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Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Sep 14, 2021; 27(34): 5630-5665
Published online Sep 14, 2021. doi: 10.3748/wjg.v27.i34.5630
Liver disorders in COVID-19, nutritional approaches and the use of phytochemicals
Nancy Vargas-Mendoza, Jazmín García-Machorro, Marcelo Angeles-Valencia, Marlet Martínez-Archundia, Eduardo Osiris Madrigal-Santillán, Ángel Morales-González, Liliana Anguiano-Robledo, José A Morales-González
Nancy Vargas-Mendoza, Jazmín García-Machorro, Marcelo Angeles-Valencia, Laboratorio de Medicina de Conservacion, Instituto Politécnico Nacional, México 11340, Mexico
Marlet Martínez-Archundia, Laboratorio de Diseño y Desarrollo de Nuevos Fármacos e Innovación Biotécnológica, Instituto Politécnico Nacional, México 11340, Mexico
Eduardo Osiris Madrigal-Santillán, Escuela Superior de Medicina, Instituto Politécnico Nacional, México 11340, Mexico
Ángel Morales-González, Escuela Superior de Cómputo, Instituto Politécnico Nacional, México 07738, Mexico
Liliana Anguiano-Robledo, Laboratorio de Farmacología Molecular, Instituto Politécnico Nacional, México 11340, Mexico
José A Morales-González, Laboratorio Medicina de Conservación, Escuela Superior de Medicina, Instituto Politécnico Nacional, México 11340, Mexico
Author contributions: The authors contributed equally to the development of the manuscript; All authors read and approved the final version.
Supported by SIP Project, No. SIP-20200341 and No. SIP-20200453; and Consejo Nacional de Ciencia y Tecnología (CONACyT) Grants, No. PAACTI 312807.
Conflict-of-interest statement: The authors declare that they have no conflicting interests.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: José A Morales-González, MD, PhD, Academic Research, Professor, Laboratorio Medicina de Conservación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Plan de San Luis y Díaz Mirón, Col. Casco de Santo Tomás, Del. Miguel Hidalgo, Mexico 11340, Mexico. jmorales101@yahoo.com.mx
Received: January 27, 2021
Peer-review started: January 27, 2021
First decision: May 13, 2021
Revised: May 19, 2021
Accepted: July 19, 2021
Article in press: July 19, 2021
Published online: September 14, 2021
Abstract

Coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has affected millions of people globally. It was declared a pandemic by the World Health Organization in March 2020. The hyperinflammatory response to the entry of SARS-CoV-2 into the host through angiotensin-converting enzyme 2 is the result of a “cytokine storm” and the high oxidative stress responsible for the associated symptomatology. Not only respiratory symptoms are reported, but gastrointestinal symptoms (diarrhea, vomiting, and nausea) and liver abnormalities (high levels of aspartate aminotransferase, alanine aminotransferase transaminases, and bilirubin) are observed in at least 30% of patients. Reduced food intake and a delay in medical services may lead to malnutrition, which increases mortality and poor outcomes. This review provides some strategies to identify malnutrition and establishes nutritional approaches for the management of COVID-19 and liver injury, taking energy and nutrient requirements and their impact on the immune response into account. The roles of certain phytochemicals in the prevention of the disease or as promising target drugs in the treatment of this disease are also considered.

Keywords: COVID-19, Infection, Liver, Nutrition therapy, Phytochemicals

Core Tip: The Coronavirus disease 2019 (COVID-19) outbreak caused by severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), was declared a pandemic by the World Health Organization in 2020. It has since affected millions of persons worldwide. In some cases, entry of the virus into the cell leads to a hyperinflammatory response, giving rise to all of the associated symptomatology. Liver abnormalities have been detected frequently during the course of COVID-19, with or without related symptoms. Herein we discuss the infectious process, the response to the immune system and to the oxidative stress induced, and provide a brief guideline for nutritional therapy in patients affected by SARS-CoV-2 and liver injury.