Pathophysiological mechanisms of liver injury in COVID-19.

Pathophysiological mechanisms of liver injury in COVID-19.
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DOI:
10.1111/liv.14730
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发表时间:
2021-01
期刊:
Liver international : official journal of the International Association for the Study of the Liver
影响因子:
--
通讯作者:
Trauner M
Trauner M
中科院分区:
其他
文献类型:
--
作者:
Nardo AD;Schneeweiss-Gleixner M;Bakail M;Dixon ED;Lax SF;Trauner M

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最近爆发的2019冠状病毒病(COVID-19)由严重急性呼吸系统综合征冠状病毒2(SARS-CoV-2)引起,导致全球大流行。弥漫性肺损伤伴急性呼吸窘迫综合征(ARDS)的发展是COVID-19死亡的主要原因。尽管在没有预先存在的肝脏疾病的情况下似乎不会发生肝衰竭,但COVID-19的肝脏受累可能与总体疾病严重程度相关,并作为发展为ARDS的预后因素。COVID-19的肝损伤范围可能包括SARS-CoV-2的直接感染、全身炎症的间接参与、缺氧变化、药物和通气等医源性原因以及基础肝病的恶化。这篇简要的综述讨论了SARS-CoV-2肝嗜性以及COVID-19中急性和可能的长期肝损伤的潜在病理生理机制。
The recent outbreak of coronavirus disease 2019 (COVID‐19), caused by the Severe Acute Respiratory Syndrome Coronavirus‐2 (SARS‐CoV‐2) has resulted in a world‐wide pandemic. Disseminated lung injury with the development of acute respiratory distress syndrome (ARDS) is the main cause of mortality in COVID‐19. Although liver failure does not seem to occur in the absence of pre‐existing liver disease, hepatic involvement in COVID‐19 may correlate with overall disease severity and serve as a prognostic factor for the development of ARDS. The spectrum of liver injury in COVID‐19 may range from direct infection by SARS‐CoV‐2, indirect involvement by systemic inflammation, hypoxic changes, iatrogenic causes such as drugs and ventilation to exacerbation of underlying liver disease. This concise review discusses the potential pathophysiological mechanisms for SARS‐CoV‐2 hepatic tropism as well as acute and possibly long‐term liver injury in COVID‐19.
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