COVID-19-associated hepatic injury differential diagnosis: Difference between revisions

Latest revision as of 11:25, 21 July 2020

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Tayyaba Ali, M.D.[2]

Overview

COVID-19-associated hepatic Injury must be differentiated from other conditions that cause elevation of liver enzymes.

Differential Diagnosis

COVID-19-associated hepatic Injury must be differentiated from other conditions that cause elevation of liver enzymes.

Disease		Clinical manifestations					Laboratory findings			Additional findings
		Symptoms			Signs		Transaminitis (elevated AST and ALT)	Viral markers	Autoimmune markers
		Nausea & vomiting	Abdominal pain	Arthralgia	Jaundice	Hepatomegaly	Transaminitis (elevated AST and ALT)	Viral markers	Autoimmune markers
Acute viral hepatitis	Hepatitis A^[1]^[2]	+++	++	+	+++	+	+++	HAV Ab	---	Fecal-oral transmission Usually acute and self limit Fever usually present
	Hepatitis B^[3]	+++	++	++	+++	+	+++	HBs Ag, HBc Ab, HBe Ag	---	Percutaneous transmission most common May cause acute hepatic failure or may become chronic Fever usually present
	Hepatitis C^[4]	+++	++	++	+++	+	+++	HCV Ab	---	Percutaneous transmission is most common Higher rate of chronic progression Associated with extra hepatic manifestation such as cryoglobulinemia and membranoproliferative glomerulonephritis Fever usually present
	Hepatitis E^[5]	++	++	+/-	++	+	+++	HEV Ab	---	Fecal-oral transmission May cause fulminant disease in pregnancy Fever usually present
	CMV hepatitis^[6]	+/-	++	-	+	+	++	CMV-specific immunoglobulin (Ig)M antibody	--	Usually manifests as mononucleosis syndrome fever usually present
	EBV hepatitis^[7]	+/-	++	-	+/-	+	++	Heterophile antibody test, monospot test	--	Systemic manifestations as mononucleosis syndrome Fever usually present
Autoimmune hepatitis^[8]		-	+	+/-	++	+	+++	---	ANA, ASMA, anti SLA/LP, ANCA, ALKM-1 antibodies	Liver biopsy may be required for diagnosis
Alcoholic hepatitis^[9]		+/-	+	-	+	-	AST>ALT	---	---	History of alcohol intake
Drug induced hepatitis^[10]		+/-	+	-	+	+	++	---	---	May cause either cholestatic or hepatocellular injury
COVID-19-associated hepatic Injury		+^[11]	+^[12]	+^[13]	-	+^[13]	++^[14]	IgG/IgM Antibodies^[15]	---	Fever usually present. Live SARS-CoV-2 is also cultured from stool samples in rare cases, providing the evidence that SARS-CoV-2 has the possibility of fecal-oral transmission.^[16]^[17]

