Evidence map›Paper›PMID 37873785›Full record

ArticleDiseases (Basel, Switzerland)2023

Liver Damage and Impaired Coagulation in COVID-19 Patients: A Case Series.

Ludovico Abenavoli, Isabella Aquila, Matteo Antonio Sacco, Giuseppe Guido Maria Scarlata, Anna Caterina Procopio, Luigi Boccuto, Emidio Scarpellini, Marta Greco, Daniela Patrizia Foti, Pietrantonio Ricci and 1 more

Open access · goldAbstract read
In one paragraph

Article in Diseases (Basel, Switzerland), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
1.2field-weighted citation impact, top 22% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 6 citations in OpenAlex.

  1. Article
  2. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 3 institutions in 3 countries.

Ludovico AbenavoliDepartment of Health Sciences, University "Magna Græcia", Viale Europa, 88100 Catanzaro, Italy.ORCID 0000-0002-5922-1524
Isabella AquilaInstitute of Legal Medicine, Department of Medical and Surgical Sciences, University "Magna Graecia", Viale Europa, 88100 Catanzaro, Italy.ORCID 0000-0002-2481-6050
Matteo Antonio SaccoInstitute of Legal Medicine, Department of Medical and Surgical Sciences, University "Magna Graecia", Viale Europa, 88100 Catanzaro, Italy.ORCID 0000-0002-1750-3742
Giuseppe Guido Maria ScarlataDepartment of Health Sciences, University "Magna Græcia", Viale Europa, 88100 Catanzaro, Italy.ORCID 0000-0002-7084-8264
Anna Caterina ProcopioDepartment of Health Sciences, University "Magna Græcia", Viale Europa, 88100 Catanzaro, Italy.
Luigi BoccutoHealthcare Genetics and Genomics Doctoral Program, School of Nursing, College of Behavioral, Social and Health Sciences, Clemson University, Clemson, SC 29631, USA.ORCID 0000-0003-2017-4270
Emidio ScarpelliniTranslationeel Onderzoek van Gastroenterologische Aandoeningen (T.A.R.G.I.D.), Gasthuisberg University Hospital, KU Leuven, Herestraat 49, 3000 Leuven, Belgium.ORCID 0000-0002-2101-1118
Marta GrecoDepartment of Health Sciences, University "Magna Græcia", Viale Europa, 88100 Catanzaro, Italy.ORCID 0000-0003-4192-3891
Daniela Patrizia FotiDepartment of Experimental and Clinical Medicine, University "Magna Græcia", Viale Europa, 88100 Catanzaro, Italy.ORCID 0000-0002-9536-5736
Pietrantonio RicciInstitute of Legal Medicine, Department of Medical and Surgical Sciences, University "Magna Graecia", Viale Europa, 88100 Catanzaro, Italy.
Francesco LuzzaDepartment of Health Sciences, University "Magna Græcia", Viale Europa, 88100 Catanzaro, Italy.ORCID 0000-0001-5120-1046
Magna Graecia University · ITClemson University · USKU Leuven · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has generated an unprecedented challenge for healthcare systems worldwide. Currently, the scientific community wonders if liver injury in patients suffering from severe forms is a direct consequence of the virus or secondary manifestations of systemic inflammation. The liver plays an essential role in the development of the inflammatory storm typical of this disease, and its involvement is associated with worse clinical outcomes and a higher risk of morbidity and mortality from Coronavirus disease 2019 (COVID-19).

methodsTen patients suffering from severe COVID-19 disease who died between January 2020 and December 2021 were included in the present analysis. These subjects underwent a post mortem examination with a focused evaluation of the hepatic injury. Also, several laboratory parameters have been evaluated, with a primary focus on prothrombin time, partial thromboplastin time, fibrinogen, antithrombin III, and D-dimers to detect coagulative changes.

resultsThe main cause of death was represented by pulmonary thromboembolism events (50%). The analysis of coagulation laboratory parameters and liver biomarkers revealed a statistically significant rise in aPTT and ALP, and a decrease in albumin, when comparing the blood value at admission and death. We also found high levels of D-dimers in most of the subjects at the time of hospitalization. Interestingly, the post mortem analysis of the liver showed ample morphologic variability, with several disease features. In detail, the liver histology revealed the following: the presence of a variable degree of micro- and macrovacuolar steatosis, inflammation (also, hepato-cholangitis), and variable fibrosis. Of mention, we were also able to detect organized fibrinous material.

conclusionsOur results indicate that in subjects with a severe form of COVID-19, liver disease is related to changes in coagulative and fibrinolytic pathways. In particular, we noted low fibrinogen levels and high D-dimer levels with histological liver findings. Our data suggest that fibrinogen and D-dimers may be used as prognostic markers to detect the severity of liver disease in patients with COVID-19. Finally, we underline the crucial role of coagulation balance in subjects with severe forms of COVID-19.

Indexed as

histologyinflammationliver diseaseSARS-CoV-2vascular disease

Identifiers

PMID37873785
PMCPMC10594514
OpenAlexW4387614516

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.