Cambios en la función hepática causados por COVID-19 y su impacto en el resultado clínico del paciente: una revisión sistemática

Palabras clave: Pruebas de función hepática, Infecciones por coronavirus

Resumen

Introducción: En marzo de 2020, la Organización Mundial de la Salud (OMS) decretó la pandemia de la enfermedad por coronavirus de 2019 (COVID-19), que consiste en la infección por coronavirus del síndrome respiratorio agudo grave de tipo 2 (SARS-CoV-2). Este virus utiliza la enzima convertidora de angiotensina II (ECA-II) como receptor celular humano, que está presente en el tejido pulmonar, cardíaco, gastrointestinal, hepático, renal y vascular, lo que configura un potencial de afectación multisistémica por parte del patógeno. El hígado puede resultar dañado tanto por la liberación excesiva de citocinas inflamatorias en COVID-19 como por la adopción de fármacos con potencial hepatotóxico en el tratamiento de sus síntomas.

Objetivo: analizar la relación entre los cambios en la función hepática causados por el SARS-CoV-2 y su impacto en el pronóstico del paciente.

Métodos: el presente estudio consiste en una revisión sistemática, realizada a partir de estudios seleccionados de las bases de datos PMC, LILACS y SciELO. Después de aplicar los criterios de inclusión y exclusión, se definieron 30 artículos para componer la base de datos de este estudio.

Resultados: La enzima aspartato-aminotransferasa (AST) estaba aumentando en mayor prevalencia, con un total de 4695 casos, mientras que la alanina-aminotransferasa (ALT) estaba elevada en 3226 casos. Se observa que los pacientes que presentaban síntomas digestivos tenían más probabilidades de presentar daño hepatocelular y, en consecuencia, alteraciones enzimáticas. Además, la mortalidad ocurrió en el 28,9 % de los casos de pacientes con función hepática alterada, mientras que, en aquellos con función normal, esta tasa fue del 9 %.

Conclusión: es evidente que existe una relación entre la afectación hepática por COVID-19 y su mortalidad. Sin embargo, todavía existe una limitación en la cantidad y, principalmente, en la homogeneidad de los estudios que realizaron dicha valoración.

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Biografía del autor/a

Tiago Almeida-Costa, Universidade Tiradentes (UNIT)

Estudiante (pregrado) de medicina. Arcaju, SE, Brasil

María Adriely Cunha-Lima, Universidad de Tiradentes - UNIT

Estudiante (pregrado) de medicina. Arcaju, SE, Brasil

Isadora Kniess, Universidad Nacional de Rosário - UNR

Estudiante (pregrado) de medicina. Rosario, Argentina

Levi Marques-Vieira, Universidad Nacional de Rosário - UNR

Estudiante (pregrado) de medicina. Rosario, Argentina

Leda Maria Delmondes-Freitas Trindade, Universidade Tiradentes - UNIT

Licenciada en Ciencias de la Salud. Profesor del Curso de Medicina. Aracaju, SE, Brasil

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Figura 1. Diagrama de flujo PRISMA del estudio. Datos de la investigación, 2020.
Publicado
2021-09-15
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Almeida Costa, T., Cunha Lima, M. A., Kniess, I., Marques Vieira, L., & Delmondes-Freitas Trindade, L. M. (2021). Cambios en la función hepática causados por COVID-19 y su impacto en el resultado clínico del paciente: una revisión sistemática . Revista Colombiana De Gastroenterología, 36(3), 302-312. https://doi.org/10.22516/25007440.713
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