Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Dec 27, 2021; 13(12): 1909-1918
Published online Dec 27, 2021. doi: 10.4254/wjh.v13.i12.1909
Liver function in COVID-19 infection
Dagmara Przekop, Ewa Gruszewska, Lech Chrostek
Dagmara Przekop, Diagnostics-Experimental Center of Sexually Transmissible Diseases, Bialystok 15-879, Poland
Ewa Gruszewska, Lech Chrostek, Department of Biochemical Diagnostics, Medical University of Bialystok, Bialystok 15-269, Poland
Author contributions: Przekop D, Gruszewska E and Chrostek L wrote the paper, contributing equally to this work.
Conflict-of-interest statement: Authors declare no conflict of interests 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:
Corresponding author: Lech Chrostek, MD, PhD, Full Professor, Department of Biochemical Diagnostics, Medical University of Bialystok, Waszyngtona 15A, Bialystok 15-269, Poland.
Received: February 25, 2021
Peer-review started: February 25, 2021
First decision: May 3, 2021
Revised: May 7, 2021
Accepted: November 24, 2021
Article in press: November 24, 2021
Published online: December 27, 2021

Coronavirus disease 2019 (COVID-19) disease affects multiple organs, including anomalies in liver function. In this review we summarize the knowledge about liver injury found during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with special attention paid to possible mechanisms of liver damage and abnormalities in liver function tests allowing for the evaluation of the severity of liver disease. Abnormalities in liver function observed in COVID-19 disease are associated with the age and sex of patients, severity of liver injury, presence of comorbidity and pre-treatment. The method of antiviral treatment can also impact on liver function, which manifests as increasing values in liver function tests. Therefore, analysis of variations in liver function tests is necessary in evaluating the progression of liver injury to severe disease.

Keywords: COVID-19, Pathogenesis of liver injury, Angiotensin-converting enzyme 2 receptor, Liver function tests, Severe COVID-19, Treatment effect

Core Tip: The frequency of abnormalities in liver function tests (LFTs) in coronavirus disease 2019 (COVID-19) infected patients increases with age and is observed in males more than females. A pre-existing history of liver disease and comorbidity increases LFT abnormality and the likelihood of severe liver damage in COVID-19 infection. Antiviral treatment and treatment of comorbid diseases intensifies the hepatotoxic effect on the liver, which often manifests itself in higher levels in LFTs.