Search

Background & Aims: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is responsible for coronavirus disease 2019 (COVID-19), which in males, especially in advanced age, can sometimes evolve into acute respiratory distress syndrome. In addition, mild to moderate alterations in liver function tests (LFTs) have been reported in the worst affected patients. Our review aims to analyse data on the incidence and prognostic value of LFT alterations, the underlying mechanisms and the management of pre-existing liver disease in COVID-19 affected patients., Methods: We searched available literature through online PubMed database using terms as "SARS-CoV-2," "Liver damage," "Liver Function tests," "COVID-19," "pre-existing liver disease," "drug-induced liver injury.", Results: Available evidence suggest that there could be a relationship between SARS-CoV-2 infection and liver damage, although the underlying involved mechanism remains unclear. Cohort studies have shown that high ALT levels, low platelet counts and low albumin levels at admission and during hospitalisation are associated with a high mortality rate. Unfortunately, little is known about the impact of COVID-19 on pre-existing liver damage. While chronic viral infections or NAFLD are associated with an increased risk of COVID-19 progression, patients with cirrhosis may have increased susceptibility to SARS-CoV-2 infection due to their systemic immunocompromised status. DILI seems common among hospitalised patient with severe pneumonia., Conclusion: Mild to moderate liver impairment during Covid-19 is common, especially in patients with pre-existing liver disease. Further studies should be performed in order to understand how pre-existing liver conditions may influence and worsen progression of liver disease in COVID-19 patients., Competing Interests: None to declare., (© 2021 The Authors. GastroHep published by John Wiley & Sons Ltd.)

Aims: To analyze the main etiological factors and some clinical features of patients with hepatocellular carcinoma (HCC) at diagnosis and to compare them with those we described ten years ago. Materials and Methods . We compared two groups of patients with HCC, Group 1 consisting of 132 patients (82 M, 50 F) diagnosed in the 2003-2008 period and Group 2 including 119 patients (82 M, 37 F) diagnosed in the 2013-2018 period. For all patients, age, sex, viral markers, alcohol consumption, serum alpha-fetoprotein (AFP) levels, and the main liver function parameters were recorded. The diagnosis of HCC was based on AASLD, EASL guidelines. The staging was classified according to the "Barcelona Clinic Liver Cancer staging system" (BCLC)., Results: Mean age was 69.0 ± 8 years in Group 1 and 71.0 ± 9 in Group 2 ( P < 0.05). HCV subjects were significantly older in Group 2 ( P < 0.05). HCV subjects were significantly older in Group 2 ( P < 0.05). HCV subjects were significantly older in Group 2 ( P < 0.05). HCV subjects were significantly older in Group 2 ( P < 0.05). HCV subjects were significantly older in Group 2 ( P < 0.05). HCV subjects were significantly older in Group 2 ( P < 0.05). HCV subjects were significantly older in Group 2 ( P < 0.05). HCV subjects were significantly older in Group 2 (., Conclusions: This study shows that over the last decade a number of features of patients with HCC in our region have changed, particularly age at onset, etiological factors, and staging of HCC., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2020 Lydia Giannitrapani et al.)

In the last years, several lines of evidence showed how metabolic factors may influence the natural history of patients with chronic hepatitis C. Chronic HCV infection is able to perturb the metabolic homeostasis of the host, in a context of complex interactions where pre-existent metabolic status and genetic background play an important role, allowing us to state that HCV infection is a systemic disease. In this review, we discuss the most recent lines of evidence on the main metabolic factors that are known to be associated with CHC, namely, insulin resistance/type 2 diabetes, steatosis, visceral obesity, atherosclerosis, vitamin D, menopause, fructose and coffee intake, lipoproteins, methylenetetrahydrofolate reductase status, and hyperuricaemia. In particular, we focus on the pathophysiological mechanisms underlying the correlation between HCV infection and metabolic disorders, the impact of metabolic factors on the progression of liver and non-liver-related diseases, and, on the contrary, the possible influence of chronic HCV infection on metabolic features. In this setting, the importance of a multifaceted evaluation of CHC patients and a prompt correction of modifiable metabolic risk factors should be emphasized.