{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T05:29:21Z","timestamp":1761802161752,"version":"build-2065373602"},"reference-count":42,"publisher":"MDPI AG","issue":"21","license":[{"start":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T00:00:00Z","timestamp":1761523200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005375","name":"Latvian Council of Science","doi-asserted-by":"crossref","award":["lzp-2021\/1-0442"],"award-info":[{"award-number":["lzp-2021\/1-0442"]}],"id":[{"id":"10.13039\/501100005375","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objectives: This study aimed to assess the dynamics of liver tests (LT) and detect signs of liver fibrosis and steatosis 2.5 years after the first COVID-19 episode in patients without pre-existing liver-related conditions. Methods: The study included 65 adult patients hospitalized with COVID-19 (including 18 with severe or critical illness) in 2020. After 2.5 years, in addition to regular LT, liver health status was assessed by the FIB-4 index, hyaluronic acid, cytokeratin 18 fragment M30 (serum, ELISA), cardiometabolic risk factors, and the multiparametric ultrasound examination. Results: LT abnormalities in the acute COVID-19 period were observed more frequently (p = 0.036) in patients with severe or critical COVID-19 (83%) than in patients with non-severe COVID-19 (55%). LT dynamics in 2.5 years showed an improvement of liver health status in most patients (p = 0.006). Persistent LT abnormalities were associated with LT abnormalities during hospitalization (p = 0.021). After 2.5 years, the presence of cardiometabolic risk factors and signs of liver fibrosis were associated with the severity of the first COVID-19 episode. However, regression analyses did not support disease severity as a predictor for LT abnormalities and liver stiffness. The latter was predicted by cardiovascular diseases in the anamnesis. Conclusions: In most patients, LT normalized despite potential risk factors. Simultaneously, in some patients, signs of liver fibrosis after COVID-19 might be stimulated by COVID-19-related metabolic dysfunction and the presence of cardiovascular diseases.<\/jats:p>","DOI":"10.3390\/jcm14217604","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T09:16:24Z","timestamp":1761729384000},"page":"7604","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Liver-Related COVID-19 Consequences: Dynamics of Liver Health in 2.5 Years"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7667-2469","authenticated-orcid":false,"given":"Ieva","family":"Vanaga","sequence":"first","affiliation":[{"name":"Department of Infectology, Riga Stradins University, 3 Linezera Street, LV-1006 Riga, Latvia"},{"name":"Riga East University Hospital, 2 Hipokrata Street, LV-1079 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2846-1242","authenticated-orcid":false,"given":"Oksana","family":"Kolesova","sequence":"additional","affiliation":[{"name":"Department of Infectology, Riga Stradins University, 3 Linezera Street, LV-1006 Riga, Latvia"},{"name":"Institute of Microbiology and Virology, Riga Stradins University, 5 Ratsupites Street, LV-1067 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4470-2453","authenticated-orcid":false,"given":"Aleksandrs","family":"Kolesovs","sequence":"additional","affiliation":[{"name":"Department of Infectology, Riga Stradins University, 3 Linezera Street, LV-1006 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maija","family":"Radzina","sequence":"additional","affiliation":[{"name":"Radiology Department, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia"},{"name":"Faculty of Health and Life Sciences, University of Latvia, 3 Jelgavas Street, LV-1004 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Davis Simanis","family":"Putrins","sequence":"additional","affiliation":[{"name":"Radiology Department, Riga Stradins University, 16 Dzirciema Street, LV-1007 Riga, Latvia"},{"name":"Faculty of Health and Life Sciences, University of Latvia, 3 Jelgavas Street, LV-1004 Riga, Latvia"},{"name":"Institute of Diagnostic Radiology, Pauls Stradins Clinical University Hospital, LV-1002 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jelena","family":"Egle","sequence":"additional","affiliation":[{"name":"Institute of Microbiology and Virology, Riga Stradins University, 5 Ratsupites Street, LV-1067 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sniedze","family":"Laivacuma","sequence":"additional","affiliation":[{"name":"Department of Infectology, Riga Stradins University, 3 Linezera Street, LV-1006 Riga, Latvia"},{"name":"Riga East University Hospital, 2 Hipokrata Street, LV-1079 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jelena","family":"Storozenko","sequence":"additional","affiliation":[{"name":"Department of Infectology, Riga Stradins University, 3 Linezera Street, LV-1006 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1826-9230","authenticated-orcid":false,"given":"Ludmila","family":"Viksna","sequence":"additional","affiliation":[{"name":"Department of Infectology, Riga Stradins University, 3 Linezera Street, LV-1006 Riga, Latvia"},{"name":"Riga East University Hospital, 2 Hipokrata Street, LV-1079 Riga, Latvia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1111\/liv.14730","article-title":"Pathophysiological mechanisms of liver injury in COVID-19","volume":"41","author":"Nardo","year":"2021","journal-title":"Liver Int."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"12","DOI":"10.5009\/gnl220327","article-title":"SARS-CoV-2 Infection and Liver Disease: A Review of Pathogenesis and Outcomes","volume":"17","author":"Baldelli","year":"2023","journal-title":"Gut Liver"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1038\/s41575-021-00426-4","article-title":"COVID-19 and liver disease: Mechanistic and clinical perspectives","volume":"18","author":"Marjot","year":"2021","journal-title":"Nat. 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