Liver injury in COVID-19: The current evidence

Saleh A Alqahtani, Jörn M Schattenberg, Saleh A Alqahtani, Jörn M Schattenberg

Abstract

Patients with novel coronavirus disease 2019 (COVID-19) experience various degrees of liver function abnormalities. Liver injury requires extensive work-up and continuous surveillance and can be multifactorial and heterogeneous in nature. In the context of COVID-19, clinicians will have to determine whether liver injury is related to an underlying liver disease, drugs used for the treatment of COVID-19, direct effect of the virus, or a complicated disease course. Recent studies proposed several theories on potential mechanisms of liver injury in these patients. This review summarizes current evidence related to hepatobiliary complications in COVID-19, provides an overview of the available case series and critically elucidates the proposed mechanisms and provides recommendations for clinicians.

Keywords: COVID-19; SARS-CoV2; cholangiocytes; cytokine storm; liver function test; liver injury; lymphopenia.

Figures

Figure 1.
Figure 1.
Clinical characteristics and pathophysiology of liver injury from COVID-19. ACE2: angiotensin-2 converting enzyme

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