Study reveals that COVID-19 is causing the new onset of acute and chronic liver disease in many!

In the aftermath of the COVID-19 pandemic, much attention has shifted to understanding the long-term effects of the virus on various organ systems, including the liver. A recent systematic review conducted by researchers from Weill Cornell Medicine-Qatar, Albany Medical College, and the University of Pennsylvania highlights new onset of acute and chronic liver diseases in individuals post-COVID-19 infection. This Medical News report will explore the study’s findings, focusing on how liver complications arise in patients after they recover from the virus, as well as the potential mechanisms involved.


Study reveals that COVID-19 is causing the new onset of acute and chronic liver diseases in many

Thailand Medical News has been warning about liver complications from COVID-19 infections irrespective if they were asymptomatic, mild, moderate or severe and that also the various COVID-19 vaccines can also trigger liver issues since mid-2020.
 
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https://www.thailandmedical.news/news/belgium-researchers-warn-that-more-hospitalized-covid-19-patients-are-manifesting-a-rare-chronic-liver-disease-known-as-sclerosing-cholangitis-could-b
 
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https://www.thailandmedical.news/news/covid-19-research-the-detrimental-effects-of-tnf%CE%B1-on-liver-during-sars-cov-2-infection-and-its-impact-on-patient-survival
 
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https://www.thailandmedical.news/news/covid-19-news-german-researchers-warn-that-sclerosing-cholangitis-emerging-as-a-consequence-of-severe-covid-19-infection
 
Liver Complications Post-COVID-19: An Overview
COVID-19 was known to affect multiple organ systems during the infection. However, as more patients recover, emerging data reveal that long-term complications are increasingly being reported. Among the organ systems affected, the liver has garnered attention due to the variety of conditions linked to post-COVID-19 syndromes. These conditions include liver steatosis, non-alcoholic fatty liver disease (NAFLD), cirrhosis, acute liver failure, and hepatitis. This article will break down the study’s key findings regarding the most common liver complications observed after COVID-19 recovery.
 
The Study Design
The researchers conducted a comprehensive literature review of 22 studies that examined patients who developed parenchymal liver diseases following COVID-19 infection. Using databases such as PubMed, Medline, and Scopus, the team focused on severe liver complications lasting for at least 12 weeks after the infection. Only studies that reported confirmed diagnoses of liver disease were included, while those that only referenced abnormal liver function tests (LFTs) without a diagnosis were excluded.
 
In total, the review involved 161,594 patients, 500 of whom sustained liver damage post-COVID-19. The researchers categorized the liver conditions into several groups: liver steatosis and NAFLD, liver fibrosis and cirrhosis, hepatitis, acute liver failure, and other parenchymal liver disorders.
 
Liver Steatosis and NAFLD: A Growing Concern
One of the most common findings was liver steatosis and NAFLD, conditions associated with fat accumulation in the liver. Of the 140 patients included in this subset, 105 developed NAFLD, while 35 had liver steatosis. According to the study, 26% of patients showed evidence of liver steatosis during a six-month follow-up period after COVID-19 infection. Additionally, the hazard ratio (HR) for developing NAFLD in post-COVID-19 patients was found to be 1.33 compared to healthy individuals.
 
NAFLD is already a common liver condition, but its association with COVID-19 has raised concerns. NAFLD can progress into more severe liver diseases, such as cirrhosis, if left untreated. Researchers suggest that factors such as changes in weight during and after infection, metabolic syndrome, and the overall inflammatory state induced by COVID-19 may contribute to the development of NAFLD.
 
The Role of Liver Fibrosis and Cirrhosis
Liver fibrosis and cirrhosis, which are conditions characterized by scarring of liver tissue, were also reported in a significant number of patients. In one study, 65% of patients exhibited elevated liver fibrosis scores following COVID-19 recovery. Interestingly, the study noted that pre-existing liver diseases did not appear to influence the development of post-COVID-19 liver fibrosis. This finding points to COVID-19 itself as a trigger for liver scarring in some patients.
 
Fibrosis is typically a precursor to cirrhosis, a more advanced stage of liver scarring that can impair liver function. Though cirrhosis was reported in some cases, the study did not establish a clear link between the severity of COVID-19 infection and the development of cirrhosis. Researchers recommend monitoring liver health in post-COVID-19 patients to detect early signs of fibrosis and intervene before it progresses.
 
Hepatitis and Acute Liver Failure: A Lesser-Known Outcome
Although less common, cases of hepatitis and acute liver failure were also documented in the study. Hepatitis, or inflammation of the liver, was found in six patients, all of whom recovered from the condition. Acute liver failure, on the other hand, was reported in three patients. Two of these patients were infants who required liver transplants, underscoring the severity of liver failure in certain individuals post-COVID-19.
 
The mechanisms behind these complications are still not fully understood. However, researchers believe that the cytokine storm seen in severe COVID-19 cases may play a role in triggering liver damage. This storm, characterized by an excessive immune response, can cause widespread inflammation, which may affect the liver and lead to acute liver failure.
 
Mechanisms of Liver Injury Post-COVID-19
One of the key questions raised by the study is how COVID-19 affects the liver. The researchers propose several mechanisms to explain the liver damage seen in post-COVID-19 patients. One theory involves the angiotensin-converting enzyme 2 (ACE-2) receptor, which serves as an entry point for the virus. This receptor is present in liver cells, making the liver a potential target for the virus. When the virus binds to the ACE-2 receptor, it may cause liver cell damage either directly or indirectly.
 
In addition to the ACE-2 receptor, the study points to the inflammatory state triggered by COVID-19 as another potential cause of liver injury. The body’s immune response to the virus can lead to inflammation in multiple organs, including the liver. This inflammation may result in conditions such as liver steatosis, fibrosis, and even liver failure.
 
Conclusion: The Long-Term Impact of COVID-19 on Liver Health
This review sheds light on the various liver conditions that can develop in individuals recovering from COVID-19. Liver steatosis, NAFLD, fibrosis, cirrhosis, hepatitis, and acute liver failure are among the most reported complications. While most patients eventually recover, the potential for long-term liver damage cannot be ignored.
 
It is crucial for healthcare providers to monitor liver function in patients who have recovered from COVID-19, especially those who had severe cases. Early detection of liver damage, such as fibrosis or steatosis, can lead to interventions that may prevent further progression of the disease. Additionally, more research is needed to understand the full scope of liver complications related to COVID-19 and how to manage them in the long term.
 
The study findings were published in the peer-reviewed journal: Biomedicines.
https://www.mdpi.com/2227-9059/12/9/2065
 
For the latest COVID-19 News, keep on logging to Thailand Medical News.
 
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