Front Med (Lausanne) 7: 398

How Patients With Chronic Liver Diseases Succeed to Deal With COVID-19?

^{Foodborne and Waterborne Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran}

^{Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran}

^{Basic and Molecular Epidemiology of Gastrointestinal Disorders Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran}

Edited by: Francesco Marotta, ReGenera R&D International for Aging Intervention, Italy

Reviewed by: Mohammad Bashashati, Texas Tech University Health Sciences Center, United States; Ruggiero Francavilla, University of Bari Aldo Moro, Italy

*Correspondence: Behzad Hatami moc.oohay@imatah_dzb

This article was submitted to Gastroenterology, a section of the journal Frontiers in Medicine

Edited by: Francesco Marotta, ReGenera R&D International for Aging Intervention, Italy

Reviewed by: Mohammad Bashashati, Texas Tech University Health Sciences Center, United States; Ruggiero Francavilla, University of Bari Aldo Moro, Italy

Received 2020 May 13; Accepted 2020 Jun 25.

This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

Abstract

The human pathogenic coronaviruses cause infections of the respiratory tract from mild to severe ranges. Mild cases may look like the common cold, while cases with severe disease may represent severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS) and coronavirus disease 2019 (COVID-19). Currently, COVID-19 is a rapidly emerging infection and the number of COVID-19 cases and its associated deaths are quickly growing around the world. COVID-19 infection can involve multiple body organs other than respiratory tract and lungs such as liver. It is hypothesized that COVID-19-associated liver injury can hamper the host drug metabolism and excretion. Liver involvement present with the elevation of enzymatic levels of alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT) accompanied by enhanced total bilirubin and decreased albumin levels has been reported in COVID-19 cases. One of the major concerns during COVID-19 outbreak is the population with a history of pre-existing liver disorders including viral hepatitis, alcoholic liver disease (ALD), non-alcoholic fatty liver disease (NAFLD), autoimmune hepatitis, hepatic compensated, and decompensated cirrhosis. Herein, we discussed the probable correlation between COVID-19 infection and liver damages, particularly chronic and pre-existing liver diseases during COVID-19 outbreak. Furthermore, we explained about the liver transplant recipients and post-transplant drugs used in patients with COVID-19 infection. Finally, we discussed about the therapeutic medications administered in COVID-19 patients with underlying liver injuries and their significant considerations.

Keywords: coronaviruses, COVID-19, infectious disease, liver injuries, chronic liver diseases, medical therapy

Abstract

Acknowledgments

The authors would like to thank all the staff of Liver Research Department in Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Acknowledgments

Footnotes

Funding. This work was supported by Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Footnotes

