INDIANAPOLIS (WISH) — People with liver disease might be more vulnerable to negative COVID-19 outcomes compared to those who don’t have liver disease, researchers suggest. The suspected mechanism, they say, has to do with how the virus enters the body through the bloodstream.
The liver–among other organs such as the heart, lungs and kidneys–houses cells called angiotensin converting enzyme 2 (ACE2). The virus attacks these ACE2 cells reducing the number. This is a problem because ACE2 helps regulate blood flow. Subsequently, a lower count of ACE2 inhibits the liver from doing its job, authors report in an editorial piece published in The Lancet.
The liver is responsible for filtering blood from the digestive tract before it passes to the rest of the body. It also detoxifies chemicals, metabolizes drugs and releases a fluid called bile that is necessary for digestion.
The authors provide some possible explanations as to why coronavirus infected liver disease patients are more susceptible to negative outcomes–whether the damage was as a result of the coronavirus or a pre-existing condition prior to infection.
A lower immune system
Scientists now know the severity of COVID-19. When the body is fighting off an infection, a person’s immune system is compromised. Compromised immunity can lead to inflammation. In response to inflammation, the body’s disease-fighting cells target the inflammation, further weakening the immune system and compromising organ function.
The cytokine storm
Cytokines are released in response to an infection. They are designed to attack viruses. But sometimes the body produces too many too quickly. The large amount and rapid release results in what scientists call a ‘cytokine storm’ which is toxic to the body. Instead of fighting off a virus, say COVID-19, the cytokines aid in its replication. The liver is particularly vulnerable to a cytokine storm because of its high levels of ACE2
Drug-induced liver damage
There is currently no treatment or vaccine for the coronavirus. However, many drugs have received FDA emergency use authorization. But some side effects of these medications include liver damage. These experimental drugs could possibly induce organ complications in a coronavirus infected patient with no pre-existing liver disease.
Reactivation of a pre-existing condition
The coronavirus may put those who’ve recovered from liver disease in the past at risk of a secondary occurrence. A secondary occurrence of any type of medical condition tends to be much more dangerous than the first occurrence. This may happen when patients with former liver damage are administered drugs meant to fight COVID-19, yet are toxic to the organ.
The World Health Organization declared COVID-19 as a global pandemic on March 12. The disease has now been penned ‘Severe Acute Respiratory Syndrome Coronavirus-2’ or SARS-Co-2. To date, according to the Center for Systems Science and Engineering at Johns Hopkins University, the virus has taken the lives of over 108,000 people in the United States. Over 2,000 of them were Hoosiers.