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Year : 2020  |  Volume : 5  |  Issue : 3  |  Page : 42

SARS CoV-2 associated hepato-renal dysfunctions

Department of Human Physiology & Food Science and Nutrition, Raja Narendra Lal Khan Women's College(Autonomous), Midnapore-721102, West Bengal, India

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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2468-838X.303799

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Emergence of new virus and their heterogeneity are growing at an alarming rate. COVID-19 officially called SARS-CoV-2 is a newly emerging human infectious disease caused by the coronavirus that led to global pandemic. Most of the studies have highlighted that COVID-19 damages the lungs as the main target organ, while few studies have described that SARS-CoV-2 is also involved in liver and kidneys impairment. Several studies had reported that liver and kidney disease is a global burden and was responsible for about 2millions of death annually, with 50% of these associated with complications due to liver cirrhosis and the other half linked to hepatocellular carcinoma and viral hepatitis. According to the studies it was noted that hepatic abnormalities significantly increases after infection with COVID-19 and during the course of the disease. In addition to liver injuries, few studies have also reported a greater occurrence of acute renal injury following COVID-19, which could be due to the manifestation of SARS-CoV-2. Moreover, it was noted that patients with acute renal injury have a greater mortality rate compared to other patients. According to the reports, biomarkers of liver injuries increases in patients with COVID-19, though, no virus was found in the liver tissue of patients who died from the disease. This is to be expected, as angiotensin-converting enzyme (ACE2) receptor, a vital performer in the “docking” and replication of the SARS-CoV-2 virus, is not expressed in hepatocytes. However, ACE2 expression has been reported in cholangiocytes, leading to the binding of SARS-CoV-2 to the epithelial cells of the biliary tree may cause biliary dysfunction. Various studies also suggest that transient liver injuries observed in COVID-19 patients may be concomitant with cytokine storm or hypoxia and drug toxicity. It was also reported that the ACE2 receptor is overexpressed in the tubular cells of patients with CKD. Alteration in kidney functions, characterised by increased serum creatinine and urea nitrogen, was also testified in patients with COVID-19. Hence, frequent and careful monitoring of liver and kidney functions in patients with COVID-19 can lead to early diagnosis of liver and kidney disorders, and also help in achieving the optimal therapeutic concentrations and reducing the risk of adverse drug reactions. Traditional medicine continues to be practised for healing the hepato-renal dysfunctions, but the effective cost of treatments, several side effects and resistance development of currently used drugs in the treatment have led to increasing emphasis on the use of probiotic lactic acid bacteria (LAB) mediated bacteriotherapy, herbal plant materials, herbal gold nanomedicines as a non-conventional alternative management for the prevention of hepatorenal dysfunctions. Hence, further investigations are required to find out the potential beneficial effects of these protective agents to fight against COVID-19 associated hepato-renal dysfunctions.

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