tetano
Editor, Senior Moderator
Clin Res Hepatol Gastroenterol
. 2025 May 1:102606.
doi: 10.1016/j.clinre.2025.102606. Online ahead of print. Evaluation of long-term changes in liver function and structure in patients exposed to SARS-CoV-2 infection: a prospective study
Erkin Saeed Saifi[SUP] 1 [/SUP], Francesco Faita[SUP] 2 [/SUP], Matteo Nardin[SUP] 3 [/SUP], Paola Orizio[SUP] 4 [/SUP], Alessandra Arrigoni[SUP] 5 [/SUP], Bianca Maria Roccon[SUP] 5 [/SUP], Beatrice Accordini[SUP] 6 [/SUP], Stefania Cecchinel[SUP] 7 [/SUP], Paolo Poisa[SUP] 8 [/SUP], Giovanni Pelizzari[SUP] 8 [/SUP], Anna Paini[SUP] 9 [/SUP], Massimo Salvetti[SUP] 5 [/SUP]
Affiliations
Background & aims: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) binds to Angiotensin Converting Enzyme - 2 (ACE2) receptor targeting various organs including liver. Liver injury is a common feature of SARS-CoV-2 acute infection. A few studies have also described chronic hepatic alterations in patients with previous COVID-19. We hypothesize that steatosis seen in COVID-19 patients reflects their metabolic profile and is not caused by persistent inflammation sustained by SARS-CoV-2.
Methods: We conducted a prospective study to evaluate long-term changes in liver function and structure in patients hospitalized for COVID-19. Patients without a prior known hepatic disease with mild to moderate COVID-19 were enrolled during hospitalization and reevaluated during a follow-up visit at a medium 16 months. Complete blood panels with metabolic profile, BMI, alcohol consumption and physical activity were compared between baseline and follow-up. Specific ultrasound scans were obtained during hospital stay and at follow-up to quantify steatosis using Steatoscore2.0.
Results: Among 55 eligible patients, 33 were included in the analysis and only 3 (9 %) had a new diagnosis of steatosis at follow-up. Steatoscore2.0 did not change significantly from baseline to follow-up (1.7 vs 1.73, p=0.348), while changes occurred in body mass index and physical activity estimated by IPAQ questionnaire (26.3 vs 26.6 kg/m[SUP]2[/SUP], p=0.005; 540 vs. 480, p=0.015, respectively). There was a statistically significant increase in total cholesterol (144.5 vs 187.0 mg/dl, p=0.003) and low-density lipoprotein-cholesterol (73.8 vs 113.9 mg/dl, p=0.003). Inflammatory markers normalized at follow-up, including C-reactive protein (41.1 vs. 0.8 mg/L, p<0.001), and ferritin (410.0 vs. 91.0 ng/dl, p<0.001). Four patients had a 3-time rise in liver transaminase levels at baseline, and this was not confirmed at follow-up. Change in Steatoscore2.0 correlated significantly with Triglyceride-glucose index as a surrogate of insulin resistance.
Conclusions: In our study, long term functional and structural changes were not observed in patients with previous SARS-CoV-2 infection. There was a significant deterioration of metabolic profile post COVID-19.
Keywords: COVID-19; MASLD; SARS-CoV-2; liver ultrasound, Steatoscore2.0.
. 2025 May 1:102606.
doi: 10.1016/j.clinre.2025.102606. Online ahead of print. Evaluation of long-term changes in liver function and structure in patients exposed to SARS-CoV-2 infection: a prospective study
Erkin Saeed Saifi[SUP] 1 [/SUP], Francesco Faita[SUP] 2 [/SUP], Matteo Nardin[SUP] 3 [/SUP], Paola Orizio[SUP] 4 [/SUP], Alessandra Arrigoni[SUP] 5 [/SUP], Bianca Maria Roccon[SUP] 5 [/SUP], Beatrice Accordini[SUP] 6 [/SUP], Stefania Cecchinel[SUP] 7 [/SUP], Paolo Poisa[SUP] 8 [/SUP], Giovanni Pelizzari[SUP] 8 [/SUP], Anna Paini[SUP] 9 [/SUP], Massimo Salvetti[SUP] 5 [/SUP]
Affiliations
- PMID: 40318843
- DOI: 10.1016/j.clinre.2025.102606
Background & aims: Severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) binds to Angiotensin Converting Enzyme - 2 (ACE2) receptor targeting various organs including liver. Liver injury is a common feature of SARS-CoV-2 acute infection. A few studies have also described chronic hepatic alterations in patients with previous COVID-19. We hypothesize that steatosis seen in COVID-19 patients reflects their metabolic profile and is not caused by persistent inflammation sustained by SARS-CoV-2.
Methods: We conducted a prospective study to evaluate long-term changes in liver function and structure in patients hospitalized for COVID-19. Patients without a prior known hepatic disease with mild to moderate COVID-19 were enrolled during hospitalization and reevaluated during a follow-up visit at a medium 16 months. Complete blood panels with metabolic profile, BMI, alcohol consumption and physical activity were compared between baseline and follow-up. Specific ultrasound scans were obtained during hospital stay and at follow-up to quantify steatosis using Steatoscore2.0.
Results: Among 55 eligible patients, 33 were included in the analysis and only 3 (9 %) had a new diagnosis of steatosis at follow-up. Steatoscore2.0 did not change significantly from baseline to follow-up (1.7 vs 1.73, p=0.348), while changes occurred in body mass index and physical activity estimated by IPAQ questionnaire (26.3 vs 26.6 kg/m[SUP]2[/SUP], p=0.005; 540 vs. 480, p=0.015, respectively). There was a statistically significant increase in total cholesterol (144.5 vs 187.0 mg/dl, p=0.003) and low-density lipoprotein-cholesterol (73.8 vs 113.9 mg/dl, p=0.003). Inflammatory markers normalized at follow-up, including C-reactive protein (41.1 vs. 0.8 mg/L, p<0.001), and ferritin (410.0 vs. 91.0 ng/dl, p<0.001). Four patients had a 3-time rise in liver transaminase levels at baseline, and this was not confirmed at follow-up. Change in Steatoscore2.0 correlated significantly with Triglyceride-glucose index as a surrogate of insulin resistance.
Conclusions: In our study, long term functional and structural changes were not observed in patients with previous SARS-CoV-2 infection. There was a significant deterioration of metabolic profile post COVID-19.
Keywords: COVID-19; MASLD; SARS-CoV-2; liver ultrasound, Steatoscore2.0.
