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Gastroenterology Insights
Volume 14
Issue 2
10.3390/gastroent14020012
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Review

Features of Liver Injury in COVID-19 Pathophysiological, Biological and Clinical Particularities

by
Cristina Maria Marginean
1,
Eliza Cinteza
2,3,
Corina Maria Vasile
3,4,*,
Mihaela Popescu
5,*,
Viorel Biciusca
1,
Anca Oana Docea
6,
Radu Mitrut
7,
Marian Sorin Popescu
8 and
Paul Mitrut
1
1
Department of Internal Medicine, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
2
Pediatrics Department, University of Medicine and Pharmacy “Carol Davila”, 020021 Bucharest, Romania
3
Department of Pediatric Cardiology, “Marie Curie” Emergency Children’s Hospital, 041451 Bucharest, Romania
4
Department of Pediatric and Adult Congenital Cardiology, Bordeaux University Hospital, 33600 Pessac, France
5
Department of Endocrinology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
6
Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
7
Department of Cardiology, University and Emergency Hospital, 050098 Bucharest, Romania
8
Ph.D. School Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
*
Authors to whom correspondence should be addressed.
Gastroenterol. Insights 2023, 14(2), 156-169; https://doi.org/10.3390/gastroent14020012
Submission received: 6 March 2023 / Revised: 23 March 2023 / Accepted: 27 March 2023 / Published: 1 April 2023
(This article belongs to the Collection Gastroenterological Aspects of COVID-19 Infection)
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Abstract

The outbreak of the coronavirus pandemic in March 2020 has caused unprecedented pressure on public health and healthcare. The spectrum of COVID-19 onset is large, from mild cases with minor symptoms to severe forms with multi-organ dysfunction and death. In COVID-19, multiple organ damage has been described, including lung damage, acute kidney injury, liver damage, stroke, cardiovascular and digestive tract disorders. The aspects of liver injury are different, sometimes presenting with only a slight increase in liver enzymes, but sometimes with severe liver injury, leading to acute liver failure requiring liver transplantation. In patients with chronic liver disease, especially liver cirrhosis, immune dysfunction can increase the risk of infection. Immune dysfunction has a multifactorial physiopathological mechanism, implying a complement system and macrophage activation, lymphocyte and neutrophil activity dysfunction, and intestinal dysbiosis. This review aims to evaluate the most relevant studies published in the last years related to the etiopathogenetic, biochemical, and histological aspects of liver injury in patients diagnosed with COVID-19. Liver damage is more evident in patients with underlying chronic liver disease, with a significantly higher risk of developing severe outcomes of COVID-19 and death. Systemic inflammation, coagulation disorders, endothelial damage, and immune dysfunction explain the pathogenic mechanisms involved in impaired liver function. Although various mechanisms of action of SARS-CoV-2 on the liver cell have been studied, the impact of the direct viral effect on hepatocytes is not yet established.
Keywords: COVID-19; liver injury; liver enzymes; SARS-CoV-2; hepatic lesions COVID-19; liver injury; liver enzymes; SARS-CoV-2; hepatic lesions

Share and Cite

MDPI and ACS Style

Marginean, C.M.; Cinteza, E.; Vasile, C.M.; Popescu, M.; Biciusca, V.; Docea, A.O.; Mitrut, R.; Popescu, M.S.; Mitrut, P. Features of Liver Injury in COVID-19 Pathophysiological, Biological and Clinical Particularities. Gastroenterol. Insights 2023, 14, 156-169. https://doi.org/10.3390/gastroent14020012

AMA Style

Marginean CM, Cinteza E, Vasile CM, Popescu M, Biciusca V, Docea AO, Mitrut R, Popescu MS, Mitrut P. Features of Liver Injury in COVID-19 Pathophysiological, Biological and Clinical Particularities. Gastroenterology Insights. 2023; 14(2):156-169. https://doi.org/10.3390/gastroent14020012

Chicago/Turabian Style

Marginean, Cristina Maria, Eliza Cinteza, Corina Maria Vasile, Mihaela Popescu, Viorel Biciusca, Anca Oana Docea, Radu Mitrut, Marian Sorin Popescu, and Paul Mitrut. 2023. "Features of Liver Injury in COVID-19 Pathophysiological, Biological and Clinical Particularities" Gastroenterology Insights 14, no. 2: 156-169. https://doi.org/10.3390/gastroent14020012

APA Style

Marginean, C. M., Cinteza, E., Vasile, C. M., Popescu, M., Biciusca, V., Docea, A. O., Mitrut, R., Popescu, M. S., & Mitrut, P. (2023). Features of Liver Injury in COVID-19 Pathophysiological, Biological and Clinical Particularities. Gastroenterology Insights, 14(2), 156-169. https://doi.org/10.3390/gastroent14020012

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