Deng ML, Chen YJ, Yang ML, Liu YW, Chen H, Tang XQ, Yang XF. COVID-19 combined with liver injury: Current challenges and management. World J Clin Cases 2021; 9(15): 3487-3497 [PMID: 34046449 DOI: 10.12998/wjcc.v9.i15.3487]
Corresponding Author of This Article
Xue-Feng Yang, MD, Full Professor, Department of Gastroenterology, The Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, No. 336 Dongfeng Road, Zhuhui District, Hengyang 421002, Hunan Province, China. yxf9988@126.com
Research Domain of This Article
Integrative & Complementary Medicine
Article-Type of This Article
Opinion Review
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/
Man-Ling Deng, Yi-Wen Liu, Hui Chen, Xue-Feng Yang, Department of Gastroenterology, The Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
Yong-Jun Chen, Department of Neurology, The Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
Mei-Ling Yang, Department of Oncology, The Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, Hengyang 421002, Hunan Province, China
Xiao-Qing Tang, Institute of Clinical Medicine, The First Affiliated Hospital, Hengyang Medical College, University of South China, Hengyang 421001, Hunan Province, China
Author contributions: Deng ML and Chen YJ equally contributed to this work; Deng ML, Chen YJ, Yang ML, Liu YW, Chen H, Tang XQ, and Yang XF all contributed to the literature review and the writing of this manuscript.
Supported byNovel Coronavirus Pneumonia Emergency Project of University of South China, No. 2020-15 and No. 2020-25; Fund Project of Hengyang City for Prevention and Control of COVID-19, No. 202010031577; and Key Research and Development Program of Hunan Province, No. 2020SK3039 and No. 2020SK3040.
Conflict-of-interest statement: All authors of this article declare that there is no conflict of interest with any person or organization.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xue-Feng Yang, MD, Full Professor, Department of Gastroenterology, The Affiliated Nanhua Hospital, Hengyang Medical College, University of South China, No. 336 Dongfeng Road, Zhuhui District, Hengyang 421002, Hunan Province, China. yxf9988@126.com
Received: January 14, 2021 Peer-review started: January 14, 2021 First decision: February 10, 2021 Revised: March 7, 2021 Accepted: March 29, 2021 Article in press: March 29, 2021 Published online: May 26, 2021 Processing time: 117 Days and 3.7 Hours
Abstract
Coronavirus disease 2019 (COVID-19) combined with liver injury has become a very prominent clinical problem. Due to the lack of a clear definition of liver injury in patients with COVID-19, the different selection of evaluation parameters and statistical time points, there are the conflicting conclusions about the incidence rate in different studies. The mechanism of COVID-19 combined with liver injury is complicated, including the direct injury of liver cells caused by severe acute respiratory syndrome coronavirus 2 replication and liver injury caused by cytokines, ischemia and hypoxia, and drugs. In addition, underlying diseases, especially chronic liver disease, can aggravate COVID-19 liver injury. In the treatment of COVID-19 combined with liver injury, the primary and basic treatment is to treat the etiology and pathogenesis, followed by support, liver protection, and symptomatic treatment according to the clinical classification and severity of liver injury. This article evaluates the incidence, pathogenesis and prevention and treatment of COVID-19 combined with liver injury, and aims to provide countermeasures for the prevention and treatment of COVID-19 combined with liver injury.
Core Tip: The prevention and treatment of coronavirus disease 2019 (COVID-19) combined with liver injury face many challenges. First, the definition of COVID-19 combined with liver injury is not clear, the selected parameters and the time of statistics are inconsistent, and the conclusions about the incidence rate are consistent. Second, the etiology and mechanism of COVID-19 combined liver injury are not clear and need to be studied in depth. Third, there is a lack of effective treatment methods. This article provides and additional view of the incidence of COVID-19-associated liver injury and explores the contemporary management modalities.
