis (AST, ALT, total Bilirubin and Albumin levels), seems to be higher in patients with severe COVID-19 infection.
32390091 The main clinical symptom of the patients were fever, sore throat and cough, which accounted for 146 cases (75.26%), 98 (50.52%) and 86 cases (44.33%), respectively. 30 patients (15.46%) showed liver dysfunction.
32391658 We also isolated alive viral strains from feces, indicating potential infectiousness of feces.Dynamic cytokine detection was necessary to timely identifying cytokine storms and application of artificial liver blood purification system. […] The artificial liver blood purification system could rapidly remove inflammatory mediators and block cytokine storm.Moreover, it also favored the balance of fluid, electrolyte and acid-base and thus improved treatment efficacy in critical illness.
32391667 Four cases (26.7%) of the HCQ group and 3 cases (20%) of the control group had transient diarrhea and abnormal liver function (P>0.05).
32391742 Of right upper quadrant ultrasounds, 87% (32 of 37) were performed for liver laboratory findings, and 54% (20 of 37) demonstrated a dilated sludge-filled gallbladder suggestive of cholestasis.
32391936 As coronavirus disease 2019 (COVID-19) is a new, emerging infectious disease, guidance or consensus on liver injury are lacking2 . […] The definition of COVID-19 associated liver injury in our manuscript was as alanine transaminase (ALT), aspartate aminotransferase (AST) or bilirubin above the upper limit of normal (ULN), which were 50 U/L, 40 U/L, and 26 μmol/l respectively. […] The abnormal test results of ALT, AST and total bilirubin at baseline data were defined as liver injury in our manuscript.
32395525 In addition, we found that ACE2 was both differential expression and related to the prognosis only in liver hepatocellular carcinoma (LIHC).
32396947 Pregnant women with suspected hypertensive disorders of pregnancy and signs and symptoms associated with the severe end of the disease spectrum (e.g., headaches, visual symptoms, epigastric pain, and pulmonary edema) should have an evaluation including complete blood count, serum creatinine level, and liver transaminases (aspartate aminotransferase and alanine aminotransferase). […] Current guidelines from the American College of Obstetricians and Gynecologists (ACOG) and The Society for Maternal-Fetal Medicine (SMFM) for management of preeclampsia with severe features suggest delivery after 34 0/7 weeks of gestation. […] With the outbreak of COVID-19, however, adjustments to this algorithm should be considered including delivery by 30 0/7 weeks of gestation in the setting of preeclampsia with severe features. […] · Earlier delivery suggested with COVID-19 and hypertensive disorder..
32397011 Among 465 COVID-19 patients, median age was 45 years, while hypertension, diabetes, and chronic liver disease were the most common comorbidities.
32400013 Herein, we present the case of a patient who underwent ABO-incompatible living donor liver transplantation without knowing that the liver donor was infected with COVID-19 during the donation procedure. […] In this case, the donor-derived transmission to the recipient was not identified, and the liver donor was found to be recovering from a COVID-19 infection.
32400017 For those who work in the field of islet transplantation, the micro vascular COVID-19 lung vessels obstructive thrombo-inflammatory syndrome (recently referred to as MicroCLOTS) is familiar, as one cannot fail to recognize the presence of similarities with the instant blood mediated inflammatory reaction (IBMIR) occurring in the liver hours and days after islet infusion.
32400087 Taken together, these data provide little evidence to suggest the presence of intact transmissible SARS-CoV in organs that can potentially be transplanted, specifically liver and heart. […] We conclude that, for selected patients with high waitlist mortality, transplant programs should consider accepting heart or liver transplants from deceased donors with SARS-CoV-2 infection.
32400965 Notably, the elderly SOT patients commonly suffer from liver and kidney dysfunction of varying degrees, resulting in worse drug metabolism.
32402090 Liver impairment has been frequently reported as a common manifestation, although its clinical significance is still unclear, particularly in patients with underlying chronic liver disease (CLD). […] To summarize the changes in liver function tests during SARS-CoV-2 infection and the impact of COVID-19 in patients with underlying CLD. […] A literature review using online database Pubmed was done using the search terms “SARS-CoV-2”, “COVID-19”, “liver”, “cirrhosis” and “liver transplantation”. […] COVID-19 is frequently associated with different degrees of abnormal liver function tests, most notably transaminases, which are usually transitory and of mild degree. […] Available evidence suggests that liver injury may result from direct pathogenic effect by the virus, systemic inflammation or toxicity from commonly used drugs in this subset of patients. […] SARS-CoV-2 infection in children is associated with minimal or no increase in liver enzymes, thus the presence of abnormal liver function tests should trigger evaluation for underlying liver diseases. […] Although it seems that patients with CLD are not at greater risk for acquiring the infection, those with cirrhosis, hepatocellular carcinoma, non-alcoholic fatty liver disease, autoimmune liver diseases or liver transplant may have a greater risk for severe COVID-19. […] Abnormal liver function tests during the course of COVID-19 are common, though clinically significant liver injury is rare. […] Further research is needed focusing on the effect of existing liver-related comorbidities on treatment and outcome of COVID-19.
32402433 We present the case of a 55-month-old girl who recovered from coronavirus disease 2019 (COVID-19) infection 5 months after undergoing liver transplantation; she had a co-infection with Epstein-Barr virus (EBV). […] To the best of our knowledge, this is the first case report of a COVID-19 infection in a pediatric patient with liver transplantation. […] On the basis of this case, we suggest that liver transplantation is not associated with COVID-19 symptom severity and development.
32402766 Concretely, this relates to (a) the inconsistent individual bioavailability of these drugs at the alveolar target cells, depending on intestinal resorption, hepatic first-pass metabolism and accumulation in liver, spleen and lung, and (b) the need for a relatively high concentration of 1-5 µM at the alveolar surface.
32403255 The mechanism of liver injury is poorly understood and may result as a consequence of viral hepatitis, systemic inflammatory response, gut barrier and microbiome alterations, intensive care treatment or drug toxicity. […] The incidence of hepatopathy among patients with coronavirus disease 2019 (COVID-19) is unclear, but studies have reported liver injury in patients with SARS and Middle East respiratory syndrome (MERS). […] A systematic literature search (PubMed/Embase/Cinahl/Web of Science) according to preferred reporting items for systematic review and meta-analysis protocols (PRISMA) was conducted from database inception until 17/03/2020 for studies that evaluated the incidence of hepatic abnormalities in SARS CoV-1, SARS CoV-2 and MERS infected patients with reported liver-related parameters. […] Liver anomalies were predominantly mild to moderately elevated transaminases, hypoalbuminemia and prolongation of prothrombin time. […] More studies to elucidate the mechanism and importance of liver injury on the clinical course and prognosis in patients with novel SARS-CoV-2 infection are warranted.
32405183 The worldwide pandemic of COVID-19, caused by the virus SARS-CoV,-2 has continued to progress, and increasing information is becoming available about the incidence of digestive symptoms as well as abnormal liver-associated enzymes in patients who are infected. […] Liver-related transaminases are elevated in a substantial proportion of patients, although generally only mildly elevated. […] Currently there is no firm evidence to suggest that severity of digestive symptoms corresponds to severity of COVID-19 clinical course, however, more severe alterations in liver enzymes may correlate with worse clinical course. […] Given use of antiviral and antibacterial agents in sicker patients, drug-induced liver injury cannot be ruled out either in these cases.
32405603 The prevalence and prognosis of digestive system involvement, including gastrointestinal symptoms and liver injury, in patients with COVID-19 remains largely unknown. […] Extracted data included author; date; study design; country; patient demographics; number of participants in severe and non-severe disease groups; prevalence of clinical gastrointestinal symptoms such as vomiting, nausea, diarrhoea, loss of appetite, abdominal pain, and belching; and digestive system comorbidities including liver disease and gastrointestinal diseases. […] The pooled prevalence of abnormal liver functions (12 studies, n=1267) was 19% (9-32; range 1-53; I2=96%). […] Subgroup analysis showed patients with severe COVID-19 had higher rates of gastrointestinal symptoms (odds ratio [OR] 1·60 [95% CI 1·09-2·36]; p=0·0020; I2=44%) and liver injury (2·20 [1·60-3·02]; p<0·00001; I2=36%) compared with those with non-severe disease. […] Patients in Hubei province, where the initial COVID-19 outbreak occurred, were more likely to present with abnormal liver functions (p<0·0001) compared with those outside of Hubei. […] Our study showed that digestive symptoms and liver injury are not uncommon in patients with COVID-19.
32405974 COVID-19 can cause multiple organ dysfunction, such as respiratory and circulatory failure, liver and kidney injury, disseminated intravascular coagulation, and thromboembolism, and even death.
32406594 Group 2 patients have higher levels of LDH, prevalence of liver dysfunction and increased IL-8 than those in group 1, a higher prevalence of increased IL-8 was found in group 2 than in group 3 (P < 0.05 for all).
32406952 Most of the literature show that the elevated liver enzymes in COVID-19 are of little clinical significance.
32407552 Some authors have reported the presence of cutaneous lesions related to new COronaVirus Disease 2019 (CoViD-19) caused by SARS-CoV-2, in up to 20.4% of the cases; however, these lesions are not well characterized either clinically or histopathologically.1 Recently, it has been highlighted the finding of congested and edematous blood vessels in the alveolar septum along with hyaline thrombi, and also in the heart, liver and kidney of autopsies of 3 patients deceased due to severe infection by SARS-CoV-2.
32407808 Multiple gastrointestinal (GI) symptoms including diarrhea, nausea/vomiting, and abdominal pain, as well liver enzyme abnormalities have been variably reported in patients with COVID-19. […] The AGA) Institute Clinical Guideline Committee and Clinical Practice Updates Committee performed a systematic review and meta-analysis of international data on GI and liver manifestations of COVID-19. […] The pooled prevalence of elevated liver abnormalities was: AST 15.0% (13.6 to 16.5) and ALT 15.0% (13.6 to 16.4). […] When analyzed comparing data from China to studies from countries other than China, diarrhea, nausea/vomiting, liver abnormalities were more prevalent outside of China with diarrhea reported in 18.3% (16.6 to 20.1). […] We also summarized of the Gl and liver adverse effects of the most commonly utilized medications for COVID19 CONCLUSIONS: GI symptoms are associated with COVID-19 in less than 10% of patients.
32409502 Compared with normal weight patients, those who were overweight had 1.84-fold odds of developing severe COVID-19 (odds ratio [OR] 1.84, 95% CI 0.99-3.43, P = 0.05), while those who were obese were at 3.40-fold odds of developing severe disease (OR 3.40, 95% CI 1.40-2.86, P = 0.007), after adjusting for age, sex, epidemiological characteristics, days from disease onset to hospitalization, presence of hypertension, diabetes, cardiovascular disease, chronic obstructive pulmonary disease, liver disease and cancer, and drug used for treatment.
32410141 Immunohistochemistry expression profiles in normal tissues and cancer tissues and TCGA survival analysis in renal and liver cancer were conducted. […] On the other side, high expression of ACE2 was correlated with increased survival rate in renal and liver cancer, indicating that ACE2 is a prognostic marker in both renal cancer and liver cancers.
32410319 Emerging evidence and past experience from other coronaviruses suggests that people with underlying liver disease including viral hepatitis could be at risk of disease severity and mortality.
32412159 Overall, 21 patients were included with a median age of 56 years (10 kidney, 5 liver, 1 pancreas, 1 lung, 1 heart and 3 combined transplantations).
32415860 Coronavirus disease 2019 (COVID-19) leads to elevated liver biochemistries in approximately half of patients on presentation. […] To date, data are limited regarding the trend of liver biochemistries over the course of illness. […] We aimed to evaluate the trend, etiology, and outcomes associated with liver biochemistries in COVID-19. […] Of 60 patients, 41 (69%) had at least one abnormal liver biochemistry on admission. […] Statin use was common prior to (40%) and during admission (80%) at our center, with no difference in peak liver biochemistries between users and non-users. […] No demographic or comorbid illness was associated with liver injury.
32416412 I hypothesized that the damage induced by free DNA is a reason for severe COVID-19, which can explain many symptoms of this disease, such as cytokine storm, acute respiratory distress syndrome (ARDS) and muscus plug, acute injuries of heart, liver and kidney, and some special symptoms of COVID-19.
32416633 As COVID-19 the disease caused by SARS-CoV-2 continues to have a profound impact on global health, there have been a number of guidelines recently published addressing the management of patients with liver disease during the COVID-19 pandemic including the recently published EASL-ESCMID Position Paper, guidelines issued by the International Liver Cancer Association and the American Association for the Study of Liver Diseases (1-3). […] All publications present a sound discussion regarding the challenges face by both patients and clinicians alike in the management of chronic liver disease in the setting of this ongoing pandemic.
32418190 Three patients showed biochemical signs of liver injury.
32418532 COVID-19 Disorders: ‘Renin-Angiotensin’ System (RAS) & Counter-regulatory RAS In the RAS pathway [1, 15], Renin (kidney) cleaves Angiotensinogen (liver) to give Angiotensin I (i.e. peptide DRVYIHPFHL).
32418852 Our study aimed to evaluate the association of liver injury and gastrointestinal symptoms (GIS) with the progression of COVID-19. […] A comprehensive search was performed on the PubMed to identify eligible studies that summarized the liver injury and GIS in COVID-19. […] Up to 53% patients had liver dysfunctions and the degree of liver damage was associated the severity of the disease. […] Gastroenterologists should pay more attention to the liver injury induced by SARS-CoV-2 during the course of infection.
32420939 We finally considered timing and selection of treatment, which depend on the disease phase, co-administration of other drugs and require the monitoring of renal, liver and cardiac function.
32420949 Up to now, there is no yet literature on the subject, but, like in general population, the presence of comorbidities such as diabetes, heart disease, pulmonary hypertension, reduced kidney and/or liver function, worsen the effects of the infection.
32421292 The comorbid medical illnesses identified as risk factors are preexisting respiratory and cardiovascular disease, immunocompromised status, morbid obesity (ie, body mass index ≥40), diabetes mellitus, and possibly significant kidney or liver impairment.
32421703 The individualized prediction nomogram included seven predictors: body temperature at admission, cough, dyspnea, hypertension, cardiovascular disease, chronic liver disease, and chronic kidney disease.
32422076 Other changes in the liver included hepatic steatosis, portal fibrosis, lymphocytic infiltrates and ductular proliferation, lobular cholestasis, and acute liver cell necrosis, together with central vein thrombosis.
32422983 The most common reported complications were: acute respiratory distress syndrome (ARDS), acute kidney injury, cardiac injury, liver insufficiency, and septic shock.
32425338 Renal dysfunction, gastrointestinal complications, liver dysfunction, cardiac manifestations, mediastinal findings, neurological abnormalities, and hematological manifestations are among the reported extrapulmonary features.
32425991 Information regarding to the how the infection affects the liver and relevance of pre-existing liver disease as a risk factor for acquiring the infection or having a severe disease are still scarce. […] Also, considerations to be considered in liver transplant patients or those having hepatocellular carcinoma or are under immunosuppressive therapy are being matter of analysis as information is being generated. […] In the present review we discuss current data on the COVID-19 and liver aiming to provide hepatologists with updated information to face this pandemic.
32429004 Two weeks after donation, COVID-19 screenings of the liver recipient and medical staffs present negative.
32429038 The aim of this study was to evaluate the severity and mortality in COVID-19 patients with underlying kidney and liver diseases. […] The data on two comorbidities, liver diseases and chronic kidney disease, were pooled and statistically analysed to explain the associated severity and mortality rate. […] The prevalence of liver diseases and chronic kidney disease (CKD) were 3% (95% CI; 2-3%) and 1% (95% CI; 1-2%), respectively. […] In patients with COVID-19 and underlying liver diseases, 57.33% (43/75) of cases were severe, with 17.65% mortality, while in CKD patients, 83.93% (47/56) of cases were severe and 53.33% (8/15) mortality was reported. […] This study found an increased risk of severity and mortality in COVID-19 patients with liver diseases or CKD.
32429249 This is a subjective analysis of literature concerning specific topics raised in our daily practice (e.g., clinical features of COVID-19 patients; ventilation of the critically ill COVID-19 patient; diagnostic of infection with SARS-CoV-2; stability of the virus; Covid-19 in specific patient populations, e.g., paediatrics, immunosuppressed patients, patients with hypertension, diabetes mellitus, kidney or liver disease; co-medication with non-steroidal anti-inflammatory drugs (NSAIDs); antiviral treatment) and we believe that these answers help colleagues in clinical decision-making.
32436017 During the 2019 novel coronavirus disease (COVID-19) outbreak, therapeutic strategies must be adapted for liver cancer patients balancing the benefit of surgical resection against the risk of contamination incurred by the patient. […] The impact of COVID-19 in liver cancer patients who undergo surgery is still unclear due to the scarcity of available data.
32436105 Liver enzyme alteration and lactate dehydrogenase (LDH) elevation were registered in all cases. […] In our series, stroke developed mostly in patients with severe pneumonia and multiorgan failure, liver enzymes and LDH were markedly increased in all cases, and the outcome was poor.
32436622 We investigated the association of metabolic associated fatty liver disease (MAFLD) to COVID-19 severity in non-diabetic patients. […] Health care professionals caring for non-diabetic patients with COVID-19 should be cognizant of the increased likelihood of severe COVID-19 in patients with metabolic associated fatty liver disease.
32437004 COVID-19 is highly contagious and has a variety of clinical manifestations, it can affect a number of other organs in addition to the lungs, and liver injury may occur. […] SARS-CoV-2 can cause liver injury through systemic inflammatory response syndrome (SIRS), cytokine storms, ischemia-reperfusion injury, side effects of treatment drugs, and underlying liver disease and can attack liver cells directly via ACE2. […] Clinical studies have found that liver injury in COVID-19 patients mainly manifests as abnormal liver biochemical indicators, but there have been no reports of liver failure caused by this disease. […] The number of COVID-19 patients with liver injury is increasing, and the incidence of liver injury in COVID-19 patients with severe disease are higher than in patients with mild disease. […] Liver injury may be a risk factor for progresses and worsens in patients with COVID-19, and it is necessary to pay attention to the occurrence of liver injury in the diagnosis and treatment of COVID-19.
32437017 Three patients with comorbidities such as hypertension, liver diseases or diabetes developed severe illness.
32437706 Subsequently, type I respiratory failure was diagnosed, coinciding with kidney injury, and subsequently, type II respiratory failure occurred, coupled with multiorgan failure including the heart and liver.
32437830 Liver enzyme abnormality is common in patients with coronavirus disease 2019 (COVID-19). […] Whether or not SARS-CoV-2 infection can lead to liver damage per se remains unknown. […] Here we reported the clinical characteristics and liver pathological manifestations of COVID-19 patients with liver enzyme abnormality. […] Postmortem liver biopsies were obtained from two cases who had elevated aminotransferase. […] We investigated the patterns of liver impairment by electron microscopy, immunohistochemistry, TUNEL assay, and pathological studies. 64 of 156 (41.0%) COVID-19 patients had elevated aminotransferase. […] The liver enzyme abnormality was associated with disease severity, as well as a series of laboratory tests including higher A-aDO2, higher GGT, lower albumin, decreased CD4+ T cells and B lymphocytes. […] SARS-CoV-2 infection in liver is a crucial cause of hepatic impairment in COVID-19 patients. […] Hence, a surveillance of viral clearance in liver and long outcome of COVID-19 is required.
32438330 This clinical protocol has not proven sufficient to save the lives of COVID-19 patients suffering from diabetes or having underlying liver diseases; hence there is utmost need to tackle this situation by other means such as Convalescent Plasma (CP) therapy. […] The patients suffering from diabetes or liver dysfunction or any other underlying diseases are at greatest risk of SARS-CoV-2 infection. […] The CP therapy can be a possible life saving alternative to treat critical COVID-19 patients having diabetes or underlying liver dysfunction.
32438331 The other two important physiological links between diabetes and COVID-19 are liver dysfunction and chronic systemic inflammation.
32438464 During the COVID-19 pandemic, transplant recipients have been recognized as more susceptible to infection, to have greater severity of disease, and prolonged shedding of this highly transmissible virus.1 However, there is limited information on the impact of COVID-19 in liver transplant (LT) recipients.
32439197 Acute respiratory distress syndrome, heart failure, renal failure, liver damage, shock, and multiorgan failure have precipitated death.
32439209 Of note is that liver function tests including AST, ALT, GGT and LDH were elevated, and albumin was decreased.
32439237 Liver transplantation is considered the ultimate solution for patients with end-stage chronic liver disease or acute liver failure. […] Patients with liver transplant need special care starting from preoperative preparation, surgical intervention ending with postoperative care. […] Such a state of immune suppression could predispose to different types of infections in liver transplant recipients. […] Certain infection control precautions are needed to protect immunocompromised and vulnerable patients, including liver transplant candidates and recipients from acquiring COVID-19 infection. […] Management of immunosuppressive therapy and drug-drug interactions in liver transplant recipients infected with COVID-19 should be cautiously practiced to prevent rejection and effectively treat the underlying infection. […] In this report, we are trying to summarize available evidence about different aspects of the management of liver transplant candidates and recipients in the era of COVID-19.
32443177 We used MIA-US for tissue sampling of lungs, liver, heart, kidneys, spleen, brain, skin, skeletal muscle and testis for histology and RT-PCR to detect SARS-COV-2-RNA. […] Small thrombi were less frequently observed in glomeruli, spleen, heart, dermis, testis, and liver sinusoids.
32443345 Liver dysfunction, myocardial injury, and coagulation disorder were suggested by laboratory findings.
32444460 Increasing age, male sex, and comorbidities including chronic cardiac disease, non-asthmatic chronic pulmonary disease, chronic kidney disease, liver disease and obesity were associated with higher mortality in hospital.
32445489 In this study, we conducted a meta-analysis to find the association between liver injuries and the severity of COVID-19 disease. […] Liver dysfunction was associated with a severe outcome of COVID-19 disease. […] Close monitoring of the occurrence of liver dysfunction is beneficial in early warning of unfavorable outcomes.
32447629 Paracetamol (acetaminophen) has been proposed as an alternative to NSAIDs but there are issues with liver toxicity at high doses.
32447721 In order to enhance scientific information interflow in the arena of liver diseases in Asia-Pacific region during this difficult time, Asian-Pacific Association for the Study of the Liver (APASL) has taken the initiative to form the APASL COVID-19 Taskforce to formulate a clinical practice guidance in Hepatology, liver-related oncology, transplantation and conduct of clinical trials. […] Based on scientific data and experiences, recommendations were made in the management of liver injury, liver transplantation, autoimmune diseases, chronic liver diseases, delivery of elective and emergency services and conduct of clinical trials.
32448405 The majority of patients had lymphopenia, elevated liver function tests and C-reactive protein.
32449224 The combination of broad-spectrum antibacterial drugs is not recommended and the risk of drug-induced liver injury should be monitored.
32450165 It is associated with the other organ damage such as cardiovascular risk via an increased level of hypertension through ACE2, gastrointestinal dysfunction, chronic kidney disease, diabetes mellitus, liver dysfunction, lung injury, CNS risk, ocular risks such as chemosis, conjunctivitis, and conjunctival hyperemia, cancer risk, venous thromboembolism, tuberculosis, aging, and cardiovascular dysfunction and reproductive risk.
32450787 Patients with novel coronavirus disease 2019 (COVID-19) experience various degrees of liver function abnormalities. […] Liver injury requires extensive work-up and continuous surveillance and can be multifactorial and heterogeneous in nature. […] In the context of COVID-19, clinicians will have to determine whether liver injury is related to an underlying liver disease, drugs used for the treatment of COVID-19, direct effect of the virus, or a complicated disease course. […] Recent studies proposed several theories on potential mechanisms of liver injury in these patients.
32451362 Patients with CVD were also more likely to develop liver function abnormality, elevated blood creatinine and lactic dehydrogenase (p<0.05).
32452979 Despite inpatient treatment for COVID-19 and a perianal abscess, the patient acutely decompensated, with worsening fever, tachycardia, fluid-refractory hypotension, elevation of liver enzymes, and transformation of the rash into purpura extending from the face to the trunk, upper and lower extremities, including the palmar and plantar surfaces of the hands and feet.
32453859 Identification of blue-green cytoplasmic inclusions in neutrophils and/or monocytes on peripheral blood smears is a rare, and likely underreported, finding described in few case reports and small case series studies in critically ill patients with acute liver dysfunction and lactic acidosis (Courville, et al 2017, Gorup, et al 2018, Haberichter and Crisan 2017, Harris, et al 2009, Hodgkins and Jones 2019, Hodgson, et al 2015, Jazaerly and Gabali 2014, Patel, et al 2017, Sin, et al 2019, Soos, et al 2019, Vicente-Steijn, et al 2020).
32454041 For patients with end-stage liver failure, liver transplantation is the only option. […] There is an urgent need for ethical frameworks to balance the need for liver transplantation against the availability of national resources. […] To describe the ethical tension arising in this setting, we propose a novel ethical framework, the Quadripartite Equipoise (QE) score, that is applicable to liver transplantation in the context of limited national resources. […] Seventeen large- and medium- sized liver transplant centers from twelve countries across four continents participated.
32455515 The patient’s condition exacerbated rapidly with multi-organ infections, and eventually developed pulmonary hemorrhage and consolidation, pulmonary hypertension, right heart failure, malignant ventricular arrhythmias, liver dysfunction, etc. […] The pathological changes were mainly diffused pulmonary hemorrhagic injuries and necrosis, fibrosis, small vessel disease with cardiac edema and lymphocyte infiltration. Conclusions: The clinical course of COVID-19 can exacerbate rapidly from mild to critical with lung, liver and heart injuries.
32460390 A total of 23 SOT transplant recipients suffering from COVID-19 were identified (n = 3 heart; n =15 kidney; n = 1 kidney-after-heart; n = 3 lung and n = 1 liver transplant recipient).
32462354 Initial investigations showed high inflammatory parameters, elevated serum creatinine and liver enzymes.
32473600 Inhibition of NAKs led to reduced viral infectivity with baricitinib using human primary liver spheroids.
32473607 Coronavirus disease 2019 (COVID-19) has been associated with acute liver injury manifested by increased liver enzymes in reports worldwide. […] Prevalence of liver injury and associated clinical characteristics are not well-defined. […] We aim to identify the prevalence of and risk factors for development of COVID-19 associated acute liver injury in a large cohort in the United States. […] Acute liver injury was categorized as mild if alanine aminotransferase (ALT) was > upper limit of normal (ULN) but < two times ULN, moderate if ALT was between two and five times ULN, and severe if ALT was > five times ULN. […] Among patients who tested positive, 45% had mild, 21% moderate, and 6.4% severe liver injury. […] In multivariable analysis, severe acute liver injury was significantly associated with elevated inflammatory markers including ferritin (OR 2.40, p<0.001) and IL-6 (OR 1.45, p=0.009). […] Patients with severe liver injury had a more severe clinical course, including higher rates of ICU admission (69%), intubation (65%), renal replacement therapy (33%), and mortality (42%). […] Acute liver injury is common in patients who test positive for SARS-CoV-2, but is most often mild. […] However, among the 6.4% of patients with severe liver injury, a severe disease course should be anticipated.
32471013 The following is a short report on COVID-19 in liver transplant recipients (n = 5) from a high volume UK liver transplant unit with a large follow-up cohort (n = 4500). […] Based on this limited data, liver transplant recipients appear to have a low incidence of COVID-19, with less severe symptoms than expected, when compared with the general population and other solid organ recipients.
32475054 We read with interest the letter by D’Antiga evaluating the early experience with Coronavirus-19 disease (COVID-19) in liver transplant (LT) recipients in Bergamo and suggesting the absence of correlation between immunosuppression and severity of disease. […] We report two cases of early liver transplant recipients infected by SARS-CoV-2 with only mild clinical manifestations.
32476233 Liver transplantation during the ongoing SARS-CoV-2 pandemic is challenging given the urgent need to reallocate resources to other areas of patient care. […] Thus, we report strategies and preliminary results in liver transplantation during the peak of the SARS-CoV-2 pandemic from a single-center in France. […] Our strategy to reorganize the transplant program included four main steps: optimization of available resources especially intensive care unit capacity, multidisciplinary risk stratification of liver transplantation candidates on the waiting list, implementation of a systematic SARS-CoV-2 screening strategy prior to transplantation and definition of optimal recipient-donor matching. […] After implementation of these four steps, we performed 10 successful liver transplantations during the peak of the pandemic with a short median intensive care unit stay (2,5 days), benchmark post-transplant morbidity and no occurrence of SARS-CoV-2 infection during follow-up. […] From this preliminary experience we conclude that efforts in resource planning, optimal recipient selection and organ allocation strategy are key to maintain a safe liver transplant activity.
32476258 We describe our institutional experience with COVID-19 among ten SOT patients, including the clinical presentation, treatment modalities, and outcomes of seven renal transplant recipients, one liver transplant recipient, one heart transplant recipient, and one lung transplant recipient.
32476793 Numerous studies have shown varying degrees of liver damage in patients infected with SARS-CoV-2. […] However, in previous case studies of COVID-19, the exact cause of liver injury has not been clearly elucidated, nor is there clear evidence of the interaction between liver injury and COVID-19. […] This study will analyze the causes of liver injury in COVID-19 and the influence of liver-related complications on the treatment and prognosis of COVID-19.
32476796 Liver chemistry abnormalities are common and include elevation of aspartate transferase, alanine transferase, and total bilirubin. […] Further research will help elucidate the association between patients with underlying GI diseases, such as chronic liver disease and inflammatory bowel disease, and severity of COVID-19.
