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Severe COVID-19 patients with liver injury: a seven-case series

X Li1, Z-C Zhang, P-L Zhang

  • 1Department of Neurology, The Third Central Clinical College of Tianjin Medical University, Tianjin, China. doctorlixia@tmu.edu.cn.

European Review for Medical and Pharmacological Sciences
|August 4, 2020
PubMed

Insights

Severe COVID-19 can cause liver injury, particularly in elderly patients with underlying conditions. Monitoring liver function is crucial for these vulnerable individuals during infection.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primarily targets the respiratory system.
  • The impact of coronavirus disease 2019 (COVID-19) on liver function, especially in severe cases, requires further investigation.

Observation:

  • Seven elderly patients with severe COVID-19 and comorbidities (hypertension, diabetes, coronary heart disease) developed hepatic injury.
  • Elevated serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were observed during the second week of illness.
  • Liver function normalized within one week with conventional supportive care.

Findings:

  • COVID-19 infection can lead to liver injury, evidenced by elevated transaminase levels.
  • Potential mechanisms include direct viral effect, immune-mediated damage (cytokine storm syndrome), and hypoxic injury to hepatocytes.
  • Hepatic injury in COVID-19 patients is associated with disease severity and patient comorbidities.

Implications:

  • Close monitoring of liver function is recommended for elderly COVID-19 patients with comorbidities.
  • Understanding COVID-19's hepatotoxicity is vital for comprehensive patient management.
  • Further research into the mechanisms of COVID-19-induced liver injury may inform therapeutic strategies.

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