id	author	title	date	pages	extension	mime	words	sentences	flesch	summary	cache	txt
cord-327601-4uqgwlnx	Bangash, Mansoor N.	SARS-CoV-2: is the liver merely a bystander to severe disease?	2020-06-02		.txt	text/plain	979	61	43	1 Their study shows SARS-CoV-2 positive patients with ≥1 week history of increased aminotransferases have worse acute pulmonary disease (radiological and physiological) than those without. Considering that Interleukin (IL)-6 and C-reactive protein (CRP) are similar between patients with normal and prolonged abnormal liver aminotransferases, the authors speculate that liver injury is a direct effect of SARS-CoV-2 viral hepatitis rather than an indirect immune mediated injury. The fact that increases in liver aminotransferases occur and tend to parallel the severity of pulmonary disease remains unquestioned 2 , however, whether the liver injury is a true viral hepatitis rather than a bystander to the multi-organ pathophysiology of critical illness requires further discussion. Based on the above perspectives, we feel that raised liver aminotransferases associated with SARS-CoV-2 positivity are more likely attributable to illness severity, in which host response and iatrogenic harm (i.e. drugs, ventilation) drive bystander liver injury, thus explaining its association with mortality and in an analogous fashion to patterns seen in sepsis.	./cache/cord-327601-4uqgwlnx.txt	./txt/cord-327601-4uqgwlnx.txt