COVID-19 Patients with Hepatic Complications During the Third Wave of Pandemic in Egypt
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Keywords

COVID-19
Hepatic complications
Third wave

DOI

10.26689/jcnr.v6i3.3726

Abstract

COVID-19 is a respiratory infection that has lately begun to affect other vital organs, including the heart, kidney, and liver. The purpose of this study was to investigate the hepatic complications in COVID-19 patients and the risk of being admitted to ICU or facing death. Methodology: Comorbidities (hypertension and diabetes), COVID-19 symptoms, laboratory findings (ALT level, AST level, and albumin), complications during hospitalization, treatment protocol used, and survival outcomes were all studied in 200 COVID-19 infected Egyptian patients who had virological symptoms and were followed up until they recovered or died. It was found that older people and those with higher blood glucose levels have a higher risk of developing liver-associated COVID-19 disorders. Also, the majority of patients who developed liver complications in the course of the infection had high mortality rates. Patients with diabetes, hypertension, or hepatic disease are at higher risk of ICU admission or death. Hence, it is important to pay attention to these problems in the diagnosis and treatment of COVID-19 to develop a suitable individualized treatment protocol. There was also a correlation between the mortality in COVID-19 patients and both, high blood glucose and liver enzyme levels. It can be attributed to the correlation between diabetes and liver disease as every disease may be a complication to the other; moreover, COVID-19 may lead to increased blood sugar levels in addition to ALT and AST levels. Another theory is that COVID-19 may affect the liver and hence people with chronic liver disease.

References

Berlin DA, Gulick RM, Martinez FJ, 2020, Severe Covid-19. New England Journal of Medicine, 383(25): 2451-2460.

Tay MZ, Poh CM, Renia L, et al., 2020, The Trinity of COVID-19: Immunity, Inflammation and Intervention. Nature Reviews Immunology, 20(6): 363-374.

Elgendy MO, El-Gendy AO, Abdelrahim ME, 2020, Public Awareness in Egypt About COVID-19 Spread in the Early Phase of the Pandemic. Patient Education and Counseling, 103(12): 2598-2601.

Elgendy MO, Abd Elmawla MN, Abdel Hamied AM, et al., 2021, COVID?19 Patients and Contacted Person Awareness About Home Quarantine Instructions. International Journal of Clinical Practice, 75(4): e13810.

World Health Organization, 2020, Clinical Management of COVID-19: Interim Guidance, 27 May 2020, World Health Organization. https://apps.who.int/iris/handle/10665/332196

Williamson EJ, Walker AJ, Bhaskaran K, et al., 2020, Factors Associated with COVID-19-Related Death Using OpenSAFELY. Nature, 584(7821): 430-436.

Ioannou GN, Locke E, Green P, et al., 2020, Risk Factors for Hospitalization, Mechanical Ventilation, or Death Among 10 131 US Veterans with SARS-Cov-2 Infection. JAMA Network Open, 3(9): e2022310-e2022310.

Paizis G, Tikellis C, Cooper ME, et al., 2005, Chronic Liver Injury in Rats and Humans Upregulates the Novel Enzyme Angiotensin Converting Enzyme 2. Gut, 54(12): 1790-1796.

Fondevila MF, Mercado-Gomez M, Rodriguez A, et al., 2021, Obese Patients with NASH Have Increased Hepatic Expression of SARS-Cov-2 Critical Entry Points. Journal of Hepatology, 74(2): 469-471.

Herath CB, Warner FJ, Lubel JS, et al., 2007, Upregulation of Hepatic Angiotensin-Converting Enzyme 2 (ACE2) and Angiotensin-(1–7) Levels in Experimental Biliary Fibrosis. Journal of Hepatology, 47(3): 387-395.

Chua RL, Lukassen S, Trump S, et al., 2020, COVID-19 Severity Correlates with Airway Epithelium–Immune Cell Interactions Identified by Single-Cell Analysis. Nature Biotechnology, 38(8): 970-979.

Ziegler CG, Allon SJ, Nyquist SK, et al., 2020, SARS-CoV-2 Receptor ACE2 Is an Interferon-Stimulated Gene in Human Airway Epithelial Cells and Is Detected in Specific Cell Subsets Across Tissues. Cell, 181(5): 1016-1035.e19.

Onabajo OO, Banday AR, Stanifer ML, et al., 2020, Interferons and Viruses Induce a Novel Truncated ACE2 Isoform and Not the Full-Length SARS-Cov-2 Receptor. Nature Genetics, 52(12): 1283-1293.

Wei C, Wan L, Yan Q, et al., 2020, HDL-Scavenger Receptor B Type 1 Facilitates SARS-Cov-2 Entry. Nature Metabolism, 2: 1391-1400.

