Yang RX, Zheng RD, Fan JG. Etiology and management of liver injury in patients with COVID-19. World J Gastroenterol 2020; 26(32): 4753-4762 [PMID: 32921955 DOI: 10.3748/wjg.v26.i32.4753]
Corresponding Author of This Article
Jian-Gao Fan, MD, PhD, Chief Doctor, Professor, Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, No. 1665 Kongjiang Road, Shanghai 200092, China. fanjiangao@xinhuamed.com.cn
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Aug 28, 2020; 26(32): 4753-4762 Published online Aug 28, 2020. doi: 10.3748/wjg.v26.i32.4753
Etiology and management of liver injury in patients with COVID-19
Rui-Xu Yang, Rui-Dan Zheng, Jian-Gao Fan
Rui-Xu Yang, Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
Rui-Dan Zheng, Diagnosis and Treatment Center for Liver Diseases, Zhengxing Hospital, Zhangzhou 363000, Fujian Province, China
Jian-Gao Fan, Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai 200092, China
Author contributions: Yang RX wrote the paper; Zheng RD contributed to the preparation of the tables and figure; and Fan JG critically revised the manuscript.
Supported bythe National Key Research and Development Program, No. 2017YFC0908903; National Natural Science Foundation of China, No. 81873565 and No. 81900507; and Hospital Funded Clinical Research, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 17CSK04.
Conflict-of-interest statement: The authors declare no conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jian-Gao Fan, MD, PhD, Chief Doctor, Professor, Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, No. 1665 Kongjiang Road, Shanghai 200092, China. fanjiangao@xinhuamed.com.cn
Received: May 8, 2020 Peer-review started: May 8, 2020 First decision: May 15, 2020 Revised: May 23, 2020 Accepted: August 12, 2020 Article in press: August 12, 2020 Published online: August 28, 2020 Processing time: 111 Days and 23.6 Hours
Abstract
The outbreak of novel coronavirus disease 2019 (COVID-19) has resulted in global emergence. With the expansion of related research, in addition to respiratory symptoms, digestive system involvement such as nausea, vomiting, and diarrhea have also been reported with COVID-19. Besides, abnormal liver function is also frequent in biochemical tests of COVID-19 patients, which is correlated with the severity and mortality of the disease course. The etiology of liver injury in patients with COVID-19 might include viral immunologic injury, drug-induced liver injury, the systemic inflammatory response, hypoxic hepatitis, and the exacerbation of preexisting liver disease. Although liver injuries in COVID-19 are often transient and reversible, health workers need to pay attention to preexisting liver disease, monitor liver function, strengthen supportive treatment, and reduce the chance of drug-induced liver injury. This article reviews the epidemiological characteristics, etiology, management, and preventive strategies for liver injury in patients with COVID-19.
Core tip: The pandemic of coronavirus disease 2019 (COVID-19) has aroused a global threat to human health. With the deepening of related research, it was found that in addition to respiratory symptoms, digestive involvements and liver injury were reported in COVID-19. Viral immunologic injury, drug-induced liver injury, secondary liver injury induced by systemic inflammatory response or hypoxia, and the exacerbation of pre-existing liver disease might be the etiologic factors for liver injury in COVID-19. Health workers need to pay attention to the management of pre-existing liver disease, monitor the liver function and strengthen supportive treatment, and reduce the chance of drug-induced liver injury with COVID-19.