References

↑ Jeong SH, Lee HS (2010). "Hepatitis A: clinical manifestations and management". Intervirology. 53 (1): 15–9. doi:10.1159/000252779. PMID 20068336.
↑ Nainan OV, Xia G, Vaughan G, Margolis HS (2006). "Diagnosis of hepatitis a virus infection: a molecular approach". Clin Microbiol Rev. 19 (1): 63–79. doi:10.1128/CMR.19.1.63-79.2006. PMC 1360271. PMID 16418523.
↑ Yuen MF, Chen DS, Dusheiko GM, Janssen HLA, Lau DTY, Locarnini SA; et al. (2018). "Hepatitis B virus infection". Nat Rev Dis Primers. 4: 18035. doi:10.1038/nrdp.2018.35. PMID 29877316.
↑ Mukherjee R, Burns A, Rodden D, Chang F, Chaum M, Garcia N; et al. (2015). "Diagnosis and Management of Hepatitis C Virus Infection". J Lab Autom. 20 (5): 519–38. doi:10.1177/2211068214563794. PMID 25609256.
↑ Kamar N, Dalton HR, Abravanel F, Izopet J (2014). "Hepatitis E virus infection". Clin Microbiol Rev. 27 (1): 116–38. doi:10.1128/CMR.00057-13. PMC 3910910. PMID 24396139.
↑ Gupta P, Suryadevara M, Das A (2014). "Cytomegalovirus-induced hepatitis in an immunocompetent patient". Am J Case Rep. 15: 447–9. doi:10.12659/AJCR.890945. PMC 4206484. PMID 25325934.
↑ Karadeniz A, Yesilbag Z, Kaya FÖ, Akgün FS (2018). "Acute hepatitis due to Epstein-Barr virus with cross-reacting antibodies to cytomegalovirus". Indian J Med Microbiol. 36 (1): 143–144. doi:10.4103/ijmm.IJMM_17_378. PMID 29735847.
↑ Manns MP, Lohse AW, Vergani D (2015). "Autoimmune hepatitis--Update 2015". J Hepatol. 62 (1 Suppl): S100–11. doi:10.1016/j.jhep.2015.03.005. PMID 25920079.
↑ Hosseini N, Shor J, Szabo G (2019). "Alcoholic Hepatitis: A Review". Alcohol Alcohol. 54 (4): 408–416. doi:10.1093/alcalc/agz036. PMC 6671387 Check |pmc= value (help). PMID 31219169.
↑ Katarey D, Verma S (2016). "Drug-induced liver injury". Clin Med (Lond). 16 (Suppl 6): s104–s109. doi:10.7861/clinmedicine.16-6-s104. PMC 6329561. PMID 27956449.
↑ Luo S, Zhang X, Xu H (2020). "Don't Overlook Digestive Symptoms in Patients With 2019 Novel Coronavirus Disease (COVID-19)". Clin Gastroenterol Hepatol. 18 (7): 1636–1637. doi:10.1016/j.cgh.2020.03.043. PMC 7154217 Check |pmc= value (help). PMID 32205220 Check |pmid= value (help).
↑ "Correction to Lancet Infectious Diseases 2020; published online April 29. https://doi.org/10.1016/ S1473-3099(20)30064-5". Lancet Infect Dis. 20 (7): e148. 2020. doi:10.1016/S1473-3099(20)30370-4. PMID 32595044 Check |pmid= value (help). External link in |title= (help)
↑ ^13.0 ^13.1 Li J, Fan JG (2020). "Characteristics and Mechanism of Liver Injury in 2019 Coronavirus Disease". J Clin Transl Hepatol. 8 (1): 13–17. doi:10.14218/JCTH.2020.00019. PMC 7132021 Check |pmc= value (help). PMID 32274341 Check |pmid= value (help).
↑ Bangash MN, Patel J, Parekh D (2020). "COVID-19 and the liver: little cause for concern". Lancet Gastroenterol Hepatol. 5 (6): 529–530. doi:10.1016/S2468-1253(20)30084-4. PMC 7270582 Check |pmc= value (help). PMID 32203680 Check |pmid= value (help).
↑ Lippi G, Simundic AM, Plebani M (2020). "Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19)". Clin Chem Lab Med. 58 (7): 1070–1076. doi:10.1515/cclm-2020-0285. PMID 32172228 Check |pmid= value (help).
↑ Wang W, Xu Y, Gao R, Lu R, Han K, Wu G; et al. (2020). "Detection of SARS-CoV-2 in Different Types of Clinical Specimens". JAMA. doi:10.1001/jama.2020.3786. PMC 7066521 Check |pmc= value (help). PMID 32159775 Check |pmid= value (help).
↑ "Infectious SARS-CoV-2 in Feces of Patient with Severe COVID-19 - Volume 26, Number 8—August 2020 - Emerging Infectious Diseases journal - CDC".

[pmid20068336-1] Jeong SH, Lee HS (2010). "Hepatitis A: clinical manifestations and management". Intervirology. 53 (1): 15–9. doi:10.1159/000252779. PMID 20068336.

