In relation to the current outbreak of respiratory infection caused by a coronavirus in China and since it is due to a novel form of this virus, it is still unknown if this infection can also affect the liver. However, data on previous epidemics due to coronavirus are available. Thus, in an outbreak that also occurred in China similar to the present one, it was found that 24% of patients infected with coronavirus had increased transaminases (liver enzymes) levels when they entered the hospital.
It should be noted that 9.5% of them showed a significant elevation of transaminases (5 times above the high limit of normality), 3% high bilirubin values and 5% changes in prothrombin time. Subsequently, up to 69% of patients admitted for coronavirus infection showed an increase in transaminases. However, the evolution was favourable since during the hospitalization period, the great majority of them normalized the transaminases (71%) and the rest showed a tendency to decrease.
Liver reaction to coronavirus action
Patients who presented very high levels of liver enzymes had a higher mortality. However, in our opinion, this fact is explained by the greater severity of the respiratory infection that affected these patients rather than coronavirus could directly damage the liver causing hepatitis (inflammation of the liver).
It is possible that the elevation of liver enzymes observed during coronavirus infection is reactive, as a defensive action of the organism to protect the vital functions of the liver.
We will have to wait until we have data on the current outbreak to determine if, in addition to acute respiratory syndrome, this new virus is capable of producing permanent liver injury or, on the contrary, the lesion is transient with recovery without treatment, which seems most likely considering previous outbreaks of coronavirus infection.
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