3Department of public health and Community medicine, Faculty o...

Background Covid-19 Induced Hepatitis CIH is a novel terminology which is used in this article for the first time in the medical literature However SARS-Cov-2 Severe Acute Respiratory Syndrome Coronavirus 2 is a coronavirus that out-broke in December 2019 in China Objective To study the pattern of liver impairment in patients with Covid-19 as well as to find acceptable and practical diagnostic criteria of Covid-19 Induced Hepatitis CIH This review article gives new insight and guidance about the diagnosis of Covid-19 Induced Hepatitis CIH possible causes of liver damage and review of recently published data about the impairment of liver function in Covid-19 patients Results 60 of patients with SARS can have abnormal liver functions Aspartate Aminotransferase AST and Alanine Aminotransferase ALT have noticeably been abnormal in around 14-53 of patients with Covid-19 7 114 6 14 P 05 Impairment in liver enzymes mainly ALT AST in severe Covid-19 pneumonia was significantly higher than patients with mild disease with mean average 37 87 32 17 vs 21 22 12 67 38 87 22 55 vs 24 39 9 79 P 001 Patients with Community Acquired Pneumonia CAP had significantly less impaired liver synthetic function 32 114 28 07 compared to Covid-19 pneumonia 60 115 52 17 which has been demonstrated with high INR P 0 01 Mild sinusoidal dilatation with lymphocyte infiltration minimal has been displayed in the liver tissue of 114 deceased with Covid-19 and liver impairment which was obtained in one hour after their death Fatality among Covid-19 and CLD with Child T-P score A was 23 9 and Child T-P score B 43 3 with 63 0 fatality among patients with Child T-P score C Moon AL Acute liver failure in Covid-19 has been reported only in 2 occasions one adult and infant who had recent liver transplant Conclusion Covid-19 Induced Hepatitis CIH is a new clinical syndrome which can be defined as a benign new transient hepatitis in a SARS-CoV-2 patients which is characterized by the following Gradual onset elevated AST and ALT Dilated sinusoidal with lymphocytic infiltration of liver parenchyma non-Obstructive jaundice stable Underlying liver disease and no Radiological new liver hepatobiliary changes Using GADOUR criteria may support the diagnosis however sensitivity and specificity are yet to be established Meticulous statistical studies need to be done before establishing overly sensitive scoring system can be reach

3Department of public health and Community medicine, Faculty of Medicine, National Ribat University, Khartoum, Sudan

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COVID-19 Induced Hepatitis (CIH), Definition and Diagnostic Criteria of a Poorly Understood New Clinical Syndrome