32478465 Only eight serious liver injuries caused by TCZ were reported before being used in the treatment of patients with COVID-19. […] We describe a patient with COVID-19-induced cytokine storm who developed drug-induced liver injury associated with the use of TCZ. […] Intensive liver function monitoring is imperative in COVID-19 patients, because of frequent polypharmacy with potentially hepatotoxic drugs.
32479682 Incidence of signs and symptoms related to PE, such as hypertension, proteinuria, thrombocytopenia, elevated liver enzymes, abnormal UtAPI and increased sFlt-1/PlGF.
32480420 The challenges associated with COVID-19 are even greater for patients with light chain (AL) amyloidosis, a rare multisystemic disease affecting the heart, kidneys, liver, gastrointestinal and nervous system.
32483005 Elevated liver enzyme levels are observed in patients with coronavirus disease 2019 (COVID-19); however, these features have not been characterized. […] Liver enzyme level elevation was defined as alanine aminotransferase level >35 U/L for men and 25 U/L for women at admission. […] Of 788 patients with COVID-19, 222 (28.2%) patients had elevated liver enzyme levels (median [interquartile range {IQR}] age, 47.0 [35.0-55.0] years; 40.5% women). […] Being male, overweight, and smoking increased the risk of liver enzyme level elevation. […] The liver enzyme level elevation group had lesser pharyngalgia and more diarrhea than the control group. […] The median time from illness onset to admission was 3 days for liver enzyme level elevation groups (IQR, 2-6), whereas the median hospitalization time for 86 (38.7%) discharged patients was 13 days (IQR, 11-16). […] We found that 28.2% of patients with COVID-19 presented with elevated liver enzyme levels on admission, which could partially be related to SARS-CoV-2 infection. […] Male patients had a higher risk of liver enzyme level elevation. […] With early medical intervention, liver enzyme level elevation did not worsen the outcomes of patients with COVID-19.
32484453 Moreover, the acute renal function damage occurred earlier than abnormal heart and liver functions (p<0.05).
32486188 However, there is evidence that these receptors are abundant throughout the body, and just as abundant in cholangiocytes as alveolar cells, posing the question of possible direct liver injury. […] While liver enzymes and function tests do seem to be deranged in some patients, it is questionable if the injury is due to direct viral damage, drug-induced liver injury, hypoxia, or microthromboses. […] Likely, the injury is multifactoral, and management of infected patients with pre-existing liver disease should be taken into consideration.
32488888 This study aimed to investigate the clinical significance of liver blood tests in COVID-19 patients. […] The relationship between liver blood test results, liver condition (HBsAb positive, HBcAb positive, and fatty liver disease), and duration of hospital stay among COVID-19 patients was analyzed. […] Abnormal results of liver blood tests in patients with COVID-19 included increased levels of alanine transaminase (ALT) (21.2%, 14 patients), AST (15.2%, 10 patients), and gamma-glutamyl transpeptidase (GGT) (22.7%, 15 patients). […] Abnormal levels of Alb and AST in patients with COVID-19 were not associated with the liver condition (all P > .05). […] Abnormal results of the liver blood test were found in COVID-19 patients.
32492165 The most common laboratory abnormalities were increased levels of alanine aminotransferase (ALT) (median [IQR], 16.0 [12.0-26.0] U/L), aspartate aminotransferase (AST) (median [IQR], 30.0 [23.0-41.8] U/L), creatine kinase MB (CK-MB) activity (median [IQR], 24.0 [18.0-34.0] U/L), and lactate dehydrogenase (LDH) (median [IQR], 243.0 [203.0-297.0] U/L), which are associated with liver and myocardial injury. […] Immunoglobin G and the neutrophil to lymphocyte ratio were negatively associated with biochemical indices related to liver and myocardial injury (immunoglobulin G, ALT: r, -0.3579; AST: r, -0.5280; CK-MB activity: r, -0.4786; LDH: r, -0.4984; and neutrophil to lymphocyte ratio, ALT: r, -0.1893; AST: r, -0.3912; CK-MB activity: r, -0.3428; LDH: r, -0.3234), while counts of lymphocytes, CD4+ T cells, and interleukin 10 showed positive associations (lymphocytes, ALT: r, 0.2055; AST: r, 0.3615; CK-MB activity: r, 0.338; LDH: r, 0.3309; CD4+ T cells, AST: r, 0.4701; CK-MB activity: r, 0.4151; LDH: r, 0.4418; interleukin 10, ALT: r, 0.2595; AST: r, 0.3386; CK-MB activity: r, 0.3948; LDH: r, 0.3794).
32492995 The Covid 19 crisis permits to increase the role of Telemedicine as a tool for the delivery of health care services at distance and to slow down the virus diffusion. […] In COVID 19 era, the goal of PCP is to reduce travels and visits in specialized center for liver disease patients.
32493473 Patients will be excluded for the following reasons: more than 72 hours from the onset of ARDS; age < 16 years; patient known to be pregnant; major trauma in previous 5 days; presence of any active malignancy (other than non-melanoma skin cancer); WHO Class III or IV pulmonary hypertension; venous thromboembolism currently receiving anti-coagulation or within the past 3 months; patient receiving extracorporeal life support; severe chronic liver disease (Child-Pugh > 12); Do Not Attempt Resuscitation order in place; treatment withdrawal imminent within 24 hours; prisoners; declined consent; non-English speaking patients or those who do not adequately understand verbal or written information unless an interpreter is available; previously enrolled in the REALIST trial.
32493478 Known moderate or severe liver disease12.
  1. Previous infection with SARS CoV2 (positive coronavirus PCR or positive serology with SARS Cov2 negative PCR and absence of symptoms); 2) Current treatment with hydroxychloroquine or chloroquine; 3) Hypersensitivity, allergy or any contraindication for taking hydroxychloroquine, in the technical sheet; 4) Previous or current treatment with tamoxifen or raloxifene; 5) Previous eye disease, especially maculopathy; 6) Known heart failure (Grade III to IV of the New York Heart Association classification) or prolonged QTc; 7) Any type of cancer (except basal cell) in the last 5 years; 6) Refusal to give informed consent; 8) Evidence of any other unstable or clinically significant untreated immune, endocrine, hematological, gastrointestinal, neurological, neoplastic or psychiatric illness; 9) Antibodies positive for the human immunodeficiency virus; 10) Significant kidney or liver disease; 11) Pregnancy or lactation.
32493514 Liver injury or failure (AST/ALT ≥ 5x ULN)4.
32495496 While several studies from China have reported COVID-19-related liver injury, there are currently no data on liver dysfunction in hospitalized COVID-19 patients in Europe. […] The aim of this study was to describe the prevalence and predictive value of abnormal liver function in patients hospitalized with COVID-19. […] Liver function was abnormal in 66.6% of patients on admission. […] In multivariate logistic regression, abnormal liver test on admission were associated with in-hospital aggravation (OR = 4.1, 95% CI 1.5-10.8; P = .004) and mortality (OR 3.3; 95% CI = 1.04-10.5; P = .04). […] This study of liver tests in a European COVID-19 population confirms a high prevalence of abnormal liver tests on admission that are predictive of severe disease course and higher in-hospital mortality.
32495578 The main meridian of these TCM is lung, heart, spleen, liver, and stomach meridian.
32496357 Solid organ transplant recipients (SOT) comprise a large proportion of this group, yet there is limited knowledge about the presentation, clinical course and immunosuppression management of this novel infection among heart, lung, liver, pancreas and kidney transplant recipients.
32500431 Patients with a high probability of postoperative intensive care unit (ICU) admission were considered as high risk and defined by an ASA score ≥ III and/or a Charlson Comorbidity Index (CCI) ≥ 6 and/or a Revised Cardiac Risk Index for Preoperative Risk (RCRI) ≥ 3. 72 patients were operated, including 12 (16.6%) liver and kidney transplantations. […] Few patients had liver cirrhosis (12.5%) or received preoperative systemic therapy (16.6%). 36 (50%) high-risk surgical procedures were performed, including major hepatectomies, pancreaticoduodenectomies, total gastrectomies, multivisceral resections, and transplantations.
32500666 We present a case of an orthotopic liver transplant recipient with well-controlled HIV who successfully recovered from a mild, flu-like illness attributed to SARS-CoV-2.
32500942 This is a report about the course and management of SARS-CoV-2 infection in liver transplant recipients from a single center in Northwestern Italy in the period March-April 2020. […] Besides depicting Covid-19 course and possible treatment scenarios in liver transplant patients, these cases are discussed in relation to the changes in our practice prompted by Covid-19 epidemic, with potential implications for other transplant programs.
32501731 Functional impairments in multiple organs have been reported in COVID-19 including lungs, heart, kidney, liver, brain and vascular system.
32501876 In this review, we summarized the latest research progress and major societies recommendations regarding the implications of COVID-19 in gastroenterology, namely the adaptations that gastroenterology/endoscopy departments and professionals must do in order to optimize the provided assistance, as well as the implications that this infection will have, in particularly vulnerable patients such as those with chronic liver disease and inflammatory bowel disease under or not immunosuppressant therapies.
32501877 COVID-19 related liver enzyme elevations have been described however the clinical presentation, enzyme kinetics, and associated laboratory abnormalities of these patients have not been well described. […] Five cases of COVID-19 associated liver enzyme elevations are reported here. […] We found that COVID-19 related liver enzyme elevations occurred in a hepatocellular pattern and persisted throughout the initial hospitalization in all patients. […] In conclusion, abnormalities in aminotransferase, lactate dehydrogenase, and ferritin levels are commonly seen in COVID-19 related liver injury. […] However, the clinical course of COVID-19 related liver injury appears benign.
32502316 The authors have provided an important assessment of liver transplant volumes across the United Network for Organ Sharing (UNOS) regions from February to March of 2019 and 2020.
32503657 Uncontrolled diseases of the blood and cardiovascular system, liver or kidney.4.
32504925 Interestingly, ACE2+ organs reveal the symptomatic repercussions, which are signals of the infection such as dry cough, shortness of breath, heart failure, liver and kidney damage, anosmia or hyposmia, and diarrhea.
32506122 Prevalence of ischemic heart disease, atrial fibrillation, heart failure, stroke, hypertension, dementia, COPD, and chronic renal failure was higher in older patients (≥ 65 years), while obesity, chronic liver disease, and HIV infection were more common in younger adults (< 65 years); 10.9% of younger patients (< 65 years) had no comorbidities, compared to 3.2% of older patients (≥ 65 years).
32506682 The recent outbreak of COVID-19 has brought elective surgeries including liver transplantation to a standstill. […] The concerns in Living Donor Liver Transplant (LDLT) were that immunosuppressed recipients and healthy donors would be exposed to nosocomial SARS- CoV-2 infection.1 However, as patients began to suffer and die, Liver Transplant Society of India (LTSI) revised its guidelines 2 and allowed LDLT for those who were very sick, or had just recovered from a life threatening decompensation (high MELD/ CTP score) or had malignancy.
32507110 Recent studies reported that patients with coronavirus disease-2019 (COVID-19) might have liver injury. […] We compared liver functional test results between the two groups. […] Elevated liver function index is very common in patients with COVID-19 infection, and the level were less than 3 × ULN, but most are reversible.
32507608 The outbreak of coronavirus disease 2019 (COVID-19) starting last December in China placed emphasis on liver involvement during infection. […] This review discusses the underlying mechanisms linking COVID-19 to liver dysfunction, according to recent available information, while waiting further studies. […] The manifestations of liver damage are usually mild (moderately elevated serum aspartate aminotransferase activities), and generally asymptomatic. […] Few patients can still develop severe liver problems, and therapeutic options can be limited. […] Liver dysfunction may affect about one-third of the patients, with prevalence greater in men than women, and in elderly. […] During new COVID-19 infections, liver injury may be observed. […] If liver involvement appears during COVID-19 infection, however, attention is required. […] This is particularly true if patients are older or have a pre-existing history of liver diseases. […] During COVID-19 infection, the onset of liver damage impairs the prognosis, and hospital stay is longer.
32511951 We, as a multidisciplinary team, reviewed the standard management options, according to the Barcelona Clinic Liver Cancer classification system, for hepatocellular carcinoma.
32512530 COVID-19 though is a predominantly respiratory illness; it can also affect brain and other organs like kidneys, heart and liver.
32513299 Combined with severe heart, lung (diagnosed with interstitial lung disease, bronchial asthma, chronic obstructive pulmonary disease, etc.), liver and kidney disease or with endocrine, rheumatic, neurologic, malignant and other systemic diseases;2.
32514228 Patients with liver disease, diabetes, high blood pressure, and obesity are more susceptible to the incidence of COVID-19 infection.
32514432 Published clinical studies have supported that SARS-CoV-2 affects the GI tract and the liver. […] Incidence of liver injury ranges from 15 to 53%.
32515125 Patients with chronic liver disease and patients after solid organ transplantation (SOT) are vulnerable to severe coronavirus disease 2019 (COVID-19). […] We evaluated fears, attitudes, and opinions associated with COVID-19 in 365 SOT recipients (95% liver, 5% pancreas/kidney), 112 SOT candidates, and 394 immediate household contacts in 2 German transplant centers.
32516847 Immunosuppressed liver transplant (LT) patients are considered to be at high risk for any kind of infection.
32519617 Here, we aimed to determine the frequency of COVID-19 in our kidney and liver transplant patients. […] Seventy-four of them were liver transplant recipients (46 male, 28 female, of which 14 were pediatric and 60 were adult patients) and 509 of them were kidney transplant recipients (347 male, 162 female, of which 16 were pediatric and 493 were adult patients).
32519892 Pannexin1 (PANX1) is a ubiquitously expressed, channel-forming protein found in a number of tissues thoughout the body (e.g. lung, vasculature, liver, central nervous system, immune system) that is important in many key physiological and immune responses.
32519953 This review addresses gastroenterologists, hepatologists, liver transplant (LT) specialists, and health-care professionals working in the field of liver diseases and liver transplantation. […] It has been written based on a limited number of publications, recommendations of national and international liver and organ transplantation societies, and experiences of patients with COVID-19 around the world. […] The purpose of this review is to provide information addressing questions and concerns about COVID-19, to reveal the effects of the novel disease on patients with chronic liver disease and LT recipients, and to share information about ways in which this pandemic will affect clinical practices. […] We, the Turkish Association for the Study of the Liver (TASL), would like to remind you that this text is actually not a practical guide.
32520225 Sixteen cases were described in liver transplant (LT) patients, and the median interval since transplantation was 5 years.
32522282 Fertile women* must not be pregnant, i.e. negative pregnancy test must be available at inclusion • Informed consent signed by the patient *Defined as after menarche and until postmenopausal (no menstruation for 12 months) Exclusion criteria: • At the time of recruitment, the patient uses >5 LO2/min (equivalent to 40% FiO2 if measured) • Known intolerance/allergy to azithromycin or hydroxychloroquine or hypersensitivity to quinine or 4-aminoquinoline derivatives • Neurogenic hearing loss • Psoriasis • Retinopathy • Maculopathy • Visual field changes • Breastfeeding • Severe liver diseases other than amoebiasis (INR> 1.5 spontaneously) • Severe gastrointestinal, neurological and hematological disorders (investigator-assessed) • eGFR <45 ml/min/1.73 m2 • Clinically significant cardiac conduction disorders/arrhythmias or prolonged QTc interval (QTc (f) of> 480/470 ms).
32524743 Our current communication shares a protocol for donor and transplant recipient selection during the COVID-19 pandemic to continue life-saving solid organ transplantation for heart, lung, liver and kidney recipients.
32525549 To provide a pooled estimate of GI symptoms, liver enzyme levels outside reference ranges, and fecal tests positive for SARS-CoV-2 among patients with COVID-19. […] Data on patients with GI symptoms (ie, diarrhea, nausea, or vomiting), liver enzyme level changes, and fecal shedding of virus were extracted. […] Study and patient characteristics with pooled detection rates for diarrhea, nausea or vomiting, liver enzyme levels outside reference ranges, and SARS-CoV-2 positivity in feces tests were analyzed.
32526061 It begins as a respiratory infection that, mainly in men with diabetes or renal impairment, evolves into a systemic disease, with SARDS, progressive endothelial cell damage, abnormal clotting and impaired cardiovascular and liver function.
32526075 We are aware that for liver disease patients this has been especially concerning. […] The editorial from Sun and colleagues [1] provides an overview of the major challenges facing liver specialists as they strive to deliver essential services, and highlights some of the critical research gaps around COVID-19 and liver disease.
32526083 Abnormality in liver function tests (LFTs) has been commonly observed in patients with COVID-19, but there is controversy on its clinical significance.
32526252 The proportion of patients with MELD≥15 increased from 13% to 26% (p=0.037), acute-on-chronic liver failure and and de novo acute liver injury occurred in 14 (28%) and 10 patients, respectively. […] Severity of lung and liver (according to CLIF-C, CLIF-OF and MELD scores) diseases independently predicted mortality. […] COVID-19 is associated with liver function deterioration and elevated mortality in cirrhotic patients.
32527344 During the treatment period, the pharynx swab test of 2019 novel coronavirus (2019-nCoV) nucleic acid was carried out every 2 days, and the routine blood test, liver and kidney functions, blood coagulation function and myocardial enzymes were re-examined.
32527345 No patient was reported with liver, kidney or heart dysfunction or secondary infection.
32528760 Apart from respiratory findings, some studies have highlighted inflammatory consequences in the heart, kidney, and/or liver as well.
32530989 Comparing the risk of abnormal liver function tests between severe and non-severe patients with coronavirus disease 2019 (COVID-19) by meta-analysis. […] The severity of COVID-19 is associated with liver damage, and can be a risk factor for abnormal liver function tests.
32530994 It is known that a substantial proportion of patients infected with COVID-19 have abnormal liver function tests; however, the consequences of this information is still not clear. […] Here we present the first case report of a patient with liver cirrhosis and COVID-19 in our centre. […] We observed only slight fluctuations of liver enzymes, bilirubin levels and INR without clinical consequences in our case.
32532356 Patients have severe liver condition (e.g., Child Pugh score >=C or AST> 5 times of the upper limit);3. […] 2.3 Blood routine: white blood cells, neutrophils, lymphocytes, monocytes, eosinophils, basophils, neutrophils, lymphocytes, monocytes, eosinophils Acidic granulocyte count, basophil count, red blood cell, hemoglobin, hematocrit, average volume of red blood cells, average red blood cell Hb content, average red blood cell Hb concentration, RDW standard deviation, RDW coefficient of variation, platelet count, platelet specific platelet average Volume, platelet distribution width,% of large platelets; 2.4 Liver and kidney function tests: alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, γ-glutamyl transferase, prealbumin, total protein, albumin, globulin, white / globule ratio , Total bilirubin, direct bilirubin, cholinesterase, urea, creatinine, total carbon dioxide, uric acid glucose, potassium, sodium, chlorine, calcium, corrected calcium, magnesium, phosphorus, calcium and phosphorus product, anion gap, penetration Pressure, total cholesterol, triacylglycerol, high density lipoprotein cholesterol, Low density lipoprotein cholesterol, lipoprotein a, creatine kinase, lactate dehydrogenase, estimated glomerular filtration rate. […] The blind strategy is kept by an investigator who does not deliver the medical care or assess primary outcome results.
32532945 Liver injury has been reported to occur during the disease in severe cases. […] Therefore, this meta-analysis study aims to investigate the incidence of liver injury among published literature from 2019-Jan-01 to 2020-April-03 to provide an outline for further studies on the liver injury of COVID-19. […] The pooled prevalence of liver injury was 19.5% (95% CI: 14.3-26.1). […] Among 288 death cases, the pooled prevalence of liver injury was 22.8% (95% CI: 11.7-39.8). […] The results of this systematic review highlight the importance of liver injury that may assist clinicians anywhere in the globe in controlling COVID-19-related infection and complications. […] Moreover, the prevalence of liver injury can be higher in severe cases than in mild cases.
32536944 However, it is possible for other organs to be affected including the central nervous system, liver, and blood cells.
32538830 CEUS with bolus delivery via a central venous catheter of 2.4 ml Sulphur hexafluoride microbubbles from the arterial phase (10-15 s) to the late phase of 5 min. […] Near the diaphragm a delayed arterial contrast of the liver was observed.
32540733 Patients with metabolic disorders like obesity, diabetes, cardiovascular and liver disease may face a higher risk of infection of COVID-19, greatly affecting the development and prognosis of the disease, being associated with significantly worse outcome in these patients.
32540736 Liver involvement is common in COVID-19. […] Limited data is available in patients with COVID-19 and metabolic dysfunction associated fatty liver disease (MAFLD). […] We systematically searched the PubMed database till May 20, 2020 and retrieved all the articles published on COVID-19 and fatty liver/MAFLD/NAFLD.
32541245 We present the unique opportunity we had to monitor the liver, IL-6 and immune cell course before, during and after COVID-19 in a boy with autoimmune hepatitis (AIH) and type 1 diabetes (T1D).
32542881 Spreading of SARS-CoV-2 infection in Italy has challenged the practice of liver transplantation in an unprecedented way.
32543348 In 788 COVID-19 patients from Zhejiang province, we observed decreased rate of severe/critical cases, increased liver/kidney damage, and prolonged period of nuclear acid positivity, compared with patients in Wuhan, China. […] Single-cell sequencing and ACE2-Furin co-expression results confirmed that the Furin expression was higher in the whole body, especially in glands, liver, kidneys, and colon.
32545518 We found that the potent Nrf2-activating composition PB125® downregulates ACE2 and TMPRSS2 mRNA expression in human liver-derived HepG2 cells. ACE2 is a surface receptor and TMPRSS2 activates the spike protein for SARS-CoV-2 entry into host cells.
32547309 The laboratory tests liver and kidney function, blood routine, coagulation function, and immune status. Results: The study population included 70 hospitalized patients with confirmed CONV-2019.
32550096 Although the impaired liver function is prevalent in COVID-19, it is poorly understood. […] It is warranted that patients with abnormal liver functions tend to have an increased risk of COVID-19. […] Thus, increased attention should be paid to the care of patients with abnormal liver functions, and testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA is warranted in the COVID era.
32552178 We performed postmortem core needle biopsies from lung, heart, and liver on 7 deceased patients who had died of coronavirus disease 2019. […] Liver biopsies showed congestion, micro- and macro-vesicular changes, and minimal to mild portal inflammation, in the majority of cases. Conclusions. […] Liver tissue sections mostly showed nonspecific findings; however, ischemia of the liver can be identified in some cases.
32553666 Recent reports showed about 2-11% of patients with COVID-19 had underlying chronic liver disease. […] Experience from previous SARS epidemic suggest that 60% of patients developed various degrees of liver damage. […] Cases of acute liver injury have been reported, associated with higher mortality. […] Hepatic involvement in COVID-19 could be multifactorial related to any of direct cytopathic effect of the virus, uncontrolled immune reaction, sepsis or drug induced liver injury. […] Interestingly, the expression of ACE2 receptors were identified in the gastrointestinal tract, vascular endothelium and cholangiocytes of the liver. […] Liver transplant recipients with COVID-19 have been reported recently. […] Effects of COVID-19 on underlying chronic liver disease requires a detailed evaluation and currently data is lacking and further research is warranted in this area.
32553772 The most severe disease manifestations are atypical pneumonia and sepsis, but the gastrointestinal tract, particularly the liver, has recently been reported to be affected by SARS-CoV-2. […] Therefore, the aim of the present work was to review the literature available on the topic and provide information about COVID-19, in both healthy and diseased livers, and issue recommendations. […] The incidence of liver injury specifically associated with COVID-19 varies from 14.8-53%. […] The majority of case series have reported altered ALT and AST, elevated total bilirubin, and low serum albumin and liver compromise has been associated with the most severe cases of COVID-19. […] Cirrhosis of the liver has a recognized immune dysfunction status that includes immunodeficiency and systemic inflammation, making it reasonable for those patients to be more susceptible to SARS-CoV-2 infection.
32553907 We aimed to describe the characteristics of liver function in patients with SARS-CoV-2 and chronic hepatitis B virus (HBV) co-infection. […] The characteristics of liver function and its relation with the severity and prognosis of disease were described. […] Of 105 SARS-CoV-2 and chronic HBV co-infected patients, elevated levels of liver test were seen in several patients at admission, including elevated levels of alanine aminotransferase (22,20.95%), aspartate aminotransferase (29, 27.62%), total bilirubin (7, 6.67%), gamma-glutamyl transferase (7, 6.67%) and alkaline phosphatase (1, 0.95%). […] 14 (13.33%) patients developed liver injury. […] Notably, 4 (28.57%) patients rapidly progressed to acute-on-chronic liver failure. […] The proportion of severe COVID-19 was higher in patients with liver injury (P= 0.042). […] Complications including ACLF, acute cardiac injury and shock happened more frequently in patients with liver injury (all P<0.05). […] The mortality was higher in individuals with liver injury (28.57% vs 3.30%, P=0.004). […] Liver injury in patients with SARS-CoV-2 and chronic HBV co-infection was associated with severity and poor prognosis of disease. […] During the treatment of COVID-19 in chronic HBV-infected patients, liver function should be taken seriously and evaluated frequently.
32558065 Prins and his colleagues for their interest in our recent article regarding the characteristics and mechanisms of liver damage caused by three highly pathogenic coronavirus infections and for their valuable insights on the liver injury among COVID-19.
32558697 Cases of liver damage or dysfunction (mainly characterized by moderately elevated serum aspartate aminotransferase levels) have been reported among patients with COVID-19. […] However, it is currently uncertain whether the COVID-19 related liver damage/dysfunction is due mainly to the viral infection by itself or other coexisting conditions, such as the use of potentially hepatotoxic medications and the coexistence of systemic inflammatory response, respiratory distress syndrome-induced hypoxia, and multiple organ dysfunction. […] This is also the same profile for those at increased risk for unrecognized underlying liver disease, especially nonalcoholic fatty liver disease. […] This could make them more susceptible to liver injury from the virus, medications used in supportive management, or hypoxia. […] So the aim of this review was to illustrate the clinical implications of COVID-19 on the liver in healthy and diseased states as well as the implications of common liver disorders on the outcome of COVID-19.
32558945 Previous studies reported that coronavirus disease 2019 (COVID-19) was likely to result in liver injury. […] However, few studies reported the impacts of COVID-19 on liver function in patients with chronic liver diseases. […] The serum albumin level and platelet counts were decreased in 2 patients with HBV-related liver cirrhosis. […] No patient was admitted to the intensive care units or developed liver failure during hospitalization. […] The abnormalities of liver function are not uncommon on COVID-19 patients with chronic HBV infection in our case series. […] However, no patient developed severe liver-related complications during hospitalization.
32559324 Besides pneumonia and acute respiratory distress syndrome, the disease leads to multisystem involvement in the form of myocarditis, arrhythmias, cardiac arrest, gastrointestinal symptoms, hypoxemic brain injury, acute liver and renal function impairment.
32559354 We present a case of a pediatric liver transplant recipient diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection four days after receiving a living donor liver allograft from her mother. […] The recipient was a 6-month-old with end-stage liver disease due to biliary atresia and failed Kasai. […] The infant had an uncomplicated implantation, excellent graft function and down-trending liver enzymes until developing fevers, diarrhea, and moderate respiratory distress requiring non-invasive respiratory support. […] Liver enzymes peaked ~1000 U/L (5-fold higher than the previous day) on POD 6.
32562397 Children with inflammatory bowel disease and post liver transplant patients do not have an increased risk of disease, and should remain on medications they are already on. […] Children with chronic liver disease should continue their medications as usual.
32562561 Which are the consequences of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection in liver transplant (LT) recipients? […] Baseline IS regimen remained unchanged in all surviving recipients, with good liver function.
32563190 Whether liver fibrosis might be a relevant player in the natural history of COVID-19 is currently unknown. […] FIB-4 ≥2.67 defined patients with risk for advanced liver fibrosis. […] The link between liver fibrosis and the natural history of COVID-19 should be evaluated in future studies.
32564624 Patients with chronic liver disease (CLD) have compromised immune function due to cirrhosis and are more susceptible to infection.
32565039 An online survey was disseminated to all E-AHPBA members to assess the effects of the pandemic on unit capacity, management of HPB cancers, use of COVID-19 screening and other aspects of service delivery. […] Delayed access to cancer surgery necessitated alternatives including increased neoadjuvant chemotherapy for pancreatic cancer and colorectal liver metastases, and locoregional treatments for hepatocellular carcinoma. […] Other aspects of service delivery including COVID-19 screening and personal protective equipment varied between units and countries. […] This study demonstrates that the COVID-19 pandemic has had a profound adverse impact on the delivery of HPB cancer care across the continents of Europe and Africa.
32565199 He underwent liver transplantation 4 years earlier due to HCV and NASH-related cirrhosis with hepatocellular carcinoma. […] The evolution of SARS-CoV-2 interstitial pneumonia in this immunosuppressed patient was moderate to severe and liver injury was not clinically significant. […] Despite its limitations, this case report confirm that the liver may be only mildly affected during SARS-CoV-2 infection, also in liver transplanted patients.
32566368 There is a significant overlap between the clinical findings in novel coronavirus disease 2019 (COVID-19) and hemolysis, elevated liver enzymes, and low platelets syndrome (HELLP). Cases Patients presented at 22 and 29 weeks of gestation with suspected COVID-19 pneumonia. […] While the patient at 22 weeks of gestation subsequently had an intrauterine fetal demise, the patient at 29 weeks of gestation delivered via an emergency cesarean delivery for nonreassuring fetal status.
