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Acute liver injury in COVID-19 patients hospitalized in the intensive care unit:Narrative review

World Journal of Gastroenterology 2022年第47期28卷 6662-6688页

作者： Effie Polyzogopoulou pinelopi amoiridou Theodore P Abraham Ioannis Ventoulis Department of Emergency Medicine Attikon University HospitalNational and Kapodistrian University of Athens Medical SchoolAthens 12462Greece Department of Intensive Care AHEPA University HospitalThessaloniki 54621Greece Hypertrophic Cardiomyopathy Center of Excellence University of CaliforniaSan FranciscoCA 94117United States Department of Occupational Therapy University of Western MacedoniaPtolemaida 50200Greece

In recent years,humanity has been confronted with a global pandemic due to coronavirus disease 2019(COVID-19),which has caused an unprecedented health and economic crisis *** from the respiratory symptoms,which are considered the principal manifestations of COVID-19,it has been recognized that COVID-19 constitutes a systemic inflammatory process affecting multiple organ *** the spectrum of organ involvement in COVID-19,acute liver injury(ALI)has been gradually gaining increasing attention by the international scientific ***-19 associated liver impairment can affect a considerable proportion of COVID-19 patients and seems to correlate with the severity of the disease ***,COVID-19 patients hospitalized in the intensive care unit(ICU)run a greater risk of developing ALI due to the severity of their clinical condition and in the context of multi-organ *** putative pathophysiological mechanisms of COVID-19 induced ALI in ICU patients remain poorly understood and appear to be multifactorial in *** theories have been proposed to explain the occurrence of ALI in the ICU setting,such as hypoperfusion and ischemia due to hemodynamic instability,passive liver congestion as a result of congestive heart failure,ischemia-reperfusion injury,hypoxia due to respiratory failure,mechanical ventilation itself,sepsis and septic shock,cytokine storm,endotheliitis with concomitant coagulopathy,druginduced liver injury,parenteral nutrition and direct cytopathic viral *** should be noted that no specific therapy for COVID-19 induced ALI ***,the therapeutic approach lies in preventive measures and is exclusively supportive once ALI *** aim of the current review is to scrutinize the existing evidence on COVID-19 associated ALI in ICU patients,explore its clinical implications,shed light on the underlying pathophysiological mechanisms and propose potential therapeutic *** research on the pa

关键词： Liver injury COVID-19 Intensive care Pathophysiological mechanisms Cytokine storm Multi-organ failure

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