Liver dysfunction in the patient with COVID-19. (Pautas nacionales para la atenci..n de pacientes adultos con COVID-19.) [Spanish]

ABSTRACT

In all patients diagnosed with COVID-19, they must evaluate the existence of previous liver disease and consider that, if it exists, it is an element of poor prognosis. In Uruguay, according to the MSP Epidemiological Report of 3/10/20, 9 of 529 deceased patients had previous liver disease as comorbidity (1.7%). In patients with hepatic dirrhosis, immunosuppression due to prolonged treatment with high doses of corticosteroids can favor the development of spontaneous bacterial peritonitis and variceal bleeding due to increased portal hypertension. According to numerous published works, 2% to 11% of patients with COVID-19 had underlying chronic liver disease. Hepatogram abnormalities to monitor in the clinical context include elevated TGO and TGP enzymes as an expression of hepatocyte injury;the elevation of lactate dehydrogenase (LDH) is also characteristic but its wide distribution in the organism is an expression of endothelial injury and hypoperfusion of various tissues, particularly muscle, not only liver.