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

• Main Authors: Hanna Wiśniewska, Karolina Skonieczna-Żydecka, Miłosz Parczewski, Jolanta Niścigorska-Olsen, Ewa Karpińska, Monika Hornung, Krzysztof Jurczyk, Magdalena Witak-Jędra, Łukasz Laurans, Katarzyna Maciejewska, Łukasz Socha, Agnieszka Leonciuk, Dorota Bander, Malwina Karasińska-Cieślak, Bogusz Aksak-Wąs, Marta Wawrzynowicz-Syczewska
• Format: Article
• Language: English
• Published: MDPI AG 2021-02-01
• Series: Journal of Clinical Medicine
• Subjects: COVID-19; SARS-CoV-2 infection; liver enzyme abnormality; liver dysfunction
• Online Access: https://www.mdpi.com/2077-0383/10/4/672

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 (<i>n</i> = 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.