Liver-spleen axis dysfunction in COVID-19  

作　　者：Sara Cococcia Marco Vincenzo Lenti Giovanni Santacroce Giovanna Achilli Federica Borrelli de Andreis Antonio Di Sabatino 

机构地区：[1]First Department of Internal Medicine,San Matteo Hospital Foundation,University of Pavia,Pavia 27100,Italy [2]Department of Gastroenterology,Royal Free Hospital,London NW32QG,United Kingdom

出　　处：《World Journal of Gastroenterology》2021年第35期5919-5931,共13页世界胃肠病学杂志（英文版）

摘　　要：Coronavirus disease 2019(COVID-19),caused by the novel severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),is an acute infectious disease that spreads mainly through the respiratory route.Besides interstitial pneumonia,a number of other clinical manifestations were noticed in COVID-19 patients.In particular,liver and spleen dysfunctions have been described both as complications of COVID-19 and as potential predisposing factors for severe COVID-19.Liver damage is rather common in COVID-19 patients,and it is most likely multifactorial,caused by the direct insult of SARS-CoV-2 to the liver by the cytokine storm triggered by the virus,by the use of hepatotoxic drugs,and as a consequence of hypoxia.Although generally mild,liver impairment has been found to be associated with a higher rate of intensive care unit admission.A higher mortality rate was reported among chronic liver disease patients.Instead,spleen impairment in patients with COVID-19 has been poorly described.The main anatomical changes are the architectural derangement of the B cell compartment,white pulp atrophy,and reduction or absence of lymphoid follicles,while,from a functional point of view,the IgM memory B cell pool is markedly depleted.The outcome of COVID-19 in asplenic or hyposplenic patients is yet to be defined.In this review,we will summarise the current knowledge regarding the impact of SARS-CoV-2 on the liver and spleen function,as well as the outcome of patients with a pre-existent liver disease or defective spleen function.

关 键 词：ASPLENIA Chronic liver disease IgM memory B cell Liver transplantation TRANSAMINASE 

分 类 号：R563.1[医药卫生—呼吸系统] R575[医药卫生—内科学] R551.1[医药卫生—临床医学]