Liver damage could be a major outcome of severe COVID-19 infection in new study

Liver damage could be a major outcome of severe COVID-19 infection in a landmark study involving TRI-based researchers. 

The study in Genes, led by senior author Associate Professor Jyotsna Batra from the Centre for Genomics and Personalised Medicine, School of Biomedical Sciences, Queensland University of Technology, found for the first time that liver fibrosis can play a role in severe COVID-19 and the manifestation is already in place in infected patients. 

“Many research studies have focused on cardiac-related issues but this study found the liver is also a major affected organ and this is where the research comes into value,” Dr Batra said.

The study evolved from the start of the COVID-19 pandemic, when Spain and Italy accounted for 29% of the total COVID-19 related deaths in Europe.

“Italian and Spanish populations were experiencing high mortality rates so we wanted to conduct a study to compare their genomic characteristics,” Dr Batra said. 

Dr Batra and her team hypothesised that shared genomic characteristics of the populations from these two countries, distinct from the rest of Europe, could be a contributing factor to a poor prognosis in these two populations.

The research team accessed an international public repository of genomic DNA sequences, focusing on Europe between 31 March and 25 May 2020, with the aim to consolidate all empirically and predicted human genes reported to have a role during SARS-CoV-2 infection in that time. 

“We analysed and combined the epidemiological and genetic data and we observed differences in genetic variations in the pathways in these two populations compared to the rest of the Europe, leading us to hypothesise that they may be contributing to the issues related to COVID-19," Dr Batra said.

Researchers identified pathways related to COVID-19 severity, shortlisting 437 candidate genes associated with host viral intake and immune evasion from SARS-like viruses. From these, 21 were associated specifically with clinically aggressive COVID-19. 

Their signalling pathway analysis identified Hepatic Fibrosis/HSC Activation as the pathway which is most significantly associated with COVID-19 severe disease.

It indicated segregation amongst the populations studied, with the Spanish/Italian populations clustered together and away from the sample set of other European populations.

“Our research showed patients with this particular genetic variation could be at risk for severe COVID-19, and this is in addition to known risk factors such as a weakened immune system and age,” Dr Batra said.

The study also noted liver tissue damage after the SARS-CoV-2 infection was reported as the second most common organ damage after the lung. 

“Our findings show that the liver plays a key role in COVID-19 infection and patients who’ve had liver fibrosis or other liver diseases, and it’s a huge number globally, should take extra precautions as exposure to COVID-19 could bring risk of severe disease,” Dr Batra said. 
Dr Batra hopes the study leads to improved treatment options for patients suffering from the virus’s serious side-effects.

“The study has potentially important clinical implications for patients with severe COVID-19 such as monitoring liver function and not just the heart, and the possible use of liver fibrosis drugs as a supplemental therapy for COVID-19,” Dr Batra said.

Future population genetic studies will help to build on Dr Batra’s research.

“Papers like these have led to bigger international collaborative genetic studies into COVID-19, which we hope will boost access to more global data to accelerate research that can be translated into better patient outcomes,” Dr Batra said.

Click here to read the paper.