Evidence Review
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Dec 7, 2022; 28(45): 6314-6327
Published online Dec 7, 2022. doi: 10.3748/wjg.v28.i45.6314
Liver injury induced by COVID 19 treatment – what do we know?
Lekha Saha, Soumya Vij, Kajal Rawat
Lekha Saha, Soumya Vij, Kajal Rawat, Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
Author contributions: All authors were equally involved in the literature search and manuscript writing and editing.
Conflict-of-interest statement: All authors report having no relevant 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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Lekha Saha, MBBS, MD, MNAMS, Full Professor, Department of Pharmacology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh 160012, India. lekhasaha@rediffmail.com
Received: September 12, 2022
Peer-review started: September 12, 2022
First decision: September 29, 2022
Revised: October 7, 2022
Accepted: November 17, 2022
Article in press: November 17, 2022
Published online: December 7, 2022
Processing time: 80 Days and 22.7 Hours
Abstract

The severity of coronavirus disease 2019 (COVID-19) may be correlated with the risk of liver injury development. An increasing number of studies indicate that degrees of hepatotoxicity have been associated with using some medications in the management of COVID-19 patients. However, limited studies have systematically investigated the evidence of drug-induced liver injury (DILI) in COVID-19 patients. An increasing number of studies indicate that degrees of hepatotoxicity have been associated with using some of these medications in the management of COVID-19 patients. Significantly, it was relieved after the cessation of these agents. However, to our knowledge, no studies have systematically investigated the evidence of DILI in COVID-19 patients. In this review, we discussed the association between hepatotoxicity in COVID-19 patients and the drugs used in these patients and possible mechanisms of hepatotoxicity. The currently available evidence on the association of different therapeutic agents with hepatotoxicity in COVID-19 patient was systematically reviewed.

Keywords: Liver injury; COVID-19; Anti-COVID drugs; Mechanisms; Clinical evidences

Core Tip: Liver damage is cited as the most frequent clinical extrapulmonary manifestation in a number of coronavirus disease 2019 (COVID-19) clinical trials. Herein, we summarized the available clinical data concerning liver injury during COVID-19. Transaminases and bilirubin levels were high in a significant majority of patients; however, the exact cause of liver damage is not entirely clear. A worse clinical course of COVID-19 may be associated with severe liver enzyme abnormalities. However, it is impossible to rule out a number of additional cofactors (drug-induced liver damage, an inflammatory response to an infection, hypoxic hepatitis, or underlying liver disease).