[pmid16418523-2] Nainan OV, Xia G, Vaughan G, Margolis HS (2006). "Diagnosis of hepatitis a virus infection: a molecular approach". Clin Microbiol Rev. 19 (1): 63–79. doi:10.1128/CMR.19.1.63-79.2006. PMC 1360271. PMID 16418523.

[pmid29877316-3] Yuen MF, Chen DS, Dusheiko GM, Janssen HLA, Lau DTY, Locarnini SA; et al. (2018). "Hepatitis B virus infection". Nat Rev Dis Primers. 4: 18035. doi:10.1038/nrdp.2018.35. PMID 29877316.

[pmid25609256-4] Mukherjee R, Burns A, Rodden D, Chang F, Chaum M, Garcia N; et al. (2015). "Diagnosis and Management of Hepatitis C Virus Infection". J Lab Autom. 20 (5): 519–38. doi:10.1177/2211068214563794. PMID 25609256.

[pmid24396139-5] Kamar N, Dalton HR, Abravanel F, Izopet J (2014). "Hepatitis E virus infection". Clin Microbiol Rev. 27 (1): 116–38. doi:10.1128/CMR.00057-13. PMC 3910910. PMID 24396139.

[pmid25325934-6] Gupta P, Suryadevara M, Das A (2014). "Cytomegalovirus-induced hepatitis in an immunocompetent patient". Am J Case Rep. 15: 447–9. doi:10.12659/AJCR.890945. PMC 4206484. PMID 25325934.

[pmid29735847-7] Karadeniz A, Yesilbag Z, Kaya FÖ, Akgün FS (2018). "Acute hepatitis due to Epstein-Barr virus with cross-reacting antibodies to cytomegalovirus". Indian J Med Microbiol. 36 (1): 143–144. doi:10.4103/ijmm.IJMM_17_378. PMID 29735847.

[pmid25920079-8] Manns MP, Lohse AW, Vergani D (2015). "Autoimmune hepatitis--Update 2015". J Hepatol. 62 (1 Suppl): S100–11. doi:10.1016/j.jhep.2015.03.005. PMID 25920079.

[pmid31219169-9] Hosseini N, Shor J, Szabo G (2019). "Alcoholic Hepatitis: A Review". Alcohol Alcohol. 54 (4): 408–416. doi:10.1093/alcalc/agz036. PMC 6671387 Check |pmc= value (help). PMID 31219169.

[pmid27956449-10] Katarey D, Verma S (2016). "Drug-induced liver injury". Clin Med (Lond). 16 (Suppl 6): s104–s109. doi:10.7861/clinmedicine.16-6-s104. PMC 6329561. PMID 27956449.

[pmid32205220-11] Luo S, Zhang X, Xu H (2020). "Don't Overlook Digestive Symptoms in Patients With 2019 Novel Coronavirus Disease (COVID-19)". Clin Gastroenterol Hepatol. 18 (7): 1636–1637. doi:10.1016/j.cgh.2020.03.043. PMC 7154217 Check |pmc= value (help). PMID 32205220 Check |pmid= value (help).

[pmid32595044-12] "Correction to Lancet Infectious Diseases 2020; published online April 29. https://doi.org/10.1016/ S1473-3099(20)30064-5". Lancet Infect Dis. 20 (7): e148. 2020. doi:10.1016/S1473-3099(20)30370-4. PMID 32595044 Check |pmid= value (help). External link in |title= (help)

[pmid32274341-13] 13.0 ^13.1 Li J, Fan JG (2020). "Characteristics and Mechanism of Liver Injury in 2019 Coronavirus Disease". J Clin Transl Hepatol. 8 (1): 13–17. doi:10.14218/JCTH.2020.00019. PMC 7132021 Check |pmc= value (help). PMID 32274341 Check |pmid= value (help).

[pmid32203680-14] Bangash MN, Patel J, Parekh D (2020). "COVID-19 and the liver: little cause for concern". Lancet Gastroenterol Hepatol. 5 (6): 529–530. doi:10.1016/S2468-1253(20)30084-4. PMC 7270582 Check |pmc= value (help). PMID 32203680 Check |pmid= value (help).

