BREAKING! COVID-19 News: Brazil Study Shows That Most Long COVID Individuals Continue To Sustain Damaged Liver Functions Up To 20 Months!
COVID-19 News : Damaged Liver Functions Up To 20 Months Feb 16, 2023 1 month ago
: A study by researchers from the State University of Pará, (UEPA)-Brazil and São Paulo University-Brazil has shown that liver function in patients up to 20 Months of Long COVID still manifest abnormalities indicating liver injury.
To date, the long-term laboratory aspects of the effects of COVID-19 on liver function are still not well understood.
The study team aimed to evaluate the hepatic clinical-laboratory profile of patients with up to 20 months of long-term COVID-19.
A total of 243 patients of both sexes aged 18 years or older hospitalized in the acute phase of COVID-19 were included in this study.
Liver function analysis was performed. Changes were identified in the mean levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), lactate dehydrogenase (LDH), gamma-glutamyl transferase (GGT), and ferritin.
Inflammatory markers such as ferritin > 300 U/L were observed in the group that presented more changes in liver function markers (ALT, AST, and GGT). Age ≥ 60 years, male sex, AST > 25 U/L, and GGT ≥ 50 or 32 U/L were associated with ALT > 29 U/L.
Interestingly, there was a correlation between ALT and AST, LDH, GGT, and ferritin.
The study findings suggest that ALT and AST levels may be elevated in patients with long-term COVID, especially in those hospitalized in the acute phase.
Furthermore, ALT > 29 U/L was associated with other markers of liver injury, such as LDH, GGT, and ferritin.
The study findings were published on preprint server and is currently being peer reviewed.
Thailand Medical News in our previous COVID-19 News
coverages had already covered various studies that showed the SARS-CoV-2 virus is able to not only invade and damage the liver but also cause variety of liver issues including some that can eventually lead to liver cancers!
Liver damage may be associated with COVID-19 due to direct injury of the viral infection to the liver cells, delayed resolution of inflammation, and viral persistence.
Past studies suggested that angiotensin-converting enzyme 2 (ACE2) expression is enriched in cholangiocytes and that SARS-CoV-2 can bind directly to ACE-positive cholangiocytes, thereby deregulating liver function.
Many studies have reported changes in serum markers in long-term COVID, including inflammatory (C-reactive protein) and liver markers (alanine aminotransferase [ALT] and aspartate aminotransferase [AST]).
This study aimed to analyze serum markers of liver damage in patients with up to 20 months of long-term COVID-19.
The study participants were composed of female individuals, non-smokers, with more than 6 months of long-term COVID, who were not hospitalized, and whose average age was approximately 50 years. Fatigue and dyspnoea were symptoms of long-term COVID that affected more than 70% of patients, and the most recurrent comorbidity was arterial hypertension.
Alterations were identified in the average levels of ALT, AST, LDH, GGT, and ferritin. The elevation of ferritin, a group of inflammatory markers, was related to the increase in the levels of other liver markers, and ESR was above the reference values in all groups in this study.
The study team observed that age > 60 years, male sex, and AST and GGT levels above the reference values were more associated with ALT > 29 U/L. The high correlation between ALT and AST levels also suggests a high risk of liver damage.
Such altered markers are the result of direct damage caused by the virus to hepatocytes and a systemic inflammatory process already documented in hospitalized patients whose levels of IFN-λ, interleukin (IL)-6, IL-10, and IL-2 are found to be high.
It has been found that patients with severe COVID-19 have elevated levels of AST, ALT, and GGT and reduced albumin levels.
In the study findings of this research, the mean albumin levels were within normal limits. AST has also been used as a liver marker. Because it is produced in the muscle, and patients with long-term COVID have fatigue and muscle weakness as the most frequent symptoms, the elevation of this marker is questionable as to its hepatic origin.
The correlation and association between ALT and AST identified in this study suggest that true liver injury is the predominant source of aminotransferase elevation.
This is among the first studies to evaluate possible liver damage in patients with up to 20 months of long COVID. Changes in liver function markers, such as ALT, AST, LDH, GGT, and ferritin, may be present in patients who have developed long-term COVID, especially those hospitalized during acute infection. This may be due to the direct injury caused by the virus to hepatocytes and a persistent systemic inflammatory process. Furthermore, the results of this study suggest that changes in markers of liver injury in patients with long-term COVID may persist for more than 1.5 years after the resolution of COVID-19.
The study team suggest that new studies be carried out, especially those that allow monitoring the evolution of these patients for a longer time to identify whether such findings are indelible or transient.
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