Поражение печени у больных COVID-19

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».

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