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COVID-19 and the liver.
- Source :
-
Journal of hepatology [J Hepatol] 2020 Nov; Vol. 73 (5), pp. 1231-1240. Date of Electronic Publication: 2020 Jun 15. - Publication Year :
- 2020
-
Abstract
- The current coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has become a major public health crisis over the past few months. Overall case fatality rates range between 2-6%; however, the rates are higher in the elderly and those with underlying comorbidities like diabetes, hypertension and heart disease. Recent reports showed that about 2-11% of patients with COVID-19 had underlying chronic liver disease. During the previous SARS epidemic, around 60% of patients were reported to develop various degrees of liver damage. In the current pandemic, hepatic dysfunction has been seen in 14-53% of patients with COVID-19, particularly in those with severe disease. Cases of acute liver injury have been reported and are associated with higher mortality. Hepatic involvement in COVID-19 could be related to the direct cytopathic effect of the virus, an uncontrolled immune reaction, sepsis or drug-induced liver injury. The postulated mechanism of viral entry is through the host angiotensin-converting enzyme 2 (ACE2) receptors that are abundantly present in type 2 alveolar cells. Interestingly, ACE2 receptors are expressed in the gastrointestinal tract, vascular endothelium and cholangiocytes of the liver. The effects of COVID-19 on underlying chronic liver disease require detailed evaluation and, with data currently lacking, further research is warranted in this area.<br />Competing Interests: Conflict of interest The authors declare no conflicts of interest that pertain to this work. Please refer to the accompanying ICMJE disclosure forms for further details.<br /> (Copyright © 2020 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.)
- Subjects :
- Angiotensin-Converting Enzyme 2
COVID-19
Comorbidity
Humans
Liver metabolism
Risk Factors
SARS-CoV-2
Severity of Illness Index
Betacoronavirus physiology
Coronavirus Infections epidemiology
Coronavirus Infections physiopathology
Liver Diseases epidemiology
Liver Diseases metabolism
Liver Diseases virology
Pandemics
Peptidyl-Dipeptidase A metabolism
Pneumonia, Viral epidemiology
Pneumonia, Viral physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 1600-0641
- Volume :
- 73
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of hepatology
- Publication Type :
- Academic Journal
- Accession number :
- 32553666
- Full Text :
- https://doi.org/10.1016/j.jhep.2020.06.006