COVID-19 and the liver - Lessons learned.
COVID-19 and the liver - Lessons learned.
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DOI：
10.1111/liv.14854
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发表时间：
2021-06
期刊：
影响因子：
--
通讯作者：
Berg T
中科院分区：
文献类型：
--
作者：
Herta T;Berg T
肝功能检查结果升高表明肝脏受累在2019冠状病毒病（COVID-19）住院患者中很常见，并与疾病严重程度和结局有关。尤其是在重度或危重COVID-19患者中，可以观察到肝功能检查结果升高的双重模式，其特征是在病程早期转氨酶升高，随后在后期胆汁淤积相关生化标志物升高。这种双重模式与炎症反应标志物和不良结局相关。目前关于COVID-19肝损伤机制的概念包括病毒对肝细胞和胆管细胞的直接细胞病变作用、缺血性和缺氧性肝损伤、药物诱导的肝损伤、过量细胞因子产生激活肝免疫细胞以及既存肝病恶化。肥胖相关非酒精性脂肪性肝病患者，特别是肝硬化患者，存在肝损伤和COVID-19致死性结局的高风险。相比之下，接受稳定的免疫抑制药物治疗自身免疫性肝病或在肝移植后长期随访期间的个体没有更高的病例感染率，并且具有相当有利的结局。本综述描述了COVID-19相关肝损伤的流行病学、特征和潜在病理机制。此外，还讨论了既存肝脏疾病对COVID-19肝损伤的易感性和严重程度的影响。
Liver involvement, indicated by elevated liver function test results, is common in hospitalized patients with coronavirus disease 2019 (COVID‐19) and has been linked to disease severity and outcome. A dual pattern of elevated liver function tests can be observed especially in patients with severe or critical COVID‐19, characterized by an increase in aminotransferases early in the course of this disease, followed by an increase in cholestasis‐associated biochemistry markers at later stages. This dual pattern is associated with inflammatory response markers and poor outcome. Current notions on the mechanisms of liver injury in COVID‐19 include direct cytopathic effects of the virus on hepatocytes and cholangiocytes, ischemic and hypoxic liver damage, drug‐induced liver injury, activation of hepatic immune cells by excess cytokine production and exacerbation of pre‐existing liver disease. Patients with obesity‐related non‐alcoholic fatty liver disease and, in particular, patients with cirrhosis are at high risk of liver injury and a fatal outcome from COVID‐19. In contrast, individuals receiving stable immunosuppressive medication for autoimmune liver diseases or during long‐term follow‐up after liver transplantation do not have a higher case‐to‐infection ratio and have a fairly favourable outcome. The present review describes the epidemiology, characteristics and potential pathological mechanisms of COVID‐19‐related liver injury. Moreover, the influence of pre‐existing liver disease on the susceptibility and severity of liver injury in COVID‐19 are discussed.
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影响因子：
4.7
作者：
Bernal-Monterde V;Casas-Deza D;Letona-Giménez L;de la Llama-Celis N;Calmarza P;Sierra-Gabarda O;Betoré-Glaria E;Martínez-de Lagos M;Martínez-Barredo L;Espinosa-Pérez M;M Arbones-Mainar J
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通讯作者：
Craxi, Antonio
DOI：
10.1016/s2468-1253(20)30293-4
发表时间：
2020-11
期刊：
The lancet. Gastroenterology & hepatology
影响因子：
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作者：
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通讯作者：
Taner T
影响因子：
13.5
作者：
Bloom, Patricia P.;Meyerowitz, Eric A.;Chung, Raymond T.
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Chung, Raymond T.
影响因子：
105.7
作者：
Docherty, Annemarie B.;Harrison, Ewen M.;Semple, Malcolm G.
通讯作者：
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