mesЭкстремальная биомедицинаExtreme Medicine3033-89643033-8972Centre for Strategic Planning of the Federal Medical and Biological Agency10.47183/mes.2022.009mes-160Research ArticleОБЗОРREVIEWПоражение печени у больных COVID-19Liver damage in patients with COVID-19ВологжанинД. А.VologzhaninD. A.

Санкт-Петербург.

Saint Petersburg

ГолотаА. С.GolotaA. S.

Александр Сергеевич Голота,

ул. Борисова, д. 9, лит. Б, 197706, г. Санкт-Петербург.

Aleksandr S. Golota,

9, lit. B, Borisova str., Saint Petersburg, 197706.

golotaa@yahoo.comКамиловаТ. А.KamilovaT. A.

Санкт-Петербург.

Saint Petersburg.

МакаренкоС. В.MakarenkoS. V.

Санкт-Петербург.

Saint Petersburg.

ЩербакС. Г.SсherbakS. G.

Санкт-Петербург.

Saint Petersburg.

Городская больница № 40 Курортного административного района; Санкт-Петербургский государственный университетРоссияCity Clinical Hospital No. 40 of the Kurortny District; St Petersburg UniversityRussian FederationГородская больница № 40 Курортного административного районаРоссияCity Clinical Hospital No. 40 of the Kurortny DistrictRussian FederationГородская больница № 40 Курортного административного района; Санкт-Петербургский государственный университетРоссияCity Clinical Hospital No. 40 of the Kurortny District; St. Petersburg UniversityRussian Federation2022271020242411320Copyright © Вологжанин Д.А., Голота А.С., Камилова Т.А., Макаренко С.В., Щербак С.Г., 20242024Вологжанин Д.А., Голота А.С., Камилова Т.А., Макаренко С.В., Щербак С.Г.Vologzhanin D.A., Golota A.S., Kamilova T.A., Makarenko S.V., Sсherbak S.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.extrememedicine.ru/jour/article/view/160

Спектр клинических проявлений инфекции SARS-CoV-2 продолжает расширяться, возникают важные фундаментальные вопросы, касающиеся ее клеточного тропизма и патогенетических механизмов. Повреждение печени происходит при всех формах COVID-19, особенно при тяжелых и крайне тяжелых, что может быть связано с прямым вирусным поражением, иммунной дисрегуляцией (системным воспалительным ответом и цитокиновым штормом), гипоксическим/ишемическим повреждением, лекарственной гепатотоксичностью и сопутствующими хроническими заболеваниями. Повреждение печени, определяемое в основном по повышению уровней трансаминаз, часто обнаруживают у пациентов с COVID-19, и оно коррелирует с клиническими исходами, включая смертность. Диагностические критерии, патогенез, клинические характеристики, лечение и прогноз поражения печени при COVID-19 должны быть уточнены в дальнейших клинических исследованиях. В настоящее время критически не хватает проверенных вариантов лечения пациентов с COVID-19, что приводит к неотложной необходимости изучения патогенеза полиорганной недостаточности и повреждения печени при этом заболевании. В обзоре представлена информация о патофизиологических механизмах повреждения печени коронавирусом SARSCoV-2 и развитии печеночной недостаточности при COVID-19. Поиск источников информации проведен в базе данных PubMed по ключевым словам «liver damage in COVID-19» и «immune liver damage in COVID-19».

The clinical spectrum of SARS-CoV-2 infection continues to expand, raising  important fundamental issues regarding the SARS-CoV-2 cellular tropism and pathogenic mechanisms. Liver damage is observed in patients with all forms of  COVID-19, especially severe and critical forms, which could be due to the direct viral damage, immune dysregulation (systemic inflammatory response and cytokine storm), hypoxia-ischemia, drug-induced hepatotoxicity, and concomitant chronic disorders. Liver damage, defined primarily by elevated transaminase levels, is often observed in patients with COVID-19 and correlates with clinical outcomes, including mortality. Diagnostic criteria, pathogenesis, clinical characteristics, treatment, and prognosis of liver injury in COVID-19 should be clarified in further clinical trials. Currently, there is a critical shortage of proven treatment options for patients with COVID-19, resulting in an urgent need to study the multiple organ failure and liver damage pathogenesis in patients with this disease. The review provides information about the pathophysiological mechanisms of the SARS-CoV-2-induced liver damage and the development of liver failure in COVID-19. Information sources were searched in the PubMed database using the keywords “liver damage in COVID-19” and “immune liver damage in COVID-19”.

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The authors declare that there are no conflicts of interest present.