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Review
. 2020 Dec 27;12(12):1182-1197.
doi: 10.4254/wjh.v12.i12.1182.

Liver injury in COVID-19: The hepatic aspect of the respiratory syndrome - what we know so far

Prajna Anirvan  1 , Pankaj Bharali  2 , Mrinal Gogoi  2 , Paul J Thuluvath  3 , Shivaram P Singh  2 , Sanjaya K Satapathy  4
Affiliations
Review

Liver injury in COVID-19: The hepatic aspect of the respiratory syndrome - what we know so far

Prajna Anirvan et al. World J Hepatol. .

Abstract

The 2019 novel coronavirus disease (COVID-19) pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed a serious threat to global public health. Although primarily, the infection causes lung injury, liver enzyme abnormalities have also been reported to occur during the course of the disease. We conducted an extensive literature review using the PubMed database on articles covering a broad range of issues related to COVID-19 and hepatic injury. The present review summarizes available information on the spectrum of liver involvement, the possible mechanisms and risk factors of liver injury due to SARS-CoV-2 infection, and the prognostic significance of the presence of liver injury. Hopefully, this review will enable clinicians, especially the hepatologists, to understand and manage the liver derangements they may encounter in these patients better and provide guidance for further studies on the liver injury of COVID-19.

Keywords: COVID-19; Hepatitis; Infectious disease; Liver injury; Management; SARS-CoV-2.

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Conflict of interest statement

Conflict-of-interest statement: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Spectrum of medications used in coronavirus disease 2019 likely to cause liver injury. COVID-19: Coronavirus disease 2019; UDP-GT: UDP-glucuronosyltransferase; NAFLD: Nonalcoholic fatty liver disease.
Figure 2
Figure 2
Potential mechanisms of liver injury in coronavirus disease 2019. ACE2: Angiotensin converting enzyme 2; ARDS: Acute respiratory distress syndrome; CAMs: Complementary and alternative medicines; IL: Interleukin.
Figure 3
Figure 3
Approach to a coronavirus disease 2019 patient with liver dysfunction. COVID-19: Coronavirus disease 2019; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; ACLF: Acute-on-chronic liver failure; USG: Ultrasonography.
See this image and copyright information in PMC

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