Tissue Sentence Context

Table 1. Analysis of context sentence of liver tissue in 314 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.