32566579 Complications included acute respiratory distress syndrome (ARDS) requiring non-invasive mechanical ventilation [1 (6.3%)], acute respiratory injury [4 (25%)], acute renal injury [1 (6.3%)], septic shock [1 (6.3%)], liver dysfunction [5 (31.3%)], electrolyte disturbance [8 (50.0%)], and hospital-acquired pneumonia [3 (18.8%)].
32567003 The present study investigated the roles of hypoproteinemia in the clinical outcome and liver dysfunction of COVID-19 patients.
32567823 However, SARS-CoV-2 can affect several human organs due to high expressions of ACE2 receptor which is the main viral target and the virus may affect not only higher and lower respiratory tracts, but also heart, kidney, gastro enteric tract, liver, pancreas, nervous system and skin.
32568186 In COVID-19 ICU patients massive aggression of lung with severe pulmonary failure, as well as kidney and liver injuries, heart, brain, bowel and spleen damages with lymph nodes necrosis and even cutaneous manifestations have been observed.
32568471 Despite the exclusion of marginal donors and organs, the implementation of COVID-19 donor testing and the availability of local procurement surgeons, only 1 organ (a liver) was accepted by a transplant center outside of New York State and 8 organs (5 livers, 4 kidneys) were transplanted in state. 11 organs (1 liver, 10 kidneys) were discarded. […] Allocation was unsuccessful for 11 additional organs (1 liver, 4 kidneys, 4 hearts, 2 lungs).
32568751 The RT-PCR did not detect viral RNA in the wall of small intestine, appendix, and gallbladder, bile, liver, and urine.
32568805 Several hypotheses are formulated to explain the liver dysfunction in COVID-19 patients which include collateral damage from cytokine storm, drug-induced liver injury, viral-induced hepatitis and hypoxia-induced damage. […] Through this case series, we would like to highlight that liver enzyme abnormalities are often seen in COVID-19 patients and would like to highlight that physicians need to serially monitor biochemical testing until the liver enzymes return to baseline. […] Physicians also need to be vigilant of liver enzyme abnormalities in these patients, especially before starting new medications.
32569446 Using liver organoids infected with SARS-CoV-2, they confirm dual antiviral and anti-inflammatory activities, and show that its administration in four COVID-19 patients is correlated with disease improvement, paving the way for more rigorous placebo-controlled trials.
32569609 Liver injury is not very severe in pregnant COVID-19 patients. […] Pregnant COVID-19 patients with liver injury had higher inflammation than those without liver injury. […] All newborns delivered by pregnant COVID-19 patients with liver injury were negative for SARS-CoV-2.
32571972 Knowledge on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in liver transplant recipients is lacking, particularly in terms of severity of the disease. […] The aim of this study was to describe the demographic, baseline clinical characteristics and early outcomes of a European cohort of liver transplant recipients with SARS-CoV-2 infection. […] We conducted an international prospective study across Europe on liver transplant recipients with SARS-CoV-2 infection confirmed by microbiological assay during the first outbreak of COVID-19 pandemic. […] In this European multicentre prospective study of liver transplant recipients, COVID-19 was associated with an overall and in-hospital fatality rate of 12% (95% CI 5% to 24%) and 17% (95% CI 7% to 32%), respectively.
32572128 In addition, many patients with COVID-19 infection have suffered liver damage which might contribute to a worse prognosis. […] We conducted a clinical epidemiological analysis to investigate the association of overweight/obesity and abnormal liver function (ALF) with hospitalized duration in patients infected with COVID-19.
32572616 White blood cells, hemoglobin, platelets, and liver enzymes counts were within the normal range in both groups.
32573419 Serum levels of CRP, ferritin, fibrinogen, lymphocytes, platelets, creatinine, D-dimer and liver enzymes were assayed at the time of the first TCZ administration, then every two days for 8 days. 40 patients were treated with TCZ. […] Most of them had several comorbidities, and all had multiple biological abnormalities (lymphopenia, increased CRP, ferritin, fibrinogen, D-dimer, liver enzymes). 30 patients (75%) benefited from TCZ and 10 patients died.
32573883 While metabolic associated fatty liver disease (MAFLD) affects a quarter of world population, its impact on COVID-19 severity has not been characterized.
32574284 We also found impaired liver, kidney, and myocardial functions; the presence of hypoproteinemia, hyponatremia, and hypocalcemia; and, in one case, abnormal coagulation function.
32574287 Lymphopenia as well as liver and renal dysfunctions may be seen.
32574408 We aimed to describe the effect of COVID-19 on the number of liver transplants (LT) in South Korea. […] The lockdown caused by COVID-19 did not affect the number of liver transplants in Korea. […] Establishing a safe process and procedure of liver transplantation within safe boundaries can be beneficial in reducing the side effects of lockdown and saving patients’ lives.
32574433 D-dimer corresponding to peripheral circulation disorders and serum cholinesterase, reflecting liver function had improved.
32574789 At baseline, all patients had multiple biological abnormalities (lymphopenia, increased CRP, ferritin, fibrinogen, D-dimer and liver enzymes). 24 patients (70.5%) recovered after TCZ therapy and 10 died (29.5%).
32575078 Besides, abnormal laboratory tests were more prevalent in severe patients than in mild cases, such as elevated levels of white blood cell counts, liver enzymes, lactate dehydrogenase, creatine kinase, C-reactive protein and procalcitonin, as well as decreased levels of lymphocytes and albumin.
32578289 In our transplant center, infection with SARS-Cov-2 virus was confirmed in 4 organ transplant recipients (3 kidney and 1 liver transplant recipients) during their early post-transplant hospital stay.
32579293 No abnormalities were found in liver and kidney function.
32579880 COVID-19 pathophysiology includes respiratory failure but involves other organ systems including gut, liver, heart, and pancreas. […] A Spike-enabled pseudo-entry virus infects pancreatic endocrine cells, liver organoids, cardiomyocytes, and dopaminergic neurons. […] We find that human pancreatic beta cells and liver organoids are highly permissive to SARS-CoV-2 infection, further validated using adult primary human islets and adult hepatocyte and cholangiocyte organoids.
32579986 Furthermore, organ-specific biomarkers demonstrate the involvement of cardiac muscle, kidney, and liver dysfunction in many patients.
32582330 The effects of COVID-19 on patients with decompensated liver disease is still not clear. […] Managing immunosuppressive drugs in liver transplant and inflammatory bowel disease is a major challenge without clear guidelines.
32585065 Liver injury has been described with COVID-19, and early reports suggested 2-11% of patients had chronic liver disease (CLD).
32585136 It is common to encounter patients with COVID-19 with abnormal liver function, either in the form of hepatitis, cholestasis, or both. […] The clinical implications of liver derangement might be variable in different clinical scenarios. […] With growing evidence of its clinical significance, it would be clinically helpful to provide practice recommendations for various common clinical scenarios of liver derangement during the COVID-19 pandemic. […] The Asia-Pacific Working Group for Liver Derangement during the COVID-19 Pandemic was formed to systematically review the literature with special focus on the clinical management of patients who have been or who are at risk of developing liver derangement during this pandemic. […] Clinical scenarios covering the use of pharmacological treatment for COVID-19 in the case of liver derangement, and assessment and management of patients with chronic hepatitis B or hepatitis C, non-alcoholic fatty liver disease, liver cirrhosis, and liver transplantation during the pandemic are discussed.
32586665 The coronavirus disease 2019 (COVID-19) pandemic is placing an increasing burden on liver transplant (LT) services worldwide.
32586669 The results showed that there were different degrees of damage to the liver, kidneys, blood coagulation, and heart function in the non-survival group.
32587443 Patients with liver disease need special attention and continuous follow-up. […] Healthcare professionals in the field of hepatology face the overwhelming task of taking care of COVID-19 patients with hepatic complications, liver disease or transplant patients who are SARS-CoV-2 positive, and the patients on routine surveillance who do not have COVID-19. […] This review will evaluate COVID-19 from the perspective of its effect on the liver and its possible effects on patients with liver disease. […] Furthermore, the level of care for liver transplant recipients during the pandemic will be discussed.
32588791 Reports of liver injury in patients with novel coronavirus disease 2019 (COVID-19) are emerging from China and the USA. […] A wide variety of liver function test abnormalities and few cases of severe liver failure have been reported. […] Markers of cholestatic liver injury were altered only in a minority of patients. […] Severe liver injury defined by 3×> upper limit of normal was observed in 9.1% over a mean time of 10.5 days. […] Importantly, patients exhibited cytotoxicity including lactate dehydrogenase and creatinine kinase elevations, but no signs of relevant liver function impairment. […] In summary, in a case series of hospitalized patients in Germany, cytotoxicity in the absence of severe liver dysfunction at admission and only few cases suggestive of severe liver injury during hospital were observed.
32589264 We harmonized the information from the recent existing literature on COVID-19 acute pandemic and mechanisms of damage in non-alcoholic fatty liver disease (NAFLD), as an example of chronic (non-communicable) metabolic pandemic. […] The deleterious interplay of inflammatory pathways chronically active in NAFLD and acutely in COVID-19 patients, can explain liver damage in a subgroup of patients, and might condition a worse outcome in metabolically-compromised NAFLD patients. […] In a subgroup of NAFLD patients, the underlying liver fibrosis might represent an additional and independent risk factor for severe COVID-19 illness, irrespective of metabolic comorbidities. […] Initial evidences suggest that increased liver fibrosis in NAFLD might affect COVID-19 outcome. […] In addition, long-term monitoring of post-COVID-19 NAFLD patients is advisable, to document further deterioration of liver damage.
32589600 Also, the increase of cardiac and liver dysfunction biomarkers has been associated with poor outcome.
32589755 The basic information, blood routine, pneumonia-related blood indexes, immune-related indexes along with liver, kidney and myocardial indexes in patients with different types were analyzed. […] In addition, the change in the total cholesterol level suggested that COVID-19 would induce some liver function damage in patients.
32589760 Seven transplanted patients (two liver, three kidneys, one double lung, one heart) admitted to the Ludwig-Maximilians-University Munich because of COVID-19 and tested positive for SARS-CoV-2 were included. […] The two liver transplant patients and the heart transplant patient had an uncomplicated course and were discharged after 14, 18 and 12 days, respectively.
32590819 The median time from disease onset to ICU admission was 10 days (IQR 6-11 days), to mechanical ventilation (MV) was 11 days (IQR 7.75-13 days), to artificial liver plasma exchange was 12 days (IQR 9.75-14.75 days), and to extracorporeal membrane oxygenation (ECMO) was 22 days (IQR 17.5-30 days). […] Nine received artificial liver plasma exchange. […] Artificial liver plasma exchange significantly reduced inflammatory cytokine levels.
32592396 Erythrocyte-associated indicators, liver function and serum lipid metabolism presented abnormal throughout during the observation period.
32592539 The coagulation parameters of COVID-19 patients were widely and closely related to the indexes of liver function and inflammation (P < .05), indicating the coagulation dysfunction of these patients may be caused by liver injury and inflammatory storm.
32592716 In this context, we have analyzed the anti-coronavirus potential of the natural product glycyrrhizic acid (GLR), a drug used to treat liver diseases (including viral hepatitis) and specific cutaneous inflammation (such as atopic dermatitis) in some countries.
32164090 Routine blood test revealed WBC<4.0×10(9)/L in 8 petients (26.67%) , (4-10) ×10(9)/L in 22 petients (73.33%) , and WBC>4.0×10(9)/L in 4 petients (13.33%) during the disease.Lymphocyte count<1.0×10(9)/L occurred in 12 petients (40%),abnormal liver function in 7 petients (23.33%) ,myocardial damage in 5 petients(16.67%), elevated D-dimer (>0.5mg/l) in 5 patients (16.67%). […] Compared with normal patients, the average exposure times, cumulative exposure time, BMI, Fever time, white blood cell count, liver enzyme, LDH, myoenzyme and D-dimer were significantly increased in severe patients, while the lymphocyte count and albumin levels in peripheral blood were significantly decreased.Chest CT mainly showed patchy shadows and interstitial changes.According to imaging examination, 11 patients (36.67%) showed Unilateral pneumonia and 19 patients (63.33%) showed bilateral pneumonia,4 patients (13.33%) showed bilateral multiple mottling and ground-glass opacity.Compared with the patients infected in the protected period, the proportion of severe infection and bilateral pneumonia were both increased in the patients infected in unprotected period. […] Severe patients had BMI increased, heating time prolonged, white blood cell count, lymphocyte count, D-dimer and albumin level significantly changed and were prone to be complicated with liver damage and myocardial damage.Strict protection measures is important to prevent infection for medical workers.
32450631 Some patients had mild liver and kidney damage.
32594085 Hemoperfusion (HP) was helpful to prevent the development and progression of acute respiratory distress syndrome (ARDS), acute kidney injury (AKI), liver failure, and septic shock by removing cytokines and other inflammatory mediators and ultimately preventing progression toward multiple organ failure.
32595360 Carvone has also been determined to be able to cross the blood-brain barrier (BBB) effectively, not a substrate for P-glycoprotein (P-gp), not to inhibit any of the cytochrome P molecules, and to have no toxic effects even on liver cells.
32595762 In this review, we summarise recent findings on the epidemiology of GI tract involvement, potential mechanisms of faecal-oral transmission, GI and liver manifestation, pathological/histological features in patients with COVID-19 and the diagnosis, management of patients with pre-existing GI and liver diseases as well as precautions for preventing SARS-CoV-2 infection during GI endoscopy procedures.
32602202 22.79 kg/m2) and lower liver computed tomography value (average 50.00 vs. […] The main mechanism is related to damage of the liver and kidney.
32602604 Although it has been reported that some COVID-19 patients showed elevated liver biochemistries, there are few studies regarding clinical features and prognosis of these patients. […] Of those, 142 (29.5%) patients showed abnormal liver biochemistries on admission, and patients with elevated alanine aminotransferase (ALT), aspartate aminotransferase (AST), and total bilirubin (TBIL) accounted for 67.6%, 69.0%, and 16.2%, respectively. […] Those with abnormal liver biochemistries showed higher percentages of severe cases and comorbidities and were more likely to have dyspnea, chest distress or pain, and increased hemoglobin (Hb) on admission. […] The multivariable regression analysis showed that chest distress or pain (odds ratio [OR], 1.765; P = 0.018), dyspnea (OR, 2.495; P = 0.001), elevated C-reactive protein [CRP] level (OR, 1.007; P = 0.008), elevated white blood count (WBC) (OR, 1.139; P = 0.013), and elevated Hb concentration (OR, 1.024; P = 0.001) were independent factors associated with elevated liver biochemistries in COVID-19 patients. […] Conclusion: Elevated liver biochemistries were common in COVID-19 patients. […] Patients with hypoxia or severe inflammation are more likely to experience increased liver biochemistries on admission.
32603060 In the context of liver transplantation (LTx), concerns are raised about organ donation shortage and safety, the ethics of using limited healthcare resources for LTx, selection criteria for LTx during the epidemic and the risk of de novo COVID-19 infection on the waiting list and after LTx.
32607420 We performed a lung transplant and a liver transplant successfully during the COVID-19 era.
32607684 In many patients, multi-organ failure with severe liver damage sets in finally, possibly as consequence of an early-onset pro-inflammatory cytokine storm and/or thrombotic microangiopathy.
32609908 There are scarce data on the impact of COVID-19 pandemic on liver transplantation (LT) in Europe. […] The aim of this study was to obtain a preliminary data on incidence, management, and outcome of COVID-19 in liver transplant recipients and candidates in Europe. […] An Internet-based survey was sent to the centers affiliated with European Liver Transplant Registry (ELTR).
32610859 These patients had deranged liver functions and had elevated pro-calcitonin levels, serum ferritin levels and LDH levels. 1 out of the these 4 cases went into ARDS during the course of treatment. 10 patients yielded negative results for Covid-19.
32612614 Thus far, there is no evidence that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) directly causes permanent damage to kidney, liver, or heart allografts.
32613308 SARS-CoV-2 infection can affect hematopoiesis, hemostasis, coagulation, fibrinolysis, bone metabolism, thyroid, parathyroid glands, the liver, and the reproductive system.
32614464 Although both of them eventually recovered and were discharged from the hospital, they were complicated with varying degrees of liver and myocardial injury.
32614976 We appreciate Philips and colleagues’ interest in our report on the associations between liver injury markers and coronavirus 2019 (COVID-19) mortality.( […] 1) They raised the question regarding the application of liver injury markers. […] We understand that use of aspartate aminotransferase (AST) in isolation cannot comprehensively characterize liver injury.
32615987 In addition, SARS-CoV-2 may affect organs other than the lung, such as the liver, with frequent onset of late cholestasis.
32616030 The immunosuppressive state induced by liver transplantation and anti-rejection therapy might contribute to the severity of COVID-19 in Case 4, who suffered from hepatitis B related hepatocellular carcinoma.
32616063 • Presenting with fever (≥37.5°C) and/or one mild symptom suggestive of COVID-19 disease (cough, dyspnoea, chills, odynophagia, diarrhoea, muscle pain, anosmia, dysgeusia, headache) OR being contact* of a SARS-CoV-2 confirmed or suspected case in the past 14 days • More than 12 weeks of gestation (dated by ultrasonography) • Agreement to deliver in the study hospitals Exclusion criteria • Known hypersensitivity to HCQ or other 4-amonoquinoline compounds • History of retinopathy of any aetiology • Concomitant use of digoxin, cyclosporine, cimetidine • Known liver disease • Clinical history of cardiac pathology including known long QT syndrome • Unable to cooperate with the requirements of the study • Participating in other intervention studies • Delivery onset (characterized by painful uterine contractions and variable changes of the cervix, including some degree of effacement and slower progression of dilatation up to 5 cm for first and subsequent labours) The study participants will be stratified by clinical presentation and SARS-CoV-2 PCR results.
  1. To compare the number of COVID-19 cases between each trial arm on the basis of positive tests (as per current clinical testing methods and/or serology) 3) To compare the percentage of COVID-19 positive individuals with current testing methods versus serologically-proven COVID-19 in each trial arm 4) To compare COVID-19 disease severity in each trial arm 5) To compare recovery time from COVID-19 infection in each trial arm EXPLORATORY OBJECTIVES: 1) To determine compliance (as measured by trough pharmacokinetic hydroxychloroquine levels) on COVID-19 positive tests 2) To determine if genetic factors determine susceptibility to COVID-19 disease or response to treatment 3) To determine if blood group determines susceptibility to COVID-19 disease 4) To compare serum biomarkers of COVID-19 disease in each arm TRIAL DESIGN: Double-blind, multi-centre, 2-arm (3:3:2 ratio) randomised placebo-controlled trial PARTICIPANTS: National Health Service (NHS) workers who have direct patient contact delivering care to patients with COVID-19. […] To be included in the trial the participant MUST: 1) Have given written informed consent to participate 2) Be aged 18 years to 70 years 3) Not previously have been diagnosed with COVID-19 4) Work in a high-risk secondary or tertiary healthcare setting (hospitals accepting COVID-19 patients) with direct patient-facing care EXCLUSION CRITERIA: The presence of any of the following will mean participants are ineligible: 1) Known COVID-19 positive test at baseline (if available) 2) Symptomatic for possible COVID-19 at baseline 3) Known hypersensitivity reaction to hydroxychloroquine, chloroquine or 4-aminoquinolines 4) Known retinal disease 5) Known porphyria 6) Known chronic kidney disease (CKD; eGFR<30ml/min) 7) Known epilepsy 8) Known heart failure or conduction problems 9) Known significant liver disease (Gilbert’s syndrome is permitted) 10) Known glucose-6-phosphate dehydrogenase (G6PD) deficiency 11) Currently taking any of the following contraindicated medications: Digoxin, Chloroquine, Halofantrine, Amiodarone, Moxifloxacin, Cyclosporin, Mefloquine, Praziquantel, Ciprofloxacin, Clarithromycin, Prochlorperazine, Fluconazole 12) Currently taking hydroxychloroquine or having a clinical indication for taking hydroxychloroquine 13) Currently breastfeeding 14) Unable to be followed-up during the trial 15) Current or future involvement in the active treatment phase of other interventional research studies (excluding observational/non-interventional studies) before study follow-up visit 16) Not able to use or have access to a modern phone device/web-based technology 17) Any other clinical reason which may preclude entry in the opinion of the investigator INTERVENTION AND COMPARATOR: Interventions being evaluated are: A) Daily hydroxychloroquine or B) Weekly hydroxychloroquine or C) Placebo The maximum treatment period is approximately 13 weeks per participant. […] Participants and trial investigators consenting participants, delivering trial assessments and procedures will be blinded to intervention.
32618658 Elevated liver enzyme levels are observed in patients with coronavirus disease 2019 (COVID-19); however, these features have not been characterized. […] Liver enzyme level elevation was defined as alanine aminotransferase level >35 U/L for men and 25 U/L for women at admission. […] Of 788 patients with COVID-19, 222 (28.2%) patients had elevated liver enzyme levels (median [interquartile range {IQR}] age, 47.0 [35.0-55.0] years; 40.5% women). […] Being male, overweight, and smoking increased the risk of liver enzyme level elevation. […] The liver enzyme level elevation group had lesser pharyngalgia and more diarrhea than the control group. […] The median time from illness onset to admission was 3 days for liver enzyme level elevation groups (IQR, 2-6), whereas the median hospitalization time for 86 (38.7%) discharged patients was 13 days (IQR, 11-16). […] We found that 28.2% of patients with COVID-19 presented with elevated liver enzyme levels on admission, which could partially be related to SARS-CoV-2 infection. […] Male patients had a higher risk of liver enzyme level elevation. […] With early medical intervention, liver enzyme level elevation did not worsen the outcomes of patients with COVID-19.
32619043 We read with interest the study by Lei and colleagues on the association between markers of liver injury and mortality in coronavirus disease 2019 (COVID-19) in China. […] They found that an increase in aspartate aminotransferase (AST) and its dynamicity correlated with COVID-19-related liver injury and patient outcomes. […] They concluded that the dynamic patterns of liver injury indicators, represented by AST, correspond with COVID-19-related liver injury.
32619279 The purpose of the study was to evaluate the relationships between liver injury indicators (alanine aminotransferase [ALT], aspartate aminotransferase [AST], alkaline phosphatase [ALP], and total bilirubin [TBIL]) and mortality in COVID-19 patients. […] The authors considered the possibility that elevated liver injury indicators, particularly AST, are strongly associated with mortality risk. […] However, the association between liver injury indicators and mortality in COVID-19 patients should be interpreted cautiously in light of the following issues.
32620390 COVID-19 has severely impacted deceased donor liver transplant (DDLT) programs throughout the world. […] Acceptance of deceased liver donors has decreased worldwide because of the unknown risks associated with COVID-19 transmission or postoperative infection in the immediate post-transplant period, along with the risks to the health care workers in a multidisciplinary setting.
32621178 An increasing number of patients with thalassemia is living with long-term complications, including cardiomyopathy, chronic liver disease, endocrinopathy, and infections.
32621206 The novel coronavirus Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) infection has been mostly leading to respiratory distress syndrome, but liver injury has also been documented. […] The mechanism of liver injury is limited and poorly understood. […] Based on the current studies, this review article emphasizes on the demographic and potential mechanisms of Corona Virus Disease (COVID)-19-related liver dysfunction.
32622450 Among its medical complications is a characteristic proinflammatory cytokine storm often associated with end-organ dysfunction, including respiratory failure, liver and renal insufficiency, cardiac injury, and coagulopathy.
32623470 In patients with severe COVID-19, we assessed the association between chronic ACEI/ARB use and the occurrence of kidney, lung, heart, and liver dysfunctions and the severity of the inflammatory reaction as evaluated by biomarkers kinetics, and their association with disease outcomes.
32623632 Its profile in patients with pre-existing chronic liver disease (CLD) is largely unknown. […] We studied the liver injury patterns of SARS-Cov-2 in CLD patients, with or without cirrhosis. […] Metabolism associated fatty liver disease (113, 61%) and viral etiology (26, 60%) were common. […] 17.2%, OR = 8.1 (1.9-38.8), p = 0.002] predisposed more to liver injury than those without these. […] Forty three percent of CLD without cirrhosis presented as acute liver injury and 20% cirrhotics presented with either acute-on-chronic liver failure [5 (11.6%)] or acute decompensation [4 (9%)]. […] Liver related complications increased (p < 0.05) with stage of liver disease; a Child-Turcotte Pugh score of 9 or more at presentation predicted high mortality [AUROC 0.94, HR = 19.2 (95 CI 2.3-163.3), p < 0.001, sensitivity 85.7% and specificity 94.4%). […] In decompensated cirrhotics, the liver injury was progressive in 57% patients, with 43% mortality. […] SARS-Cov-2 infection causes significant liver injury in CLD patients, decompensating one fifth of cirrhosis, and worsening the clinical status of the already decompensated.
32623633 Liver function derangements have been reported in coronavirus disease (COVID-19), but reported rates are variable. […] We estimated overall prevalence, stratified prevalence based on severity, estimated risk ratio (RR), and estimated standardized mean difference (SMD) of liver function parameters in severe as compared to non-severe COVID. […] The pooled prevalence and RR of chronic liver disease as a comorbidity was 2.64% (1.73-4) and 1.69 (1.05-2.73) respectively. […] The most frequent abnormality in liver functions was hypoalbuminemia followed by derangements in gamma-glutamyl transferase and aminotransferases, and these abnormalities were more frequent in severe disease. […] The systematic review was, however, limited by heterogeneity in definitions of severity and liver function derangements. […] Also estimates for overall/total liver disease (TLD) and chronic liver disease (CLD) amongst COVID-19 patients are depicted in a, b, d.
32628793 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is frequently associated with liver test abnormalities. […] To describe the evolution of liver involvement during SARS-CoV-2 infection and its effect on clinical course and mortality. […] The association between liver test abnormalities (baseline and peak values) and ICU admission or death was also explored. […] Liver test abnormalities were found in 161 (31.3%) patients. […] Baseline liver test abnormalities were associated with increased risk of ICU admission (OR 2.19 [95% CI 1.24-3.89], P = 0.007) but not with mortality (OR 0.84 [95% CI 0.49-1.41], P = 0.51). […] Alterations of liver test worsened within 15 days of hospitalisation; however, in patients with the longest median follow-up, the prevalence of liver test alterations decreased over time, returning to around baseline levels. […] In SARS-CoV-2-positive patients without pre-existing severe chronic liver disease, baseline liver test abnormalities are associated with the risk of ICU admission and tend to normalise over time.
32630032 COVID-19 patients admitted to the ICU underwent computed tomography within 24 hours and about 20 days later, to evaluate the parameters of the body and liver composition. […] The main results were the loss of the lean mass index and a greater increase in liver attenuation in obese subjects.
32631405 The presence or absence of involvement of organs other than the lungs (e.g., heart, liver, kidneys) 8.
32631771 Initial laboratory studies were significant for hyponatremia, elevated liver function tests including direct hyperbilirubinemia, and leukocytosis with neutrophilia.
32633236 There is also evidence that this infection may lead to liver and pancreatic injury. […] Patients with preexisting liver disease, especially metabolic associated liver fatty disease (MALFD) with fibrosis or liver cirrhosis, are at high risk for severe COVID-19.
32634827 Included covariates were age, hypertension, diagnoses including obesity, alcohol, sleep apnea, diabetes, chronic obstructive pulmonary disease, previous myocardial infarction (MI), ischemic heart disease (IHD), heart failure (HF), atrial fibrillation (AF), stroke, peripheral artery disease, cancer, liver-, rheumatic-, and chronic kidney disease (CKD).
32637437 There is also a growing body of evidence to suggest that liver injury is frequent. […] We present a patient diagnosed with coronavirus who presented with several days of GI symptoms and discuss the relevance of GI disease and liver injury in these patients.
32638436 The incidence of elevated liver chemistries and the presence of pre-existing chronic liver disease (CLD) have been variably reported in COVID-19. […] To assess the prevalence of CLD, the incidence of elevated liver chemistries and the outcomes of patients with and without underlying CLD/elevated liver chemistries in COVID-19. […] We included studies reporting underlying CLD or elevated liver chemistries and patient outcomes in COVID-19. 107 articles (n = 20 874 patients) were included for the systematic review. […] The pooled incidence of elevated liver chemistries in COVID-19 was 23.1% (19.3-27.3) at initial presentation. […] Additionally, 24.4% (13.5-40) developed elevated liver chemistries during the illness. […] The pooled incidence of drug-induced liver injury was 25.4% (14.2-41.4). […] COVID-19 patients with elevated liver chemistries had increased risk of mortality (OR-3.46 [2.42-4.95, P < 0.001]) and severe disease (OR-2.87 [95% CI, 2.29-3.6, P < 0.001]) compared to patients without elevated liver chemistries. […] Elevated liver chemistries are common at presentation and during COVID-19. […] The severity of elevated liver chemistries correlates with the outcome of COVID-19. […] Further studies are needed to analyse the outcomes of compensated and decompensated liver disease.
32639062 Statistically significant RORs emerged for 13 DMEs, with drug-induced liver injury (n = 91; LL 95% CI 3.07), pancreatitis (151; 1.41), and pulmonary fibrosis (222; 7.21) as unpredictable AEs. […] A total of 174 cases of liver-related DMEs were retrieved (proportion of deaths = 18.4%), with median onset of 27.5 days.
32639084 Furthermore, the patients with common chronic diseases regarding angiocardiopathy, type 2 diabetes, liver, pneumonia and hypertension were also with higher ACE2 expression compared to related controls, which were validated using independent data sets.
