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Hepatic manifestations of COVID-19

Sara El Ouali1, Carlos Romero-Marrero2, Miguel Regueiro2

  • 1Department of Gastroenterology, Hepatology & Nutrition, Digestive Diseases and Surgery Institute, Cleveland Clinic ELOUALS2@ccf.org.

Cleveland Clinic Journal of Medicine
|August 29, 2020
PubMed

Insights

Elevated liver enzymes in COVID-19 patients indicate higher risks of severe outcomes. Monitoring liver function is crucial, considering both COVID-19 and unrelated causes of liver injury.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Elevated liver enzymes are common in COVID-19 patients.
  • This elevation correlates with adverse hospital outcomes, including ICU admission, intubation, and mortality.
  • Non-COVID-19 related liver injury must be considered in patient assessment.

Purpose of the Study:

  • To highlight the significance of liver enzyme monitoring in COVID-19 patients.
  • To emphasize the association between liver enzyme levels and COVID-19 severity.
  • To inform clinical practice regarding liver health in COVID-19 management.

Main Methods:

  • Observational analysis of hospitalized COVID-19 patients.
  • Review of clinical data including liver enzyme levels and patient outcomes.
  • Assessment of potential confounding factors and comorbidities.

Main Results:

  • COVID-19 is frequently associated with elevated liver enzymes.
  • Higher liver enzyme levels predict increased risk of ICU admission, intubation, and mortality.
  • COVID-19 therapies may affect liver enzymes but are generally safe in patients with pre-existing liver conditions.
  • Regular liver enzyme monitoring is recommended for all hospitalized COVID-19 patients.
  • Patients with pre-existing liver disease (e.g., cirrhosis, transplant recipients) face higher risks of severe COVID-19.

Conclusions:

  • Liver enzyme monitoring is essential for managing COVID-19 patients.
  • Understanding liver injury in COVID-19 is critical for predicting patient prognosis.
  • Proactive management of liver health can improve outcomes for COVID-19 patients, especially those with underlying liver conditions.

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