[pmid32172228-15] Lippi G, Simundic AM, Plebani M (2020). "Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19)". Clin Chem Lab Med. 58 (7): 1070–1076. doi:10.1515/cclm-2020-0285. PMID 32172228 Check |pmid= value (help).

[pmid32159775-16] Wang W, Xu Y, Gao R, Lu R, Han K, Wu G; et al. (2020). "Detection of SARS-CoV-2 in Different Types of Clinical Specimens". JAMA. doi:10.1001/jama.2020.3786. PMC 7066521 Check |pmc= value (help). PMID 32159775 Check |pmid= value (help).

[urlInfectious_SARS-CoV-2_in_Feces_of_Patient_with_Severe_COVID-19_-_Volume_26,_Number_8—August_2020_-_Emerging_Infectious_Diseases_journal_-_CDC-17] "Infectious SARS-CoV-2 in Feces of Patient with Severe COVID-19 - Volume 26, Number 8—August 2020 - Emerging Infectious Diseases journal - CDC".

[1]

[2]

[3]

[4]

[5]

[6]

[7]

[8]

[9]

[10]

[11]

[12]

[13]

[14]

[15]

[16]

[17]

@@ Line 1: / Line 1: @@
 __NOTOC__
-[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/COVID-19-associated hepatic injury]]
+[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/COVID-19-associated_hepatic_injury]]
 {{CMG}}; {{AE}}{{TAM}}
 ==Overview==
 COVID-19-associated hepatic Injury must be differentiated from other conditions that cause elevation of [[liver enzymes]].
@@ Line 30: / Line 28: @@
 |-
 | rowspan="6" style="background:#4479BA; color: #FFFFFF" |Acute viral hepatitis
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatitis A]]
+| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatitis A]]<ref name="pmid20068336">{{cite journal| author=Jeong SH, Lee HS| title=Hepatitis A: clinical manifestations and management. | journal=Intervirology | year= 2010 | volume= 53 | issue= 1 | pages= 15-9 | pmid=20068336 | doi=10.1159/000252779 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20068336  }} </ref><ref name="pmid16418523">{{cite journal| author=Nainan OV, Xia G, Vaughan G, Margolis HS| title=Diagnosis of hepatitis a virus infection: a molecular approach. | journal=Clin Microbiol Rev | year= 2006 | volume= 19 | issue= 1 | pages= 63-79 | pmid=16418523 | doi=10.1128/CMR.19.1.63-79.2006 | pmc=1360271 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16418523  }} </ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +++
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ++
@@ Line 44: / Line 42: @@
 * [[Fever]] usually present
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatitis B]]
+| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatitis B]]<ref name="pmid29877316">{{cite journal| author=Yuen MF, Chen DS, Dusheiko GM, Janssen HLA, Lau DTY, Locarnini SA | display-authors=etal| title=Hepatitis B virus infection. | journal=Nat Rev Dis Primers | year= 2018 | volume= 4 | issue=  | pages= 18035 | pmid=29877316 | doi=10.1038/nrdp.2018.35 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29877316  }} </ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +++
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | ++
@@ Line 58: / Line 56: @@
 * [[Fever]] usually present
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatitis C]]
+| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatitis C]]<ref name="pmid25609256">{{cite journal| author=Mukherjee R, Burns A, Rodden D, Chang F, Chaum M, Garcia N | display-authors=etal| title=Diagnosis and Management of Hepatitis C Virus Infection. | journal=J Lab Autom | year= 2015 | volume= 20 | issue= 5 | pages= 519-38 | pmid=25609256 | doi=10.1177/2211068214563794 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25609256  }} </ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" | +++
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>++</nowiki>
@@ Line 73: / Line 71: @@
 * [[Fever]] usually present
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatitis E]]
+| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Hepatitis E]]<ref name="pmid24396139">{{cite journal| author=Kamar N, Dalton HR, Abravanel F, Izopet J| title=Hepatitis E virus infection. | journal=Clin Microbiol Rev | year= 2014 | volume= 27 | issue= 1 | pages= 116-38 | pmid=24396139 | doi=10.1128/CMR.00057-13 | pmc=3910910 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24396139  }} </ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>++</nowiki>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>++</nowiki>
