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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Severe acute respiratory syndrome coronavirus 2 may cause liver injury via Na+/H+ exchanger
Medine Cumhur Cure, Department of Biochemistry, Private Tanfer Hospital, Istanbul 34394, Turkey
Erkan Cure, Department of Internal Medicine, Bagcilar Medilife Hospital, Istanbul 34200, Turkey
Author contributions: Cumhur Cure M and Cure E contributed equally to this minireview; All authors have read and approved the final manuscript.
Conflict-of-interest statement: MCC and EC declare that they have no conflict of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Medine Cumhur Cure, MD, Associate Professor, Biochemistry, Private Tanfer Hospital, Mecidiyeköy, Aytekin Kotil Cd. No: 25, Şişli, Istanbul 34394, Turkey. medinecure@yahoo.com
Received: August 27, 2022
Peer-review started: August 27, 2022
First decision: September 25, 2022
Revised: October 3, 2022
Accepted: November 21, 2022
Article in press: November 21, 2022
Published online: January 25, 2023
Processing time: 143 Days and 7.8 Hours
Peer-review started: August 27, 2022
First decision: September 25, 2022
Revised: October 3, 2022
Accepted: November 21, 2022
Article in press: November 21, 2022
Published online: January 25, 2023
Processing time: 143 Days and 7.8 Hours
Core Tip
Core Tip: Severe acute respiratory syndrome coronavirus 2 readily infects the liver by angiotensin-converting enzyme 2. Increased angiotensin II causes Na+/H+ exchanger (NHE) overstimulation allowing the accumulation of Na+ and Ca2+ in hepatocytes. Thus, hepatocytes are damaged and eventually die. Increased cytokine release increases fibrinogen levels, enhancing thrombotic events. Cytokine storms can be triggered by NHE overstimulation. Severe acute respiratory syndrome coronavirus 2-induced NHE overstimulation can change bile acid structure, which disrupts gut microbiota and can trigger cytokine storms. Liver damage from the virus can be considered the most important cause of disease progression and mortality.