COVID-19 and liver damage: narrative review and proposed clinical protocol for critically ill pediatric patients
Clinics
; 75: e2250, 2020. tab, graf
Article
en En
| LILACS
| ID: biblio-1133423
Biblioteca responsable:
BR1.1
ABSTRACT
SARS-CoV-2 shares nearly 80% of its' genomic sequence with SARS-CoV and MERS-CoV, both viruses known to cause respiratory symptoms and liver impairment. The emergence of pediatric cases of multisystem inflammatory syndrome related to the SARS-CoV-2 infection (PIM-TS) has raised concerns over the issue of hepatic damage and liver enzyme elevation in the critically ill pediatric population with COVID-19. Some retrospective cohorts and case series have shown various degrees of ALT/AST elevation in SARS-CoV-2 infections. A limited number of liver histopathological studies are available that show focal hepatic periportal necrosis. This liver damage was associated with higher levels of inflammatory markers, C-reactive protein (CRP), and pro-calcitonin. Proposed pathophysiological mechanisms include an uncontrolled exacerbated inflammatory response, drug-induced liver injury, direct viral infection and damage to cholangiocytes, hypoxic-ischemic lesions, and micro-thrombosis in the liver. Based on the physiopathological characteristics described, our group proposes a clinical protocol for the surveillance, evaluation, management, and follow-up of critically ill pediatric COVID-19 patients with liver damage.
Palabras clave
Texto completo:
1
Banco de datos:
LILACS
Asunto principal:
Neumonía Viral
/
Enfermedad Crítica
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Infecciones por Coronavirus
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Pandemias
Tipo de estudio:
Guideline
/
Observational_studies
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Risk_factors_studies
Límite:
Child
/
Humans
Idioma:
En
Año:
2020
Tipo del documento:
Article