Liptak P, Nosakova L, Rosolanka R, Skladany L, Banovcin P. Acute-on-chronic liver failure in patients with severe acute respiratory syndrome coronavirus 2 infection. World J Hepatol 2023; 15(1): 41-51 [PMID: 36744167 DOI: 10.4254/wjh.v15.i1.41]
Corresponding Author of This Article
Lenka Nosakova, MD, PhD, Doctor, Clinic of Internal Medicine-Gastroenterology, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University, Kollarova 2, Martin 03601, Slovakia. lenka.bubernakova@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Jan 27, 2023; 15(1): 41-51 Published online Jan 27, 2023. doi: 10.4254/wjh.v15.i1.41
Acute-on-chronic liver failure in patients with severe acute respiratory syndrome coronavirus 2 infection
Peter Liptak, Lenka Nosakova, Robert Rosolanka, Lubomir Skladany, Peter Banovcin
Peter Liptak, Lenka Nosakova, Peter Banovcin, Clinic of Internal Medicine-Gastroenterology, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University, Martin 03601, Slovakia
Robert Rosolanka, Clinic of Infectology and Travel Medicine, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University, Martin 03601, Slovakia
Lubomir Skladany, Department of Internal Medicine II, Division Hepatology, Gastroenterology and Liver Transplantation, FD Roosevelt University Hospital of Slovak Medical University, Banska Bystrica 97517, Slovakia
Author contributions: Liptak P wrote the manuscript, prepared the figure and completed the manuscript; Nosakova L and Rosolanka R wrote the manuscript and prepared the tables; Skladany L and Banovcin P supervised and coordinated manuscript preparation.
Supported byResearch and Development of a Telemedicine System to Support the Monitoring of the Possible Spread of COVID-19 in Order to Develop Analytical Tools Used to Reduce the Risk of Infection, No. ITMS: 313011ASX4.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior authors or other coauthors who contributed their efforts to this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lenka Nosakova, MD, PhD, Doctor, Clinic of Internal Medicine-Gastroenterology, University Hospital in Martin, Jessenius Faculty of Medicine in Martin, Comenius University, Kollarova 2, Martin 03601, Slovakia. lenka.bubernakova@gmail.com
Received: September 13, 2022 Peer-review started: September 13, 2022 First decision: October 20, 2022 Revised: November 3, 2022 Accepted: November 28, 2022 Article in press: November 28, 2022 Published online: January 27, 2023
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had a significant impact on the lives of millions of people, especially those with other concomitant diseases, such as chronic liver diseases. To date, seven coronaviruses have been identified to infect humans. The main site of pathological action of these viruses is lung tissue. However, a substantial number of studies have proven that SARS-CoV-2 shows affinity towards several organs, including the gastrointestinal tract and the liver. The current state of evidence points to several proposed mechanisms of liver injury in patients with COVID-19 and their combination. Liver impairment is considered to be the result of the direct effect of the virus on the hepatic tissue cells, a systemic reaction consisting of inflammation, hypoxia and cytokine storm, drug-induced liver injury, with the possible contribution of a perturbed gut-liver axis. Reactivation of chronic hepatic disease could be another factor for liver impairment in patients with SARS-CoV-2 infection. Acute-on-chronic liver failure (ACLF) is a relatively new syndrome that occurs in 10%–30% of all hospitalized patients with chronic liver disease. It is crucial to recognize high-risk patients due to the increased morbidity and mortality in these cases. Several published studies have reported virus infection as a trigger factor for ACLF. However, to date, there are few relevant studies describing the presence of ACLF in patients with acute SARS-CoV-2 infection. In this minireview we summarize the current state of knowledge regarding the relation between ACLF and acute SARS-CoV-2 infection.
Core Tip: The main aim of this brief review is to summarize current knowledge on the acute-on-chronic liver failure (ACLF) in patients with coronavirus disease 2019 (COVID-19). We also describe several mechanisms by which severe acute respiratory syndrome coronavirus 2 infection induces liver injury. Although several systematic reviews have already been published regarding liver impairment in COVID-19, there are few studies focusing on ACLF. We believe that this brief review has an informative value for clinicians and could contribute to better understanding of the disease and therefore improved management of this serious condition.
