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Review
. 2023 Feb 7;29(5):800-814.
doi: 10.3748/wjg.v29.i5.800.

Impact of chronic liver disease on SARS-CoV-2 infection outcomes: Roles of stage, etiology and vaccination

Affiliations
Review

Impact of chronic liver disease on SARS-CoV-2 infection outcomes: Roles of stage, etiology and vaccination

Riccardo Nevola et al. World J Gastroenterol. .

Abstract

Since the first identification in December of 2019 and the fast spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, it has represented a dramatic global public health concern. Though affecting mainly the respiratory system, SARS-CoV-2 disease, defined as coronavirus disease 2019 (COVID-19), may have a systemic involvement leading to multiple organ dysfunction. Experimental evidence about the SARS-CoV-2 tropism for the liver and the increasing of hepatic cytolysis enzymes during infection support the presence of a pathophysiological relationship between liver and SARS-CoV-2. On the other side, patients with chronic liver disease have been demonstrated to have a poor prognosis with COVID-19. In particular, patients with liver cirrhosis appear extremely vulnerable to infection. Moreover, the etiology of liver disease and the vaccination status could affect the COVID-19 outcomes. This review analyzes the impact of the disease stage and the related causes on morbidity and mortality, clinical outcomes during SARS-CoV-2 infection, as well as the efficacy of vaccination in patients with chronic liver disease.

Keywords: COVID-19; Chronic liver disease; Cirrhosis; Liver injury; Non-alcoholic fatty liver disease; SARS-CoV-2 infection.

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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
Impact of chronic liver disease on severe acute respiratory syndrome coronavirus 2 infection outcomes: role of stage, etiology and vaccination. ALD: Alcohol-related liver disease; CLD: Chronic liver disease; COVID-19: Coronavirus disease 2019; HCC: Hepatocellular carcinoma; NAFLD: Non-alcoholic fatty liver disease; SARS-CoV-2: Severe acute respiratory syndrome-coronavirus 2.

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