COVID-19 and liver disease
COVID-19 and liver disease
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DOI：
10.1136/gutjnl-2021-326792
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发表时间：
2022-06-14
期刊：
影响因子：
24.5
通讯作者：
Tilg, Herbert
中科院分区：
文献类型：
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作者：
Dufour, Jean-Francois;Marjot, Thomas;Tilg, Herbert
疫情期间，有关SARS-CoV-2感染及其导致的COVID-19肝病的知识迅速增加。因此，我们回顾了COVID-19在非肝病患者中与SARS-CoV-2感染相关的肝脏表现和病理生理学方面，以及COVID-19对慢性肝病（CLD）患者的影响，特别是肝硬化和肝移植（LT）。SARS-CoV-2感染与明显的促炎细胞因子谱相关，这可能是观察到的早期和晚期肝脏异常的主要原因。CLD，特别是失代偿性肝硬化，应被视为严重COVID-19和死亡的风险因素。LT在大流行期间受到影响，主要是由于对捐赠和接受者感染的担忧。然而，LT本身并不代表不良结局的风险因素。尽管缺乏，但关于特殊人群（如LT接受者）的COVID-19特异性治疗的数据似乎很有希望。COVID-19疫苗诱导的免疫力似乎在CLD和LT接受者中受损，因此主张修改该人群的疫苗接种时间表。
Knowledge on SARS-CoV-2 infection and its resultant COVID-19 in liver diseases has rapidly increased during the pandemic. Hereby, we review COVID-19 liver manifestations and pathophysiological aspects related to SARS-CoV-2 infection in patients without liver disease as well as the impact of COVID-19 in patients with chronic liver disease (CLD), particularly cirrhosis and liver transplantation (LT). SARS-CoV-2 infection has been associated with overt proinflammatory cytokine profile, which probably contributes substantially to the observed early and late liver abnormalities. CLD, particularly decompensated cirrhosis, should be regarded as a risk factor for severe COVID-19 and death. LT was impacted during the pandemic, mainly due to concerns regarding donation and infection in recipients. However, LT did not represent a risk factor per se of worse outcome. Even though scarce, data regarding COVID-19 specific therapy in special populations such as LT recipients seem promising. COVID-19 vaccine-induced immunity seems impaired in CLD and LT recipients, advocating for a revised schedule of vaccine administration in this population.