Evaluation of long-term changes in liver function and structure in patients exposed to SARS-CoV-2 infection: A prospective study - 10/05/25
, Francesco Faita b, Matteo Nardin c, d, Paola Orizio e, Alessandra Arrigoni f, Bianca Maria Roccon f, g, Beatrice Accordini h, Stefania Cecchinel i, Paolo Poisa j, Giovanni Pelizzari j, Anna Paini a, Massimo Salvetti f
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Highlights |
• | The impact of SARS-CoV-2 infection on liver function and structure is not well established. |
• | Our findings suggest that exposure to SARS-CoV-2 does not determine long-term structural and functional changes in the liver. |
• | Variation in TyG index as a surrogate of insulin resistance and an indicator of metabolic dysfunction is related to that of steatoscore2.0. |
Abstract |
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/m2, 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
Le texte complet de cet article est disponible en PDF.Keywords : SARS-CoV-2, COVID-19, MASLD, Liver ultrasound, Steatoscore2.0
Plan
Vol 49 - N° 6
Article 102606- juin 2025 Retour au numéro
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