SARS-CoV-2 Infection and Liver Involvement

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enveloped, single-stranded RNA virus that can also be transmitted from person to person via the droplet (secretions shed when speaking, sneezing, or coughing) route, suspended droplet nuclei, and the mucous membranes of the eyes, nose, and mouth after touching a contaminated surface. It enters the cells through the angiotensin converting enzyme 2 (ACE- 2) receptor. Although non-specific respiratory symptoms such as fever, loss of smell/taste, runny nose, and cough are most common, SARS-CoV-2 can lead to a systemic and multiorgan involvement, including the gastrointestinal tract. The liver is the second most frequently involved organ after the lung. Gastrointestinal symptoms such as diarrhea, anorexia, nausea, vomiting, loss of appetite and abdominal pain are also common. Abnormal liver function enzyme levels may also be observed. The liver is affected by direct infection of hepatocytes, medical therapy of the management, or by indirect means if there is an underlying co-morbid disease. However, there are significant differences between studies in the reporting of gastrointestinal and liver symptoms. The most frequently reported gastrointestinal symptom in COVID-19 disease is diarrhea, reported in 1-36% of patients. In this review, it is aimed to review the current data on the effects of COVID-19 on the liver.

Keywords

• COVID-19
• hepatitis
• AST
• ALT
• childhood

SARS-CoV-2 Enfeksiyonu ve Karaciğer tutulumu

Abstract

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) insandan insana damlacık yolu (konuşurken, hapşırırken veya öksürürken saçılan sekresyonlar vb.), asılı damlacık çekirdekleri ve kontamine yüzeylere dokunma sonrası gözler, burun ve ağız mukozası ile temas sonrası bulaşabilen zarflı, tek zincirli bir RNA virüsüdür. Hücrelere anjiotensin converting enzim 2 (ACE- 2) reseptör aracılığı ile girmektedir. En sık ateş, koku/tat kaybı, burun akıntısı ve öksürük gibi non-spesifik solunum yolu semptomları görülse de SARS-CoV-2 enfeksiyonu gastrointestinal sistemi de içeren sistemik ve çoklu organ tutulumu ile giden bir tabloya yol açabilir. Karaciğer, akciğerden sonra ikinci sık tutulan organdır. İshal, anoreksi, mide bulantısı, kusma, iştah kaybı ve karın ağrısı gibi gastrointestinal semptomlar da sık görülmektedir. Anormal karaciğer fonksiyon enzim düzeyleri de gözlenebilir. Karaciğer hepatositlerin direk enfekte olmasıyla, tedavide kullanılan ilaçlar üzerinden ya da altta yatan bir ko-morbid hastalık varsa indirek yollar ile etkilenir. Bununla beraber, gastrointestinal ve karaciğer semptomlarının bildirilmesinde, çalışmalar arasında ciddi farklılıklar söz konusudur. COVID-19 hastalığında da en sık bildirilen gastrointestinal semptom ishal olup, hastaların %1-36'sında bildirilmiştir. Bu derlemede COVID-19 hastalığının karaciğer üzerindeki etkilerine ilişkin güncel verilerin gözden geçirilmesi amaçlanmıştır.

Keywords

• COVID-19
• hepatit
• AST
• ALT
• çocukluk çağı

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