Published online Feb 7, 2023. doi: 10.3748/wjg.v29.i5.800
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
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.
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.