Lviv clinical bulletin 2022, 1(37)-2(38): 67-74

Liver Injuries Associated with Coronavirus Disease 2019: View on the Problem

V. Prysyazhnyuk, T. Ilashchuk, L. Voloshyna, V. Vasjuk, I. Prysiazhniuk, K. Bobkovych

Bukovinian State Medical University

Introduction. Major cardiovascular and pulmonary comorbidities, as well as diabetes mellitus and certain cancers, are associated with worse clinical outcomes of coronavirus disease-2019 (COVID-19). Meanwhile, the impact of concomitant liver diseases on the COVID-19 natural course together with the influence of the COVID-19 on the hepatic tissues have been rarely investigated.

The aim of the study was to analyse the available data regarding impact of liver pathologies on COVID-19 natural course and outcome, and, reciprocally, hepatic injuries development induced by COVID-19.

Materials and methods. Content analysis, systematic and comparative analysis, bibliosemantic method of investigation of current scientific research results on liver damage associated with COVID-19 were used.

Results. The potential mechanism of liver injury in COVID-19 is complex and includes direct cytopathic viral injury, proinflammatory cytokine outbreak, hypoxia/reperfusion damage and potential drug induced liver injury. Among the medications used for the treatment of COVID-19 patients, there are certain that could potentially cause drug-induced liver injury. Treatment of liver transplant patients can be challenging taking into consideration the possible necessity of immunosuppressive therapy correction combined with the needs to find a balance between the risk of graft rejection and effective elimination of the virus.

Conclusions. Current review of the available database revealed that liver diseases are among substantive comorbidities in COVID-19 patients alongside with liver injuries which are rather frequent complications of COVID-19 treatment. Potential drug-induced liver injuries in patients subjected tocertain antiviral agents in combination with supportive therapy drugs should be taken into consideration. Special precautions are required to prevent potential drug-to-drug interactions in case of COVID-19 treatment in liver transplant patients.


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