Impaired coagulation,liver dysfunction and COVID-19:Discovering an intriguing relationship

作     者：Damiano D'Ardes Andrea Boccatonda Giulio Cocco Stefano Fabiani Ilaria Rossi Marco Bucci Maria Teresa Guagnano Cosima Schiavone Francesco Cipollone 

作者机构：“Clinica Medica”InstituteDepartment of Medicine and Aging Sciences“G.D’Annunzio”University of Chieti-PescaraChieti 66100Italy Unit of Ultrasound“G.D’Annunzio”University of Chieti-PescaraChieti 66100Italy 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2022年第28卷第11期

页      面：1102-1112页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：COVID-19 SARS-CoV-2 Liver Coagulation 

摘      要：Coronavirus disease 2019(COVID-19)is,at present,one of the most relevant global health *** the literature hepatic alterations have been described in COVID-19 patients,and they are mainly represented by worsening of underlying chronic liver disease leading to hepatic decompensation and liver failure with higher *** potential mechanisms used by severe acute respiratory syndrome coronavirus 2(SARS-Co V-2)to cause liver damage have been ***-19 primary liver injury is less common than secondary liver *** of the available data demonstrate how liver damage in SARSCo V-2 infection is likely due to systemic inflammation,and it is less likely mediated by a cytopathic effect directed on liver ***,liver alterations could be caused by hypoxic injury and drugs(antibiotics and non-steroidal antiinflammatory drugs,remdesivir,tocilizumab,tofacitinib and dexamethasone).SARS-Co V-2 infection can induce multiple vascular district atherothrombosis by affecting simultaneously cerebral,coronary and peripheral vascular *** in the literature highlight how the virus triggers an exaggerated immune response,which added to the cytopathic effect of the virus can induce endothelial damage and a prothrombotic dysregulation of *** leads to a higher incidence of symptomatic and confirmed venous thrombosis and of pulmonary embolisms,especially in central,lobar or segmental pulmonary arteries,in *** are currently fewer data for arterial thrombosis,while myocardial injury was identified in 7%-17%of patients hospitalized with SARS-Co V-2 infection and 22%-31%in the intensive care unit *** data also revealed a higher occurrence of stroke and more serious forms of peripheral arterial disease in COVID-19 *** dysregulation is observed during the COVID-19 *** platelet count,mildly increased prothrombin time and increased Ddimer are typical laboratory features of patients with severe SAR