COVID-19 impact on pre-existing liver pathologies
DISCOVERIES REPORTS (ISSN 2393249X), 2021, volume 4

Access FULL text of the manuscript here:

GO BACK to 2021, VOLUME 4

CITATION: Kamwal C, Shivakumar J, Bhattarai S, Peethambar G, Gor D, Sama S, Kishore M, Karam A, Garimella V, Salvador R, Bhatt KP, Avila M, Nasiff L, Selub S, Michel G. COVID-19 impact on pre-existing liver pathologies. Discoveries Reports 2021; 4(3): e25. DOI: 10.15190/drep.2021.10  Submitted: Aug. 03, 2021; Revised: Oct. 05, 2021; Accepted: Dec. 11, 2021; Published: Dec. 31, 2021.

COVID-19 impact on pre-existing liver pathologies 

Chhaya Kamwal1, Jeevan Shivakumar1, Sanket Bhattarai1, Gowri Peethambar (1), Dhairya Gor (2), Srikar Sama (1), Mehwish Kishore (1), Alvina Karam (3), Vamsi Garimella (4), Romarie Salvador (1), Kinal Paresh Bhatt (1,*), Mark Avila (5), Luis Nasiff (5), Steven Selub (5), George Michel (5)

(1) Division of Clinical and Translational, Larkin Health System, South Miami, FL, USA
(2) Jersey Shore University Medical Center, Neptune City, NJ, USA
(3) Khyber Medical College, Peshawar, Khyber, Pakistan
(4) University of Miami Holy Cross Hospital, Fort Lauderdale, FL, USA
(5) Larkin Community Hospital, South Miami, FL, USA 

* Corresponding author: Kinal Paresh Bhatt, MD, MPH, Division of Clinical and Translational, Larkin Health System, 7031 SW 62nd Ave, South Miami, FL 33124, USA; Phone: (928) 225 0273; Email: kinalbhatt@gmail.com

Abstract

Liver damage in patients with COVID-19 may be due to multiple factors ranging from direct viral entry into hepatocytes, pneumonia-induced hypoxia, immune-mediated hepatitis, and drug-induced hepatotoxicity. The impact of COVID-19 on the liver is discussed in a wide range of studies. Even though the respiratory system has been identified as the target organ to be involved with this infection, recent reports showed that about 2-11% of patients with COVID-19 had underlying chronic liver disease. This further emphasizes that there is a need for more research on the subject. This article explores how SARS-COV-2 infection has affected the course of hepatocellular carcinoma, autoimmune hepatitis, and hepatitis B and C infection in terms of risk of acquisition of the disease, diagnosis, treatment, and treatment and prevention modalities of these diseases.