32639420 However, the data describing the global prevalence of liver injury associated with COVID-19 is lacking secondary to the novelty of this ongoing pandemic. […] Therefore, we conducted a meta-analysis to determine the association between COVID-19 and liver injury. […] A systematic literature search of indexed databases including, PubMed, Medline, and Embase databases from inception to 14 April 2020, was used to identify studies that reported data of liver chemistry in patients diagnosed with COVID 19. […] The overall prevalence of abnormal liver chemistry and relevant 95% confidence interval was used to estimate the pooled results studies. […] The pattern of abnormal liver enzymes was notable for higher aspartate aminotransferase (AST) than alanine aminotransferase (ALT) levels. […] Co-existing chronic liver disease presented up to 37.6% of patients with COVID-19. […] A fourth of COVID-19 patients had elevated liver enzymes and associated with disease severity. […] Intensive monitoring for liver injury may be needed in cases with severe COVID-19.
32639848 Cases with gastrointestinal symptoms are more likely to be complicated by liver injury and acute respiratory distress syndrome (ARDS).
32640331 Prevention and treatment of non-communicable diseases (NCDs), including cardiovascular disease, diabetes, obesity, cancer, Alzheimer’s and Parkinson’s disease, arthritis, non-alcoholic fatty liver disease and various infectious diseases; lately most notably COVID-19 have been in the front line of research worldwide.
32641037 We previously showed that the autophagy inhibitor chloroquine (CQ) increases inflammatory cleaved caspase-1 activity in myocytes, and that caspase-1/11 is protective in sterile liver injury.
32641296 Hematological, liver, kidney, and inflammation laboratory values were analyzed on the day of drug level determination.
32641369 Published studies have revealed that some patients with COVID-19 had abnormal liver function in laboratory tests. […] Furthermore, these meta-analyses were suspected of overestimating the incidence of liver injury in patients with COVID-19 because some studies considered transaminase elevation as liver injury, which might partially result from cardiac and muscle injury. […] This systematic review aims to enrol published literatures related to COVID-19 without language restriction, analyse the data based on the severity of the COVID-19 and explore the impact of varied definitions of liver injury on the incidence of liver injury. […] We have conducted a preliminary search on PubMed and Excerpta Medica Database on 13 April 2020, for the studies published after December 2019 on the prevalence of acute liver injury and hypertransaminemia in patients with COVID-19. […] We will estimate the pooled incidence of hypertransaminemia and acute liver injury in patients with COVID-19 by using the random-effects model.
32641471 Data on serial liver biochemistries of patients infected by different human coronaviruses (HCoVs) are lacking. […] The impact of liver injury on adverse clinical outcomes in coronavirus disease 2019 (COVID-19) patients remains unclear.
32642770 Based on collected proteomic datasets from human lung, colon, kidney, liver and heart, we constructed a virus-receptor network, a virus-interaction network and a virus-perturbation network.
32645300 Abdominal and pelvic computed tomography showed a normal liver and spleen without lymphadenopathy.
32646061 Based on studies in a range of in vitro and in vivo models, ergothioneine has exhibited the ability to modulate inflammation, scavenge free radicals, protect against acute respiratory distress syndrome, prevent endothelial dysfunction, protect against ischemia and reperfusion injury, protect against neuronal damage, counteract iron dysregulation, hinder lung and liver fibrosis, and mitigate damage to the lungs, kidneys, liver, gastrointestinal tract, and testis, amongst many others.
32646502 Patients will be followed-up by specialist physicians and Primary Health Care professionals. - Men and women. - Age between 18 and 75 years old. - Diagnosed SARS-CoV-2 infection, by PCR and/or IgM+ antibody test and/or antigen test. - Clinical diagnosis of lung involvement: (respiratory symptoms +/- pathological auscultation +/- O2 desaturation) - Chest X-ray with mild-moderate alterations or normal. - Patients who give their verbal informed consent in front of witnesses, which will be reflected in the patients’ medical records. - Oxygen desaturation below 93% or P02 < 62. - Moderate-severe dyspnea or significant respiratory or general deterioration that makes admission advisable. - Chest X-ray with multifocal infiltrates. - Insulin-dependent diabetes with poor control or glycaemia in the emergency room test greater than 300 mg/ml (fasting or not). - Other significant comorbidities: Severe renal failure (creatinine clearance < 30 mL/min); cirrhosis or chronic liver disease, poorly controlled hypertension. - Heart rhythm disturbances (including prolonged QT). - Severe immunosuppression (HIV infection, long-term use of immunosuppressive agents); cancer. - Pregnant or breast-feeding women. - Patients under use of glucocorticoids for other diseases. - History of allergy or intolerance to any of the drugs in the study (prednisone, azithromycin or hydroxychloroquine). - Patients who took one or more of the study drugs in the 7 days prior to study inclusion. - Patients taking non-suppressible drugs with risk of QT prolongation or significant interactions. - Patients unwilling or unable to participate until study completion. - Participation in another study.
32646657 Although liver transplant patients represent only a minority of the population, the hepatologists who follow these patients have tried to coordinate efforts to produce a protocol the management of immunosuppression during SARS-CoV-2 infection.
32649840 Different degrees of liver injury or liver dysfunctions have been reported in patients with COVID-19 infection. […] However, currently, it remains unclear to what extent liver diseases should be considered as significant risk factors for the severity and mortality of COVID-19. […] Moreover, the mechanisms involved in liver injury in severe COVID-19 infection are not yet well understood. […] This review summarizes the current evidence on liver function abnormalities in COVID-19 patients and the effects of preexisting liver disease on the disease severity. […] This review also illustrates the possible underlying mechanisms linking COVID-19 to liver injury, as well as provides recommendations to prevent liver damage in COVID-19 infection. […] The drug’s effects, possible viral inclusion in liver cells, systemic inflammation and hypoxia are potential causes of liver injury in severe COVID-19.
32650675 While the COVID-19 pandemic evolves, we are beginning to understand the role the gastrointestinal tract plays in the disease and the impact of the infection on the care of patients with gastrointestinal (GI) and liver diseases. […] We review the data and understanding around the virus related to the digestive tract, impact of the pandemic on delivery of GI services and daily gastroenterology clinical practice, and the effects on patients with pre-existing GI diseases.
32651938 We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25-97; 79 males) who were admitted to our internal medicine unit in March 2020. […] We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. […] A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. […] Liver function tests were altered in 62.4% of patients, and improved during follow-up. […] None of the seven patients with known chronic liver disease had liver decompensation. […] Only one patient developed acute liver failure. […] In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07-5.11, p = 0.033). […] To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome.
32654210 However, evidence showed that, even if the prevalence of COVID-19 damage consists in pulmonary lesions and symptoms, it could also affect other organs, such as heart, liver, and spleen.
32654313 Qin and Wang report a case of a 37-year old patient with COVID-19 disease after undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC). […] While these are interesting data on the course of COVID-19 disease in an immunosuppressed patient, we would like to highlight some particularly important issues related to management of liver disease and post-transplant care.
32654359 Although lungs seem to be the main target of the infection, very few information are available about liver involvement, possibly evocating a systemic disease. […] Post-mortem wedge liver biopsies from 48 patients died from severe pulmonary COVID-19 disease with respiratory failure were collected from two main hospitals in northern Italy. […] No patient had clinical symptoms of liver disease or signs of liver failure before and during hospitalization; for each of them liver function tests were available. […] All liver samples showed minimal inflammation features. […] Our preliminary results confirm the clinical impression that liver failure is not a main concern and this organ is not the target of significant inflammatory damage.
32655724 Mildly abnormal liver function tests (LFTs) are common in COVID-19 patients and are mostly due to systemic inflammatory response, hepatic ischemia or hepatotoxic medications. […] Close monitoring of liver function and supportive care of COVID-19 patients are recommended.
32655733 Currently, the first articles reporting outcomes of liver transplant recipients infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are published. […] The aim of the present study was to summarise the existing evidence of impact of COVID-19 global pandemic on liver transplant recipients. […] Five studies were selected from a pool of 12 studies with a total of 854 liver transplant recipients of whom 700 were children and the rest 154 were adults. […] The present evidence, based on case reports and series demonstrated lower mortality in liver transplant recipients compared to general population.
32656222 Background: Liver injury commonly occurs in patients with COVID-19. […] There is limited data describing the course of liver injury occurrence in patients with different disease severity, and the causes and risk factors are unknown. […] We aim to investigate the incidence, characteristics, risk factors, and clinical outcomes of liver injury in patients with COVID-19. […] From January 19, 2020 to February 20, 2020, patients confirmed with COVID-19 (≥18 years) and without liver injury were enrolled and divided into non-critically ill and critically ill groups. […] The incidence and characteristics of liver injury were compared between the two groups. […] Demographics, clinical characteristics, treatments, and treatment outcomes between patients with or without liver injury were compared within each group. […] The multivariable logistic regression model was used to explore the risk factors for liver injury. […] A total of 76 patients developed liver injury (mild, 40.5%; moderate, 15.3%; severe, 2.3%) with a median occurrence time of 10.0 days. […] 61.1%) of liver function than non-critically ill patients. […] Multivariable regression showed that the number of concomitant medications (odds ratio [OR]: 1.12, 95% confidence interval [CI]: 1.05-1.21) and the combination treatment of lopinavir/ritonavir and arbidol (OR: 3.58, 95% CI: 1.44-9.52) were risk factors for liver injury in non-critically ill patients. […] The metabolism of arbidol can be significantly inhibited by lopinavir/ritonavir in vitro (p < 0.005), which may be the underlying cause of drug-related liver injury. […] Liver injury was related to increased length of hospital stay (mean difference [MD]: 3.2, 95% CI: 1.3-5.2) and viral shedding duration (MD: 3.0, 95% CI: 1.0-4.9). […] Conclusions: Critically ill patients with COVID-19 suffered earlier occurrence, greater injury severity, and slower recovery from liver injury than non-critically ill patients. […] Drug factors were related to liver injury in non-critically ill patients. […] Liver injury was related to prolonged hospital stay and viral shedding duration in patients with COVID-19.
32656688 Numerous reports handled emergency cesarean delivery. […] Although the mortality rate is reported to be high after surgery in patients with COVID-19, cesarean delivery was successfully performed under regional anesthesia in most cases and postoperative course was favorable both in the parents and newborns. […] There is no direct evidence of vertical mother-to-child transmission of SARS-CoV-2; however, a diagnosis of COVID-19 was made in a newborn two hours after delivery from a pregnant woman with COVID-19, based on the increased immunoglobulin levels and deranged liver function, suggesting that its possibility cannot be completely eliminated.
32656794 The global pandemic of coronavirus disease-2019 (COVID-19) has led to significant disruptions in care delivery. […] Patients with chronic liver diseases require a high level of care and are therefore particularly vulnerable to disruptions in medical services during COVID-19. […] Recent data has also identified chronic liver disease as an independent risk factor for COVID-19 related hospital mortality. […] In response to the pandemic, national and international societies have recommended interim changes to the management of patients with liver diseases. […] There is concern that reduced access to diagnosis and treatment can also lead to increased morbidity in patients with liver diseases and we may witness a delayed surge of hospitalizations related to decompensated liver disease after the COVID-19 pandemic has receded. […] Therefore, it is paramount that liver practices craft a comprehensive plan for safe resumption of clinical operations while minimizing the risk of exposure to patients and healthcare professionals. […] Here, we provide a broad roadmap for how to safely resume care for patients with chronic liver disease according to various phases of the pandemic with particular emphasis on outpatient care, liver transplantation, liver cancer care and endoscopy.
32657473 We present TWIRLS (Topic-wise inference engine of massive biomedical literatures), a method that can deal with various scientific problems, such as liver cancer, acute myeloid leukemia, and so forth, which can automatically acquire, organize, and classify information.
32660185 Liver injury is a common complication of patients receiving COVID-19 treatment and its possible high incidence may affect the outcome of the disease. […] The pathogenesis of COVID-19 combined with liver injury in existing studies is still unclear, and relevant guidelines and expert consensuses are insufficient for clinical diagnosis and treatment.
32660964 COVID-19 and cirrhosis characteristics, development of organ failures and acute-on-chronic liver failure (ACLF) and mortality (inpatient death+hospice) were compared. 37 patients with cirrhosis+COVID-19 were matched with 108 patients with COVID-19 and 127 patients with cirrhosis from seven sites. […] Patients with cirrhosis alone had higher cirrhosis-related complications, maximum model for end-stage liver disease (MELD) score and lower BiPAP/ventilation requirement compared with patients with cirrhosis+COVID-19, but CCI and ACLF rates were similar.
32660993 Previously, ivermectin (1 to 10 mg/kg of body weight) was shown to inhibit the liver-stage development of Plasmodium berghei in orally dosed mice. […] The safety, pharmacokinetics, and efficacy of oral ivermectin (0.3, 0.6, and 1.2 mg/kg) with and without chloroquine (10 mg/kg) administered for 7 consecutive days were evaluated for prophylaxis or radical cure of P. cynomolgi liver stages in rhesus macaques.
32662342 Additional laboratory biochemical tests, including monitoring the change in blood cells, blood gas, coagulation, liver function, cardiac markers, and inflammatory responses such as cytokine levels in plasma, are also critical in combating COVID-19.
32663351 We undertook a web-based survey among parents of post-liver transplant pediatric patients to assess knowledge and concerns regarding COVID-19 pandemic and impact of social media on them. […] A 19-item questionnaire was sent to 172 parents of post-liver transplant children. 106 (62%) of parents responded.
32664161 Many commonly discussed medications being used to treat COVID-19 are not without potentially harmful side effects such as heart, liver, kidney problems, or other clinical symptoms. […] Primary outcomes would be used to evaluate the mortality rate, C-reactive protein (CRP), creatine, troponin, liver enzymes (aspartate aminotransferase and alanine aminotransferase), blood pressure, clinical symptoms (including fever, fatigue, myalgia, cough, skin rash, nausea, vomiting, and diarrhea), and serum cytokine levels.
32665039 Exclusion criteria include: currently pregnant, planning to become pregnant during the study period, and/or breast feeding; known hypersensitivity/allergy to hydroxychloroquine or to 4-aminoquinoline compounds; current use of hydroxychloroquine; known prolonged QT syndrome and/or baseline resting ECG with QTc>450 ms and/or concomitant medications which simultaneously may prolong the QTc that cannot be temporarily suspended/replaced; known pre-existing retinopathy, G6PD deficiency, porphyria, liver disease including cirrhosis, encephalopathy, hepatitis or alcoholism, diabetes on oral hypoglycemics or insulin, or renal insufficiency/failure; disclosure of self-administered use of hydroxychloroquine or chloroquine within 12 weeks prior to study; confirmed symptomatic COVID-19 at time of enrollment.
32665398 Severe liver damage is associated with worse outcome in COVID-19. […] Our aim was to explore the degree of liver damage, liver stiffness (LS) and severity of illness in patients with COVID-19. […] We performed laboratory testing, liver and spleen sonography and elastography to measure organ stiffness. 12 patients (38%) showed elevated aminotransferases and gamma-glutamyltransferase levels. […] Even mild liver damage raised LS significantly in COVID-19 as it was in patients with gastrointestinal symptoms. […] Transient elastography is a useful and non-invasive tool to assess onset and severity of acute liver injury in patients with COVID-19 patients.
32666588 Liver transplant (LT) recipients are considered at a particularly high risk for developing critical COVID-19 infection.
32667418 Patients with inflammatory bowel disease or chronic liver disease are not at greater risk of infection by SARS-CoV-2 relative to the general population.
32667668 Factors independently associated with death included older age (≥80 vs <40 years of age: odds ratio [OR], 11.15; 95% CI, 6.19-20.06), male sex (OR, 1.50; 95% CI, 1.19-1.90), higher body mass index (≥40 vs <25: OR, 1.51; 95% CI, 1.01-2.25), coronary artery disease (OR, 1.47; 95% CI, 1.07-2.02), active cancer (OR, 2.15; 95% CI, 1.35-3.43), and the presence of hypoxemia (Pao2:Fio2<100 vs ≥300 mm Hg: OR, 2.94; 95% CI, 2.11-4.08), liver dysfunction (liver Sequential Organ Failure Assessment score of 2 vs 0: OR, 2.61; 95% CI, 1.30-5.25), and kidney dysfunction (renal Sequential Organ Failure Assessment score of 4 vs 0: OR, 2.43; 95% CI, 1.46-4.05) at ICU admission.
32667716 The impact of coronavirus disease-19 (COVID-19) in liver recipients remains largely unknown. […] We aimed to report a single-center case series of five consecutive patients in the early postoperative period of deceased-donor liver transplantation who developed nosocomial COVID-19.
32668494 Although the clinical features of COVID-19 related liver injury have been investigated, there have been no reports and studies on the clinical characteristics of COVID-19 patients co-infected with Hepatitis B Virus (HBV). […] This study aimed to evaluate whether SARS-CoV-2/HBV co-infection could influence liver function and the disease outcome. […] The clinical, laboratory data and the length of stay were collected and analyzed retrospectively. 20 patients with HBV co-infection (6.1%) and 306 patients (93.9%) without HBV infection showed no differences in the level of liver function parameters. […] Taken together, we found no evidence that SARS-CoV-2/HBV co-infection could aggravate liver injury or extend duration of hospitalization.
32669866 In this study, we assessed the characteristics of markers of the liver in patients with COVID-19 to provide new insights in improving clinical treatment. […] We recruited 279 patients who confirmed COVID-19 and the data of liver biomarkers and complete blood count of patients were defined as the day onset when the patients admitted to the hospital. […] Hepatic injury and abnormal liver enzymes related to COVID-19 infection is an acute non-specific inflammation alteration.
32679617 Liver impairment is frequent in patients with novel coronavirus disease (COVID-19) and direct viral tropism for the liver has been proven. […] Since several of the currently administered drugs against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are possibly hepatotoxic, the management of patients with COVID-19 and liver failure is still an almost unexplored field. […] Where the available therapeutic options are scarce, we here propose hemoperfusion (HP) as an attractive alternative to both delay any late-stage progression of hyper inflammation process in COVID-19 and remove the toxins involved in acute liver failure.
32681166 One case showed hemophagocytosis in the spleen but none showed hemophagocytosis in liver or bone marrow.
32681674 Although not common, gastrointestinal and liver symptoms have reportedly been the initial presentation of coronavirus disease-2019 (COVID-19) in a large group of patients. […] A systematic review and meta-analysis of the available data on the gastrointestinal and liver manifestations of patients with COVID-19 was performed. […] Original studies providing information on clinical digestive symptoms or biomarkers of liver function in patients with polymerase chain reaction confirmed diagnosis of COVID-19 were included. […] After adjusting for preexisting gastrointestinal (5.9%) and liver diseases (4.2%), the most common gastrointestinal findings were diarrhea (8.7%, 95% CI = 5.4%-13.9%), anorexia (8.0%, 95% CI = 3.0%-19.8%), and nausea (5.1%, 95% CI = 2.2%-14.3%). […] Gastrointestinal and liver manifestations are not rare in patients with COVID-19, but their prevalence might be affected by preexisting diseases. […] Diarrhea and mild liver abnormalities seem to be relatively common in COVID-19, regardless of comorbidities.
32682358 High neutrophil/lymphocyte ratio, low lymphocyte, monocyte and platelet count, elevated liver enzymes, low GFR, high levels of muscle enzymes, ferritin and IL-6 on admission were found to be associated with SARI/critical disease (p<0.05). […] This cohort study regarding COVID-19 cases in Turkey reveals that older age, presence of co-morbidity, bilateral infiltration on CT, high neutrophil/lymphocyte ratio, low monocyte and platelet count, elevated liver enzymes, low GFR, high levels of muscle enzymes, and high levels of ferritin and IL-6 on admission are predictors of SARI and severe disease.
32683613 Steatosis was measured with placement of a single ROI in the right lobe of the liver (segments VI-VII) and defined as a liver attenuation value ≤ 40 HU. […] These findings are in accordance with other recent studies linking obesity and COVID-19 infection, as there is an intricate relationship between liver steatosis, metabolic syndrome and obesity.
32685180 Therefore, early evaluation and monitoring of both liver and kidney functions, as well as hematologic parameters, are pivotal to forecast the progression of COVID-19. […] In this study, we performed a systematic review and meta-analysis to investigate the association between several complications, including acute kidney injury (AKI), acute liver injury (ALI), and coagulopathy, with poor outcomes in COVID-19. […] Acute liver injury and coagulopathy were not defined in most of the studies.
32685369 We report a case of COVID-19 in a patient with a kidney and liver transplant and discuss the early use of tocilizumab to prevent the cytokine storm and attempt to reduce the likelihood of progression to Acute Respiratory Distress Syndrome (ARDS).
32686219 In preclinical models, senolytics delay, prevent or alleviate frailty, cancers and cardiovascular, neuropsychiatric, liver, kidney, musculoskeletal, lung, eye, haematological, metabolic and skin disorders as well as complications of organ transplantation, radiation and cancer treatment.
32687645 Hypoglycaemia elevated liver function tests and QT prolongation were monitored in both groups.
32688374 Biological markers of inflammation and liver/kidney function were monitored.
32692464 Several recent studies have reported an abnormal liver chemistry profile among patients with coronavirus disease 2019 (COVID-19), although its clinical significance remains unknown. […] This novel systematic review and meta-analysis identified six studies of 586 patients delineating liver chemistries among patients with severe/critical illness versus mild cases of COVID-19 infection. […] Comorbidities, including CAD, cerebrovascular disease, and COPD, are more prevalent in hospitalized Chinese patients with severe/critical illness from COVID-19, and these patients are more likely to manifest with abnormal liver chemistries.
32693151 After 4 weeks of implementation of intra-hospital protocols for the control of the Covid-19 epidemic, 112 patients were operated on (104 oncology or emergency surgeries and 8 liver transplants).
32694915 Thus, this narrative review describes clinically important considerations about the treatment of COVID-19 and immunosuppressive regimens regarding modifications, side effects, and interactions in adult kidney or liver allograft recipients.
32695551 0.42 (0.28-0.79) mg/L, p = 0.000; While the liver function parameter alanine aminotransferase (ALT) and aspartate aminotransferase (AST) didn’t show significance between two groups, ALT 30.80 (19.00-58.30) IU/L vs.
32696264 These organs include the kidney, liver, muscles, nervous system, and spleen.
32697870 The effect of COVID-19 on liver injury has not been fully presented. […] To evaluate the dynamic changes in liver function and the relationship between liver function damage and prognosis in patients with COVID-19. […] Patients were classified as normal, abnormal liver function and liver injury. […] Of 675 patients, 253 (37.5%) had abnormal liver function during hospitalisation, and 52 (7.7%) had liver injury. […] The dynamic changes of ALT and AST levels were more significant in patients with liver injury and in those who died. […] Increased leucocytes, decreased lymphocytes and female sex were independently associated with liver injury. […] The dynamic changes in liver function may have a significant correlation with the severity and prognosis of COVID-19. […] Increased index of liver injury was closely related to mortality and need for mechanical ventilation.
32701969 We measured incident Grade 3 or 4 blood count and liver test abnormalities, ventricular arrhythmias, and vomiting and diarrhea within 10 days after HCQ initiation, and the proportion of patients who completed HCQ therapy. […] Incident blood count and liver test abnormalities occurred in <15% of patients and incident vomiting or diarrhea was rare.
32703730 The impact of SARS-CoV-2 on the quality of care for patients with liver disease is still unknown. […] The Italian Association for the Study of the Liver (AISF) conducted a survey to assess the impact of SARS-CoV-2 on hepatology units activities in Italy. […] All hepatological activities, including the management of patients with decompensated liver disease, liver transplant and HCC had been significantly reduced/stopped. […] This survey can serve as a basis to compare the impact of future measures aimed at delivering an acceptable level of liver care during a national pandemic or crisis.
32705604 However, safety issues related both to the risk of bleeding and to that of developing rare but serious liver and brain damage mostly among children (i.e., Reye’s syndrome) should be considered.
32705906 However, recent data have highlighted the impact of the Sars-CoV-2 related disease namely COVID-19 on the liver. […] Hepatic abnormalities significantly increase during COVID-19 and a more severe infection occurs in patients with pre-existing liver diseases, among which the most frequent is metabolic-associated fatty liver disease (MAFLD). […] It has been described that MAFLD patients had a higher risk of progression to severe COVID-19, higher abnormal liver tests and longer viral shedding time. […] Due to the overgrowing prevalence of MAFLD, it could be speculated that a large proportion of the population might be at risk of severe COVID-19 and the identification of these patients possibly by using liver enzymes as risk predictors may be crucial for an early diagnosis and for the management of the infection.
32706953 Prolongation of the corrected QT interval and elevation of liver-enzyme levels were more frequent in patients receiving hydroxychloroquine, alone or with azithromycin, than in those who were not receiving either agent.
32707089 NAC blocked hemolysis and elevation of liver enzymes, C-reactive protein (CRP), and ferritin and allowed removal from respirator and veno-venous extracorporeal membrane oxygenator and full recovery of the G6PD-deficient patient.
32708319 Results show that Ly6E ablation at hematopoietic stem cells (HSCs) leads to a progressive impaired immune response in both liver and spleen. […] Specifically, depletion of the normal leukocyte mediated immunity and chemokine signaling is observed in the liver of Ly6E Δ H S C mice.
32710250 Except for lung injury, it is possible that COVID-19 patients develop liver injury. […] Thus, we conducted a systematic review and meta-analysis to explore the incidence, risk factors, and prognosis of abnormal liver biochemical tests in COVID-19 patients. […] The incidence of abnormal liver biochemical tests, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma-glutamyl transpeptidase (GGT), total bilirubin (TBIL), and albumin (ALB), was pooled. […] Risk ratio (RR) was calculated to explore the association of abnormal liver biochemical tests with severity and prognosis of COVID-19 patients. […] The pooled incidence of any abnormal liver biochemical indicator at admission and during hospitalization was 27.2% and 36%, respectively. […] Among the abnormal liver biochemical indicators observed at admission, abnormal ALB was the most common, followed by GGT, AST, ALT, TBIL, and ALP (39.8%, 35.8%, 21.8%, 20.4%, 8.8%, and 4.7%). […] Among the abnormal liver biochemical indicators observed during hospitalization, abnormal ALT was more common than AST and TBIL (38.4%, 28.1%, and 23.2%). […] Severe and/or critical patients had a significantly higher pooled incidence of abnormal liver biochemical indicators at admission than mild and/or moderate patients. […] Non-survivors had a significantly higher incidence of abnormal liver biochemical indicators than survivors (RR = 1.34, p = 0.04). […] Abnormal liver biochemical tests are common in COVID-19 patients. […] Liver biochemical indicators are closely related to the severity and prognosis of COVID-19 patients.
32710910 Liver abnormalities in severe acute respiratory syndrome-coronavirus 2 infection, including hepatitis and cholestasis, have been observed in adults and are associated with worse outcomes.
32713118 Abnormal liver function is a common form of extra-pulmonary organ damage in patients with coronavirus disease 2019 (COVID-19). […] Patients with severe COVID-19 have a higher probability and progression of liver injury than those without severe disease. […] We aimed to evaluate the prognosis of liver injury in patients with COVID-19. […] Clinical features and survival of patients with and without liver injury were compared. […] Among the 502 patients enrolled, 301 patients had abnormal liver function with increased neutrophil count, C-reactive protein, creatinine, troponin I (TnI), D-dimer, lactose dehydrogenase and creatine kinase. […] Patients with abnormal liver functions had a higher mortality rate (28.9% vs 9.0%, P < 0.001), a higher ratio of male sex (65.1% vs 40.8%, P < 0.001) and a higher chance of developing systemic inflammatory response syndrome (53.5% vs 41.3%, P = 0.007). […] Among patients with abnormal liver functions, patients with grade 2 liver damage (with both abnormal alanine aminotransferase or aspartate aminotransferase levels and abnormal alkaline phosphatase or gamma-glutamyl transpeptidase levels) had a higher ratio of male patients, elevated neutrophil count, procalcitonin, D-dimer levels and mortality rate. […] Multivariate Cox regression analyses suggested that the grade of liver damage (hazard ratio: 1.377, 95% confidence interval: 1.000-1.896, P = 0.049) was an independent predictor of death. […] Patients with COVID-19 and abnormal liver functions have a higher mortality than those with normal liver functions. […] Liver damage is an independent prognostic factor of COVID-19.
32714077 After comparing the patients between intensive care (ICU) group and non-ICU group, several important factors were found to significantly increase the risk of exacerbations in patients with NCIP, and they included hypertension (RR=2.34; 95% CI=1.21 to 4.51; P=0.01), cardiovascular diseases (RR=2.28; 95% CI=1.13 to 4.58; P=0.02), COPD (RR=7.65; 95% CI=1.24 to 47.13; P=0.03), dyspnea (RR=2.89; 95% CI=2.05 to 4.08; P<0.00001), myalgia or fatigue (RR=1.24; 95% CI=1.01 to 1.52; P=0.04), but several factors such as gender, Huanan Seafood Wholesale Market exposure, diabetes, chronic liver disease, malignancy, fever, cough, expectoration, headache and diarrhoea appeared to have no obvious effect on the exacerbation of pneumonia.
32714688 We reviewed the mechanisms, clinical manifestation, impact on pre-existing liver diseases, and recommendations endorsed by the several GI societies for the management and prevention of its transmission.
32718894 Compared with non-severe patients, severe patients had more obvious abnormal laboratory results related to inflammation, coagulation disorders, liver and kidney damage (all P < 0.05).
32719218 Safety outcomes included an increase in liver transaminases and/or evidence of infection.
32719737 Kidney, Liver and Heart along with coagulopathies.
32720031 This is expressed in human tissues, not only in the respiratory epithelia, but also in the small intestines, heart, liver, and kidneys.