Grove J, Huby T, Stamataki Z, et al., 2007, Scavenger Receptor BI and BII Expression Levels Modulate Hepatitis C Virus Infectivity. Journal of Virology, 81(7): 3162-3169.

Singh S, Khan A, 2020, Clinical Characteristics and Outcomes of Coronavirus Disease 2019 Among Patients with Preexisting Liver Disease in the United States: A Multicenter Research Network Study. Gastroenterology, 159(2): 768.

Weber S, Hellmuth JC, Scherer C, et al., 2021, Liver Function Test Abnormalities At Hospital Admission Are Associated With Severe Course Of SARS-Cov-2 Infection: A Prospective Cohort study. Gut, 70(10): 1925-1932.

Yadav DK, Singh A, Zhang Q, et al., 2021, Involvement of Liver in COVID-19: Systematic Review and Meta-Analysis. Gut, 70(4): 807-809.

Wu T, Li J, Shao L, et al., 2018, Development of Diagnostic Criteria and a Prognostic Score for Hepatitis B Virus-Related Acute-on-Chronic Liver Failure. Gut, 67(12): 2181-2191.

Diaz LA, Idalsoaga F, Cannistra M, et al., 2020, High Prevalence of Hepatic Steatosis and Vascular Thrombosis in COVID-19: A Systematic Review and Meta-Analysis of Autopsy Data. World Journal of Gastroenterology, 26(48): 7693.

Da BL, Kushner T, El Halabi M, et al., 2020, Liver Injury in Hospitalized Patients with COVID?19 Correlates with Hyper Inflammatory Response and Elevated IL?6. Hepatology Communications, 5(2): 177-188.

Ioannou GN, Liang PS, Locke E, et al., 2020, Cirrhosis and SARS?CoV?2 Infection in US Veterans: Risk of Infection, Hospitalization, Ventilation and Mortality. Hepatology, 2020: PMC7753324.

Bernabeu-Wittel M, Ternero-Vega JE, Diaz-Jimenez P, et al., 2020, Death Risk Stratification in Elderly Patients With Covid-19. A Comparative Cohort Study in Nursing Homes Outbreaks. Archives of Gerontology and Geriatrics, 91: 104240.

Sayed AM, Khalaf AM, Abdelrahim MEA, et al., 2020, Repurposing of Some Anti?Infective Drugs for COVID?19 Treatment: A Surveillance Study Supported by An in Silico Investigation. International Journal of Clinical Practice, 75(4): e13877.

Elgendy MO, Abdelrahim ME, 2021, Public Awareness About Coronavirus Vaccine, Vaccine Acceptance, and Hesitancy. Journal of Medical Virology, 93(12): 6535-6543.

Singh AK, Gupta R, Ghosh A, et al., 2020, Diabetes in COVID-19: Prevalence, Pathophysiology, Prognosis and Practical Considerations. Diabetes & Metabolic Syndrome: Clinical Research & Reviews, 14(4): 303-310.

Elgendy MO, Abdelrahman MA, Osama H, et al., 2021, Role of Repeating Quarantine Instructions and Healthy Practices on COVID?19 Patients and Contacted Persons to Raise Their Awareness and Adherence to Quarantine Instructions. International Journal of Clinical Practice, 5(10): e14694.

Iqbal F, Soliman A, De Sanctis V, et al., 2020, Prevalence, Clinical Manifestations, and Biochemical Data of Hypertensive Versus Normotensive Symptomatic Patients with COVID-19: A Comparative Study. Acta Bio Medica: Atenei Parmensis, 91(4): e2020164.

Mercante G, Ferreli F, De Virgilio A, et al., 2020, Prevalence of Taste and Smell Dysfunction in Coronavirus Disease 2019. JAMA Otolaryngology-Head & Neck Surgery, 146(8): 723-728.

Cai Q, Huang D, Yu H, et al., 2020, COVID-19: Abnormal Liver Function Tests. Journal of Hepatology, 73(3): 566-574.

Ali N, 2020, Relationship Between COVID-19 Infection and Liver Injury: A Review of Recent Data. Frontiers in Medicine, 7: 458.

Li Y, Xiao SY, 2020, Hepatic Involvement in COVID?19 Patients: Pathology, Pathogenesis, and Clinical Implications. Journal of Medical Virology, 92(9): 1491-1494.

Tian D, Ye Q, 2020, Hepatic Complications of COVID?19 and Its Treatment. Journal of Medical Virology, 92(10): 1818-1824.

Zhang Y, Zheng L, Liu L, et al.,2020, Liver Impairment in COVID?19 Patients: A Retrospective Analysis of 115 Cases from a Single Centre in Wuhan City, China. Liver International, 40(9): 2095-2103.