References

1. Su L, Ma X, Yu H, Zhang Z, Bian P., Han Y, et al. . The different clinical characteristics of corona virus disease cases between children and their families in China - the character of children with COVID-19. Emerg Microbes Infect. (2020) 9:707–13. 10.1080/22221751.2020.1744483 ] [
2. Varghese L, Zachariah P, Vargas C, LaRussa P, Demmer RT, Furuya YE, et al. . Epidemiology and clinical features of human coronaviruses in the pediatric population. J Pediat Inf Dis Soc. (2018) 7:151–8. 10.1093/jpids/pix027 ] [
3. Zimmermann P, Curtis N. Coronavirus infections in children including COVID-19: an overview of the epidemiology, clinical features, diagnosis, treatment and prevention options in children. Pediatr Infect Dis J. (2020) 39:355–68. 10.1097/INF.0000000000002660 ] [
4. Goldsmith CS, Tatti KM, Ksiazek TG, Rollin PE, Comer JA, Lee WW, et al. . Ultrastructural characterization of SARS coronavirus. Emerging Infect Dis. (2004) 10:320–6. 10.3201/eid1002.030913 ] [
5. Neuman BW, Adair BD, Yoshioka C, Quispe JD, Orca G, Kuhn P, et al. . Supramolecular architecture of severe acute respiratory syndrome coronavirus revealed by electron cryomicroscopy. J Virol. (2006) 80:7918–28. 10.1128/JVI.00645-06 ] [
6. Fehr AR, Perlman S. Coronaviruses: an overview of their replication and pathogenesis. Methods Mol Biol. (2015) 1282:1–23. 10.1007/978-1-4939-2438-7_1 ] [
7. Lai MM, Cavanagh D. The molecular biology of coronaviruses. Adv Virus Res. (1997) 48:1–100. 10.1016/S0065-3527(08)60286-9 ] [
8. de Groot RJ, Baker SC, Baric RS, Brown CS, Drosten C, Enjuanes L, et al. . Middle east respiratory syndrome coronavirus (MERS-CoV): announcement of the Coronavirus Study Group. J Virol. (2013) 87:7790–2. 10.1128/JVI.01244-13 ] [
9. Chang CK, Hou MH, Chang CF, Hsiao CD, Huang TH. The SARS coronavirus nucleocapsid protein-forms and functions. Antiviral Res. (2014) 103:39–50. 10.1016/j.antiviral.2013.12.009 ] [
10. Du L, He Y, Zhou Y, Liu S, Zheng BJ, Jiang S. The spike protein of SARS-CoV–a target for vaccine and therapeutic development. Nat Rev Microbiol. (2009) 7:226–36. 10.1038/nrmicro2090 ] [
11. Gheblawi M, Wang K, Viveiros A, Nguyen Q, Zhong JC, Turner AJ, et al. . Angiotensin converting enzyme 2: SARS-CoV-2 receptor and regulator of the renin-angiotensin system. Circ Res. (2020) 126:1456–74. 10.1161/CIRCRESAHA.120.317015 ] [
12. Oudit GY, Kassiri Z, Jiang C, Liu PP, Poutanen SM, Penninger JM, et al. . SARS-coronavirus modulation of myocardial ACE2 expression and inflammation in patients with SARS. Eur J Clin Invest. (2009) 39:618–25. 10.1111/j.1365-2362.2009.02153.x ] [
13. Kuba K, Imai Y, Rao S, Gao H, Guo F, Guan B, et al. . A crucial role of angiotensin converting enzyme 2 (ACE2) in SARS coronavirus-induced lung injury. Nat Med. (2005) 11:875–9. 10.1038/nm1267 ] [
14. Zhang H, Penninger JM, Li Y, Zhong N, Slutsky AS(2020) Angiotensin-converting enzyme 2 (ACE2) as a SARS-CoV-2 receptor: molecular mechanisms and potential therapeutic target. Intensive Care Med. 46:586–90. 10.1007/s00134-020-05985-9 ] [[Google Scholar]
15. Zhang C, Shi L, Wang FS. Liver injury in COVID-19: management and challenges. Lancet Gastroenterol Hepatol. (2020) 5:428–30. 10.1016/S2468-1253(20)30057-1 ] [
16. Xu L, Liu J, Lu M, Yang D, Zheng X. Liver injury during highly pathogenic human coronavirus infections. Liver Int. (2020) 40:998–1004. 10.1111/liv.14435 ] [
17. Rismanbaf A, Zarei S. Liver and kidney injuries in COVID-19 and their effects on drug therapy; a letter to editor. Arch Acad Emerg Med. (2020) 8:e17.
18. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. . Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet. (2020) 395:497–506. 10.1016/S0140-6736(20)30183-5 ] [