32720223 The skin, the kidneys, the liver, the endocrine organs and the eyes are also affected by the systemic COVID-19 disease.
32720678 We did not find strong evidence that SARS-CoV-2 plays a role in damage of liver and the central nervous system.
32720827 On admission, the platelet count and liver function tests were within normal limits.
32721038 There was mild liver function injury (aspartate aminotransferase, 65.8 ± 12.7 vs 67.4 ± 9.3 U/L, P = 0.246; alanine aminotransferase, 66.4 ± 13.2 vs 69.6 ± 12.7 U/L, P = 0.352), and normal renal function was intact (blood urea nitrogen 6.4 ± 2.5 vs 5.6 ± 2.8 mmol/L P = 0.358; creatinine 85.7 ± 37.2, 91.2 ± 32.6 μmol/L, P = 0.297).
32721533 In patients with severe/fatal COVID-19, the most prevalent chronic comorbidities were obesity (42%, 95% CI 34-49%) and hypertension (40%, 95% CI 35-45%), followed by diabetes (17%, 95% CI 15-20%), cardiovascular disease (13%, 95% CI 11-15%), respiratory disease (8%, 95% CI 6-10%), cerebrovascular disease (6%, 95% CI 4-8%), malignancy (4%, 95% CI 3-6%), kidney disease (3%, 95% CI 2-4%), and liver disease (2%, 95% CI 1-3%). […] No correlation was observed between liver disease and COVID-19 aggravation (OR 1.54, 95% CI 0.95-2.49).
32721580 Recently, the Food and Drug Agency (FDA) and the European Medicines Agency (EMA) recommended remdesivir for the treatment of patients hospitalized with severe coronavirus disease 2019 (COVID-19) infection.1,2 In the remdesivir clinical development program, some cases have raised concerns regarding potential hepatobiliary disorders associated with remdesivir, including in healthy volunteers and patients with COVID-19.3 In cohort studies of patients hospitalized for severe COVID-19 who were treated with compassionate-use remdesivir, elevated hepatic enzymes were the most frequent adverse drug reaction reported.4,5 In the first randomized, double-blind, placebo-controlled clinical trial assessing the effect of intravenous remdesivir in adults admitted to hospital with severe COVID-19 (n = 237), a higher proportion of remdesivir recipients than placebo recipients had dosing prematurely stopped by the investigators because of adverse events including aminotransferase or bilirubin increases (3 versus 0).6 Although there is no signal from the available data of severe hepatotoxicity or drug-induced liver injury in clinical trials, the number of patients exposed to remdesivir was too limited.
32721928 The impact of COVID-19 on liver function is not well described. […] COVID-19 is frequently associated with mild liver function abnormality, particularly in individuals with severe/critical COVID-19 who were older. […] Liver function should be monitored carefully during infection, with judicious use of hepatotoxic agents where possible and avoidance of prolonged hypotension to minimize liver injury in older patients. […] We analyzed the incidence of liver function test (LFT) abnormality in these patients with confirmed COVID-19 infection.
32725453 Abnormal liver enzymes are seen in 20% of hospitalized patients with COVID-19. […] The etiology of elevated liver enzymes is thought to be multifactorial including medications and underlying liver disease. […] The true prevalence and clinical significance of underlying chronic liver diseases (CLD) in COVID-19 remains poorly defined. […] To date, the clinical importance of chronic liver diseases among COVID-19 infection has remained undefined. […] In this novel systematic review and meta-analysis, the presence of underlying chronic liver disease was significantly associated with more severe COVID-19 infections and mortality.
32725890 Liver injury has been reported as a non-pulmonary manifestation of COVID-19 but characterization of liver test abnormalities and their association with clinical outcomes is incomplete. […] Clinical characteristics, liver tests (AST, ALT, ALP, TBIL, albumin) at three time points (pre-infection baseline, admission, peak hospitalization), and hospitalization outcomes (severe COVID-19, ICU admission, mechanical ventilation, death) were analyzed. […] Abnormal liver tests were commonly observed in hospitalized patients with COVID-19, both at admission (AST 66.9%, ALT 41.6%, ALP 13.5%, TBIL 4.3%) and peak hospitalization (AST 83.4%, ALT 61.6%, ALP 22.7%, TBIL 16.1%). […] Most patients with abnormal liver tests at admission had minimal elevations 1-2x ULN (AST 63.7%, ALT 63.5%, ALP 80.0%, TBIL 75.7%). […] A significant proportion of these patients had abnormal liver tests pre-hospitalization (AST 25.9%, ALT 38.0%, ALP 56.8%, TBIL 44.4%). […] Multivariate analysis revealed an association between abnormal liver tests and severe COVID-19, including ICU admission, mechanical ventilation, and death; associations with age, male gender, BMI, and diabetes mellitus were also observed. […] Medications used in COVID-19 treatment (lopinavir/ritonavir, hydroxychloroquine, remdesivir, and tocilizumab) were associated with peak hospitalization liver transaminase elevations >5x ULN. […] Conclusion: Abnormal liver tests occur in most hospitalized patients with COVID-19 and may be associated with poorer clinical outcomes.
32727662 The impact of the virus on the liver is not well known, but in patients with chronic liver disease, mostly in advanced stages, it can critically compromise survival and trigger decompensation. […] Moreover, the pandemic has also negatively impacted patients with liver disease who have not contracted COVID-19, since the reallocation of human and material resources to the care of patients with the virus has resulted in a decrease in the treatment, diagnosis and follow-up of patients with liver disease, which will surely have negative consequences in the near future. […] Efficient reorganization of hepatology units is a priority to minimise the impact of the pandemic on a population as vulnerable as liver disease patients.
32729013 Coronavirus disease 2019 (COVID-19) is associated with elevated liver biochemistries in approximately half of hospitalized patients, with many possible etiologies. […] To assess agreement on the etiology of abnormal liver biochemistries and diagnostic recommendations in COVID-19. […] Kappa agreement between hepatologists on the primary etiology of elevated liver biochemistries was 0.10 (p = 0.03). […] Agreement was greater around drug-induced liver injury 0.51 (p < 0.0001) and SARS-CoV-2-related liver injury 0.17 (p = 0.03). […] Serial liver biochemistries were recommended in all consultations over other evaluations. […] In COVID-19, elevated liver biochemistries present a diagnostic challenge and can often be monitored conservatively.
32729953 Concomitant liver disease could increase the severity of COVID-19 disease, and chronic liver disease patients sometimes require frequent admission and gastrointestinal endoscopy. […] Thus, clarifying the prevalence of asymptomatic COVID-19 in outpatients with liver disease is essential for preventing nosocomial infections. […] We aimed to clarify the time-dependent changes in COVID-19 seroprevalence in liver disease outpatients, who were asymptomatic for COVID-19, in an area of Japan experiencing a second wave of COVID-19. […] We included the preserved sera of 100, 300, and 300 consecutive liver disease outpatients, who were asymptomatic for COVID-19, from May 2019, March 2020, and May 2020, respectively. […] The cumulative seroprevalence of COVID-19 by the Elecsys Anti-SARS-CoV-2 assay in outpatients with liver disease in Sapporo, who were asymptomatic for COVID-19, was 0.17% (1/600; 95% CI, 0.0-0.9%) until May 2020.
32732586 We discuss the pathologic findings of the lungs, gastrointestinal tract, liver, brain, kidneys, heart, and the reproductive and immune systems that are associated with COVID-19.
32733785 The expression level of hACE2 protein was determined to be high in hearts, kidneys, and brains of dTg mice, whereas lung, liver, and testis tissues expressed low levels.
32733980 Prevalence of comorbidities including hypertension, diabetes mellitus, cardiovascular disease, chronic lung disease, chronic kidney disease, malignancies, cerebrovascular diseases, chronic liver disease and smoking were extracted to measure the pooled estimates. […] Other most prevalent finding was diabetes mellitus (DM) in 11%, cerebrovascular disease in 2.4%, cardiovascular disease in 5.8%, chronic kidney disease in 3.6%, chronic liver disease in 2.9%, chronic pulmonary disease in 2.0%, malignancy in 2.7%, and smoking in 8.7% of the patients.
32734407 We examine the incidence of acute on chronic liver failure (ACLF) in COVID-19 patients with pre-existing compensated chronic liver disease (CLD). […] Pre-existing CLD includes those with liver cirrhosis assessed by APRI/FIB-4 score and /or ultrasound; NAFLD as identified by either ultrasound or hepatic steatosis index with significant liver fibrosis and chronic hepatitis B (CHB) or hepatitis C (CHC) infection. […] All patients had liver function test at least twice weekly till discharge with full recovery or death. […] In total, 3 had liver cirrhosis, 6 patients had CHB, 13 had NAFLD with significant liver fibrosis (one also had CHB). […] On admission, none had liver decompensation. […] One patient with CLD had acute-on-chronic liver failure (ACLF).
32738141 The IF pattern was composed of liver and gastric mucosa staining on rat kidney/liver/stomach sections.
32738845 Coronavirus disease 2019 (COVID 2019) outbreak caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is observed to cause liver dysfunction. […] We aimed to observe abnormal liver function tests (LFTs) in COVID-19 patients admitted in our hospital. […] Thorough clinical examination and laboratory investigations including Complete Blood Count, Renal function Tests, Liver Function Tests, Chest X-ray, ECG, etc. were done. […] The prevalence of Abnormal Liver function tests in patients of COVID-19 is 59.04%. […] Abnormal liver functions were more in males.
32740969 Clinical research in hepatology has had a rich tradition in several domains, including the discovery and therapeutic development for diseases such as hepatitis B and C, and studying the natural history of many forms of chronic liver disease.
32744713 Liver injury occurred in all seven cases during the course of the disease. […] The liver function recovered in all patients within one week of conventional liver protection treatment. […] In some cases, especially in patients with severe disease type, COVID-19 may also cause liver injury. […] The liver function of patients with severe COVID-19 should be very carefully monitored, especially if the patients are elderly and have underlying comorbidities.
32745298 In a From the Cover article in this issue of Molecular Ecology, McDonald et al. (2020) compare transcriptomic responses to co-infection by the two chytrid fungi in the skin, liver and spleen of Eastern newts (Notophthalmus viridescens).
32745308 The profiles of liver function abnormalities in COVID-19 patients need to be clarified. […] Liver function abnormalities were observed in 29.1% of the elderly COVID-19 patients, which were slightly and transient in most cases. […] Liver function abnormalities in COVID-19 may be correlated with bacterial infection.
32749642 It is also reassuring that the outcome of COVID-19 is unaffected by the underlying GI disorder or its treatment, though potential concerns remain in regard to the use of immunomodulatory treatments in inflammatory bowel disease (IBD) and liver transplant recipients. […] Decompensation of liver cirrhosis is, however, possible during COVID-19 episodes.
32750019 To be prepared for any possibility, we consider it important to summarize the current knowledge regarding COVID-19 of liver and kidney transplant patients. […] Stop (kidney transplanted patients) or decrease (liver transplanted patients) immunosuppression and maintain corticosteroids when pulmonal injury develops and consider anti-IL1 and anti-IL6 monoclonal antibody use when hyperinflammatory syndrome is evolving.
32750442 Prospective nationwide study including a consecutive cohort of liver transplant patients with Covid-19 recruited during the Spanish outbreak from February 28th to April 7th, 2020. […] Age- and gender-standardized incidence and mortality ratios (SIR and SMR) were calculated using data from the Ministry of Health and the Spanish liver transplant registry. […] A total of 111 liver transplant patients were diagnosed with Covid-19 (SIR=191.2 [95%CI 190.3-192.2]). […] The epidemiological curve and geographic distribution overlapped widely between liver transplant and general populations. […] Being chronically immunosuppressed, liver transplant patients have an increased risk of acquiring Covid-19 but their mortality rates are lower than matched general population.
32754041 Increases in the level of serum liver enzymes, D-dimer, cardiac troponin I, and creatinine have been observed in severely ill patients, indicating that multiple organ failure had occurred in these cases.
32754608 COVID-19 infection can involve multiple body organs other than respiratory tract and lungs such as liver. […] It is hypothesized that COVID-19-associated liver injury can hamper the host drug metabolism and excretion. […] Liver involvement present with the elevation of enzymatic levels of alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT) accompanied by enhanced total bilirubin and decreased albumin levels has been reported in COVID-19 cases. […] One of the major concerns during COVID-19 outbreak is the population with a history of pre-existing liver disorders including viral hepatitis, alcoholic liver disease (ALD), non-alcoholic fatty liver disease (NAFLD), autoimmune hepatitis, hepatic compensated, and decompensated cirrhosis. […] Herein, we discussed the probable correlation between COVID-19 infection and liver damages, particularly chronic and pre-existing liver diseases during COVID-19 outbreak. […] Furthermore, we explained about the liver transplant recipients and post-transplant drugs used in patients with COVID-19 infection. […] Finally, we discussed about the therapeutic medications administered in COVID-19 patients with underlying liver injuries and their significant considerations.
32756323 Emerging evidence has shown its role in liver diseases through the immune system cross-talk. […] We review herein literature data regarding the triangular interaction between gut microbiota, immune system and liver in health and disease. […] We conducted a search on the main medical databases for original articles, reviews, meta-analyses, randomized clinical trials and case series using the following keywords and acronyms and their associations: gut microbiota, microbiome, gut virome, immunity, gastrointestinal-associated lymphoid tissue (GALT), non-alcoholic fatty liver disease (NAFLD), non-alcoholic steato-hepatitis (NASH), alcoholic liver disease, liver cirrhosis, hepatocellular carcinoma. […] The latter maintain health but are also involved in the pathophysiology and in the outcome of several liver diseases, particularly those with metabolic, toxic or immune-mediated etiology. […] In this context, gut virome has an emerging role in liver diseases and needs to be further investigated, especially due to the link reported between severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection and hepatic dysfunctions. […] Changes in gut microbiota composition and alterations in the immune system response are involved in the pathogenesis of metabolic and immune-mediated liver diseases.
32757500 One patient in the 10-day group received RDV for only 5 days because of nausea and elevated liver transaminases. […] Half of the patients developed elevated liver transaminases and three had nausea.
32758298 ◦ Liver enzymes > 5 times the upper normal range.
32758659 Seventeen factors were independently associated with an increased hazard of death, the strongest among them including advanced age, liver cirrhosis, low age-adjusted oxygen saturation, higher concentrations of C-reactive protein and lower estimated glomerular filtration rate.
32758877 Together with the reported markers of liver injury, such hyperinflammatory state may trigger significant derangements in hepatic cytochrome P450 metabolic machinery, and subsequent modulation of drug clearance that may result in unexpected therapeutic/toxic response.
32761128 Moderate disease was present in 40 cases and cardiac injury occurred in 38 cases, following by liver dysfunction in 20 cases and lymphocytosis in no cases.
32761993 With the current coronavirus disease (COVID-19) pandemic and high endemic levels of chronic hepatitis B virus (HBV) infection worldwide, it is urgent to investigate liver function changes of COVID-19 patients with chronic HBV infection, and how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in turn affects the course of chronic HBV infection. […] After PSM, the longitudinal changes of median values for liver biochemistries were not significantly different between the two groups. […] Liver dysfunction presented in COVID-19 patients with/without chronic HBV. […] It is necessary to monitor liver function of COVID-19 patients, as well as HBV-DNA levels for those co-infected with HBV during the whole disease course.
32762168 In addition, in the process of nutrition implementation, it is necessary to closely monitor the adverse reactions such as abdominal distention, diarrhea, regurgitation, phlebitis and liver function damage, timely adjust the nutrition program to ensure the smooth implementation of nutritional support.
32764201 Of 83, 14 (16.8%) had elevated lipase (>3 × ULN), which was associated with higher rates of leukocytosis (P < 0.001) and abnormal liver enzymes (P < 0.01).
32765012 Medical history, imaging data (CT chest findings), and measured hematological and biochemical parameters at diagnosis were recorded in the form of complete blood counts and differential counts; CRP, ESR, serum ferritin, creatinine, and liver function tests .
32765952 Patients with hypertension (odds ratio [OR] = 2.40; 95% CI, 2.08-2.78), cardiovascular disease (CVD) (OR = 3.54; 95% CI, 2.68-4.68), chronic obstructive pulmonary disease (COPD) (OR=3.70; 95% CI, 2.93-4.68), chronic liver disease (CLD) (OR=1.48; 95% CI, 1.09-2.01), chronic kidney disease (CKD) (OR = 1.84; 95% CI, 1.47-2.30), chronic cerebrovascular diseases (OR = 2.53; 95% CI, 1.84-3.49) and chronic gastrointestinal (GI) disease (OR = 2.13; 95% CI, 1.12-4.05) were more likely to develop severe COVID-19.
32766427 The early effects of coronavirus disease 2019 (COVID-19) on transplantation are dramatic: >75% of kidney and liver programs are either suspended or operating under major restrictions.
32766541 Among acute myocardial injury (AMI), acute kidney injury (AKI) and acute liver injury (ALI), the heart was the earliest injured organ, whereas the time from AKI to death was the shortest.
32766543 We present a COVID-19 autopsy series including findings in lungs, heart, kidneys, liver, and bone, from a New York academic medical center.
32766565 Urinary β2-microglobulin, liver-type fatty acid-binding protein were serially measured. […] Urine tests revealed that low β2-microglobulin and liver-type fatty acid-binding protein levels were associated with mild disease, whereas high levels were associated with severe disease. […] In severe cases, liver-type fatty acid-binding protein tended to be persistently high. […] The resulting cutoff values were β2-microglobulin; severe versus moderate + mild: 2,457 μg/dL (specificity 76.9% and sensitivity 90.0%, area under the receiver operating characteristic curve 85.9%), liver-type fatty acid-binding protein; severe versus moderate + mild: 22.0 μg/gCre (specificity 84.6% and sensitivity 90%, area under the receiver operating characteristic curve 91.8%). […] Evaluating urinary biomarkers such as β2-microglobulin and liver-type fatty acid-binding protein may allow determination of coronavirus disease 2019 patients with active cytokines and recognition of patients likely to become critically ill and requiring careful observation and early intervention.
32766815 Four hundred eighty-two SOT recipients from >50 transplant centers were included: 318 (66%) kidney or kidney/pancreas, 73 (15.1%) liver, 57 (11.8%) heart, and 30 (6.2%) lung.
32767788 First, the authors believed that elevated levels of liver injury markers, particularly aspartate aminotransferase (AST), may reflect true hepatic injury in coronavirus disease 2019 (COVID-19). […] However, it should be noted that AST is usually considered a less specific marker for liver injury than alanine aminotransferase (ALT).
32767854 We read with interest the article by Bloom et al reporting liver biochemistry-associated trends, etiologies, and outcomes in 60 patients with coronavirus disease 2019 (COVID-19). […] The authors reported that 69% of the patients had abnormal liver function tests (LFTs) on admission and 93% during their hospital stay, with an aspartate aminotransferase (AST) predominance.
32769260 We aimed to evaluate the distribution of abnormal liver-related biomarkers in patients with coronavirus disease (COVID-19) and explore the prognostic value of elevated liver enzymes and abnormal liver synthetic capacity with regards to patient mortality. […] However, changes in liver-related biomarkers were not associated with poor outcome in multivariate analysis (p > 0.05). […] Moreover, changes in liver-related biomarkers is not a salient feature of COVID-19.
32769892 The items for laboratory tests included blood routine examination, liver function, C-reactive protein, procalcitonin, creatine kinase, creatine kinase-MB, markers of myocardial injury, B-type natriuretic peptide, D-dimer, and so forth.
32770973 The patient had undergone liver transplantation 3 years prior to his referral due to primary sclerosing cholangitis in association with ulcerative colitis and was using immunosuppressive medications. […] Our patient who had liver transplantation and COVID-19 did not present more severe symptoms compared to his counterpart without liver transplantation and did not need to be hospitalized or be given antiviral drugs for COVID-19.
32771032 Those pregnant or lactating, severely dyspneic or with respiratory distress, already undergoing treatment, and with serious comorbidities like liver or kidney failure will be excluded.
32771034 Inclusion Criteria: - Patients with mild COVID19 (defined as upper respiratory tract infection symptoms in the absence of clinical or radiological signs of pneumonia). - Adult (18 - 65 years old). - Written informed consent by the patient (or legally authorized representative) prior to initiation of any study procedures. - All patients should understand and agree to comply with planned study procedures. - Polymerase chain reaction (PCR)-confirmed infection with Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) from throat swab. - Patients with pneumonia or severe illness requiring admission to intensive care unit. - Severe chronic kidney disease (i.e. estimated glomerular filtration rate [eGFR] < 30 mL / min) or end stage renal disease requiring dialysis - Severe chronic liver disease (Alanine transaminase [AlT] or Aspartate transaminase [AST] > 5 times the upper limit of normal). - Pregnancy or breast feeding. - Anticipated transfer within 72 hours to another hospital that is not a study site. - Allergy to the study medication The trial is currently conducted on patients recruited from King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
32771488 Administration of anti-C5 monoclonal antibody eculizumab led to a marked decline in D-dimers and neutrophil counts in all three cases, and normalization of liver functions and creatinine in two.
32773818 The patient’s symptoms (such as fever, chills, dry cough, muscle aches), laboratory tests (such as decreased white blood cell count, elevated liver enzymes and D-dimer, positive viral nucleic acid test), and chest CT (multiple left lower lung plaque ground glass shadow) were similar to those of non-transplanted novel coronavirus pneumonia patients.
32775790 Owing to the coronavirus disease 2019 (COVID-19) pandemic, radiation oncology departments have adopted various strategies to deliver radiation therapy safely and efficiently while minimizing the risk of severe acute respiratory syndrome coronavirus-2 transmission among patients and health care providers. […] One practical strategy is to deliver stereotactic body radiation therapy (SBRT) in a single fraction, which has been well established for treating bone metastases, although it has been infrequently used for other extracranial sites. […] Prospective and retrospective studies supporting a single-fraction regimen are limited, although outcomes are promising for renal cell carcinoma, liver metastases, and adrenal metastases.
32776161 Liver dysfunction has been reported to occur frequently in patients with COVID-19, although its significance has not yet been elucidated. […] Hepatocellular-type liver injury, defined as elevation of the serum AST and/or ALT levels to ≥ 3 times the ULN, was seen in 2 patients (5.7%), and cholestasis-type liver injury, defined as elevation of the serum ALP, γ-GTP and/or total bilirubin levels to ≥ twice the ULN, was seen in 4 patients (11.4%). […] A total of 9 patients (25.7%) fulfilled the criteria for liver injury. […] The percentage of patients with liver injury was higher in patients with severe COVID-19 than in the remaining patients (P = 0.001). […] Both the hepatic CT attenuation values and the liver-to-spleen attenuation (L/S) ratios at admission were lower in the former patients than in the latter patients (P < 0.001). […] Liver dysfunction associated with reduced hepatic CT attenuation values correlated with the disease severity in patients with COVID-19.
32777322 The objective of this analysis was to evaluate the incremental change in hepatitis C liver-related deaths and liver cancer, following a 3-month, 6-month, or 1-year hiatus in hepatitis elimination program progress. […] The “1-year delay” scenario resulted in 44,800 (95% UI: 43,800 - 49,300) excess hepatocellular carcinoma (HCC) cases and 72,300 (95% UI: 70,600 - 79,400) excess liver-related deaths (LRDs), relative to the “no delay” scenario globally, from 2020-2030.
32777784 Abnormal liver function has been reported in patients with COVID-19 infection. […] Aim of our study was to report on the prevalence of liver injury in our cohort, to evaluate the association of mild vs severe liver injury with mortality in COVID-19 patients and to scrutinize the temporal pattern of viral detection and liver injury. […] The patients were divided into three groups according to their liver status during treatment. […] The first group included patients without elevated alanine aminotransferase or bilirubin, the third patients meeting the biochemical criteria of acute liver failure (ALF) and the second all other patients. […] Liver injury was detected in 75 (50.7%) and 93 (63%) patients by admission and during treatment respectively. […] Mortality was associated with the presence of ALF (OR=9.423, 95%CI 2.410-36.858) in contrast to milder liver injury (OR 1.101, 95%CI 0.435-2.791). […] In 30% of patients with mild liver injury and in 50% of ALF patients, peak liver injury was observed at a time point, when the virus was no longer detectable in the respiratory tract. […] Mild liver injury was not associated with worse outcome in our cohort and the pattern of liver injury did not fit well to the theory of SARS-CoV-2 directly causing liver impairment. […] Instead, severe liver injury in our cohort was associated multiple-organ failure and acute vascular events.
32779808 Study cohort consisted of 885 patients, of them 24 SOT recipients (n = 22, kidney, n = 2 liver).
32779820 The most prevalent group was the kidney 57.0%, followed by 17.2% heart, and 13.6% liver.
32783168 The Corona Virus Disease-19 (COVID-19) is not limited to the respiratory system but has widespread involvement including the gastrointestinal (GI) tract and liver, with evidence of prolonged fecal shedding and feco-oral transmission.
32784239 We report the first case of a patient affected with sudden-onset severe pre-eclampsia complicated by acute fatty liver disease of pregnancy, HELLP (haemolysis, elevated liver enzymes and low platelet) syndrome and acute kidney injury following SARS-CoV-2 infection.
32787909 IHC revealed positive cells with a heterogeneous distribution in the lungs of 11 of the 17 (65%) patients; RT-PCR yielded a wide distribution of SARS-CoV-2 in different tissues, with 8 patients showing viral presence in all tested organs (i.e., lung, heart, spleen, liver, colon, kidney, and brain).
32788159 The patient developed hypertension and biological disorders suggesting pre-eclampsia and HELLP (haemolysis, elevated liver enzyme levels and low platelet levels) syndrome. […] Given the severity of ARDS, delivery by caesarean section was contemplated. […] Because the ratio was normal and the patient’s respiratory condition stabilised, delivery was postponed. […] She spontaneously delivered a healthy boy at 33.4 WG.
32788235 From a total of 14 MSI-H metastatic prostate cancer patients at participating centers, nine patients with mCRPC with 56% bone, 33% nodal, 11% liver and 11% soft-tissue metastases and a median PSA of 29.3 ng/dL, were treated with pembrolizumab after 2 lines of therapy for CRPC.
32789044 Banti’s syndrome is a rare disorder characterized by splenomegaly, ascites, and portal hypertension without coexisting cirrhosis of the liver.
32790075 Post-TCZ toxicities evaluated included: elevated liver function tests (LFTs), GI perforation, diverticulitis, neutropenia, hypertension, allergic reactions, and infusion-related reactions.
32791568 Recently, the severity of COVID-19 has been attributed to a systemic, thrombotic, and inflammatory disease that damages not only the lungs but also multiple organs, including the heart, brain, toes, and liver.
32792598 Studies quantifying viral load in the liver are lacking. […] Here we report the clinical and histologic findings related to the liver in 40 patients who died of complications of COVID-19. […] A subset of liver tissue blocks were subjected to polymerase chain reaction (PCR) for viral ribonucleic acid (RNA). […] PCR of liver tissue was positive in 11 of 20 patients tested (55%). […] We also identified viral RNA in a sizeable subset of liver tissue samples.
32793223 They also promote the gut microbiota dysbiosis, increased intestinal permeability, and fatty liver disease.
32793616 Background: Abnormal liver chemistries are common findings in patients with COVID-19. […] It is unclear whether abnormal liver chemistries can predict the severity of COVID-19. […] Therefore, we compared the serum liver chemistries such as hepatic transaminases, total bilirubin, albumin, and prothrombin time to evaluate whether they can predict severity and mortality in COVID-19. […] Methods: An electronic search was performed on PubMed/Medline, EMBASE, and Google Scholar for studies comparing liver chemistries in severe and mild COVID-19. […] The literature search was performed using keywords “COVID-19,” “Liver,” Aspartate Aminotransferase (AST)," and “Alanine Aminotransferase (ALT),” “AST,” and “ALT,” in various combinations of “AND/OR” from December 1, 2019, till May 8, 2020. […] The pooled weighted mean difference (WMD) and 95% confidence interval (CI) were calculated for each component of liver chemistries. […] Seventeen studies compared liver chemistries for severe vs. mild COVID-19, whereas five studies compared liver chemistries in survival vs. non-survival groups. […] Conclusion: Our meta-analysis shows that deranged liver chemistries may indicate severe COVID-19 and could also predict mortality. […] Larger studies are needed to evaluate the relationship between derangement in liver chemistries and mortality in COVID-19.
32793619 Lung injury is the main outcome of COVID-19 infection; however, damage can occur in other organs including the liver. […] Currently, limited data are available that link underlying liver injury with the severe SARS-CoV-2 infection. […] This review summarizes the available data on liver test abnormalities in COVID-19 patients; critically evaluates the possible causes of liver injury and provides recommendations for clinicians. […] In laboratory tests, serum levels of liver test markers notably transaminase, gamma-glutamyl transferase and total bilirubin were significantly higher in severe patients with COVID-19 infection. […] The use of certain drugs especially lopinavir and ritonavir showed an association with the progression of liver damage in severe cases. […] Available data suggest that liver injury in COVID-19 patients may result from direct effect by the virus, immune-mediated inflammation or drug-induced toxicity. […] Some studies demonstrated that COVID-19 patients with pre-existing liver disease are at higher risk for hospitalizations and mortality. […] Therefore, the impact of pre-existing liver disease on treatment and clinical outcomes of COVID-19 should be determined. […] Large-scale clinical studies are needed to identify the causes of liver injury in patients with COVID-19 infection.
32793725 Two patients appeared transient abnormal of liver or renal function indicator, and they can gradually recover.
32794597 The prevalence of nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), have steadily increased and now affect approximately 25% of the global population.
