Liver: Function and dysfunction in COVID-19

Context: COVID-19 is known to cause extrapulmonary manifestations, including gastrointestinal and abnormal liver afunctions. Multiple mechanisms have been proposed to explain the pathobiology of liver damage: ACE2 receptor cholangiocytes mediated systemic inflammation, cytokine storm, hyperinflammat...

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Bibliographic Details
Published in:Journal of family medicine and primary care 2022-02, Vol.11 (2), p.758-761
Main Authors: Harisha, E, Gosavi, Siddharth, Rao, Amogh, Sahana, G, Manjunath, Sanath, Meghana, T
Format: Article
Language:English
Subjects:
coronavirus
hypoalbuminemia
Liver
Liver diseases
liver function test
Medical colleges
Medical research
Medicine, Experimental
Original
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Summary:Context: COVID-19 is known to cause extrapulmonary manifestations, including gastrointestinal and abnormal liver afunctions. Multiple mechanisms have been proposed to explain the pathobiology of liver damage: ACE2 receptor cholangiocytes mediated systemic inflammation, cytokine storm, hyperinflammation, and hypoxic changes. This was a cross-sectional study done in Department of General Medicine,JJM Medical College Davangere between July and September 2020 of patients falling under Category B and Category C. Materials and Methods: The aim is to describe the clinical characteristics in patients of COVID-19 and investigate the gender difference with particular regard to liver impairment.Confirmation of COVID-19 positivity was based on RT-PCR for SARS-CoV-2 RNA. Laboratory investigations and clinical data was analyzed using SPSS Statistics 27. Results: The final study population consisted of 116 patients. On performing the Mann Whitney U test, adjusted P values reveal a significant difference in ALT (P = 0.0348), total bilirubin (P = 0.0012) and direct bilirubin (P = 0.0024). The degree of hypoalbuminemia in males was significantly higher than in females (P = 0.0075). Other biochemical parameters, however, did not show significant difference amongst patients based on gender. Acute kidney injury was the most prevalent condition, present in 67.2% of the patients. Other co-morbidities were diabetes mellites, chronic liver disease, hypertension, hepatitis B and C, and hypothyroidism. Conclusion: Ultrasonography of the abdomen is an essential investigation for all patients testing positive for COVID-19. Pre-existing disease may aggravate the viral hepatic injury, thereby worsening the clinical outcome. The profiles of liver toxicity of the drugs used in the treatment of COVID-19 also warrant watchful monitoring of liver function.
ISSN:2249-4863
2278-7135
DOI:10.4103/jfmpc.jfmpc_7_21