Sekulovski M, Bogdanova-Petrova S, Peshevska-Sekulovska M, Velikova T, Georgiev T. COVID-19 related liver injuries in pregnancy. World J Clin Cases 2023; 11(9): 1918-1929 [PMID: 36998958 DOI: 10.12998/wjcc.v11.i9.1918]
Corresponding Author of This Article
Tsvetoslav Georgiev, MD, PhD, Associate Professor, First Department of Internal Medicine, Medical University-Varna, 1 Hristo Smirnenski str., Varna 9010, Bulgaria. tsetso@medfaculty.org
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Metodija Sekulovski, Department of Anesthesiology and Intensive Care, University Hospital Lozenetz, Sofia 1407, Bulgaria
Metodija Sekulovski, Monika Peshevska-Sekulovska, Tsvetelina Velikova, Medical Faculty, Sofia University St. Kliment Ohridski, Sofia 1407, Bulgaria
Simona Bogdanova-Petrova, Tsvetoslav Georgiev, First Department of Internal Medicine, Medical University-Varna, Varna 9010, Bulgaria
Simona Bogdanova-Petrova, Tsvetoslav Georgiev, Clinic of Rheumatology, University Hospital “St. Marina”, Varna 9010, Bulgaria
Monika Peshevska-Sekulovska, Department of Gastroenterology, University Hospital Lozenetz, Sofia 1407, Bulgaria
Tsvetelina Velikova, Department of Clinical Immunology, University Hospital Lozenetz, Sofia 1407, Bulgaria
Author contributions: Georgiev T and Sekulovski M contributed to the conceptualization; Georgiev T Sekulovski M, Bogdanova-Petrova S and Peshevska-Sekulovska M contributed to the resources and literature review; Georgiev T, Sekulovski M, Bogdanova-Petrova S and Peshevska-Sekulovska M contributed to the preparation of original draft; Georgiev T, Sekulovski M, Velikova T contributed to the review and editing; Georgiev T, and Velikova T contributed to the supervision; All authors revised and approved the final version of the manuscript.
Conflict-of-interest statement: The authors declare they have no conflicts of interest.
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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tsvetoslav Georgiev, MD, PhD, Associate Professor, First Department of Internal Medicine, Medical University-Varna, 1 Hristo Smirnenski str., Varna 9010, Bulgaria. tsetso@medfaculty.org
Received: November 22, 2022 Peer-review started: November 22, 2022 First decision: January 3, 2023 Revised: January 17, 2023 Accepted: February 21, 2023 Article in press: February 21, 2023 Published online: March 26, 2023
Abstract
While severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) quickly spread across the globe, our understanding of its pathogenic mechanisms evolved. Importantly, coronavirus disease 2019 (COVID-19) is now considered a syndromic multisystem inflammatory disease involving not only the respiratory system but also the cardiovascular, excretory, nervous, musculoskeletal, and gastrointestinal systems. Moreover, a membrane-bound form of angiotensin-converting enzyme 2, the entry receptor for SARS-CoV-2, is expressed on the surface of cholangiocytes and hepatocytes, suggesting the potential of COVID-19 to involve the liver. With the widespread distribution of SARS-CoV-2 throughout the population, infection during pregnancy is no longer a rare occurrence; however, little is known about the course of hepatic injuries and related outcomes in pregnant SARS-CoV-2-positive women. Thus, the understudied topic of COVID-related liver disease during pregnancy poses a great challenge for the consulting gynecologist and hepatologist. In this review, we aim to describe and summarize potential liver injuries in pregnant women with COVID-19.
Core Tip: Angiotensin-converting enzyme 2 receptors are expressed in hepatocytes and cholangiocytes, suggesting the potential for liver involvement by coronavirus disease 2019 (COVID-19). Liver dysfunction is mainly observed in patients with severe or critical disease. However, little is known about the course of liver involvement and its sequelae in pregnant women positive for severe acute respiratory syndrome coronavirus 2. Several cases of hepatic injury in pregnant women with severe COVID-19 have been reported, making the liver the second most commonly affected organ following the lung.