32795165 These were all elective surgeries and included ultrasound-guided Mammotome biopsy, endoscopic polypectomy, hernia repair, pediatric surgeries, cholecystectomy, choledochoscopy, radical mastectomy, percutaneous transhepatic cholangial drainage, liver biopsy, video-assisted thoracoscopic surgery, laparoscopic resection of colon cancer, colostomy apotheosis, and varicose vein surgery.
32796176 Although current literature has addressed gastrointestinal presentations including nausea, vomiting, diarrhea, abnormal liver chemistries, and hyperlipasemia as possible coronavirus disease 2019 (COVID-19) manifestations, the risk and type of gastrointestinal bleeding (GIB) in this population is not well characterized.
32796355 To inform the liver community on the potential relevance of COVID-19, we performed a systematic review and meta-analysis of published data on liver injury in patients with COVID-19 infection. […] The prevalence of pre-existing liver disease was reported at 3.1%. […] Only two studies reported the prevalence of elevated liver function tests according to normal ward versus ICU and here the frequency of elevated levels of AST was 50% and 62% versus ALT 40.8% and thus quantitatively higher in ICU-treated patients. […] Cholestatic liver function tests were only incompletely reported in 510 patients. […] Prospective studies are needed to define the clinical relevance of liver injury in COVID-19.
32800515 Normothermic machine perfusion (NMP) helps safely prolong liver preservation up to 38 hours. […] Here we present the case of a 29-year-old liver transplant recipient in whom prolonged liver preservation required for SARS-CoV-2 screening was accomplished through NMP. […] NMP can extend preservation times in liver transplantation while awaiting SARS-CoV-2 test results and available intensive care unit capacity.
32801291 Diagnostic criteria for rhabdomyolysis are elevated serum creatine kinase, liver enzyme levels, and myalgia. […] Her creatine kinase and liver enzyme levels were significantly elevated. […] The patient’s creatine kinase and liver enzyme levels peaked on Day 2 and then decreased. […] Clinicians should be aware that a significant elevation in liver enzyme levels and myalgia can be the presenting features of rhabdomyolysis in patients with COVID-19.
32801640 Here, we reviewed the literature on clinical effects in COVID-19 patients of these antiviral agents and provided the potential antiviral agent options for pregnant women, elderly patients, liver or renal dysfunction patients, and severe or critically ill patients receiving renal replacement therapy or ECMO after SARS-CoV-2 infection.
32801943 Although liver injury is common in patients with COVID-19, little is known about its clinical presentation and management in liver transplantation. […] This is the first report from Iran that presented two cases of liver transplantation with COVID-19, neither of which had pulmonary signs and symptoms, but after diagnostic imaging, both had lung involvement. […] We also reviewed some literature on the management of COVID-19 in liver transplant patients.
32803231 Although the clinical manifestations of COVID-19 are dominated by respiratory symptoms, some patients present other severe damage such as cardiovascular, renal and liver injury or/and multiple organ failure, suggesting a spread of the SARS-CoV-2 in blood.
32803716 There is a paucity of data on the clinical presentations and outcomes of Corona Virus Disease-19 (COVID-19) in patients with underlying liver disease. […] Patients with known chronic liver disease who presented with superimposed COVID-19 (n = 28) between 22 April 2020 and 22 June 2020 were studied. […] A total of 28 COVID-19 patients (two without cirrhosis, one with compensated cirrhosis, sixteen with acute decompensation [AD], and nine with acute-on-chronic liver failure [ACLF]) were included. […] The etiology of cirrhosis was alcohol (n = 9), non-alcoholic fatty liver disease (n = 2), viral (n = 5), autoimmune hepatitis (n = 4), and cryptogenic cirrhosis (n = 6).
32804803 The weekly organ donation and liver transplant numbers over a 3-month period (17th Feb 2020 till 17th May 2020) for the USA, UK and India were compared to their previous year’s activity. […] Liver transplant activity in 6 centers from these countries with varying local COVID-19 caseload was also compared. […] The COVID-19 pandemic has led to a significant contraction in organ donation and liver transplantation in all 3 countries. […] The reduction was different for deceased donor and living donor liver transplantation and varied between centers within a country. […] There was early evidence of recovery of deceased donation in the USA and UK and resumption of living donor liver transplantation activity in India towards the end of the study period. […] There was a substantial reduction in organ donation and liver transplantation activity across the 3 countries with signs of recovery towards the end of the study period.
32805726 On the premise of similar demographics between both groups, patients with COVID-19 pneumonia had worse indicators of liver and coagulation function.
32806897 There was also an abnormal lipoprotein, glucose, and amino acid signature consistent with diabetes and coronary artery disease (low total and HDL Apolipoprotein A1, low HDL triglycerides, high LDL and VLDL triglycerides), plus multiple highly significant amino acid markers of liver dysfunction (including the elevated glutamine/glutamate and Fischer’s ratios) that present themselves as part of a distinct SARS-CoV-2 infection pattern. […] The breadth of the disturbed pathways indicates a systemic signature of SARS-CoV-2 positivity that includes elements of liver dysfunction, dyslipidemia, diabetes, and coronary heart disease risk that are consistent with recent reports that COVID-19 is a systemic disease affecting multiple organs and systems.
32807512 Studies have shown mild to moderate elevation of liver enzymes. […] The pattern of liver abnormalities can be hepatocellular, cholestatic or mixed. […] Patients with severe infection have significantly higher rates of liver injury and worse outcomes. […] Patients with diarrhea and liver disease may have a worse prognosis.
32808185 Besides lung drastic involvement, SARS-CoV-2 severely affected other systems including liver. […] Emerging epidemiological studies brought the attentions towards liver injury and impairment as a potential outcome of COVID19. […] Understanding that may reflect how such medications may affect the level of infectivity and permissibility of the liver following COVID-19.
32810894 We report the clinical and biochemical features of liver involvement, and the comorbidities that present with hepatitis, in a substantial cohort of patients. […] We evaluated the number of patients who developed hepatitis and examined both demographics and inflammatory laboratory values to ascertain those that were at higher risk for liver involvement and more severe disease. […] The single patient with liver failure also developed multiorgan failure requiring vasopressors, hemodialysis, and mechanical ventilation. […] Despite the positive outcomes reported here, close follow-up is warranted given the limited knowledge of the long-term impact of SARS-CoV-2 on the liver.
32816615 Various scientific studies demonstrated that Sumac had a free oxygen radical-scavenging effect, a protective effect against liver damage, antihemolytic, leukopenia, and antifibrogenic effects, along with its antiviral, antimicrobial, anti-inflammatory, and antioxidant properties.
32818235 Trends observed by serial laboratory measurements during hospitalization including progressive decrease of lymphocyte count, thrombocytopenia, elevated CRP, procalcitonin, increased liver enzymes, decreased renal function, and coagulation derangements were more common in critically ill patient groups and associated with a high incidence of clinical complications.
32821882 Drugs that contain phosphates (and phosphonates or phosphinates) have intrinsic absorption issues and are therefore often delivered in prodrug forms to promote their uptake. […] The recent emergency use authorization of the antiviral remdesivir for COVID-19 exemplifies a new approach for delivery of phosphate prodrugs by parenteral dosing, which minimizes payload release during transit and maximizes tissue payload distribution. […] Through examining prior structure-activity studies on prodrug forms and the choices that led to development of remdesivir and other clinical drugs and drug candidates, a better understanding of their ability to distribute to the planned site of action, such as the liver, plasma, PBMCs, or peripheral tissues, can be gained.
32825963 Herein, we thoroughly reviewed multiple organs including lung, gastrointestinal tract, liver, kidney, skin, heart, blood, spleen, lymph nodes, brain, blood vessels, and placenta in terms of COVID-19-related pathological alterations.
32826529 We evaluated FFPE sections from 8 COVID-19 autopsies, including 19 pulmonary and 39 extrapulmonary samples including the heart, liver, kidney, small intestine, skin, adipose tissue, and bone marrow. […] ISH, IHC, and qRT-PCR failed to detect the virus in the heart, liver, and kidney.
32826796 We present 53 SOT recipients (31 kidney, 8 liver, 5 heart, 5 lung, 3 liver-kidney and one kidney-after-heart), transplanted at a Swedish high-volume transplant center and each diagnosed with COVID-19 between February 21, 2020, and June 22, 2020.
32834950 The novel PBPK model allows in-depth description of the pharmacokinetics of CQ in several key organs (lung, heart, liver, and kidney), and was applied to design dosing strategies in patients with acute COVID-19 (Day 1: 750 mg BID, Days 2-5: 500 mg BID, CQ phosphate), patients with moderate COVID-19 (Day 1: 750 mg and 500 mg, Days 2-3: 500 mg BID, Days 4-5: 250 mg BID, CQ phosphate), and other vulnerable populations (e.g., renal and hepatic impairment and elderly patients, Days 1-5: 250 mg BID, CQ phosphate).
32835190 During the early stages of the coronavirus disease 2019 (COVID-19) pandemic, EASL and ESCMID published a position paper to provide guidance for physicians involved in the care of patients with chronic liver disease. […] In addition, many studies have been published focusing on how COVID-19 may affect the liver and how pre-existing liver diseases might influence the clinical course of COVID-19. […] While many aspects remain poorly understood, it has become increasingly evident that pre-existing liver diseases and liver injury during the disease course must be kept in mind when caring for patients with COVID-19. […] This review should serve as an update on the previous position paper, summarising the evidence for liver disease involvement during COVID-19 and providing recommendations on how to return to routine care wherever possible.
32835245 An increase in liver aminotransferases occurred in seven (13%) patients in the anakinra group and four (9%) patients in the historical group.
32836899 Pathological changes are primarily found in lung tissues but there are also reports concerning direct or indirect (histo)pathological changes due to SARS-CoV‑2 infections in samples from the kidneys, liver and myocardium.
32837094 A cross-sectional online survey was conducted between 23rd March 2020 and 1st April 2020 among 154 liver transplant recipients, transplanted between October 2018 and February 2020. […] Our liver transplant recipients have a reasonable awareness regarding COVID-19.
32837750 Adverse events, serious adverse events, liver function, kidney function and concurrent treatments will be monitored and recorded throughout the trial.
32837834 Hence, in this study, a meta-analysis was undertaken to quantify the overall risk of liver damage in COVID-19 patients and also find the overall variation in risk outcome. […] The pooled means reported in this study can be useful for working out the degree of liver damage in COVID-19 patients.
32838045 They evaluated the liver-to-spleen ratio (CTL/S) and defined tomographic steatosis as a CTL/S index ≤0.9.
32838102 Liver enzymes were repeated during SARS-CoV-2 infection in all hospitalized cases; they remained within the normal range in all cases, and improved in the two acute cases treated with high-dose steroids.
32838103 This pandemic has taxed our healthcare system and disrupted normal operations, even of lifesaving procedures like liver transplants. […] Continuing to perform resource intense advanced procedures is challenging, as is caring for patients with end-stage liver disease or patients with urgent needs for liver tumor control. […] Liver transplantation in particular requires critical resources like blood products and critical care beds, which are fairly limited in the COVID19 pandemic. […] Therefore, transplant programs must re-evaluate the ethicality, feasibility, and safety of performing liver transplants during this pandemic. […] Herein, we discuss the clinical and ethical challenges posed by performing liver transplants and offer guidance for managing patients with end-stage liver disease during the COVID19 pandemic.
32838104 Although abnormal liver chemistries are linked to a higher risk of coronavirus disease 2019 (COVID-19)-related death, liver manifestations may be diverse and even confusing. […] Thus, we performed a meta-analysis of published liver manifestations and described the liver damage in patients with COVID-19 who died or discharged alive. […] We analyzed pooled data on liver chemistries stratified by the main clinical outcome of COVID-19, using a fixed or random-effects model. […] In this meta-analysis, according to the main clinical outcome of COVID-19, we comprehensively described three patterns of liver impairment related to COVID-19, hepatocellular injury, cholestasis, and hepatocellular disfunction. […] The patients who died from COVID-19 tended to have different liver chemistries from those discharged alive. […] Special caution should be given to the patients with relatively higher index of liver chemistries.
32838105 Despite the emergency situation, all efforts have been done to preserve liver transplant (LT) activity and to minimize the impact of current scenario on transplant waiting list time and mortality. […] We report here the case of a young patient requiring inpatient care due to severe decompensated liver disease (MELD 24), justifying her referral from her local hospital to our high-volume LT unit, despite the unfavourable COVID-19 epidemiology in our Region. […] She was quickly listed for liver transplant (MELD 26), but 5 days later she was incidentally diagnosed with COVID-19 in the setting of our surveillance program for very sick patients and, despite her underlying condition, had an indolent course of the viral disease. […] Concerns about potential COVID-19 consequences in a LT candidate were overruled by the severity of liver disease (MELD 36), forcing our team to proceed with an urgent successful LT as soon as 9 days after the COVID-19 diagnosis, 2 days after the first negative SARS-CoV-2 RNA by a nasopharyngeal swab and 1 day after the confirmation of its negativity on bronchoalveolar lavage.
32838106 Initially, in the 82 patients without chronic liver disease and alcohol history; age older than 40 years (P = 0.027); male gender (P = 0.0145); elevated CRP (P = 0.0366), ALT (P < 0.0001), and ALP (P = 0.0003); and increased TGs (P = 0.0002) were found to be associated with elevated GGT levels. […] This elevation supports involvement of the liver in persons with COVID-19.
32838107 We aimed to describe the changes in liver care before and after COVID-19 restricted access to health care. […] We obtained data on the number of liver clinic visits, abdominal ultrasound, computed tomography, and magnetic resonance imaging using electronic query or clinic registry at three medical centers in the United States, Japan, and Singapore for the following periods: February 1 to March 14, 2018, 2019, and 2020; and March 15 to May 1, 2018, 2019, and 2020. […] In total, 14,403 visits were made to the liver clinics at the three centers: 5,900 in 2018, 5,270 in 2019, and 3,233 in 2020. […] There were significant decreasing trends in the total number of liver clinic visits overall (p-trend = 0.038) and in the subanalysis for chronic hepatitis B, C, and other liver diseases. […] Conclusion: Liver clinic visits, hepatoma surveillance, and diagnostic abdominal imaging fell dramatically as social distancing measures were instituted.
32838108 Previous studies reported that coronavirus disease 2019 (COVID-19) was likely to result in liver injury. […] However, few studies investigated liver injury in COVID-19 patients with chronic liver diseases. […] We described the clinical features in COVID-19 patients with non-alcoholic fatty liver disease (NAFLD). […] 100 (35.7%) patients presented abnormal liver function on admission. […] No patient developed liver failure or death during hospitalization. […] NAFLD patients are more likely to develop liver injury when infected by COVID-19. […] However, no patient developed severe liver-related complications during hospitalization.
32838177 It is still unknown the way coronavirus damages the liver, brain, and reproductive system.
32839667 Over the last decade, a rapid rise in deaths due to liver disease has been observed especially amongst young people. […] Nowadays liver disease accounts for approximately 2 million deaths per year worldwide: 1 million due to complications of cirrhosis and 1 million due to viral hepatitis and hepatocellular carcinoma. […] Besides primary liver malignancies, almost all solid tumours are capable to spread metastases to the liver, in particular, gastrointestinal cancers, breast and genitourinary cancers, lung cancer, melanomas and sarcomas. […] A big portion of liver malignancies undergo palliative care. […] To this end, the paradigm of the palliative care in the liver cancer management is evolving from “just end of the life” care to careful evaluation of all aspects relevant for the survivorship. […] In the presented study, an evidence-based approach has been taken to target molecular pathways and subcellular components for modelling most optimal conditions with the longest survival rates for patients diagnosed with advanced liver malignancies who underwent palliative treatments. […] In conclusion, multi-faceted cancer control within the palliative care of liver malignancies is crucial for improved disease outcomes including individualised patient profiling, predictive models and implementation of corresponding cost-effective risks mitigating measures detailed in the paper.
32839726 SARS-CoV-2 is not only responsible for causing pneumonia, but there are also concerns regarding the involvement of other organs such as the heart, liver, and kidneys.
32839751 After 5 days, blood analyses revealed normal hemoglobin, PT-INR 2.15, and a slight alteration of liver function.
32840571 We reported two fatal cases of acute liver failure secondary to Herpes Simplex Virus 1 infection in COVID-19 patients, following tocilizumab and corticosteroid therapy.Screening for and prompt recognition of Herpes Simplex Virus 1 reactivation in these patients, undergoing immunomodulatory treatment, may have potentiallyrelevant clinical consequences.
32841167 Patients treated with antivitamin K anticoagulants and with liver disease were excluded.
32842793 Considering that the most severely impacted group of patients are already suffering from other conditions, accessing the impact that metabolic associated fatty liver disease (MAFLD), obesity, and diabetes has on patients by sharing information between different healthcare facilities is of vital importance.
32843598 We present a case of COVID-19 diagnosed during the early postoperative period in a recipient whose liver transplantation was performed on late March during the lockdown in Spain, with donor and recipient previously negative rRT-PCR to SARS-CoV-2. […] To date, few early post-liver transplantation SARS-CoV-2 infected recipients have been published, but only one was an early postoperative infection. […] In our case the outcome was favorable, even though it was an early post -liver transplantation COVID-19 in a frail patient.
32845926 We analyzed 11 comorbidities: cardiovascular diseases, hypertension, diabetes, congestive heart failure, cerebrovascular disease, chronic kidney disease, chronic liver disease, cancer, chronic obstructive pulmonary disease, asthma, and HIV/AIDS.
32848621 SARS-CoV-2 is reported to be able to infect the lungs, the intestines, blood vessels, the bile ducts, the conjunctiva, macrophages, T lymphocytes, the heart, liver, kidneys, and brain.
32850926 In addition, univariate and multivariate Cox analyses of potential factors for poor outcome patients indicated that cytokine storms and uncontrolled inflammation responses as well as liver, kidney, and cardiac dysfunction are related to the development of a poor outcome. […] We found that cytokine storms and uncontrolled inflammation responses as well as liver, kidney, and cardiac dysfunction may play important roles in the final outcome of severely ill patients with COVID-19.
32851063 During disease progression, the amounts of arterial gases worsened, and liver, renal, and heart dysfunction was observed.
32851877 Cardiovascular, liver, kidneys, gastrointestinal and central nervous systems are involved with different frequencies and degrees of severity.
32855179 Patients with COVID-19 commonly have elevated liver enzyme levels, which is associated with adverse outcomes during hospitalization including increased risk of ICU admission, intubation, and mortality. […] When assessing these patients, it is important to consider causes of liver injury unrelated to COVID-19. […] Therapies for COVID-19 may increase liver enzyme levels but are not contraindicated in patients with baseline abnormal liver tests. […] Liver enzymes should be regularly monitored in all hospitalized patients with COVID-19. […] Patients with preexisting liver disease such as cirrhosis and those who have received a liver transplant may be an increased risk of severe COVID-19 outcomes.
32855361 Previous work has described acute liver injury (ALI) in coronavirus disease 2019 (COVID-19) pneumonia patients, However, there is limited analyses available investigating chronic liver disease (CLD) in COVID-19 patients. […] The CLD group contained a higher mortality rate and slight liver injury. […] COVID-19 patients also diagnosed with CLD suffered longer LOS, slight liver injuries and a higher mortality when compared to COVID-19 patients without CLD.
32856702 The fibrosis-4 index (FIB-4), developed to predict fibrosis in liver disease, was used to identify patients with COVID-19 who will require ventilator support as well as associated with 30-day mortality.
32858226 Liver dysfunction is one of the most striking affections among patients suggesting that SARS-CoV-2 may represent a new king of liver aggressor. […] In this work, we overview the most recent findings between the molecular biology of the virus, pathogenic mechanisms, and its relationship to liver disease observed in patients.
32859408 The primary involvement is respiratory; however, the virus can also affect other organs, such as the gastrointestinal tract and liver.
32859555 In Italy, liver transplant activity was carried on, but despite all efforts, a 25% reduction of procured organs has already been observed during the first 4 weeks of the outbreak. […] We compared the liver transplants performed in our Center between February 24th and April 17th, 2020 with liver transplants performed in the same period in 2019. […] In 2020, 21 patients underwent liver transplantation from deceased donors, exactly as the year before, without statistically significant difference. […] We were able to perform 3 multiorgan transplants and one acute liver failure. […] Team working allowed our Center to maintain its activity level, taking care of patients before and after liver transplantation.
32860214 Furthermore, severe and fatal courses are associated with organ damages mainly affecting the heart, liver and kidneys.
32861070 The typically clinical characteristics of COVID-19 patients were fever and respiratory symptoms, and a proportion of patients were accompanied by extrapulmonary symptoms including cardiac injury, kidney injury, liver injury, digestive tract injury, and neurological symptoms. […] The mRNA expressions of both ACE2 and TMPRSS2 were observed in the heart, digestive tract, liver, kidney, brain and other organs.
32864162 We also identified other variants, that are associated with adverse effects, most notable in hydroxychloroquine/chloroquine (G6PD; hemolysis), ribavirin (ITPA; hemolysis), and interferon β -1b (IRF6; liver toxicity).
32864178 The lung is the main target organ attacked by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) while immune organs, liver, blood vessels and other organs are damaged to varying degrees. […] Liver volume is increased, and mild active inflammation and focal necrosis are observed in the portal area. […] Virus particles have also been detected in liver cells.
32864250 Background and Aims The prevalence and extent of liver damage in coronavirus disease 2019 (COVID-19) patients remain poorly understood, primarily due to small-sized epidemiological studies with varying definitions of “liver injury”. […] We conducted a meta-analysis to derive generalizable, well-powered estimates of liver injury prevalence in COVID-19 patients. […] We also aimed to assess whether liver injury prevalence is significantly greater than the baseline prevalence of chronic liver disease (CLD). […] Our secondary aim was to study whether the degree of liver injury was associated with the severity of COVID-19. […] Materials and Methods Electronic databases (PubMed and Scopus) were systematically searched in June 2020 for studies reporting the prevalence of baseline CLD and current liver injury in hospitalized COVID-19 patients. […] Liver injury was defined as an elevation in transaminases >3 times above the upper limit of normal. […] For the secondary analysis, all studies reporting mean liver enzyme levels in severe versus non-severe COVID-19 patients were included. […] Among a cohort of 8,817 patients, the prevalence of current liver injury was 15.7% (9.5%-23.0%), and this was significantly higher than the proportion of patients with a history of CLD (4.9% [2.2%-8.6%]; p < 0.001). […] Conclusions Patients with COVID-19 have a higher than expected prevalence of liver injury, and the extent of the injury is associated with the severity of the disease.
32864332 But the rate of abnormal liver function in the combined medication group is higher than that in the single LH group.
32865077 About 20% of patients had abnormal liver function.
32865603 COVID-19 affects the upper respiratory tract, lungs (pneumonia, acute respiratory distress syndrome [ARDS]), heart, liver, gastrointestinal tract, and other organs.
32866433 Despite concerns that patients with liver transplants might be at increased risk of adverse outcomes from COVID-19 because of coexisting comorbidities and use of immunosuppressants, the effect of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on this patient group remains unclear. […] In this multicentre cohort study, we collected data on patients with laboratory-confirmed SARS-CoV-2 infection, who were older than 18 years, who had previously received a liver transplant, and for whom data had been submitted by clinicians to one of two international registries (COVID-Hep and SECURE-Cirrhosis) at the end of the patient’s disease course. […] For comparison, data from a contemporaneous cohort of consecutive patients with SARS-CoV-2 infection who had not received a liver transplant were collected from the electronic patient records of the Oxford University Hospitals National Health Service Foundation Trust. […] A propensity score-matched analysis was done to test for an association between liver transplant and death. […] Between March 25 and June 26, 2020, data were collected for 151 adult liver transplant recipients from 18 countries (median age 60 years [IQR 47-66], 102 [68%] men, 49 [32%] women) and 627 patients who had not undergone liver transplantation (median age 73 years [44-84], 329 [52%] men, 298 [48%] women). […] The groups did not differ with regard to the proportion of patients hospitalised (124 [82%] patients in the liver transplant cohort vs 474 [76%] in the comparison cohort, p=0·106), or who required intensive care (47 [31%] vs 185 [30%], p=0·837). […] However, ICU admission (43 [28%] vs 52 [8%], p<0·0001) and invasive ventilation (30 [20%] vs 32 [5%], p<0·0001) were more frequent in the liver transplant cohort. 28 (19%) patients in the liver transplant cohort died, compared with 167 (27%) in the comparison cohort (p=0·046). […] In the propensity score-matched analysis (adjusting for age, sex, creatinine concentration, obesity, hypertension, diabetes, and ethnicity), liver transplantation did not significantly increase the risk of death in patients with SARS-CoV-2 infection (absolute risk difference 1·4% [95% CI -7·7 to 10·4]). […] Multivariable logistic regression analysis showed that age (odds ratio 1·06 [95% CI 1·01 to 1·11] per 1 year increase), serum creatinine concentration (1·57 [1·05 to 2·36] per 1 mg/dL increase), and non-liver cancer (18·30 [1·96 to 170·75]) were associated with death among liver transplant recipients. […] Liver transplantation was not independently associated with death, whereas increased age and presence of comorbidities were. […] Factors other than transplantation should be preferentially considered in relation to physical distancing and provision of medical care for patients with liver transplants during the COVID-19 pandemic. […] European Association for the Study of the Liver, US National Institutes of Health, UK National Institute for Health Research.
32867706 Leucopenia and lymphopenia were the most common signs of infection while liver and kidney damage were rare but may cause bad outcomes for patients.
32868652 Nonalcoholic fatty liver disease (NAFLD) represents the hepatic manifestation of metabolic syndrome. […] We performed a retrospective, case-control study, enrolling 71 consecutive COVID-19 patients who were divided into two groups according to the presence or absence of fatty liver by computed tomography scan.
32871990 The patient was also found to have liver damage. […] On the 21st day after discharge, the patient had no recurrence of disease, no recurrence of pulmonary lesions, and normal liver function.
32873520 Inflammatory cytokines such as interleukin-6 (IL-6) cause acute liver injury while serum detectability indicates systemic inflammation. […] We explored a link between systemic IL-6, related acute phase proteins and liver injury in hospitalized COVID-19 patients. 655 patients with suspected COVID-19 were screened in the emergency department at the University Hospital of Innsbruck, Austria, between February and April 2020. 96 patients (∼15%) were hospitalized with COVID-19. 15 patients required intensive-care treatment (ICT). […] Liver injury correlated with systemic IL-6 (p < 0.001), CRP (p < 0.001), ferritin (p < 0.001) and LDH (p < 0.001) concentration.
32875925 From the Western-blot and activity-analysis it was observed that Nigellidine (sulfuryl-group-drug) showed no impact on Phenol-catalyzing ASTIV and Steroid-catalyzing estrogen-sulfotransferase expressions and activities in liver-tissue and thus has no influence in sulfation-mediated adverse metabolic-processes.
32876011 Both cases were observed to have elevated liver transaminases, which is consistent with other studies.
32876633 The goal of this review is to present what has been described in recent studies, published worldwide and including our country, that have reported clinical manifestations, outlining possible mechanisms of liver dysfunction related to COVID-19 and its repercussions, especially on the digestive system. […] These studies analyze and discuss the potential impact on liver diseases, offering recommendations of experts and scientific organizations regarding prevention, control and management measures, outlining also some public health strategies in our country for the proper care of COVID-19 patients in times of widespread crisis.
32878840 The patient had deranged liver function tests at presentation, along with elevated bile acids. […] With supportive management, this patient improved enough to be discharged, and has gone on to deliver a healthy neonate at term.
32879103 A few critically ill patients may not only rapidly develop into acute respiratory distress syndrome, but also may cause coagulopathy, as well as multiple organs failure (such as heart, liver and kidney) or even death.
32879106 To analyze the clinical characteristics in patients of coronavirus disease 2019 (COVID-19) complicated with liver injury, to explore the relationship between COVID-19 clinical classification and liver injury, and to elucidate whether COVID-19 complicated with hepatitis B virus can aggravate liver injury. […] The abnormal liver function in 110 patients in the First Hospital of Changsha, who were confirmed COVID-19 and admitted to the designated hospital from January 17, 2020 to February 20, 2020, wereretrospectively analyzed. […] A total of 49.1% of the COVID-19 patients had liver injury. […] There was also no significant difference in the liver function injury between the HBsAg-positive COVID-19 patients and HBsAg-negative COVID-19 patients (P>0.05). […] Acute liver injury was not found to be a direct cause of death in the patients. […] In the COVID-19 patients, the incidence of liver injury is high with the increase of ALT and AST and the decrease of ALB. […] Severe and critical patients have obvious liver injury, and those patients complicated with hepatitis B virus infection don’t show aggravated liver injury.
32879591 Several clinical studies refer to liver injury as the most frequent clinical extrapulmonary manifestation. […] In this review, we summarize the available clinical data concerning liver injury during COVID-19. […] Although the underlying mechanism of liver impairment is somewhat unclear, transaminases and bilirubin levels are elevated in a substantial proportion of patients. […] Moreover, more severe alterations in liver enzymes may correlate with a worse clinical course of COVID-19. […] However, several other cofactors, such as drug-induced liver injury, hyper-inflammatory response to infection, hypoxic hepatitis or preexisting underlying liver disease, cannot be excluded.
