ABSTRACT
Liver injury-expressed as elevated liver enzymes-is common in patients with COVID-19. Little is known about the potential mechanisms of liver damage by SARS-CoV-2. A direct cytopathic effect on hepatocytes as well as injury related to hypoxia or hepatotoxicity are being considered. The aim of the study was to compare the clinical characteristic of COVID-19 disease in patients with normal and abnormal liver enzymes activity. A group of 150 patients with COVID-19, hospitalized in our center, was analyzed. Patients with the known liver comorbidities were excluded (n = 15). Clinical features and laboratory parameters were compared between patients with normal and abnormal aminotransferase values. Liver injury expressed as any alanine aminotransferase (ALT) elevation was noted in 45.6% of patients hospitalized due to COVID-19. The frequencies of aspartate aminotransferase (AST) elevation were lower. It was noted that elevated ALT/AST unfavorably affected other parameters related to liver function such as albumin level; gamma-glutamyl transpeptidase (GGTP); and partly, ALP activity and influenced inflammation-related parameters. The most probable cause of mild hepatitis during COVID-19 was anoxia and immune-mediated damage due to the inflammatory response following SARS-CoV-2 infection. A direct cytopathic effect of SARS-CoV-2 on hepatocytes, albeit less probable, can be considered as well. The use of potentially hepatotoxic drugs may contribute to liver damage.
ABSTRACT
Increased incidence of hepatocellular carcinoma related to hepatitis C virus (HCV) infection has been noted recently. Only in year 2000 seven new cases of HCC in HCV-positive patients were diagnosed. In all cases liver tumors were found in cirrhotic patients and they were at advanced stage (multiple or large in size) precluding successful therapy. More than half of HCC cases related to HCV infection were connected with blood transfusion(s) in the past. Patients transfused a few decades ago should be screened for HCV infection and those with liver cirrhosis require careful and regular monitoring including ultrasound and a-fetoprotein examinations in order to detect focal lesions at less advanced stage making medical intervention possible.
