COVID-19: a viewpoint from hepatic perspective

Area of Science:

• Virology
• Infectious Diseases
• Hepatology

Background:

• Coronaviruses, known since the last century, are named for their crown-like spikes.
• COVID-19, caused by a novel coronavirus, is highly infectious, differing from SARS and MERS.
• Initial high case fatality rates for COVID-19 have decreased; many cases are asymptomatic or present with fever, breathlessness, and GI symptoms.

Purpose of the Study:

• To review the characteristics of COVID-19, including its pathogenesis and impact on specific patient groups.
• To discuss the implications of COVID-19 on liver function and potential risks for individuals with pre-existing liver conditions or undergoing immunosuppression.
• To highlight the need for further research into COVID-19-associated liver injuries and treatment side effects.

Main Methods:

• Review of existing literature on coronaviruses, SARS, MERS, and COVID-19.
• Analysis of COVID-19 pathogenesis, particularly its interaction with ACE 2 receptors.
• Examination of clinical observations regarding COVID-19 symptoms, risk factors (hypertension), and liver enzyme derangements.

Main Results:

• COVID-19 pathogenesis involves ACE 2 receptors, leading to increased cases and mortality among hypertensive individuals, especially those using ACE inhibitors.
• Deranged liver enzymes are common in COVID-19, though serious liver injury is less documented, potentially linked to the disease or antiviral drugs.
• Individuals with autoimmune hepatitis, liver cancer, or immunosuppression require extra precautions.

Conclusions:

• COVID-19 presents a significant public health challenge with varied clinical manifestations and potential impacts on liver health.
• Hypertensive patients, particularly those on ACE inhibitors, face elevated risks.
• Further research is crucial to understand and manage COVID-19-related liver injuries and treatment side effects, especially in vulnerable populations.