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Liver Injury in Patients with COVID-19 without Underlying Liver Disease

Department of Infectious Disease and Hepatology, Wroclaw Medical University, 50-367 Wroclaw, Poland
Department of Infectious Diseases, Regional Specialistic Hospital, 50-149 Wroclaw, Poland
Department of Internal Medicine and Geriatrics, Faculty of Medicine, Jagiellonian University Medical College, 31-008 Kraków, Poland
Department of Endoscopy, University Hospital in Kraków, 30-688 Kraków, Poland
Department of Pharmaceutical Biochemistry, Wroclaw Medical University, 50-556 Wroclaw, Poland
Author to whom correspondence should be addressed.
Academic Editor: Yasuhito Tanaka
J. Clin. Med. 2022, 11(2), 308;
Received: 1 December 2021 / Revised: 20 December 2021 / Accepted: 31 December 2021 / Published: 8 January 2022
(This article belongs to the Section Gastroenterology & Hepatopancreatobiliary Medicine)
SARS-CoV-2 shows a high affinity for the ACE-2 receptor, present on the epithelial cells of the upper and lower respiratory tract, within the intestine, kidneys, heart, testes, biliary epithelium, and—where it is particularly challenging—on vascular endothelial cells. Liver involvement is a rare manifestation of COVID-19. Material and Methods: We reviewed 450 patients admitted due to the fact of SARS-CoV-2 infection (COVID-19) including 88 with liver injury. Based on medical history and previous laboratory test results, we excluded cases of underlying liver disease. The analysis involved a clinical course of COVID-19 in patients without underlying liver disease as well as the type and course of liver injury. Results: Signs and symptoms of liver injury were present in 20% of patients, mostly presenting as a mixed-type pattern of injury with less common cases of standalone hepatocellular (parenchymal) or cholestatic injury. The liver injury symptoms resolved at the end of inpatient treatment in 20% of cases. Sixteen patients died with no cases where liver injury would be deemed a cause of death. Conclusions: (1) Liver injury secondary to COVID-19 was mild, and in in 20%, the signs and symptoms of liver injury resolved by the end of hospitalization. (2) It seems that liver injury in patients with COVID-19 was not associated with a higher risk of mortality. (3) The underlying mechanism of liver injury as well as its sequelae are not fully known. Therefore, caution and further monitoring are advised, especially in patients whose liver function tests have not returned to normal values. View Full-Text
Keywords: SARS-CoV-2 infection; liver injury; cholestasis SARS-CoV-2 infection; liver injury; cholestasis
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MDPI and ACS Style

Pazgan-Simon, M.; Serafińska, S.; Kukla, M.; Kucharska, M.; Zuwała-Jagiełło, J.; Buczyńska, I.; Zielińska, K.; Simon, K. Liver Injury in Patients with COVID-19 without Underlying Liver Disease. J. Clin. Med. 2022, 11, 308.

AMA Style

Pazgan-Simon M, Serafińska S, Kukla M, Kucharska M, Zuwała-Jagiełło J, Buczyńska I, Zielińska K, Simon K. Liver Injury in Patients with COVID-19 without Underlying Liver Disease. Journal of Clinical Medicine. 2022; 11(2):308.

Chicago/Turabian Style

Pazgan-Simon, Monika, Sylwia Serafińska, Michał Kukla, Marta Kucharska, Jolanta Zuwała-Jagiełło, Iwona Buczyńska, Kamila Zielińska, and Krzysztof Simon. 2022. "Liver Injury in Patients with COVID-19 without Underlying Liver Disease" Journal of Clinical Medicine 11, no. 2: 308.

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