32879813 The overwhelming pathology seems to be in the upper and lower respiratory tract; however, the involvement of other organs, including the liver, has also been reported. […] Whether liver enzyme derangement is a common feature of COVID-19 is not known. […] For those patients who have concomitant liver enzyme derangement with COVID-19, the prevalence, extent, and rate of progression to liver failure is not known. […] In view of unclear evidence regarding this, we conducted a systematic review of the literature on liver injury in COVID-19 patients. […] The aim of this review was to ascertain whether liver enzyme derangement is a common feature in adult patients with confirmed COVID-19 infection, determine the relation of deranged liver enzymes with outcome or mortality in COVID-19, and determine if liver failure is a common feature of COVID-19. […] Cross-sectional studies and case-control studies involving adult patients with confirmed COVID-19 and having data on liver enzymes were included. […] Many of the COVID-19 patients in the various studies had a varying degree of deranged liver enzymes. […] Severe liver injury causing significant liver damage, liver failure, or death is uncommon. […] The main limitations of the study were the heterogeneity of studies and incomplete data on the trajectory of liver tests during the disease course as well as the final outcomes of the patients in the studies.
32879836 Extrapulmonary manifestations of coronavirus disease 2019 (COVID-19) include thrombotic like pulmonary emboli, acute cerebrovascular accident, myocardial infarction, cardiac arrhythmias, liver injury, gangrene, diarrhea, acute renal failure, and so on.
32880667 The articles address (1) pulmonary valve repair in patients with tetralogy of Fallot and in patients with congenital pulmonary stenosis which seems to be a promising technique in selected patients, (2) the use of Losartan in patients with Marfan syndrome mostly in addition to beta blockers may result in a lower aortic root dilation rate and better clinical outcomes, (3) a summary of the characteristics of adults with congenital heart disease in the USA showed a wide variation in prevalence, associated morbidities, health care utilization and insurance type in different locations in the USA, (4) a large single center study confirmed that right ventricular morphology is associated with worse outcomes after the Fontan operation and that atrioventricular valve regurgitation is an important predictor of worse outcomes and precedes ventricular dysfunction post Fontan operation, (5) a large study describing the multi system inflammatory syndrome in children temporarily related to the COVID-19 pandemic in the USA showing that ventricular dysfunction is the most common cardiac manifestation (6) the reality of “limping to transplantation” showing that patients with one or more modifiable risk factors including mechanical ventilation, kidney or liver dysfunction are at significant increase risk post cardiac transplantation.
32882393 Data on the prevalence and degree of COVID-19 associated liver injury among patients with COVID-19 remain limited. […] We conducted a systematic review and meta-analysis to assess the prevalence and degree of liver injury between patients with severe and non-severe COVID-19. […] COVID-19 associated liver injury is more common in severe COVID-19 than non-severe COVID-19. […] Physicians should be aware of possible progression to severe disease in subjects with COVID-19-associated liver injury.
32884218 Viral RNA has also been detected in stool and blood samples, indicating the possibility of liver damage, which has been reported in COVID-19 patients. […] The presence of chronic liver disease appears to be a risk factor for severe complications and a poorer prognosis, however data from these cases is lacking.
32884226 We investigated the clinical characteristics and risk factors for liver injury in COVID-19 patients in Wuhan by retrospectively analyzing the epidemiological, clinical, and laboratory data for 218 COVID-19 patients and identifying the risk factors for liver injury by multivariate analysis. […] To investigate the clinical characteristics and risk factors for liver injury in COVID-19 patients in Wuhan. […] Patients with liver injury were older than those with normal liver function by a median of 12 years, with a significantly higher frequency of males (68.4% vs 28.8%, P < 0.001) and more coexisting illnesses (48.1% vs 27.3%, P = 0.002). […] Significantly more patients had fever and shortness of breath (87.3% vs 69.8% and 29.1% vs 14.4%, respectively) in the liver injury group. […] Patients with severe liver injury had a significantly higher frequency of abnormal transaminases than non-severe patients, but only one case had very high levels of aminotransferases. […] Multivariate analysis revealed that male sex, high D-dimer level, and high neutrophil percentage were linked to a higher risk of liver injury. […] Male sex and high D-dimer level and neutrophil percentage may be important predictors of liver injury in patients with COVID-19. […] Male sex and high D-dimer level and neutrophil percentage may be important predictors of liver injury in patients with COVID-19.
32884603 However, during metabolism about 60% of both the drugs remain unchanged and about 40% of the drugs are metabolized into two metabolites, desethylchloroquine and bisdesethylchloroquine by the action of the cytochrome P450 (CYP) enzymes in the liver.
32886333 Liver injury is found in some of patients with COVID-19. […] Liver injury of COVID-19 patients based on severity grading and abdominal radiological signs have not been reported until now. […] Abnormal liver function was observed in some of patients with COVID-19. […] Common findings of upper abdominal CT scan were liver hypodensity (26.09%) and pericholecystic fat stranding (21.27%); liver hypodensity was more frequently found in critical cases (58.82%). […] The severity of COVID-19 correlated with semi-quantitative CT score of pulmonary lesions, CT-quantified liver/spleen attenuation ratio in patients with COVID-19. […] Some of the patients with COVID-19 displayed liver damage revealed by liver functional tests and upper abdominal CT imaging, and the severity of COVID-19 patients correlated with some of liver functional tests and CT signs; thus, it will allow an earlier identification of high-risk patients for early effective intervention.
32886936 Liver injury can result from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with more than one-third of COVID-19 patients exhibiting elevated liver enzymes. […] Microvesicular steatosis, inflammation, vascular congestion, and thrombosis in the liver have been described in autopsy samples from COVID-19 patients. […] Several factors, including direct cytopathic effect of the virus, immune-mediated collateral damage, or an exacerbation of preexisting liver disease may contribute to liver pathology in COVID-19. […] Due to its immunological functions, the liver is an organ likely to participate in the viral response against SARS-CoV-2 and this may predispose it to injury. […] A better understanding of the mechanism contributing to liver injury is needed to develop and implement early measures to prevent serious liver damage in patients suffering from COVID-19. […] This review summarizes current reports of SARS-CoV-2 with an emphasis on how direct infection and subsequent severe inflammatory response may contribute to liver injury in patients with and without preexisting liver disease.
32887569 Her condition rapidly worsened leading to severe liver and coagulation impairment. […] Severe COVID-19 promptly improved by the termination of the pregnancy or atypical HELLP (Hemolysis, Elevated Liver Enzymes and Low Platelet Count) exacerbated by concomitant COVID-19 infection could not be ruled out.
32890139 Median age of SOT recipients(9-heart, 3-lung, 16-kidney, 8-liver, 5-dual-organ) was 60 years, 80% were male and 67% were Black.
32891405 Liver transplant recipients may be at increased risk for adverse outcomes with coronavirus disease 2019 (COVID-19) infection because of chronic immunosuppression and associated comorbidities. […] There is a paucity of literature describing clinical presentation, treatments, and outcomes in liver transplant recipients with COVID-19. […] A systematic search was performed for articles published up to June 15, 2020, revealing 223 liver transplant recipients with COVID-19 in 15 studies. […] In conclusion, liver transplant recipients with severe acute respiratory syndrome coronavirus 2 are overrepresented with regard to severe disease and hospitalizations. […] Older liver transplant patients with diabetes mellitus or hypertension, who are on maintenance corticosteroids, with a diagnosis of COVID-19 and describing breathlessness should be aggressively monitored for signs of deterioration because of the risk for mortality.
32891697 Obese patients who often present metabolic dysfunction-associated fatty liver disease (MAFLD) are at risk of severe presentation of coronavirus disease 2019 (COVID-19). […] Among these pharmaceuticals, antiretrovirals such as lopinavir/ritonavir and remdesivir, antibiotics and antifungal agents can induce drug-induced liver injury (DILI), whose mechanisms are not always understood. […] These patients present several concomitant factors, which individually can favour DILI: polypharmacy, systemic inflammation at risk of cytokine storm, fatty liver and sometimes nonalcoholic steatohepatitis (NASH) as well as insulin resistance and other diseases linked to obesity. […] Hence, in obese COVID-19 patients, some drugs might cause more severe (and/or more frequent) DILI, while others might trigger the transition of fatty liver to NASH, or worsen pre-existing steatosis, necroinflammation and fibrosis.
32892325 The deliveries occurred in a negative pressure isolation room, and the neonates were separated from their mothers immediately after birth for further observation and treatment. […] No differences were detected in the whole blood cell, lymphocytes, platelet, and liver and renal function among the three groups.
32894801 There was a significantly higher rate of hypertension, diabetes, chronic pulmonary disease, liver disease, cancer and substance abuse among the readmitted compared with non-readmitted patients.
32895966 We appreciate Gao et al. for their interest in our recent manuscript on the association between elevated liver biochemistries and severe COVID-19 infection.
32896175 Apart from attacking respiratory system, it can induce multiorgan dysfunction, including cardiovascular system, liver, kidney, gastrointestinal, nervous system, and immune system.
32896833 The response strategy has involved implementing measures like social distancing, and care delivery modalities like telemedicine have been promoted to reduce the risk of transmission. […] The aim of this study was to analyze the benefits of using telemedicine services for patients with chronic liver disease (CLD) at a tertiary care center in Italy during the COVID-19-mandated lockdown. […] From March 9 to May 3, 2020, a prospective observational study was conducted in the Liver Unit of the University Hospital of Naples Federico II to evaluate the impact of (1) a fully implemented telemedicine program, partially restructured in response to COVID-19 to include video consultations; (2) extended hours of operation for helpline services; and (3) smart-working from home to facilitate follow-up visits for patients with CLD while adhering to social distancing regulations. […] Of the nearly 1700 patients with CLD who attended a follow-up visit at our Liver Unit, none contracted COVID-19, and there was no need to alter treatment schedules. […] This system of health care delivery was appreciated by patients since it gave them the opportunity to be in contact with physicians while respecting social distancing rules.
32897891 Hepatic dysfunction and the slight elevation of liver enzymes have been reported in cases of COVID-19 infection.
32899640 Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with abnormal liver function tests. […] We hypothesized that early altered liver biochemistries at admission might have different clinical relevance than subsequent changes during hospitalization. […] Liver test abnormalities were defined as the elevation of either gamma-glutamyltransferase (GGT), alanine aminotransferase (ALT), or aspartate aminotransferase (AST), above the upper limit of normality set by our laboratory. […] A total of 319 (64.3%) had at least one abnormal liver test result at admission. […] This dual pattern of liver damage might reconcile previous conflicting reports.
32899833 Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) can differentially infect multiple tissues (i.e., lung, vessel, heart, liver) in different stages of disease, and in an age- and sex-dependent manner.
32901451 We read with interest the article by Kovalic et al.(1) on elevated liver biochemistries in hospitalized Chinese patients with severe coronavirus disease 2019 (COVID-19). […] This important work showed that comorbidities, such as coronary artery disease (CAD) and cerebrovascular disease, are more prevalent in hospitalized Chinese patients with severe/critical COVID-19, and these patients are more likely to manifest with abnormal liver chemistries.
32903640 Coronavirus disease 2019 (COVID-19) caused by SARS-CoV2 is associated with various comorbidities; cardiovascular diseases, hypertension, diabetes, liver, lung diseases, and neurological ailments. […] We have noted that deaths due to liver diseases are least associated with COVID-19 among all comorbidities.
32903864 Background: Abnormal liver function is a common indication of coronavirus disease 2019 (COVID-19) patients. […] Two proposed mechanisms are liver injury mediated by angiotensin-converting enzyme 2 (ACE2) and the involvement of the systemic immune response. […] We investigated the role played by these to determine the cause of liver abnormality in the early stages of COVID-19. […] We compared clinical characteristics, viremia status, and cytokine profile on admission between patients with and without liver disorder. […] Lymphopenia was more common in the liver disorder group. […] Conclusions: Due to the infrequency of viremia, ACE2-mediated viral hepatitis does not seem to account for the commonly observed liver disorders in COVID-19 patients. […] By contrast, a dysregulated immune response may be a crucial pathogenic factor for liver disorder in the early stages of COVID-19.
32904541 The age-adjusted meta-regression models showed significant association of mortality with male (r: 0.14; OR: 1.15; 95% CI: 1.07-1.23; I2: 95.2%), comorbidities including pre-existing cerebrovascular disease (r: 0.35; 1.42 (1.14-1.77); I2: 96.1%), and chronic liver disease (r: 0.08; 1.08 (1.01-1.17); I2: 96.23%), complications like septic shock (r: 0.099; 1.10 (1.02-1.2); I2: 78.12%) and ARDS (r: 0.04; 1.04 (1.02-1.06); I2: 90.3%), ICU admissions (r: 0.03; 1.03 (1.03-1.05); I2: 95.21%), and IMV utilization (r: 0.05; 1.05 (1.03-1.07); I2: 89.80%). […] COVID-19 patients with comorbidities including cardiovascular disease, cerebrovascular disease, and chronic liver disease had poor outcomes.
32904923 Patients in the acute encephalopathy group were older (67 vs. 61 years) and had higher prevalence of medical co-morbidities including obesity, hypertension, diabetes, heart disease, COPD, chronic kidney and liver disease among others.
32905406 The remaining (n=7/12, 58%) CT studies demonstrated no acute intraabdominal pathology with incidental findings including fatty liver disease, cirrhosis, and splenomegaly.
32905553 For instance, remdesivir, a potent SARS-CoV-2 antiviral drug based on studies in vitro, if administered orally would be poorly effective because low drug levels would reach the lungs due to its high first pass destruction in the liver. […] Since the mid-1960s, pharmacologists have investigated the use of lipid-based nanoparticles for efficient delivery of antivirals to tissues, for example by transforming the route of administration from intravenous to oral, subcutaneous or aerosol administrations.
32907635 Subjects with any known coagulopathy or bleeding diathesis, including known significant liver disease associated with coagulopathy.
32907791 Data on COVID-19 in Liver Transplant (LT) recipients are scanty, but one can hypothesize that they are more susceptible to infection due to chronic immunosuppression. […] We invited LT recipients from the Liver Transplant Follow-up Center of the University Hospital of Salerno to access remote consultation. […] Among the remaining LT recipients, 50/79 (63.3%) responded to the survey; mean time from liver transplantation was 12 ± 7 years; 94% of the sample reported at least one comorbidity; 44% of LT recipients declared to be “very much/much” worried because of COVID-19 infection, and 64% considered themselves more vulnerable than the general population.
32908494 Mild liver damage and activation of the immuno-inflammatory system were the most common abnormalities observed in patients with mild COVID-19 symptoms but no significant differences were found (P > 0.05).
32909541 We report a unique case of an immunosuppressed 67-year-old female with homozygous Z-allele mutation A1AT deficiency and liver transplant with baseline chronic kidney disease (CKD) stage IIIa with creatinine of 1 mg/dL and glomerular filtration rate (GFR) of 49 mL/min/1.73m2 ~ 6 months before the presentation.
32909852 We hope that our study can extend use of telehealth in the evaluation of patients with other causes of chronic liver disease.
32911500 Multivariate logistic regression analyses showed older age (odds ratio [OR] per year 1.06; 95% confidence interval [CI] 1.06-1.07; p < 0.001), male sex (OR 1.75; 95% CI 1.55-1.98; p < 0.001), being black or African American compared to white (OR 1.50; 95% CI 1.31-1.71; p < 0.001), myocardial infarction (OR 1.97; 95% CI 1.64-2.35; p < 0.001), congestive heart failure (OR 1.42; 95% CI 1.21-1.67; p < 0.001), dementia (OR 1.29; 95% CI 1.07-1.56; p = 0.008), chronic pulmonary disease (OR 1.24; 95% CI 1.08-1.43; p = 0.003), mild liver disease (OR 1.26; 95% CI 1.00-1.59; p = 0.046), moderate/severe liver disease (OR 2.62; 95% CI 1.53-4.47; p < 0.001), renal disease (OR 2.13; 95% CI 1.84-2.46; p < 0.001), and metastatic solid tumor (OR 1.70; 95% CI 1.19-2.43; p = 0.004) were associated with higher odds of mortality with COVID-19.
32912404 To describe the characteristics of liver damage in severe coronavirus disease 2019 (COVID-19) patients in Sichuan area and the effect of antiviral drugs on liver function. […] The clinical data of severe COVID-19 patients admitted to Chengdu Public Health Clinical Medical Center from January 21 to February 24, 2020 were retrospectively collected, including demographic data, clinical manifestations and liver function changes within 1 week after admission to intensive care unit (ICU). […] The changes of liver function during the course of disease in severe COVID-19 patients were analyzed and summarized, and group analysis was performed. […] It was shown that the incidence of liver dysfunction in patients taking kaletra was significantly higher than those who did not take kaletra (7-day abnormal rate of ALT was 54% vs. 33%, the abnormal rate of AST was 38% vs. 33%, the abnormal rate of TBil was 8% vs. 0%), but there were no statistical differences (all P > 0.05). […] It was shown that patients taking low-dose kaletra had a smaller effect on liver function within 1 week after ICU admission than those receiving normal dosage, and ALB, TBil in the reduced dose group were significantly lower than those in the normal dose group on the 2nd day after ICU admission [ALB (g/L): 33.3±2.0 vs. […] Severe COVID-19 patients in Sichuan area suffered obvious liver damage in the early course of the disease and have a slower recovery. […] It is important to pay attention to avoid using drugs that can aggravate liver damage while treating the disease. […] If there is no alternative drug, liver protection treatment should be considered appropriately.
32913847 Though it has claimed fame due to its ability to compromise the respiratory system, it possess the capability to infect other organs as well including the liver. […] Presentation with gastrointestinal symptoms and involvement of the liver can be subtle and can be misdiagnosed. […] Those with pre-existing liver disease may be more susceptible as well as those who are immunosuppressed or have other co-morbidities. […] This review article provides a brief overview of some of the information that is available so far with regards to how the liver is impacted by the coronavirus.
32914853 Tissues from the lung, heart, liver, kidney, spleen and bone marrow (but not the brain) were examined.
32918645 In addition, significant association for high risk of mortality were also found for cerebrovascular disease, COPD, coronary heart disease, chronic renal disease, chronic liver disease, chronic lung disease and chronic kidney disease.
32918766 In our first survey of transplant centers in March 2020, >75% of kidney and liver programs were either suspended or operating under restrictions. […] Suspension of live donor transplantation decreased from 72% in March to 30% in May for kidneys and from 68% to 52% for livers. […] Restrictions/suspension of deceased donor transplantation decreased from 84% to 58% for kidneys and from 73% to 42% for livers.
32920162 In our study, we aim to investigate the relationship between the liver enzymes on admission (AST, ALT, ALP, GGT) and severity of COVID-19. […] We evaluated course of disease, hospital stay, liver damage and mortality. […] Patients with liver disease, hematological and solid organ malignancy with liver metastases were excluded, resulting in 554 patients who met our inclusion criteria. […] We retrospectively evaluated liver transaminase levels, AST/ALT ratio, cholestatic enzyme levels and R ratio during hospital admission and these were compared in terms of morbidity, mortality and clinical course. […] The mean values of liver enzymes on admission were AST (36.2±33.6U/L), ALT (34.01±49.34U/L), ALP (78.8±46.86U/L), GGT (46.25±60.05U/L).
32921703 Method and results: In our ward (liver transplant), 4 ICU beds and 16 ward beds were allocated to non-COVID-19 patients.
32921751 Elevation of liver transaminases in the patients’ sera has been described in up to 53% of the COVID-19 positive patients. […] The underlying pathogenic mechanisms of the virus on the liver cells are unclear and only few hypotheses are currently available. […] The patient showed a progressive decrease of transaminases after the delivery of the fetus. […] We speculate that in our case the delivery of the fetus contributed to the normalization of the liver enzymes. […] In patients affected by COVID-19, at term of gestation, with elevated transaminases, delivery of the fetus is an appealing option.
32921955 Besides, abnormal liver function is also frequent in biochemical tests of COVID-19 patients, which is correlated with the severity and mortality of the disease course. […] The etiology of liver injury in patients with COVID-19 might include viral immunologic injury, drug-induced liver injury, the systemic inflammatory response, hypoxic hepatitis, and the exacerbation of preexisting liver disease. […] Although liver injuries in COVID-19 are often transient and reversible, health workers need to pay attention to preexisting liver disease, monitor liver function, strengthen supportive treatment, and reduce the chance of drug-induced liver injury. […] This article reviews the epidemiological characteristics, etiology, management, and preventive strategies for liver injury in patients with COVID-19.
32922517 In addition, these drugs play a role in controlling liver metabolism and can lead to the development of hepatic steatosis.
32924000 Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and non-alcoholic steatohepatitis (NASH) is the aggressive form of NAFLD.
32926272 For the benefit of the scientific community and public, the effect of COVID-19 on major vital organs such as the kidneys, liver, and intestines has been briefly discussed.
32928903 SARS-CoV-2 shows a high affinity to ACE2 receptors, making sites of high ACE2 receptor expression, such as lungs, GI tract, brain, kidneys, heart, liver and immune system, a prime target for infection.
32929211 Compared to patients without SUD, patients with SUD had significantly higher prevalence of chronic kidney, liver, lung diseases, cardiovascular diseases, type 2 diabetes, obesity and cancer.
32929826 The interaction between existing chronic liver diseases caused by hepatitis B virus (HBV) infection and COVID-19 has not been studied. […] The original characteristics of COVID-19 cases combined with HBV infection were higher rate of liver injury, coagulation disorders, severe/critical tendency and increased susceptibility.
32931622 In the natural history of SARS-CoV-2 infection, liver injury is frequent but quite mild and it is defined as any liver damage occurring during disease progression and treatment of infection in patients with or without pre-existing liver diseases. […] The underlying mechanisms for hepatic injury in patients with COVID-19 are still unclear but the liver damage in SARS-CoV-2 infection seems to be directly caused by virus-induced cytopathic effects. […] In this review, we will summarize all data of updated literature, regarding the relationship between SARS-CoV-2 infection, acute response and liver involvement. […] An overview will be given on liver injury, liver transplant and the possible consequences of COVID-19 in patients with pre-existing liver diseases.
32933552 Underlying diseases, including chronic heart disease, chronic hypertension, severe renal failure, severe liver failure, and thyroid disorders.
32939636 The protocol required 20 cores of the liver, 30 of lung, 12 of spleen, 20 of heart, 20 of kidney, 4 of breast, 4 of testis, 2 of skeletal muscle, and 4 of fat with total of 112 cores per patient. […] Highest SARS-CoV-2 viral load was detected in the lung, liver, and spleen that had small to moderate amount, and low viral load in was detected in the heart in 2/5 (40%). […] Highest SARS-CoV-2 viral load was seen in the lung, followed by liver and spleen with small amount in the myocardium.
32942274 Patterns of liver injury were heterogeneous, featuring 10 (36%) with frequent large basophilic structures in sinusoidal endothelium, and increased immunoblast-like cells in lymph nodes. […] However, many patients also have widespread microscopic thromboses, as well as characteristic findings in the liver and lymph nodes.
32942796 Based on search criteria, 12 studies were found for lung, 52 for heart, 23 for liver, 16 for stroke, and 9 for kidney. […] Twenty of 23 trials for liver failure from different etiologies revealed favorable outcomes.
32945110 Six days before this hospitalization, when the patient was asymptomatic, 18 F-FDG PET/CT images were performed for the therapeutic control of liver metastases of colorectal cancer.
32946851 Non-survivors combined with more comorbidities, more severe infection, and worse liver, kidney and cardiac function in patients without diabetes.
32946915 In this review, we focused on COVID-19 coupled with the coagulopathy contributes to severe outcome inclusive of comorbidities such as venous thromboembolism, stroke, diabetes, lung, heart attack, AKI, and liver injury. […] Along with that endothelial dysfunction activates the complement system pathways and contributes to the acute and chronic inflammation via cytokine storm with the production of the cytokines and chemokines, coagulation in different organs such as lung, brain, liver, heart, kidney and further leads to multi-organ failure.
32948978 ATTR amyloidosis is caused by systemic deposition of transthyretin (TTR) and comprises ATTRwt (wt for wild-type) amyloidosis, ATTRv (v for variant) amyloidosis, and acquired ATTR amyloidosis after domino liver transplantation. […] Although liver transplantation has been performed for patients with ATTRv amyloidosis since 1990, late-onset patients were not eligible for this treatment.
32949098 Among 5 transplant centers, 26 patients (62% male) were reviewed with a median age of 8 years. 6 were heart recipients, 8 kidney, 10 liver, and 2 lung.
32949175 We classified the patients according to the presence and number of damaged organs (heart, liver, and kidney).
32949888 LHQW herbs have relationships to Stomach-, Heart-, Liver- and Spleen-systems, but most (10 of the 13 herbs) to the Lung system, indicating specific effects in lung diseases.
32950749 Chronic liver disease (CLD) represents a major global health burden. […] The liver-specific factors associated with independent risk of higher overall mortality were alcohol-related liver disease (ALD) (hazard ratio [HR] 2.42, 95% confidence interval [CI] 1.29-4.55), decompensated cirrhosis (HR 2.91 [1.70-5.00]) and hepatocellular carcinoma (HCC) (HR 3.31 [1.53-7.16]).
32952870 Since the first reports of coronavirus disease 2019 (COVID-19) cases in December 2019 in China, numerous papers have been published describing a high frequency of liver injury associated with severe acute respiratory syndrome coronavirus 2 infection, many of them proposing a link between these findings and patient outcomes. […] Although absolute changes in these parameters are frequently seen, other variables, such as the ratio above the upper limit of normal, the onset of liver injury as a complication in severe cases and histopathological findings, reinforce that liver changes are of dubious clinical relevance in the course of this disease. […] Other factors must also be considered in these analyses, such as the repercussions of hemodynamic changes, the presence of thrombotic events, and, mainly, the possible drug-induced liver injury with the current, yet off-label, treatment. […] This paper aimed to analyze the currently available data on liver injury in patients with COVID-19.
32952875 According to the current recommendations, all treatment-naïve and treatment-experienced children with CHC virus infection should be considered for DAA therapy to prevent the possible progression of hepatitis C virus-related liver disease and its complications. […] These efforts include promoting telemedicine in the outpatient setting, using local laboratory testing for follow-up visits, and engaging in the home delivery of DAAs for patients under antiviral therapy whenever possible.
32956843 Depending on the viral load, infection spread through the ACE2 receptor further to various organs such as heart, liver, kidney, brain, endothelium, GIT, immune cell, and RBC (thromboembolism).
32956871 Despite liver injury in patients infected with severe acute respiratory syndrome (SARS) coronavirus (CoV)-2 (SARS-CoV-2) is associated with prolonged hospitalization, and liver dysfunction is mainly described in patients with severe viral disease. […] How liver abnormalities may affect virus infection is still unknown. […] Improved understanding of host genetics, lifestyle, underlying comorbidities and adequate follow-up of patients with liver damage are critical in the new scenario of the pandemic virus.
32957548 A severe course of COVID-19 was associated with an elevation of proinflammatory markers; an efflux of immature granulocytes into peripheral blood; the activation of CD8 T cells, which infiltrated the lungs; transient liver disease.
32958991 The inflammation and coagulation biomarkers were normal in the majority of the cases, as for liver and kidney function.
32959007 SARS-CoV-2 contains the spike protein site that gets activated by an enzyme furin which is found in the lung, liver, and small intestine of humans.
32961074 Acute respiratory distress syndrome, heart failure, renal failure, liver damage, shock and multi-organ failure are strongly associated with morbidity and mortality.
32961244 Presence (versus absence) of pre-existing kidney disease OUTCOME(S): In-hospital mortality (primary); respiratory failure, shock, ventricular arrhythmia/ cardiac arrest, thromboembolic event, major bleed, and acute liver injury (secondary) ANALYTICAL APPROACH: We used standardized differences to compare patient characteristics (values >0.10 indicate a meaningful difference between groups) and multivariable adjusted Fine and Gray survival models to examine outcome associations.
32964510 Coronavirus disease 2019 (COVID-19) is associated with liver injury, but the prevalence and patterns of liver injury in liver transplant (LT) recipients with COVID-19 is not defined. […] Analysis of peak values of alanine aminotransferase (ALT) during COVID-19 showed moderate liver injury (ALT 2-5x ULN) in 22.2% (n= 18) and severe liver injury (ALT > 5x ULN) in 12.3% (n= 10). […] Compared to age and gender matched non-transplant patients with CLD and COVID-19 (n=375), the incidence of acute liver injury was lower in LT recipients (47.5% vs. […] Variables associated with liver injury in LT recipients were younger age (p= 0.009, odds ratio (OR) 2.06 [1.20-3.54]), Hispanic ethnicity (p= 0.011; OR 6.01 [1.51-23.9]), metabolic syndrome (p= 0.016; OR 5.87 [1.38-24.99]), vasopressor use (p= 0.018; OR 7.34 [1.39-38.52]) and antibiotic use (p= 0.046; OR 6.93 [1.04-46.26]). […] Reduction in immunosuppression (49.4%) was not associated with liver injury (p= 0.156) or mortality (p= 0.084). […] Liver injury during COVID-19 was significantly associated with mortality (p= 0.007; OR 6.91 [95% CI: 1.68-28.48]) and ICU admission (p=0.007; OR 7.93[1.75-35.69]) in LT recipients. […] Liver injury is associated with higher mortality and ICU admission in LT recipients with COVID-19. […] Hence, monitoring liver enzymes closely can help in early identification of patients at risk for adverse outcomes.
32968798 ACE2 is highly expressed in the bladder, ileum, kidney and liver, comparing with ACE2 expression in the lung-specific pulmonary alveolar type II cells.
32970391 Their expression levels were found to be significantly altered in cancer types, including colon, kidney, liver, testis, thyroid and skin cancers (P < 0.0001); AUC > 0.80 suggests that TMPRSS2, CLEC4M and DPP4 are relevant markers of kidney, liver, and thyroid cancer, respectively.
