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Review
. 2021 Apr 21;27(15):1531-1552.
doi: 10.3748/wjg.v27.i15.1531.

Impact of cytokine storm and systemic inflammation on liver impairment patients infected by SARS-CoV-2: Prospective therapeutic challenges

Fares E M Ali  1 , Zuhair M Mohammedsaleh  2 , Mahmoud M Ali  3 , Osama M Ghogar  3
Affiliations
Review

Impact of cytokine storm and systemic inflammation on liver impairment patients infected by SARS-CoV-2: Prospective therapeutic challenges

Fares E M Ali et al. World J Gastroenterol. .

Abstract

Coronavirus disease 2019 (COVID-19) is a devastating worldwide pandemic infection caused by a severe acute respiratory syndrome namely coronavirus 2 (SARS-CoV-2) that is associated with a high spreading and mortality rate. On the date this review was written, SARS-CoV-2 infected about 96 million people and killed about 2 million people. Several arguments disclosed the high mortality of COVID-19 due to acute respiratory distress syndrome or change in the amount of angiotensin-converting enzyme 2 (ACE2) receptor expression or cytokine storm strength production. In a similar pattern, hepatic impairment patients co-infected with SARS-CoV-2 exhibited overexpression of ACE2 receptors and cytokine storm overwhelming, which worsens the hepatic impairment and increases the mortality rate. In this review, the impact of SARS-CoV-2 on hepatic impairment conditions we overviewed. Besides, we focused on the recent studies that indicated cytokine storm as well as ACE2 as the main factors for high COVID-19 spreading and mortality while hinting at the potential therapeutic strategies.

Keywords: COVID-19; Cytokine storm; Hepatic impairment; Immuno-modulators receptors; SARS-CoV-2.

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Conflict of interest statement

Conflict-of-interest statement: No potential conflicts of interest and financial support for this work. Manuscript source: Invited manuscript

Figures

Figure 1
Figure 1
Angiotensin-converting enzyme 2 as a host for severe acute respiratory syndrome coronavirus 2 infection. SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2; ACE: Angiotensin-converting enzyme; Ang: angiotensin; ATR: Angiotensin receptors type.
Figure 2
Figure 2
Coronavirus disease 2019 and devastating cytokine storm. COVID-19: Coronavirus disease 2019; SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2; C5a: Complement component 5a; RAAS: Renin-angiotensin-aldosterone system; NLRPR: Nucleotide-binding oligomerization domain, Leucine-rich repeat and pyrin domain-containing receptor; PPRs: Pattern recognition receptors; ARDS: Acute respiratory distress syndrome.
See this image and copyright information in PMC

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