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  1. Home
  3. Sars-cov-2: A Liver Brief.
  1. Home
  3. Sars-cov-2: A Liver Brief.

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SARS-CoV-2: A Liver Brief.

Youness Limami1, Hicham Wahnou2, Martin Ndayambaje2

  • 1Sciences and Engineering of Biomedicals, Biophysics and Health Laboratory, Higher Institute of Health Sciences, Hassan First University, Settat, Morocco.

Wires Mechanisms of Disease
|November 3, 2025

View abstract on PubMed

Summary
This summary is machine-generated.

The COVID-19 virus (SARS-CoV-2) causes liver injury through direct infection and immune responses. Understanding these mechanisms is key to treating liver damage in COVID-19 patients.

Keywords:
COVID‐19SARS‐CoV‐2liver diseases

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Area of Science:

  • Molecular and Cellular Physiology
  • Infectious Diseases

Background:

  • COVID-19 pandemic caused by SARS-CoV-2 leads to multi-organ damage, notably liver injury.
  • Mechanisms of liver dysfunction involve direct viral infection, immune responses (cytokine storm), and the gut-liver axis.
  • Pre-existing liver conditions like MAFLD, ALD, and fibrosis increase COVID-19 severity.

Purpose of the Study:

  • Explore the molecular mechanisms of liver dysfunction in COVID-19 patients.
  • Investigate viral entry pathways into liver cells.
  • Understand the impact of immune responses and pre-existing conditions on COVID-19 liver injury.

Main Methods:

  • Review of molecular mechanisms of SARS-CoV-2 entry into hepatocytes.
  • Analysis of immune-mediated liver damage pathways.
  • Examination of the role of the gut-liver axis in COVID-19 pathogenesis.

    • Main Results:

    • SARS-CoV-2 utilizes ACE2/TMPRSS2 and alternative receptors (DC-SIGN, AXL) for liver cell entry.
    • Immune responses, particularly cytokine storm, significantly contribute to hepatocyte damage.
    • Pre-existing liver diseases exacerbate COVID-19 outcomes.
    • Post-COVID-19 complications include fibrosis progression and persistent liver damage.
    • Drug-Induced Liver Injury (DILI) is a concern with COVID-19 treatments.

    Conclusions:

    • Understanding SARS-CoV-2-induced liver injury is crucial for patient outcomes.
    • Targeted therapies are needed to mitigate liver complications in acute and Long COVID-19.
    • Further research into chronic inflammation, viral persistence, and autoimmune reactions post-COVID-19 is warranted.