32973125 The main target of COVID-19 is the lungs; however, it can involve other organs, including the liver. […] Patients with severe COVID-19 have an increased incidence of abnormal liver function, and patients with liver disorders are considered to be at a higher risk of severe COVID-19 infection. […] The mechanism of liver injury reported in 14% to 53% of COVID-19 patients is poorly recognized and several possibilities need to be considered (cytokine storm, direct viral action, hypoxia). […] The incidence of underlying liver comorbidities in patients with a COVID-19 infection ranges from 1% to 11%. […] CASE REPORT This is a report of 2 nosocomial COVID-19 infections and severe COVID-19 pneumonia in 2 patients who were hospitalized during treatment for alcoholic liver disease (ALD).
32974111 In contrast, among younger people, men had higher odds of severe pneumonia, need for high oxygen support, acute kidney injury and acute liver injury when compared to women.
32976118 The authors assessed subjects retrospectively for cardiac and liver injury, shock, ventilation, mortality, and viral clearance.
32976196 Various studies have highlighted that patients infected with COVID-19 may develop various degrees of liver injury. […] Here, we discuss the impact of underlying liver disease and manifestations of hepatic injury with COVID-19. […] We identified 13 studies that assessed the impact of underlying liver disease in patients infected with COVID-19 (N=3046). […] Underlying liver disease was one of the most common known comorbid categories in patients infected with COVID-19. […] Liver injury is highly prevalent in patients that present with COVID-19. […] Since the liver is one of the most affected organs outside of the respiratory system in COVID-19, more intensive surveillance is warranted for severe cases, particularly among those with pre-existing advanced liver disease.
32976364 We found 85 patients (66 liver, 16 kidney, 2 kidney-pancreas and 1 liver-kidney recipient) who acquired COVID-19. […] Overall, 17 patients (20%) died which included 31.3% of patients with kidney transplantations and 21.9% of patients with liver transplantations.All 4 pediatric patients in our series died. […] Liver and kidney transplant recipients have an increased risk of mortality compared to the general population due to COVID-19.
32978919 Elderly with or without following comorbidities i.e Diabetes, hypertension, cardiac disease, chronic respiratory illnesses, chronic liver disease, CKD, malignancy and immunocompromised hosts are at increased risk of developing complicated course.
32979013 We describe the successful pediatric liver transplant for unresectable hepatoblastoma in a 4-year-old male with COVID-19 prior to transplant. […] The patient was actively listed for liver transplant after completing four blocks of a SIOPEL-4 based regimen due to his PRETEXT IV disease which remained unresectable. […] Following three additional negative NP swabs and resolution of symptoms for four weeks, he underwent a whole-organ pediatric liver transplant. […] We describe one of the earliest, if not the first case of liver transplant following recent recovery from COVID-19 in a pediatric patient with a lethal malignant liver tumor. […] This case highlights that pediatric liver transplantation can be safely performed upon clearance of COVID-19.
32979193 Here we propose a management model for the reorganization of liver transplant (LT) activities and policies in a local intensive care unit (ICU) assigned to liver transplantation affected by restrictions on mobility and availability of donors and recipients as well as health personnel and beds.
32979398 SARS-CoV-2 infection can also affect the gastrointestinal tract, liver and pancreatic functions, leading to gastrointestinal symptoms.
32979740 A total of 52 postmortem tissue biopsy samples were obtained from the lungs and liver of decedents. […] Liver specimens mainly showed macrovesicular steatosis, portal lymphoplasmacytic inflammation and passive congestion.
32979742 Other organs like liver and kidneys may be involved secondarily.
32980900 Based on the characteristics that shelter hospital only treats patients with mild illness, tests of shelter laboratory, including coronavirus nucleic acid detection, IgM/IgG antibody serology detection, monitoring and auxiliary diagnosis and/or a required blood routine, urine routine, C-reactive protein, calcitonin original, biochemical indicators (liver enzymes, myocardial enzymes, renal function, etc.) and blood coagulation function test etc, were used to provide important basis for the diagnosis and treatment of the disease.
32980956 To characterize the impact of HS on disease severity and liver injury in COVID-19. […] HS was defined by either hepatic steatosis index > 36 (for Asians) or > 39 (for non-Asians) or liver imaging demonstrating steatosis > 30 days before onset of COVID-19. […] In a sensitivity analysis including only patients with liver imaging > 30 days before onset of COVID-19, imaging evidence of hepatic steatosis remained associated with disease severity and risk of transaminitis.
32983698 The present systematic review and meta-analysis aims to assess gastrointestinal symptoms and liver enzymes trend in corona virus infection. […] Conclusions Our meta-analysis shows that patients with COVID-19 infection can present with nausea, vomiting and diarrhea in addition to elevated liver enzymes including AST, ALT and a decline in albumin and platelet count which is more marked in severe disease.
32983735 Gastrointestinal/hepatic sequelae such as diarrhea, nausea, vomiting, and elevated liver enzymes have been reported as well. […] Studies and data so far on coronavirus infections from China, Singapore, and other countries showed that liver enzymes elevation could be seen in 20-50% of cases. […] More severe disease can correlate with the worsening of liver enzymes. […] However, acute liver failure in patients with COVID-19 has not been described. […] Herein we report a case of acute liver failure in an elderly patient with COVID-19 infection who did not have a history of preexisting liver disease.
32983832 ATTR amyloidosis is caused by systemic deposition of transthyretin (TTR) and comprises ATTRwt (wt for wild-type) amyloidosis, ATTRv (v for variant) amyloidosis, and acquired ATTR amyloidosis after domino liver transplantation. […] Although liver transplantation has been performed for patients with ATTRv amyloidosis since 1990, late-onset patients were not eligible for this treatment.
32984539 The results showed that there were different degrees of damage to the liver, kidneys, blood coagulation, and heart function in the non-survival group.
32984567 Coronaviruses are positive-sense RNA viruses widely distributed among different animal species and humans in which they cause respiratory, enteric, liver and neurological symptomatology.
32984786 The spectrum of biochemical abnormalities and their kinetics were consistent with a multi-organ involvement, including lung, kidney, heart, liver, muscle, and pancreas, along with a severe inflammatory syndrome.
32985328 In the context of secondary pulmonary infection and progressive liver failure, the patient had a sudden cardiac arrest.
32986102 Patients who died were older (mean [SD] age, 68.7 [14.8] years vs 60.3 [16.0] years; p <0.0001), had dementia (35 [28.7%] vs 34 [11.4%]; p <0.0001), hemiplegia (14 [11.5%] vs 12 [4.0%]; p=0.004), malignancy (11 [9.0%] vs 12 [4.0%]; p=0.04), and moderate-severe liver disease (4 [3.3%] vs 1 [0.3%]; p=0.01).
32988758 In this literature review, we summarize the most recent studies, which covered the pathophysiology of COVID-19 induced liver injury including; hepatic pathological findings, therapy related liver damage, and the effects of the viral infection on pre-existing liver diseasesin context of the most recent recommendations. […] Conclusions: This review sheds light on the impact of COVID-19 infection on the liver, as well as the prognostic effect of liver laboratory markers on disease outcome. […] Temporal variations in liver parameters during disease course as well as different patterns of derangement are depicted. […] More intensive surveillance and individualized therapeutic approaches should be tailored for immunocompromised patients with advanced liver disease, hepatocellular carcinoma, and liver transplant patients. […] Despite the limited studies on COVID-19 infected patients with preexisting liver disease, this comprehensive overview provides a perspective on the management of liver disease during COVID-19.
32990149 We aimed to analyse the relationship between coagulation dysfunction and liver damage in patients with COVID-19. […] A case control study was conducted to analyse the correlation between the occurrence of coagulation dysfunction and liver damage in COVID-19 patients. […] Alanine aminotransferase (ALT) and aspartate aminotransferase (AST), markers of liver damage, were positively correlated with coagulopathy (p = 0.039, OR 2.960, 95% CI 1.055-8.304; and p = 0.028, OR 3.352, 95% CI 1.137-9.187). […] Coagulation dysfunction in patients with COVID-19 is closely related to liver damage. […] A longer course of the disease may cause a vicious circle of coagulopathy and liver damage. […] Clinicians need to closely monitor coagulation and liver function tests and to give prophylactic or supportive therapy when needed.
32992052 Liver injury due to coronavirus disease 2019 (COVID-19) is being increasingly recognized. […] Abnormal liver chemistry tests of varying severities occur in a majority of patients. […] However, there is a dearth of accompanying liver histologic studies in these patients. […] Liver biopsies were analyzed under light microscopy, portions of liver tissue were hybridized with a target probe to the severe acute respiratory syndrome coronavirus-2 S gene, and small sections from formalin-fixed paraffin-embedded liver tissue were processed for electron microscopy. […] The liver histology of both cases showed a mixed inflammatory infiltrate with prominent bile duct damage, endotheliitis, and many apoptotic bodies. […] Furthermore, some of the histopathologic changes may resemble acute cellular rejection occurring after liver transplantation.
32992075 Key safety endpoints for the statin hypothesis include rise in liver enzymes >3 times upper normal limit and clinically-diagnosed myopathy.
32994803 Pharmacological studies had shown that SB has a wide range of pharmacological activities such as antiinflammatory, antibacterial, antiviral, anticancer, liver protection, etc. […] The active ingredients of SB were mostly distributed in liver and kidney, and couldn’t be absorbed into brain via oral absorption. […] SB’s toxicity was mostly manifested in liver fibrosis and allergic reactions, mainly caused by baicalin.
32998791 We observed that compared with survivors, non-survivors were older and illustrated higher respiratory rate, neutrophil-to-lymphocyte ratio, D-dimer and lactate dehydrogenase (LDH), but lower SpO2 as well as impaired liver function, especially synthesis function.
32999264 Objective Liver injury is a notable complication of coronavirus disease 2019 (COVID-19). […] This study aimed to clarify the clinical features and liver injury in Japanese patients with COVID-19. […] We defined liver injury as alanine aminotransferase (ALT) or gamma-glutamyl transferase (GGT) levels over the upper limit of normal. […] Two patients had underlying liver diseases, and two were diagnosed as having COVID-19 without any symptoms. […] Elevated ALT and GGT levels were found in 12 and 12 patients, respectively, and liver injury was observed in 15 patients (68.2%). […] Compared with the patients without liver injury, those with liver injury had a significantly higher fever during the clinical course (median, 37.5°C vs. […] A significant correlation was found between the highest serum liver values and the highest body temperature in each patient. […] Liver injury was not associated with the severity or mortality of COVID-19. […] Conclusion Elevated levels of liver enzymes in the Japanese patients with COVID-19 were associated with the highest body temperature during the clinical course but not with the severity or mortality of COVID-19.
33001040 We analyzed clinical parameters and risk factors for coronavirus disease 2019 (COVID-19)-related liver damage. […] Of the 332 COVID-19 patients, 98 (29.5%) were admitted with liver injury. […] The patient’s sex, COVID-19 severity, and a low liver CT density strongly correlated with liver injury (ORs: 2.936, 6.543, and 3.387, respectively). […] Though not severe, the liver injury among COVID-19 patients was pervasive. […] Being male, COVID-19 severity, low CT density, and medications may be risk factors for liver damage. […] Following recovery, liver function gradually returns to normal. […] Liver indicators were evaluated on admission. […] The risk factors, medications, and the dynamic change of liver functions were analyzed.
33002740 Serum IL-18 were correlated with other inflammatory markers and biochemical markers of organ injury; creatinine, liver enzymes and troponin.
33006138 Here we present two cases of suspected remdesivir-associated acute liver failure (ALF) in which the liver failure improved following continuous infusion acetylcysteine and withdrawal of remdesivir.
33006440 Patients with myocardial injury had higher levels of inflammation markers, poorer liver and kidney function, and more complications compared with patients without myocardial injury.
33006798 Rate of SARS-CoV-2 infection and impact of liver fibrosis stage upon infection rates in persons with hepatitis C virus (HCV) infection are unknown. […] We determined the number of persons tested, proportion who tested positive for SARS-CoV-2 and the infection rate by age and liver fibrosis stage. […] The degree of liver fibrosis does not appear to have an impact on infection rate.
33010411 After adjusting for potential confounders, the presence of gastrointestinal symptoms at any time (odds ratio 0.93, 95% confidence interval 0.76-1.15) or liver test abnormalities on admission (odds ratio 1.31, 95% confidence interval 0.80-2.12) were not independently associated with mechanical ventilation or death. […] Among patients hospitalized with COVID-19, gastrointestinal symptoms and liver test abnormalities were common but the majority were mild and their presence was not associated with a more severe clinical course.
33010495 SARS-CoV-2 could infect and productively replicate in the ex vivo human intestinal tissues with the release of infectious virus particles, but not in ex vivo human liver and kidney tissues.
33010584 However, the Covid-19 infection disrupts various organs, including the liver, kidney, and nervous system.
33011088 The association between metabolic-associated fatty liver disease (MAFLD) and disease progression in patients with the coronavirus disease 2019 (COVID-19) are unclear.
33011887 The multi-organ dysfunction is characterized by acute lung failure, acute liver failure, acute kidney injury, cardiovascular disease, and as well as a wide spectrum of hematological abnormalities and neurological disorders. […] Although the presence of angiotensin-converting enzyme 2, a receptor of SARS-CoV2 in the lung, heart, kidney, testis, liver, lymphocytes, and nervous system was confirmed, there are controversial findings to about the observation of SARS-CoV2 RNA in these organs.
33012543 Here we report a single-center cohort of 6 patients (4 kidney only, and 2 simultaneous liver/kidney transplants) diagnosed with COVID-19 at a median of 1.9 years (range = 0.2-9.3 years) post transplant.
33014097 In addition, a practical algorithm, considering renal and liver function, which facilitates the anticoagulation choice at discharge is presented.
33014641 This article is about a known case of heart failure presented with acute liver failure following a coronavirus disease-2019 (COVID-19) respiratory tract infection. […] Elevated liver enzymes, severe coagulopathy, and hypoglycemia were apparent without any clinical or laboratory findings of sepsis, acute viral hepatitis, medicine related or drug-induced, or autoimmune-related acute liver failure. […] Supportive and therapeutic measures related to his cardiovascular, respiratory, and liver function were executed in the ICU.
33015108 Most patients had organ dysfunction during hospitalization, including 11 (29.7%) with ARDS, 8 (21.6%) with acute kidney injury, 17 (45.9%) with acute cardiac injury, and 33 (89.2%) with acute liver dysfunction. […] Cardiac function was enhanced in the early stage and less likely to develop into acute cardiac injury, but most patients suffered with acute liver injury.
33015111 The medium impact (RR = 2-3) group comprised chronic pulmonary disease RR = 2.615 (95% CI, 2.061-3.319) and chronic liver disease RR = 1.577 (95% CI, 1.183-2.104) and the low impact group (RR<2) -coronary heart disease RR = 0.664 (95% CI, 0.581-0.758), cancer RR = 0.515 (95% CI, 0.416-0.637) and stroke RR = 0.468 (95% CI, 0.370-0.593).
33015402 Hyperemia, regional consolidation and subpleural air accumulation was observed on necropsy, with similar histopathological and immunohistochemistry findings in the lungs, heart, stomach, intestines, liver, spleen and kidneys. […] Peak viral loads were detected in the lungs, with virus RNA present in the kidneys, jejunum, liver, spleen and heart.
33015551 There is evidence that Covid-19 can infect liver tissue and may cause transaminemia. […] The Model for End-Stage Liver Disease-Sodium (MELD-Na) score is a mortality assessment tool in liver transplant patients that has been found to be prognostic in other clinical situations.
33015653 In histological analyses of organs (sampled from nine to 21 patients per organ), an extensive inflammatory response was present in the lungs, heart, liver, kidneys, and brain. […] Thrombi and neutrophilic plugs were present in the lungs, heart, kidneys, liver, spleen, and brain and were most frequently observed late in the disease course (15 patients with thrombi, median disease course 22 days [5-44]; ten patients with neutrophilic plugs, 21 days [5-44]).
33015748 Although COVID-19 is predominantly a respiratory illness, other systems including gastrointestinal (GI) system and liver may be involved because of the ubiquitous nature of ACE-2 receptors in various cell lines that SARS-CoV-2 utilizes to enter host cells. […] It appears that GI symptoms and liver enzyme abnormalities are common in COVID-19. […] The involvement of the GI tract and liver correlates with the severity of disease. […] Liver enzymes are elevated, usually mild (2-3 times), in a substantial proportion of patients. […] There are many confounding factors that could cause liver enzyme abnormalities including medications, sepsis, and hypoxia. […] Although infection rates in those with preexisting liver disease are similar to that of general population, once infected, patients with liver disease are more likely to have a more severe disease and a higher mortality.
33017170 Trials excluded pregnant women and adults with severe kidney or liver disease.
33017864 We describe the case of an orthotopic liver transplantation (OLT) in a young female who presented with acute liver failure secondary to acetaminophen toxicity to manage abdominal pain and in the setting of a positive SARS-CoV2 test.
33021025 No evidence-based treatment has been approved so far.2 Outcomes of COVID-19 in Liver Transplant (LT) recipients are not well known at present.
33023552 To the best of the authors knowledge, to this date very little data exists on COVID-19 in a pediatric patient with liver transplantation. […] We report a three year-old boy who had liver transplantation at 18 months old.
33023681 Vitamin K plays a crucial role in the activation of both pro- and anticlotting factors in the liver and the activation of extrahepatically synthesised protein S which seems to be important in local thrombosis prevention. […] In contrast to MGP, Covid-19 patients have normal levels of activated factor II, in line with previous observations that vitamin K is preferentially transported to the liver for activation of procoagulant factors.
33023827 The microbiota-gut-liver-lung axis plays a bidirectional role in the pathophysiology of a number of infectious diseases. […] Moreover, there is convincing preliminary evidence linking microbiota-gut-liver axis perturbations, proinflammatory status, and endothelial damage in noncommunicable preventable diseases with coronavirus disease 2019 (Covid-19) severity. […] This review provides evidence on gut-liver axis involvement in Covid-19 as well as insights into the hypothesis that intestinal endotheliitis and permeability changes with bacterial translocation are key pathophysiologic events modulating systemic inflammatory response. […] Moreover, it presents an overview of readily applicable measures for the modulation of the gut-liver axis and microbiota in clinical practice.
33024082 Following CP transfusion, six out of eight patients showed improved oxygen support status; chest CT indicated varying degrees of absorption of pulmonary lesions in six patients within 8 days; the viral load was decreased to a negative level in five patients who had the previous viremia; other laboratory parameters also tended to improve, including increased lymphocyte counts, decreased C-reactive protein, procalcitonin, and indicators for liver function.
33026573 This study was designed to evaluate the clinical characteristics and risk factors of COVID-19-associated liver injury. […] Clinical and laboratory data were derived from electronic medical records and compared between patients with or without liver injury. […] Multivariate logistic regression method was used to analyze the risk factors for liver injury. […] Among 657 patients, 303 (46.1%) patients had liver injury with higher rate in severe/critically ill patients [148/257 (57.6%)] than those in moderate cases [155/400 (38.8%)]. […] The incidence of liver injury was much higher in male [192/303 (63.4%)] than female [111/303 (36.6%)], and in severe/critical patients [148/303 (48.8%)] with percutaneous oxygen saturation ≤ 93% [89/279 (31.9%)] or peak body temperature ≥ 38.5 °C [185/301 (61.5%)] on admission. […] Liver injury-related inflammations included increased white blood cells, neutrophils and decreased lymphocytes. […] More patients with liver injury than without had increased serum IL-2R, TNFα, ferritin, hsCRP, PCT, ESR, γ-GT, and LDH. […] Multivariate regression analysis revealed that increasing odds of liver injury were related to male, higher serum hsCRP (≥ 10 mg/L), and neutrophil-to-lymphocyte ratio (NLR) (≥ 5). […] Liver injury is a common complication in COVID-19 patients. […] The potential risk factors of liver injury include male, hsCRP and NLR score. […] A close monitor of liver function should be warned in COVID-19 patients, especially in severe/critical individuals.
33028689 While liver damage was observed in symptomatic patients, as indicated by elevated liver enzymes and decreased liver-synthesized proteins in the blood, asymptomatic patients showed normal liver measurements. […] This may have been due to more active cellular immune responses and normal liver function.
33029105 The novel coronavirus is not only causing respiratory problems, but it may also damage the heart, kidneys, liver, and other organs; in Wuhan, 14 to 30% of COVID-19 patients have lost their kidney function and now require either dialysis or kidney transplants. […] The inflammatory chemicals released during COVID-19 infection cause the liver to produce proteins that defend the body from infections.
33029494 More patients in the nonsurviving group had increased levels of nonspecific infection markers, abnormal liver and kidney function, cardiac injury, and blood coagulation abnormalities on admission.
33031439 Although metabolic risk factors are associated with more severe COVID-19, there is little evidence on outcomes in patients with non-alcoholic fatty liver disease (NAFLD). […] This study included all consecutive patients admitted for COVID-19 between February and April 2020 at Imperial College Healthcare NHS Trust, with either imaging of the liver available dated within one year from the admission or a known diagnosis of NAFLD. […] Among NAFLD patients, male gender (p = 0.01), ferritin (p = 0.003) and EWS (p = 0.047) were associated with in-hospital mortality, while the presence of intermediate/high risk FIB-4 or liver cirrhosis was not.
33032841 Paradoxically, the patient with more risks of developing a severe disease, a 64-year-old woman, 2-years liver transplant recipient under treatment with tacrolimus, presented a similar outcome compared to the two other members of the family. […] The present observation states that liver recipients’ patients with COVID-19 may not have worse outcomes when compared with other patients that have COVID-19 risk factors and puts in evidence the two mechanisms related to tacrolimus.
33035628 Chronic liver disease (CLD) and cirrhosis are associated with immune dysregulation leading to concerns that these patients may be at risk of adverse outcomes following SARS-CoV-2 infection. […] However, the impact of COVID-19 among patients with pre-existing liver disease remains ill-defined. […] After adjusting for baseline characteristics, factors associated with death in the total CLD cohort were age (OR 1.02; 1.01-1.04), CTP-A (OR 1.90; 1.03-3.52), CTP-B (OR 4.14; 2.4-7.65), CTP-C cirrhosis (OR 9.32; 4.80-18.08) and alcohol related liver disease (ALD) (OR 1.79; 1.03-3.13). […] Acute hepatic decompensation occurred in 46% of patients with cirrhosis, of which 21% had no respiratory symptoms. 50% of those with hepatic decompensation had acute-on-chronic liver failure. […] We demonstrate that baseline liver disease stage and ALD are independent risk factor for death from COVID-19.
33035673 By multivariate analysis, mortality was associated with older age (HR = 1.09, p < 0.001), chronic heart failure (HR = 4.4, p = 0.003), and chronic liver disease (HR = 4.69, p = 0.004).
33035967 Patients with severe COVID-19 may also develop acute cardiac, kidney and liver injury that are associated with poor prognosis and can lead to high mortality rate.
33036662 Underlying diseases, including heart disease, chronic hypertension, severe renal failure, severe liver failure, and thyroid disorders 2.
33036894 On day 15, we observed renal, liver, and coagulation dysfunction, indicating multi-organ failure.
33037657 The cumulative incidence of COVID-19 among liver transplant (LT) recipients was highly variable in different European countries in the early survey of European Liver and Intestine Transplantation Association (ELITA) and European Liver Transplant Registry (ELTR). […] Combining data from all European countries in one platform/study would provide a unique opportunity to monitor the incidence of COVID-19 in liver transplantation setting, adding a dynamic dimension to our first report, and most importantly to collect additional information on treatment strategies to optimize the management of COVID 19 in the very special population of LT recipients.
33039144 Owing to limited data available, it remains unclear to what extent liver transplant recipients should be considered at a higher risk of severe disease. […] We describe a moderate course of coronavirus disease 2019 (COVID-19) in a patient who underwent a liver transplant 2 years earlier because of Budd-Chiari syndrome. […] With this case report, we demonstrate that liver transplantation and immunosuppression is not necessarily associated with severe COVID-19 and emphasize that more information on this matter is urgently required.
  • COVID-19 caused by SARS-CoV-2 leads to myriad range of organ involvement including liver dysfunction. […] To analyse the liver function in patients with COVID-19 and their association with respect to age, sex, severity of disease and clinical features. […] Liver function tests were compared among different severity groups. […] Of 91 patients with COVID-19, 70 (76.9%) had abnormal liver function. […] There was no statistical difference between males and females with regard to abnormal liver function. […] Liver injury was seen in 64.3% cases of hypertension and 73.3% cases of diabetes. […] Liver injury is common in SARS-CoV-2 infection and is more prevalent in the severe disease group. […] Aspartate transaminase and alkaline phosphatase are better indicators of covid-19 induced liver injury than alanine transaminase and total bilirubin.
33040042 The SARS-CoV-2 outbreak has disrupted the delivery of routine healthcare services on a global scale. […] We describe an atypical case of Lemierre’s syndrome involving the brain, liver and lungs following a dental infection in a young male who delayed seeking dental or medical attention due to a lack of routine services and concerns about the SARS-CoV-2 outbreak.
33040064 COVID-19 was initially considered to be a respiratory disease but soon after the pandemic established it became clear that the SARS-CoV-2 virus which caused the disease could lead to serious systemic consequences affecting most of the major organs including the digestive tract, liver and pancreas. […] This review brings together the new information which is clinically relevant to the gastroenterologist including the origins of the disease, mechanisms of tissue damage and how this affects specific patient groups, including those with inflammatory bowel disease, comorbidities and the role of immunosuppression, chronic liver disease and the risk of decompensation for those with cirrhosis. […] Some re-purposed drugs used against SARS-CoV-2 can cause or aggravate some of the COVID-19 GI symptoms and also can induce iatrogenic liver injury.
33040065 Anastasioua et al(1), wherein the authors described the effect of SARS-CoV-2 infection on mortality in patients suffering from Mild or severe liver injury. […] They demonstrated that while the mild liver injury was not associated with worse outcomes in their cohort, a cohort with severe liver injury showed multiple-organ failure and acute vascular events leading to higher mortality(1).
33040430 A 42 year male with alcoholic hepatitis underwent a successful deceased donor liver transplantation 71 days after the initial diagnosis of COVID-19.
33041326 After intravenous administration of 20 mg/kg RDV in mice, the concentrations of the parent drug, nucleotide monophosphate (RMP) and triphosphate (RTP), as well as nucleoside (RN), in the blood, heart, liver, lung, kidney, testis, and small intestine were quantified. […] Moreover, RDV presented an extensive distribution, and the lung, liver and kidney showed high levels of the parent drug and metabolites. […] The metabolic stabilities of RDV and RMP were also evaluated using lung, liver, and kidney microsomes. […] RDV showed higher clearances in the liver and kidney than in the lung, with intrinsic clearance (CLint) values of 1740, 1253, and 127 mL/(min∙g microsomal protein), respectively.
33043228 Consequently, the ability to treat patients with organ failure, in particular patients with end stage liver disease where no temporizing treatments exist, and to obtain expected excellent outcomes for new liver transplant recipients has been challenged during this time. […] We summarize some of the negative effects of the current pandemic on organ recovery and liver transplantation as well as offer considerations and strategies for their mitigation that could have a lasting impact on the field even after COVID-19 has waned.
33043235 FX is known to be primarily produced in the liver, but it is also expressed by multiple cells types, including alveolar epithelium, cardiac myocytes, and macrophages.
33043283 Our results are consistent with a model in which SARS-CoV-2 infection induces liver damage associated with dyslipidemia and oxidative stress.
33043651 Liver injury may happen in a minority of patients.
33043888 Serum lactate dehydrogenase and liver enzymes were elevated.
33045618 In patients with confirmed COVID-19, care should be taken to avoid drug interactions, between lipid-lowering medications and drugs that may be used to treat COVID-19, especially in patients with abnormalities in liver function tests.
33046317 Among the complications, besides the respiratory worsening, renal failure, liver failure and the state of sepsis were most frequently found; less frequent complications were lesions induced by ventilation with a barotrauma mechanism, ischemic heart disease, the appearance of central neurological events of sensory alterations, meningo - encephalitis and cerebral hemorrhage, and peripheral neurological events with polyneuro - myopathies.
33046644 As coronaviruses cause severe economic losses in the pork industry and swine are key intermediate hosts of human disease outbreaks, we synthetically resurrected a recombinant virus (rSADS-CoV) as well as a derivative encoding tomato red fluorescent protein (tRFP) in place of ORF3. rSADS-CoV replicated efficiently in a variety of continuous animal and primate cell lines, including human liver and rectal carcinoma cell lines.
33046686 Patients with severe disease are more likely to have increased liver enzymes. […] The disease can affect the liver through various mechanisms.
33047431 Liver dysfunction is sometimes observed in patients with coronavirus disease 2019 (COVID-19), but most of studies are from China and the frequency in other countries is unclear. […] In addition, previous studies suggested several mechanisms of liver damage but precise or additional mechanisms are not clearly elucidated. […] Therefore, we examined COVID-19 patients to explore the proportion of patients with liver dysfunction and also the factors associated with liver dysfunction. […] Considering that higher D-dimer level and WBC count were independently associated with ALT elevation, liver dysfunction in COVID-19 patients might be induced by microvascular thrombosis in addition to systemic inflammation.
33047475 Thus it is unclear, when and if liver transplantation can be safely offered to patients that suffered from COVID-19. […] Here, we report on a successful liver transplantation shortly after convalescence from COVID-19 with subsequent partial seroreversion as well as recurrence and prolonged shedding of viral RNA.