@@ Line 87: / Line 85: @@
 * [[Fever]] usually present
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cytomegalovirus infection natural history, complications and prognosis|CMV hepatitis]]
+| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cytomegalovirus infection natural history, complications and prognosis|CMV hepatitis]]<ref name="pmid25325934">{{cite journal| author=Gupta P, Suryadevara M, Das A| title=Cytomegalovirus-induced hepatitis in an immunocompetent patient. | journal=Am J Case Rep | year= 2014 | volume= 15 | issue=  | pages= 447-9 | pmid=25325934 | doi=10.12659/AJCR.890945 | pmc=4206484 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25325934  }} </ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+/-</nowiki>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>++</nowiki>
@@ Line 100: / Line 98: @@
 * [[fever]] usually present
 |-
-| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[EBV]] hepatitis
+| style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[EBV]] hepatitis<ref name="pmid29735847">{{cite journal| author=Karadeniz A, Yesilbag Z, Kaya FÖ, Akgün FS| title=Acute hepatitis due to Epstein-Barr virus with cross-reacting antibodies to cytomegalovirus. | journal=Indian J Med Microbiol | year= 2018 | volume= 36 | issue= 1 | pages= 143-144 | pmid=29735847 | doi=10.4103/ijmm.IJMM_17_378 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=29735847  }} </ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+/-</nowiki>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>++</nowiki>
@@ Line 113: / Line 111: @@
 * Fever usually present
 |-
-| colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Autoimmune hepatitis
+| colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Autoimmune hepatitis<ref name="pmid25920079">{{cite journal| author=Manns MP, Lohse AW, Vergani D| title=Autoimmune hepatitis--Update 2015. | journal=J Hepatol | year= 2015 | volume= 62 | issue= 1 Suppl | pages= S100-11 | pmid=25920079 | doi=10.1016/j.jhep.2015.03.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25920079  }} </ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
@@ Line 125: / Line 123: @@
 * Liver biopsy may be required for diagnosis
 |-
-| colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Alcoholic hepatitis
+| colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Alcoholic hepatitis<ref name="pmid31219169">{{cite journal| author=Hosseini N, Shor J, Szabo G| title=Alcoholic Hepatitis: A Review. | journal=Alcohol Alcohol | year= 2019 | volume= 54 | issue= 4 | pages= 408-416 | pmid=31219169 | doi=10.1093/alcalc/agz036 | pmc=6671387 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=31219169  }} </ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+/-</nowiki>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
@@ Line 137: / Line 135: @@
 * History of alcohol intake
 |-
-| colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Drug induced hepatitis
+| colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |Drug induced hepatitis<ref name="pmid27956449">{{cite journal| author=Katarey D, Verma S| title=Drug-induced liver injury. | journal=Clin Med (Lond) | year= 2016 | volume= 16 | issue= Suppl 6 | pages= s104-s109 | pmid=27956449 | doi=10.7861/clinmedicine.16-6-s104 | pmc=6329561 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27956449  }} </ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+/-</nowiki>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
@@ Line 150: / Line 148: @@
 |-
 | colspan="2" align="center" style="background:#4479BA; color: #FFFFFF;" |COVID-19-associated hepatic Injury
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki><ref name="pmid32205220">{{cite journal| author=Luo S, Zhang X, Xu H| title=Don't Overlook Digestive Symptoms in Patients With 2019 Novel Coronavirus Disease (COVID-19). | journal=Clin Gastroenterol Hepatol | year= 2020 | volume= 18 | issue= 7 | pages= 1636-1637 | pmid=32205220 | doi=10.1016/j.cgh.2020.03.043 | pmc=7154217 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32205220  }} </ref>
