Selected article for: "acute liver failure and liver failure"
Author: Li, Jie; Fan, Jian-Gao
Title: Characteristics and Mechanism of Liver Injury in 2019 Coronavirus Disease
  • Document date: 2020_3_30
    • ID: v3qx51f8_20
    Snippet: Moderate microvascular steatosis with mild hepatic inflammation in a COVID-19 patient indicates the possibility of druginduced liver injury. 23 In clinical practice, a large number of patients had history of using antipyretic drugs for treatment of fever. 38 Most antipyretic drugs contain paracetamol, which is generally recognized as a common reason for liver injury. 39 In addition, many patients with COVID-19 have history of simultaneous use of .....
    Document: Moderate microvascular steatosis with mild hepatic inflammation in a COVID-19 patient indicates the possibility of druginduced liver injury. 23 In clinical practice, a large number of patients had history of using antipyretic drugs for treatment of fever. 38 Most antipyretic drugs contain paracetamol, which is generally recognized as a common reason for liver injury. 39 In addition, many patients with COVID-19 have history of simultaneous use of multiple antiviral drugs, i.e. oseltamivir, abidol, and lopinavir/ritonavir. 40, 41 These antiviral drugs can induce liver injury as well. A clinical trial of lopinavir/ritonavir or abidol for treatment of COVID-19 from Shanghai showed that two cases of each group occurred liver injury among twohundred and sixty-two patients. 42 Thus, if abnormality of liver enzymes occurs after using a hepatotoxic drug, drug-induced liver injury should first be confirmed or ruled out. In addition, given the high burden of chronic liver disease in China, nonalcoholic fatty liver disease, chronic hepatitis B, and liver cirrhosis might be the major alternative causes of liver injury in Chinese patients with COVID-19. 43 SARS-CoV-2 infection and related immune changes might be regarded as a "second hit" to simple fatty liver, and can induce incident liver injury and steatohepatitis. Stress and sepsis are particularly problematic in cirrhotic patients, as either can trigger acute-on-chronic liver failure. However, the information of pre-existing liver diseases has not been outlined in most studies of COVID-19 and the interaction between existing liver disease and SARS-CoV-2 infection has not yet been studied. 36

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