Liver injury in COVID-19: Clinical features, potential mechanisms, risk factors and clinical treatments

Abstract

The coronavirus disease 2019 (COVID-19) pandemic has been a serious threat to global health for nearly 3 years. In addition to pulmonary complications, liver injury is not uncommon in patients with novel COVID-19. Although the prevalence of liver injury varies widely among COVID-19 patients, its incidence is significantly increased in severe cases. Hence, there is an urgent need to understand liver injury caused by COVID-19. Clinical features of liver injury include detectable liver function abnormalities and liver imaging changes. Liver function tests, computed tomography scans, and ultrasound can help evaluate liver injury. Risk factors for liver injury in patients with COVID-19 include male sex, preexisting liver disease including liver transplantation and chronic liver disease, diabetes, obesity, and hypertension. To date, the mechanism of COVID-19-related liver injury is not fully understood. Its pathophysiological basis can generally be explained by systemic inflammatory response, hypoxic damage, ischemia-reperfusion injury, and drug side effects. In this review, we systematically summarize the existing literature on liver injury caused by COVID-19, including clinical features, underlying mechanisms, and potential risk factors. Finally, we discuss clinical management and provide recommendations for the care of patients with liver injury.

Evaluation of Remdesivir Utilization Pattern in Critically Ill Patients With COVID-19 in Jazan Province

“…SARS-CoV-2 infection predominately involves the host's respiratory system; however, SARS-CoV-2-induced renal and hepatic damage has also been reported [31,32]. Major pathophysiological features of liver injury in SARS-CoV-2 infection include hepatic lobular and portal inflammation, steatosis, congestion, focal necrosis with neutrophil infiltration, microthrombosis, and mild-to-moderate increases in liver aminotransferase (five times the upper limit of normal {ULN}) [33]. Remdesivir use in SARS-CoV-2 patients is associated with mild-to-moderate self-limiting hepatic injury, with no signs of jaundice [34].…”