COVID-19 and hepatic damage: what we know?

Area of Science:

• Hepatology
• Infectious Diseases
• Pediatric Medicine

Background:

• The COVID-19 pandemic, caused by SARS-CoV-2, has had a global impact since late 2019.
• Understanding the pathogenesis, epidemiology, and clinical manifestations of COVID-19, particularly in children, remains an area of active research.
• Liver involvement in COVID-19, especially in pediatric cases, requires further elucidation.

Purpose of the Study:

• To investigate the characteristics of liver involvement and damage in pediatric patients with COVID-19.
• To synthesize current knowledge on COVID-19 and hepatic injury in both adult and pediatric populations.

Main Methods:

• A systematic literature review was conducted, adhering to PRISMA guidelines.
• Key electronic databases (PubMed, Google Scholar) were searched for studies published between December 2019 and September 2020.
• Search terms included "coronavirus," "SARS-CoV-2," "COVID-19," "liver injury," "hepatic injury," "children," and "pediatric."

Main Results:

• Determining the precise cause of liver damage in COVID-19 is challenging, with potential contributions from direct viral effects, immune system responses, drug toxicity, or other organ failures.
• Liver function should be routinely monitored upon hospital admission and throughout the patient's stay.

Conclusions:

• Liver injury in COVID-19 is likely multifactorial, with aberrant immune responses to SARS-CoV-2 being a probable primary driver.
• Close monitoring of liver injury markers in all COVID-19 patients is essential.
• Prompt initiation of liver-protective therapies is recommended for patients exhibiting altered hepatic markers.