Abstract
The current pandemic caused by SARS-CoV-2 originated in the city of Wuhan, China with an outbreak of pneumonia. The reported symptoms were mostly respiratory, but mounting evidence began to indicate that COVID-19 could reach other organs and systems. Among the gastrointestinal symptoms, liver involvement appears to be more common, with changes in liver enzymes (ALT and AST) being the first sign. Therefore, the present study aims to evaluate and discuss the hepatic manifestations in COVID-19 as the infection, manifestations, and drug effects. The study was based on a literature review, of a qualitative nature and an exploratory type. The mechanism that SARS-CoV-2 uses to reach the liver is still uncertain, there are currently 3 hypotheses: ACE2 receptors in cholangiocytes, cytokine storm, and drug-induced liver injury, due to the increase in the indiscriminate use of hepatotoxic drugs without scientific comprovation, hydroxychloroquine can lead to fulminant hepatic failure and azithromycin potentiates these effects, the role of remdesivir on the liver are still uncertain. Liver damage in mild cases of COVID-19 can be transient, but doctors should monitor and be alert to any changes in liver enzymes. When severe liver damage occurs, liver protective drugs have usually been given to these patients. Thus, this review provides a review of hepatic impairment and the management of patients considering the main studies carried out to date.
Highlights
At the end of 2019 the World Health Organization (WHO) received notification of a cluster group of patients affected by pneumonia due to an unknown cause from Wuhan, China (Del Rio, 2019)
On January 9, 2020, it was reported that this novel type of coronavirus, termed as “novel coronavirus-2019” (SARS-CoV-2), was responsible for the outbreak (Chakraborty, 2020) leading the WHO in March 11, 2020 to characterize the infection as a pandemic (WHO, 2020)
Consisting of articles selected through searches in national and international databases, such as Medical Literature Analysis and Retrieval System Online (MEDLINE), National Library of Medicine (PUBMED), in addition the Google Academic tool, with publication date from 2014 to 2021 and include the keywords used (Covid-19; Sars-CoV-2 liver infection; Drug induced liver injury (DILI); Patient’s management)
Summary
At the end of 2019 the World Health Organization (WHO) received notification of a cluster group of patients affected by pneumonia due to an unknown cause from Wuhan, China (Del Rio, 2019). The SARS-CoV-2 infects the human cells by spike glycoprotein binding to its cellular receptor, angiotensin-converting enzyme 2 (ACE2) (Ge, 2020). A varying degree of liver test abnormalities has been described in COVID-19 affected patients (Guan, 2020), elevated markers of liver cell injury (ALT, AST) are more common (Fan et al, 2020). There is not an effective antiviral drug for COVID-19, symptomatic and supportive treatments are crucial, many patients are treated with antiviral and antipyretic drugs, both drugs have adverse reactions, including liver injury (Fan et al, 2020).it is important for clinicians not to be distracted by minimally elevated liver enzymes and focus on general management and supportive care (Cha, 2020). The characteristics’ explanations of hepatic involvement caused by SARS-CoV-2 infection, the drug's effects used as treatment, and the patients' management are summarized
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callMore From: RECIMA21 - Revista Científica Multidisciplinar - ISSN 2675-6218
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