References

1. The WorldHealthOrganization. WHO COVID-19 Dashboard. Geneva: WorldHealthOrganization, 2020.https://covid19.who.int (Accessed: September 13, 2021).
2. Jothimani D, Venugopal R, Abedin MF, Kaliamoorthy I, Rela M. COVID-19 and the liver. J Hepatol. 2020 Nov;73(5):1231-1240. Epub 2020 Jun 15.
3. Diaz A, Sarac BA, Schoenbrunner AR, Janis JE, Pawlik TM: Elective surgery in the time of COVID-19. Am J Surg. 2020, 219:900–2. 10.1016/j.amjsurg.2020.04.014
4. Blach S, Kondili LA, Aghemo A, et al.: Impact of COVID-19 on global HCV elimination efforts. J Hepatol. 2021, 74:31–6. 10.1016/j.jhep.2020.07.042
5. Chau TN, Lee KC, Yao H, et al. SARS-associated viral hepatitis caused by a novel coronavirus: report of three cases. Hepatology. 2004;39(2):302-310.
6. Alsaad KO, Hajeer AH, Al Balwi M, et al. Histopathology of Middle East respiratory syndrome coronavirus (MERS-CoV) infection - clinicopathological and ultrastructural study. Histopathology. 2018;72(3):516-524.
7. Reddy KR. SARS-CoV-2 and the Liver: Considerations in Hepatitis B and Hepatitis C Infections. Clin Liver Dis (Hoboken). 2020 May 21;15(5):191-194.
8. Téllez L, Martín Mateos RM. COVID-19 and liver disease: An update [Actualización en COVID-19 y enfermedad hepática]. Gastroenterología y Hepatología (English Edition). 2020;43(8):472-480.
9. Chan SL, Kudo M. Impacts of COVID-19 on Liver Cancers: During and after the Pandemic. Liver Cancer. 2020;9(5):491-502.
10. Zhang C, Shi L, Wang F-S: Liver injury in COVID-19: management and challenges. Lancet Gastroenterol Hepatol. 2020, 5:428–30. 10.1016/S2468-1253(20)30057-1
11. Hamming I, Timens W, Bulthuis MLC, Lely AT, Navis GJ, van Goor H: Tissue distribution of ACE2 protein, the functional receptor for SARS coronavirus. A first step in understanding SARS pathogenesis. J Pathol. 2004, 203:631–7. 10.1002/path.1570
12. Chai X, Hu L, Zhang Y, et al.: Specific ACE2 Expression in Cholangiocytes May Cause Liver Damage After 2019-nCoV infection. bioRxiv. 2020, 2020.02.03.931766. 10.1101/2020.02.03.931766
13. Wen Seow JJ, Pai R, Mishra A, et al.: scRNA-seq reveals ACE2 and TMPRSS2 expression in TROP2+ Liver Progenitor Cells: Implications in COVID-19 associated Liver Dysfunction. bioRxiv. 2020, 2020.03.23.002832. 10.1101/2020.03.23.002832
14. Kumar P, Sharma M, Kulkarni A, Rao PN: Pathogenesis of Liver Injury in Coronavirus Disease 2019. 2020, 10:641–2. 10.1016/j.jceh.2020.05.006
15. Henderson LA, Canna SW, Schulert GS, et al.: On the Alert for Cytokine Storm: Immunopathology in COVID-19. Arthritis Rheumatol Hoboken NJ. 2020, 72:1059–63. 10.1002/art.41285
16. Mahamid M, Mader R, Safadi R: Hepatotoxicity of tocilizumab and anakinra in rheumatoid arthritis: management decisions. Clin Pharmacol Adv Appl. 2011, 3:39–43. 10.2147/CPAA.S24004
17. Kulkarni AV, Kumar P, Tevethia HV, et al.: Systematic review with meta-analysis: liver manifestations and outcomes in COVID-19. Aliment Pharmacol Ther. 2020, 52:584–99. 10.1111/apt.15916
18. Siegel RL, Miller KD, Jemal A: Cancer statistics, 2020. CA Cancer J Clin. 2020, 70:7–30. 10.3322/caac.21590
19. Amaddeo G, Brustia R, Allaire M, et al.: Impact of COVID-19 on the management of hepatocellular carcinoma in a high-prevalence area. JHEP Rep. 2021, 3:. 10.1016/j.jhepr.2020.100199
20. McGlynn KA, Petrick JL, London WT: Global Epidemiology of Hepatocellular Carcinoma: An Emphasis on Demographic and Regional Variability. Hepatocell Carcinoma Adults Child. 2015, 19:223–38. 10.1016/j.cld.2015.01.001
21. Heneghan MA, Yeoman AD, Verma S, Smith AD, Longhi MS: Autoimmune hepatitis. The Lancet. 2013, 382:1433–44. 10.1016/S0140-6736(12)62163-1
22. Jepsen P, Grønbæk L, Vilstrup H: Worldwide Incidence of Autoimmune Liver Disease. Dig Dis. 2015, 33(suppl 2):2–12. 10.1159/000440705
23. Terziroli Beretta-Piccoli B, Mieli-Vergani G, Vergani D: Autoimmune hepatitis: Standard treatment and systematic review of alternative treatments. World J Gastroenterol. 2017, 23:6030–48. 10.3748/wjg.v23.i33.6030
24. Albillos A, Lario M, Álvarez-Mon M: Cirrhosis-associated immune dysfunction: Distinctive features and clinical relevance. J Hepatol. 2014, 61:1385–96. 10.1016/j.jhep.2014.08.010
25. Efe C, Dhanasekaran R, Lammert C, et al.: Outcome of COVID-19 in Patients with Autoimmune Hepatitis: an International Multi-Centre Study. Hepatology. 2021, n/a: 10.1002/hep.31797
26. Hyun Kim B, Ray Kim W: Epidemiology of Hepatitis B Virus Infection in the United States. Clin Liver Dis. 2018, 12:1–4. 10.1002/cld.732
27. WorldHealthOrganization: Global hepatitis report 2017: web Annex B: WHO estimates of the prevalence and incidence of hepatitis C virus infection by WHO region, 2015. WorldHealthOrganization: Geneva; 2018.