19. Su TH, Kao JH. The clinical manifestations and management of COVID-19-related liver injury. J Formos Med Assoc. (2020) 119:1016–8. 10.1016/j.jfma.2020.04.020 ] [
20. Ji D, Qin E, Xu J, Zhang D, Cheng G, Wang Y, et al. . Non-alcoholic fatty liver diseases in patients with COVID-19: a retrospective study. J Hepatol. (2020) 10.1016/j.jhep.2020.03.044. [Epub ahead of print]. ] [
21. Ebrahimi M, Saki A, rahim F. Laboratory findings, signs and symptoms, clinical outcomes of Patients with COVID-19 Infection: an updated systematic review and meta-analysis. medRxiv. (2020). 10.1101/2020.03.25.20043703 [[PubMed]
22. Mantovani A, Beatrice G, Dalbeni A. Coronavirus disease 2019 (COVID-19) and prevalence of chronic liver disease: a meta-analysis. Liver Int. (2020) 40:1316–20. 10.1111/liv.14465 [] [[PubMed]
23. Wang D, Hu B, Hu C, Zhu F, Liu X, Zhang J, et al. . Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA. (2020) 2020:e201585. 10.1001/jama.2020.1585 ] [
24. Fan Z, Chen L, Li J, Tian C, Zhang Y, Huang S, et al. . Clinical features of COVID-19 related liver damage. medRxiv. (2020). 10.1101/2020.02.26.20026971 ] [
25. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. . Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet. (2020) 395:507–13. 10.1016/S0140-6736(20)30211-7 ] [
26. Xu XW, Wu XX, Jiang XG, Xu KJ, Ying LJ, Ma CL, et al Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARS-Cov-2) outside of Wuhan, China: retrospective case series. BMJ. (2020) 368:m792 10.1136/bmj.m792 [] [[PubMed][Google Scholar]
27. Yang X, Yu Y, Xu J, Shu H, Xia J, Liu H, et al. . Clinical course and outcomes of critically ill patients with SARS-CoV-2 pneumonia in Wuhan, China: a single-centered, retrospective, observational study. Lancet Respir Med. (2020) 8:475–81. 10.1016/S2213-2600(20)30079-5 ] [
28. Boettler T, Newsome PN, Mondelli MU, Maticic M, Cordero E, Cornberg M, et al. . Care of patients with liver disease during the COVID-19 pandemic: EASL-ESCMID position paper. JHEP Rep. (2020) 2:100113. 10.1016/j.jhepr.2020.100113 ] [
29. Ramadori G. Hypoalbuminemia: an underestimated, vital characteristic of hospitalized COVID-19 positive patients?. Hepatoma Res. (2020) 6:28 10.20517/2394-5079.2020.43 [[PubMed]
30. Cai Q, Huang D, Ou P, Yu H, Zhu Z, Xia Z, et al. . COVID-19 in a designated infectious diseases hospital outside Hubei Province, China. Allergy. (2020) 1–11. 10.1111/all.14309 [] [[PubMed]
31. Omrani-Nava V, Maleki I, Ahmadi A, Moosazadeh M, Hedayatizadeh-Omran A, Roozbeh F, et al Evaluation of hepatic enzymes changes and association with prognosis in COVID-19 patients. Hepat Mon. (2020) 20:e103179 10.5812/hepatmon.103179 [[PubMed][Google Scholar]
32. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, et al. . Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. (2020) 20:425–34. 10.1016/S1473-3099(20)30086-4 ] [
33. Banales JM, Huebert RC, Karlsen T, Strazzabosco M, LaRusso NF, Gores GJ. Cholangiocyte pathobiology. Nat Rev Gastroenterol Hepatol. (2019) 16:269–81. 10.1038/s41575-019-0125-y ] [
34. Fang L, Karakiulakis G, Roth M. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?Lancet Respir Med. (2020) 8:e21. 10.1016/S2213-2600(20)30116-8 ] [
35. Bangash MN, Patel J, Parekh D. COVID-19 and the liver: little cause for concern. Lancet Gastroenterol Hepatol. (2020) 5:529–30. 10.1016/S2468-1253(20)30084-4 ] [
36. Yeo C, Kausha lS, Yeo D. Enteric involvement of coronaviruses: is faecal-oral transmission of SARS-CoV-2 possible?Lancet Gastroenterol Hepatol. (2020) 5:335–7. 10.1016/S2468-1253(20)30048-0 ] [
