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COVID-19 and the liver: overview
1Hepatogastroenterology, Cairo University, Cairo, Egypt.
Insights
COVID-19 can cause liver damage, but it is unclear if this is due to the virus itself or other factors like medications and hypoxia. This review examines COVID-19
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- The COVID-19 pandemic has been associated with reported cases of liver damage or dysfunction.
- The exact cause of COVID-19-related liver injury remains uncertain, with potential contributions from viral infection, medications, hypoxia, and systemic inflammation.
Purpose of the Study:
- To review the clinical implications of COVID-19 on liver health in both healthy and diseased states.
- To explore how pre-existing liver disorders may influence COVID-19 outcomes.
Main Methods:
- Literature review of clinical studies and case reports.
- Analysis of the interplay between COVID-19, liver injury, and patient comorbidities.
Main Results:
- Patients with COVID-19 may exhibit elevated liver enzymes, indicating potential liver dysfunction.
- Individuals with underlying liver conditions, such as nonalcoholic fatty liver disease, may be at higher risk for severe COVID-19 and liver injury.
Conclusions:
- COVID-19 poses risks to liver function, influenced by viral load, co-existing conditions, and treatments.
- Understanding the bidirectional relationship between liver health and COVID-19 is crucial for patient management and prognosis.
Abstract:
On 12 March 2020, the WHO declared that the coronavirus disease 2019 (COVID-19) constitutes a pandemic. Cases of liver damage or dysfunction (mainly characterized by moderately elevated serum aspartate aminotransferase levels) have been reported among patients with COVID-19. However, it is currently uncertain whether the COVID-19 related liver damage/dysfunction is due mainly to the viral infection by itself or other coexisting conditions, such as the use of potentially hepatotoxic medications and the coexistence of systemic inflammatory response, respiratory distress syndrome-induced hypoxia, and multiple organ dysfunction. Individuals at high risk for severe COVID-19 are typical of older age and/or present with comorbid conditions such as diabetes, cardiovascular disease, and hypertension. This is also the same profile for those at increased risk for unrecognized underlying liver disease, especially nonalcoholic fatty liver disease. This could make them more susceptible to liver injury from the virus, medications used in supportive management, or hypoxia. So the aim of this review was to illustrate the clinical implications of COVID-19 on the liver in healthy and diseased states as well as the implications of common liver disorders on the outcome of COVID-19.
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