Abstract
A novel strain of coronoviridae (SARS-CoV-2) was reported in Wuhan China in December 2019. Initially, infection presented with a broad spectrum of symptoms which typically included muscle aches, fever, dry cough, and shortness of breath. SARS-CoV-2 enters cells via ACE2 receptors which are abundant throughout the respiratory tract. However, there is evidence that these receptors are abundant throughout the body, and just as abundant in cholangiocytes as alveolar cells, posing the question of possible direct liver injury. While liver enzymes and function tests do seem to be deranged in some patients, it is questionable if the injury is due to direct viral damage, drug-induced liver injury, hypoxia, or microthromboses. Likely, the injury is multifactoral, and management of infected patients with pre-existing liver disease should be taken into consideration. Ultimately, a vaccine is needed to aid in reducing cases of SARS-CoV-2 and providing immunity to the general population. However, while considering the types of vaccines available, safety concerns, particularly of RNA- or DNA-based vaccines, need to be addressed.
Highlights
A novel strain of coronaviridae (SARS-CoV-2) was first reported in the Wuhan province of China in December 2019
It is unclear to what extent pre-existing liver disease contributes to liver injury seen in Severe Acute Respiratory Syndrome (SARS)-CoV-2 patients
A very recent study conducted in the UK on more than 17 million people has identified pre-existing liver disease as an independent risk factor of death in SARS-CoV-2 infections [42]
Summary
A novel strain of coronaviridae (SARS-CoV-2) was first reported in the Wuhan province of China in December 2019. SARS-CoV-2 injury patients by had liver injury bya seems to p excessive inflammatory (‘cytokine storm’), responsible for severe cardiopulmonary manifestations, sometimes leading to acute respiratory distress syndrome, shock, and death vomiting, diarrhoea, vomiting, diarrhoea, rashes, vomiting, and skin vasculitic rashes, diarrhoea, and manifestations. Respiratory in particular hypoxia, have been the main indication for hospitalisation It has beensymptoms, reported that of SARS-CoV-2 patients hadby liver injury by symptoms as14.8%–53%. This isdeath confirmed in and death andbiphasic elevatedpattern gamma-glutamyl transferase These abnormalities seem to the occur during abnormal liver function tests—mainly elevated alanine aminotransferase (ALT), hypoalbuminemia, manifestations, manifestations, sometimes leading sometimes manifestations, to acute leading respiratory sometimes toviral acute distress respiratory leading syndrome, todistress acute shock, respiratory syndrome, and death distress shock, and syndrome, shock, first phase to (‘viremia’), invasion corresponding of body, causes to viral invasion of the body, causes of liver injury andthat the current advice regarding management of for liver disease patients including liver liver function tests—mainly elevated alanine aminotransferase (ALT), hypoalbuminemia, andthe elevated recent reports.
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