37. Gacouin A, Locufier M, Uhel F, Letheulle J, Bouju P, Fillatre P, et al. . Liver cirrhosis is independently associated with 90-day mortality in ARDS patients. Shock. (2016) 45:16–21. 10.1097/SHK.0000000000000487 [] [[PubMed]
38. Fix OK, Hameed B, Fontana RJ, Kwok RM, McGuire BM, Mulligan DC, et al. . Clinical best practice advice for hepatology and liver transplant providers during the COVID-19 pandemic: AASLD expert panel consensus statement. Hepatology. (2020). 10.1002/hep.31281. [Epub ahead of print]. ] [
39. Zhou Q, Chen V, Shannon CP, Wei XS, Xiang X, Wang X, et al Interferon-a2b treatment for COVID-19. Front Immunol. (2020) 11:1061 10.3389/fimmu.2020.01061 ] [[Google Scholar]
40. El-Lababidia RM, Mooty M, Maria-Fernanda Bonilla MF, Nouran Salem MNM. Treatment of severe pneumonia due to COVID-19 with peginterferon alfa 2a. IDCases. (2020) 21:e00837. 10.1016/j.idcr.2020.e00837 ] [
41. Elfiky AA. Ribavirin, remdesivir, sofosbuvir, galidesivir, and tenofovir against SARS-CoV-2 RNA dependent RNA polymerase (RdRp): A molecular docking study. Life Sci. (2020) 253:117592. 10.1016/j.lfs.2020.117592 ] [
42. Schütte A, Ciesek S, Wedemeyer H, Lange CM. Influenza virus infection as precipitating event of acute-on-chronic liver failure. J Hepatol. (2019) 70:797–9. 10.1016/j.jhep.2018.11.015 [] [[PubMed]
43. Alcohol and COVID-19: What You Need to Know World Health Organization: (2020). [PubMed]
44. Da BL, Im GY, Schiano TD. COVID-19 hangover: a rising tide of alcohol use disorder and alcohol-associated liver disease. Hepatology. (2020) 10.1002/hep.31307 [] [[PubMed]
45. Strnad P, Tacke F, Koch A, Koch A, Trautwein C. Liver -guardian, modifier and target of sepsis. Nat Rev Gastroenterol Hepatol. (2020) 14:55–66. 10.1038/nrgastro.2016.168 [] [[PubMed]
46. Schütte A, Ciesek S, Wedemeyer H, Lange CM. Influenza virus infection as precipitating event of acute-on-chronic liver failure. J Hepatol. (2019) 70:788–816. 10.1016/j.jhep.2018.11.031 [] [[PubMed]
47. Xiao Y, Pan H, She Q, Wang F, Chen M. Prevention of SARS-CoV-2 infection in patients with decompensated cirrhosis. Lancet Gastroenterol Hepatol. (2020) 5:528–9. 10.1016/S2468-1253(20)30080-7 ] [
48. Liu H, He X, Wang Y, Zhou S, Zhang D, Zhu J, et al. . Management of COVID-19 in patients after liver transplantation: Beijing working party for liver transplantation. Hepatol Int. (2020) 1–5. 10.1007/s12072-020-10043-z ] [
49. Lau G, Sharma M. Clinical practice guidance for hepatology and liver transplant providers during the COVID-19 pandemic: APASL expert panel consensus recommendations. Hepatol Int. 1–14. 10.1007/s12072-020-10054-w ] [
50. Zhai P, Ding Y, Wub X, Long J, Zhong Y, Li Y. The epidemiology, diagnosis and treatment of COVID-19. Int J Antimicrob Agents. (2020) 55:105955. 10.1016/j.ijantimicag.2020.105955 ] [
51. Cinatl J, Morgenstern B, Bauer G, Chandra P, Rabenau H, Doerr HW. Glycyrrhizin, an active component of liquorice roots, and replication of SARS-associated coronavirus. Lancet. (2003) 361:2045–6. 10.1016/S0140-6736(03)13615-X ] [
52. Hansen Chen H, Du Q. Potential natural compounds for preventing 2019-nCoV infection. Europe PMC. (2020). 10.20944/preprints202001.0358.v3 [[PubMed]
53. Kumar A, Kubota Y, Chernov M, Kasuya H. Potential role of zinc supplementation in prophylaxis and treatment of COVID-19. Med Hypotheses. (2020). 10.1016/j.mehy.2020.109848 ] [
54. Tan CW, Ho LP, Kalimuddin S, Cherng B. P. Z, Teh YE, Thien SY, et al. A cohort study to evaluate the effect of combination Vitamin D, Magnesium and Vitamin B12 (DMB) on progression to severe outcome in older COVID-19 patients. (2020). medRxiv. 10.1101/2020.06.01.20112334 [[PubMed]