Review
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 7, 2023; 29(5): 800-814
Published online Feb 7, 2023. doi: 10.3748/wjg.v29.i5.800
Impact of chronic liver disease on SARS-CoV-2 infection outcomes: Roles of stage, etiology and vaccination
Riccardo Nevola, Livio Criscuolo, Domenico Beccia, Augusto Delle Femine, Rachele Ruocco, Simona Imbriani, Maria Alfano, Angela Villani, Antonio Russo, Pasquale Perillo, Raffaele Marfella, Luigi Elio Adinolfi, Ferdinando Carlo Sasso, Aldo Marrone, Luca Rinaldi
Riccardo Nevola, Livio Criscuolo, Domenico Beccia, Augusto Delle Femine, Rachele Ruocco, Simona Imbriani, Maria Alfano, Angela Villani, Raffaele Marfella, Luigi Elio Adinolfi, Ferdinando Carlo Sasso, Aldo Marrone, Luca Rinaldi, Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
Riccardo Nevola, Pasquale Perillo, Internal Medicine and Hepatology Unit, Ospedale Evangelico Betania, Naples 80147, Italy
Antonio Russo, Department of Mental Health and Public Medicine, University of Campania “Luigi Vanvitelli”, Naples 80138, Italy
Author contributions: Nevola R and Criscuolo L contributed to the study conception and design; Criscuolo L, Nevola R, Beccia D, Delle Femine A, Imbriani S, Alfano M, Ruocco R, Villani A, Russo A and Perillo P reviewed the literature; The first draft of the manuscript was written by Criscuolo L and Nevola R; Claar E, Marfella R, Adinolfi LE, Sasso FC, Marrone A and Rinaldi L edited the draft and revised the manuscript for important intellectual content; All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
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: Riccardo Nevola, MD, PhD, Doctor, Department of Advanced Medical and Surgical Sciences, University of Campania “Luigi Vanvitelli”, Miraglia Place, Naples 80138, Italy. riccardo.nevola@unicampania.it
Received: November 22, 2022
Peer-review started: November 22, 2022
First decision: December 10, 2022
Revised: December 12, 2022
Accepted: January 18, 2023
Article in press: January 18, 2023
Published online: February 7, 2023
Abstract

Since the first identification in December of 2019 and the fast spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, it has represented a dramatic global public health concern. Though affecting mainly the respiratory system, SARS-CoV-2 disease, defined as coronavirus disease 2019 (COVID-19), may have a systemic involvement leading to multiple organ dysfunction. Experimental evidence about the SARS-CoV-2 tropism for the liver and the increasing of hepatic cytolysis enzymes during infection support the presence of a pathophysiological relationship between liver and SARS-CoV-2. On the other side, patients with chronic liver disease have been demonstrated to have a poor prognosis with COVID-19. In particular, patients with liver cirrhosis appear extremely vulnerable to infection. Moreover, the etiology of liver disease and the vaccination status could affect the COVID-19 outcomes. This review analyzes the impact of the disease stage and the related causes on morbidity and mortality, clinical outcomes during SARS-CoV-2 infection, as well as the efficacy of vaccination in patients with chronic liver disease.

Keywords: SARS-CoV-2 infection, COVID-19, Chronic liver disease, Cirrhosis, Non-alcoholic fatty liver disease, Liver injury

Core Tip: It has been observed, since the early months of the pandemic, that pre-existing liver disease was associated with a worsening of clinical outcomes in severe acute respiratory syndrome coronavirus 2 infection. A correlation exists between severity of liver disease and coronavirus disease 2019-related adverse outcomes. The etiology of liver disease could significantly affect mortality rates, as well as vaccination status.