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki><ref name="pmid32595044">{{cite journal| author=| title=Correction to Lancet Infectious Diseases 2020; published online April 29. https://doi.org/10.1016/ S1473-3099(20)30064-5. | journal=Lancet Infect Dis | year= 2020 | volume= 20 | issue= 7 | pages= e148 | pmid=32595044 | doi=10.1016/S1473-3099(20)30370-4 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32595044  }} </ref>
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki><ref name="pmid32274341">{{cite journal| author=Li J, Fan JG| title=Characteristics and Mechanism of Liver Injury in 2019 Coronavirus Disease. | journal=J Clin Transl Hepatol | year= 2020 | volume= 8 | issue= 1 | pages= 13-17 | pmid=32274341 | doi=10.14218/JCTH.2020.00019 | pmc=7132021 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32274341  }} </ref>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki>
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>-</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki><ref name="pmid32274341">{{cite journal| author=Li J, Fan JG| title=Characteristics and Mechanism of Liver Injury in 2019 Coronavirus Disease. | journal=J Clin Transl Hepatol | year= 2020 | volume= 8 | issue= 1 | pages= 13-17 | pmid=32274341 | doi=10.14218/JCTH.2020.00019 | pmc=7132021 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32274341  }} </ref>
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>+</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>++</nowiki><ref name="pmid32203680">{{cite journal| author=Bangash MN, Patel J, Parekh D| title=COVID-19 and the liver: little cause for concern. | journal=Lancet Gastroenterol Hepatol | year= 2020 | volume= 5 | issue= 6 | pages= 529-530 | pmid=32203680 | doi=10.1016/S2468-1253(20)30084-4 | pmc=7270582 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32203680  }} </ref>
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>++</nowiki>
+| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki> IgG/IgM Antibodies</nowiki><ref name="pmid32172228">{{cite journal| author=Lippi G, Simundic AM, Plebani M| title=Potential preanalytical and analytical vulnerabilities in the laboratory diagnosis of coronavirus disease 2019 (COVID-19). | journal=Clin Chem Lab Med | year= 2020 | volume= 58 | issue= 7 | pages= 1070-1076 | pmid=32172228 | doi=10.1515/cclm-2020-0285 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32172228  }} </ref>
-| style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>---</nowiki>
 | style="padding: 5px 5px; background: #F5F5F5;" align="center" |<nowiki>---</nowiki>
 | style="padding: 5px 5px; background: #F5F5F5;" align="left" |
-* May cause both cholestatic or hepatocellular injury
+* Fever usually present.
+*Live [[SARS-CoV-2]] is also cultured from stool samples in rare cases, providing the evidence that [[SARS-CoV-2]] has the possibility of fecal-oral transmission.<ref name="pmid32159775">{{cite journal| author=Wang W, Xu Y, Gao R, Lu R, Han K, Wu G | display-authors=etal| title=Detection of SARS-CoV-2 in Different Types of Clinical Specimens. | journal=JAMA | year= 2020 | volume=  | issue=  | pages=  | pmid=32159775 | doi=10.1001/jama.2020.3786 | pmc=7066521 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=32159775  }} </ref><ref name="urlInfectious SARS-CoV-2 in Feces of Patient with Severe COVID-19 - Volume 26, Number 8—August 2020 - Emerging Infectious Diseases journal - CDC">{{cite web |url=https://wwwnc.cdc.gov/eid/article/26/8/20-0681_article |title=Infectious SARS-CoV-2 in Feces of Patient with Severe COVID-19 - Volume 26, Number 8—August 2020 - Emerging Infectious Diseases journal - CDC |format= |work= |accessdate=}}</ref>
 |}
 == References ==
 {{reflist|2}}

COVID-19-associated hepatic injury differential diagnosis: Difference between revisions

Latest revision as of 11:25, 21 July 2020

Overview

Differential Diagnosis

References

Navigation menu