Hepatotropic Properties of SARS-CoV-2—Preliminary Results of Cross-Sectional Observational Study from the First Wave COVID-19 Pandemic

Wiśniewska, Hanna; Skonieczna-Żydecka, Karolina; Parczewski, Miłosz; Niścigorska-Olsen, Jolanta; Karpińska, Ewa; Hornung, Monika; Jurczyk, Krzysztof; Witak-Jędra, Magdalena; Laurans, Łukasz; Maciejewska, Katarzyna; Socha, Łukasz; Leonciuk, Agnieszka; Bander, Dorota; Karasińska-Cieślak, Malwina; Aksak-Wąs, Bogusz; Wawrzynowicz-Syczewska, Marta

Liver injury—expressed as elevated liver enzymes—is common in patients with COVID-19. Little is known about the potential mechanisms of liver damage by SARS-CoV-2. A direct cytopathic effect on hepatocytes as well as injury related to hypoxia or hepatotoxicity are being considered. The aim of the study was to compare the clinical characteristic of COVID-19 disease in patients with normal and abnormal liver enzymes activity. A group of 150 patients with COVID-19, hospitalized in our center, was analyzed. Patients with the known liver comorbidities were excluded (n = 15). Clinical features and laboratory parameters were compared between patients with normal and abnormal aminotransferase values. Liver injury expressed as any alanine aminotransferase (ALT) elevation was noted in 45.6% of patients hospitalized due to COVID-19. The frequencies of aspartate aminotransferase (AST) elevation were lower. It was noted that elevated ALT/AST unfavorably affected other parameters related to liver function such as albumin level; gamma-glutamyl transpeptidase (GGTP); and partly, ALP activity and influenced inflammation-related parameters. The most probable cause of mild hepatitis during COVID-19 was anoxia and immune-mediated damage due to the inflammatory response following SARS-CoV-2 infection. A direct cytopathic effect of SARS-CoV-2 on hepatocytes, albeit less probable, can be considered as well. The use of potentially hepatotoxic drugs may contribute to liver damage.