Gastrointestinal and hepatic diseases during the COVID-19 pandemic: Manifestations, mechanism and management

Figure 5 Mechanisms of liver injury in patients with coronavirus disease 2019. (1) Angiotensin-converting enzyme 2-mediated targeting of cholangiocytes; (2) Antibody-dependent enhancement of infection; (3) Systemic inflammatory response syndrome and cytokine storms; and (4) Drug-induced liver injury. SARS-CoV-2: Severe acute respiratory syndrome coronavirus 2; ACE2: Angiotensin-converting enzyme 2; ADE: Antibody-dependent enhancement of infection; SIRS: Systemic inflammatory response syndrome; ARDS: Acute respiratory distress syndrome; IFN-γ: Interferon-γ; IL-6: Interleukin-6; IL-18: Interleukin-18; TNF-α; Tumor necrosis factor-α; ROS: Reactive oxygen species; ATP: Adenosine triphosphate.