Abstract
Liver enzyme abnormalities occur frequently in patients diagnosed with Coronavirus disease 2019 (COVID-19). It has been suggested that patients with severe acute liver injury are more likely to be admitted to intensive care, require intubation or renal replacement therapy and their mortality rate is higher than patients without severe acute liver injury. This review article explores the possible aetiologies of liver dysfunction seen in patients with COVID-19 and also the effect of COVID-19 on patients with pre-existing liver disease. Finally, we suggest clinical approaches to treating a patient with liver enzyme disturbance and COVID-19 and also caring for patients who require liver transplantation in the COVID-19 era.
Keywords: COVID-19, liver disease, liver transplant, hepatitis, MAFLD, coronavirus disease 2019.
Graphical Abstract
[http://dx.doi.org/10.1016/j.cell.2020.02.052] [PMID: 32142651]
[http://dx.doi.org/10.1111/liv.14730] [PMID: 33190346]
[http://dx.doi.org/10.1016/j.jhep.2020.09.031] [PMID: 33038433]
[http://dx.doi.org/10.1186/s40779-020-00256-6] [PMID: 32507110]
[http://dx.doi.org/10.1016/S0140-6736(20)30211-7] [PMID: 32007143]
[http://dx.doi.org/10.1002/hep.31404] [PMID: 32473607]
[http://dx.doi.org/10.1016/j.jhep.2020.04.006] [PMID: 32298767]
[http://dx.doi.org/10.1159/000510758] [PMID: 32777784]
[http://dx.doi.org/10.1016/j.aohep.2020.09.015] [PMID: 33099028]
[http://dx.doi.org/10.1002/hep.31301] [PMID: 32359177]
[http://dx.doi.org/10.1002/hep.31487] [PMID: 32725890]
[http://dx.doi.org/10.1007/s12072-020-10078-2] [PMID: 32725453]
[http://dx.doi.org/10.1016/j.cgh.2020.04.002] [PMID: 32283325]
[http://dx.doi.org/10.1016/S2468-1253(20)30084-4] [PMID: 32203680]
[http://dx.doi.org/10.1001/jama.2020.6775] [PMID: 32320003]
[http://dx.doi.org/10.1056/NEJMoa2002032] [PMID: 32109013]
[http://dx.doi.org/10.1111/liv.14435] [PMID: 32170806]
[http://dx.doi.org/10.3390/biomedicines8090328] [PMID: 32899640]
[http://dx.doi.org/10.1016/S2213-2600(20)30076-X] [PMID: 32085846]
[http://dx.doi.org/10.1101/2020.02.03.931766]
[http://dx.doi.org/10.15252/msb.20209610] [PMID: 32715618]
[http://dx.doi.org/10.1002/hep.31480] [PMID: 32702162]
[http://dx.doi.org/10.1093/cid/ciaa247] [PMID: 32161968]
[http://dx.doi.org/10.1159/000511325] [PMID: 32942274]
[http://dx.doi.org/10.1016/S0140-6736(20)30628-0] [PMID: 32192578]
[http://dx.doi.org/10.1097/MEG.0000000000002034] [PMID: 33405427]
[http://dx.doi.org/10.1056/NEJMoa2015301] [PMID: 32459919]
[http://dx.doi.org/10.3748/wjg.v23.i47.8263] [PMID: 29307986]
[http://dx.doi.org/10.1038/nrgastro.2013.34] [PMID: 23458891]
[http://dx.doi.org/10.1016/j.jhep.2020.03.044] [PMID: 32278005]
[http://dx.doi.org/10.1016/j.jhep.2020.09.006] [PMID: 33223215]
[http://dx.doi.org/10.1016/j.jhep.2020.04.027] [PMID: 32348790]
[http://dx.doi.org/10.1016/j.jhep.2020.05.051] [PMID: 32574578]
[http://dx.doi.org/10.1053/j.gastro.2020.02.055] [PMID: 32142773]
[http://dx.doi.org/10.14309/ajg.0000000000000620] [PMID: 32287140]
[http://dx.doi.org/10.1111/liv.14774] [PMID: 33351265]
[http://dx.doi.org/10.1111/liv.14774] [PMID: 33351265]
[http://dx.doi.org/10.1111/hepr.13553] [PMID: 32761993]
[PMID: 32502247]
[http://dx.doi.org/10.1016/j.immuni.2014.01.005] [PMID: 24530057]
[http://dx.doi.org/10.1097/TP.0000000000001623] [PMID: 28045877]
[http://dx.doi.org/10.12998/wjcc.v8.i22.5831] [PMID: 33344581]
[http://dx.doi.org/10.12688/f1000research.22457.2] [PMID: 32194944]
[http://dx.doi.org/10.1101/2020.03.22.20034041] [PMID: 33235105]
[http://dx.doi.org/10.1016/j.jhep.2021.01.021] [PMID: 33508378]
[http://dx.doi.org/10.1053/j.gastro.2020.09.033] [PMID: 33010251]
[http://dx.doi.org/10.1016/j.jhep.2020.07.040] [PMID: 32750442]
[http://dx.doi.org/10.1097/TP.0000000000003528] [PMID: 33165237]