28. Chen X, Jiang Q, Ma Z, et al.: Clinical Characteristics of Hospitalized Patients with SARS-CoV-2 and Hepatitis B Virus Co-infection. Virol Sin. 2020, 35:842–5. 10.1007/s12250-020-00276-5
29. Zha L, Li S, Pan L, et al.: Corticosteroid treatment of patients with coronavirus disease 2019 (COVID-19). Med J Aust. 2020, 212:416–20. 10.5694/mja2.50577
30. Téllez L, Martín Mateos RM. COVID-19 and liver disease: An update [Actualización en COVID-19 y enfermedad hepática]. Gastroenterología y Hepatología (English Edition). 2020;43(8):472-480.
31. Zhang L, Zhu F, Xie L, et al. Clinical characteristics of COVID-19-infected cancer patients: a retrospective case study in three hospitals within Wuhan, China. Ann Oncol. 2020;31(7):894-901
32. Amaddeo G, Brustia R, Allaire M, et al. Impact of COVID-19 on the management of hepatocellular carcinoma in a high-prevalence area. JHEP Rep. 2021;3(1):100199.
33. Bollipo S, Kapuria D, Rabiee A, et al. One world, one pandemic, many guidelines: management of liver diseases during COVID-19. Gut. 2020;69(8):1369-1372.
34. Ang TL, Li JW, Vu CKF, et al. Chapter of Gastroenterologists professional guidance on risk mitigation for gastrointestinal endoscopy during COVID-19 pandemic in Singapore. Singapore Med J. 2020;61(7):345-349.
35. Marjot T, Buescher G, Sebode M, et al. SARS-CoV-2 infection in patients with autoimmune hepatitis [published online ahead of print, 2021 Jan 26]. J Hepatol. 2021; S0168-8278(21)00033-7.
36. Gerussi A, Rigamonti C, Elia C, Cazzagon N, Floreani A, Pozzi R, Pozzoni P, Claar E, Pasulo L, Fagiuoli S, Cristoferi L, Carbone M, Invernizzi P. Coronavirus Disease 2019 (COVID-19) in autoimmune hepatitis: a lesson from immunosuppressed patients. Hepatol Commun. 2020 Jun 9;4(9):1257–62.
37. Efe C, Dhanasekaran R, Lammert C, et al. Outcome of COVID-19 in Patients with Autoimmune Hepatitis: An International Multi-Centre Study [published online ahead of print, 2021 Mar 13]. Hepatology. 2021;10.1002/hep.31797.
38. Oren Fix, K Rajender Reddy, Keith D Lindo, Kristen M Robson, Shilpa Grover, COVID-19: Issues related to liver disease in adults: Post TW., ed. UpToDate. https://www.uptodate.com/contents/covid-19-issues-related-to-liver-disease-in-adults Mar 2021, Accessed November 19, 2019.
39. Lleo A, Invernizzi P, Lohse AW, Aghemo A, Carbone M. Management of patients with autoimmune liver disease during COVID-19 pandemic. J Hepatol. 2020;73(2):453-455.
40. The WorldHealthOrganization. Global Hepatitis Report, 2017. https://apps.who.int/iris/bitstream/ handle/10665/255016/9789241565455-eng.pdf;jsessionid=DC3616B5BDF94FA8B6AC2FDBC71E5B51?sequence=1 (Accessed on June 17, 2020).
41. WorldHealthOrganization. Web Annex B. WHO estimates of the prevalence and incidence of hepatitis C virus infection by WHO region, 2015. In: Global hepatitis report 2017. https://apps.who.int/iris/ bitstream/handle/ 10665/277005/WHO-CDS-HIV-18.46-eng.pdf (Accessed on May 21, 2019).
42. Mirzaie H, Vahidi M, Shokoohi M, Darvishian M, Sharifi H, et al. COVID-19 Among Patients With Hepatitis B or Hepatitis C: A Systematic Review, Hepat Mon. 2020; 20(11):e111617.
43. Yu R, Tan S, Dan Y, et al. Effect of SARS-CoV-2 coinfection was not apparent on the dynamics of chronic hepatitis B infection. Virology. https://www.sciencedirect.com/science/article/pii/S0042682220302385#appsec1. Published November 28, 2020. Accessed April 15, 2021.
44. Butt AA, Yan P, Chotani RA, Shaikh OS. Mortality is not increased in SARS-CoV-2 infected persons with hepatitis C virus infection [published online ahead of print, 2021 Feb 3]. Liver Int. 2021;10.1111/liv.14804.
45. Wang Q, Davis PB, Xu R. COVID-19 risk, disparities and outcomes in patients with chronic liver disease in the United States. EClinicalMedicine. 2021;31:100688.
46. Zhao J, Liao X, Wang H, et al. Early Virus Clearance and Delayed Antibody Response in a Case of Coronavirus Disease 2019 (COVID-19) With a History of Coinfection with Human Immunodeficiency Virus Type 1 and Hepatitis C Virus. Clin Infect Dis. 2020;71(16):2233-2235.
47. Blach S, Kondili LA, Aghemo A, et al. Impact of COVID-19 on global HCVelimination efforts. J Hepatol. 2021;74(1):31-36.
48. Chien M, Anderson TK, Jockusch S, et al. Nucleotide Analogues as Inhibitors of SARS-CoV-2 Polymerase, a Key Drug Target for COVID-19. J Proteome Res. 2020;19(11):4690-4697.
49. Jácome R, Campillo-Balderas JA, Ponce de León S, Becerra A, Lazcano A. Sofosbuvir as a potential alternative to treat the SARS-CoV-2 epidemic. Sci Rep. 2020;10(1):9294. Published 2020 Jun 9.
50.    Sadeghi A, Ali Asgari A, Norouzi A, et al. Sofosbuvir and daclatasvir compared with standard of care in the treatment of patients admitted to hospital with moderate or severe coronavirus infection (COVID-19): a randomized controlled trial. J Antimicrob Chemother. 2020;75(11):3379-3385.