SARS-CoV-2 infection in people with pre-existing liver disease: Further research is warranted

Abstract

Patients with severe liver disease who have been infected with severe acute respiratory syndrome coronavirus-2 (coronavirus disease 2019) frequently develop acute respiratory distress syndrome and multiple organ failure, with a high mortality rate, as a result of the hyper-proinflammatory state known as the cytokine storm. Clinicians must recognize cytokine storms earlier to avoid intensive care admission and multi-organ damage, a critical life-threatening condition with prognostic and therapeutic implications

Keywords: Cytokine storm; Liver disease; Angiotensin-converting enzyme 2; Therapeutics; Inflammatory markers

Core Tip: Understanding the hepatic consequences of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and its molecular mechanism has greatly evolved. Evidence suggests that coronavirus disease 2019 fatalities are primarily due to cytokine storm and abnormal immune function. Throughout the infection, interleukin-6, nuclear factor kappa B, and tumor necrosis factor-alpha are inflammatory cytokines released by SARS-CoV-2-infected macrophages and monocytes that cause acute liver injury. Anti-viral treatment with anti-inflammatory receptors, such as monoclonal antibodies, can be used to reduce the morbidity and mortality associated with SARS-CoV-2 infection.