COVID-19 and the liver: Are footprints still there?

Area of Science:

• Hepatology
• Infectious Diseases
• Internal Medicine

Background:

• The COVID-19 pandemic poses significant risks to patients with chronic diseases.
• Chronic liver disease, particularly cirrhosis, is associated with immune dysfunction, increasing mortality risk.
• Liver function abnormalities are frequently observed in severe COVID-19 cases.

Purpose of the Study:

• To discuss the relationship between COVID-19 and chronic liver diseases (cirrhosis, hepatitis B, hepatitis C, NAFLD).
• To review the liver manifestations of COVID-19.
• To highlight risk factors and potential long-term consequences.

Main Methods:

• Review of existing literature and case reports on COVID-19 and liver disease.
• Analysis of factors contributing to liver dysfunction in COVID-19 patients.
• Examination of epidemiological data on mortality and disease severity.

Main Results:

• Patients with chronic liver disease, especially decompensated cirrhosis, exhibit increased COVID-19 mortality.
• COVID-19 can cause liver injury through cytokine storm, direct viral effects, or drug toxicity.
• Metabolic syndrome, obesity, diabetes, and NAFLD are linked to worse COVID-19 outcomes.
• COVID-19-associated cholangiopathy and potential long-term autoimmune risks are emerging concerns.

Conclusions:

• Chronic liver disease is a significant risk factor for severe COVID-19 and mortality.
• Understanding COVID-19's impact on the liver is crucial for patient management.
• Further research is needed on long-term sequelae, including autoimmune liver disease risk.