Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 May 15:455:152765.
doi: 10.1016/j.tox.2021.152765. Epub 2021 Mar 23.

COVID-19 and the liver: an adverse outcome pathway perspective

Mathieu Vinken  1
Affiliations
Review

COVID-19 and the liver: an adverse outcome pathway perspective

Mathieu Vinken. Toxicology. .

Abstract

Liver damage is observed in up to half of hospitalized COVID-19 patients and can result either from actions of SARS-CoV-2 as such or from pharmacological treatment. The present paper introduces an adverse outcome pathway construct that mechanistically describes the pathways induced by SARS-CoV-2 leading to liver injury. This can be caused by direct binding of the virus and local actions in cholangiocytes, but may also indirectly result from the general state of hypoxia and systemic inflammation in COVID-19 patients. Further research is urgently needed to fill remaining knowledge gaps. This will be anticipated to create a solid basis for future and more targeted development of vaccines and, in particular, therapies.

Keywords: AOP; COVID-19; Liver; Mechanism; SARS-CoV-2.

PubMed Disclaimer

Conflict of interest statement

The author declares that he has no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Adverse outcome pathway describing the effects of COVID-19 on the liver (ACE2, angiotensin-converting enzyme 2; AO, adverse outcome; KE, key event; MIE, molecular initiating event).
See this image and copyright information in PMC

References

    1. Ankley G.T., Bennett R.S., Erickson R.J., Hoff D.J., Hornung M.W., Johnson R.D., Mount D.R., Nichols J.W., Russom C.L., Schmieder P.K., Serrrano J.A., Tietge J.E., Villeneuve D.L. Adverse outcome pathways: a conceptual framework to support ecotoxicology research and risk assessment. Environ. Toxicol. Chem. 2010;29:730–741. - PubMed
    1. Bangash M.N., Patel J., Parekh D. COVID-19 and the liver: little cause for concern. Lancet Gastroenterol. Hepatol. 2020;5:529–530. - PMC - PubMed
    1. Boregowda U., Aloysius M.M., Perisetti A., Gajendran M., Bansal P., Goyal H. Serum activity of liver enzymes is associated with higher mortality in COVID-19: a systematic review and meta-analysis. Front. Med. 2020;7:431. - PMC - PubMed
    1. Brill A., Suidan G.L., Wagner D.D. Hypoxia, such as encountered at high altitude, promotes deep vein thrombosis in mice. J. Thromb. Haemost. 2013;11:1773–1775. - PMC - PubMed
    1. Brosnahan S.B., Smilowitz R.S., Amoroso N.E., Barfield M., Berger J.S., Goldenber R., Ishida K., Talmor N., Torres J., Yaghi S., Yuriditsky E., Maldonado T.S. Thrombosis at hospital presentation in patients with and without coronavirus disease 2019. J. Vasc. Surg. Venous Lymphat. Disord. 2021 in press. - PMC - PubMed

Publication types

MeSH terms