Covid-19 and Liver Injury: Role of Inflammatory Endotheliopathy, Platelet Dysfunction, and Thrombosis.
Matthew J McConnellReiichiro KondoNao KawaguchiYasuko IwakiriPublished in: Hepatology communications (2021)
Liver injury, characterized predominantly by elevated aspartate aminotransferase and alanine aminotransferase, is a common feature of coronavirus disease 2019 (COVID-19) symptoms caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). Additionally, SARS-CoV-2 infection is associated with acute-on-chronic liver failure in patients with cirrhosis and has a notably elevated mortality in patients with alcohol-related liver disease compared to other etiologies. Direct viral infection of the liver with SARS-CoV-2 remains controversial, and alternative pathophysiologic explanations for its hepatic effects are an area of active investigation. In this review, we discuss the effects of SARS-CoV-2 and the inflammatory environment it creates on endothelial cells and platelets more generally and then with a hepatic focus. In doing this, we present vascular inflammation and thrombosis as a potential mechanism of liver injury and liver-related complications in COVID-19.
Keyphrases
- liver injury
- respiratory syndrome coronavirus
- drug induced
- sars cov
- coronavirus disease
- liver failure
- oxidative stress
- endothelial cells
- pulmonary embolism
- hepatitis b virus
- risk factors
- machine learning
- type diabetes
- cardiovascular events
- cardiovascular disease
- risk assessment
- depressive symptoms
- intensive care unit
- vascular endothelial growth factor
- african american
- alcohol consumption
- extracorporeal membrane oxygenation