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World J Hepatol. Jun 27, 2022; 14(6): 1099-1110
Published online Jun 27, 2022. doi: 10.4254/wjh.v14.i6.1099
Liver dysfunction during COVID-19 pandemic: Contributing role of associated factors in disease progression and severity
Tarun Sahu, Babita Pande, Manasa PL, Henu Kumar Verma
Tarun Sahu, Babita Pande, Department of Physiology, All India Institute of Medical Sciences, Raipur 492001, Chhattisgarh, India
Manasa PL, Center for Basic Sciences, Pt. Ravishankar Shukla University, Raipur 492001, Chhattisgarh, India
Henu Kumar Verma, Department of Immunopathology, Institute of Lungs Health and Immunity, Munich 85764, Bavaria, Germany
Author contributions: Verma HK designed the review; Sahu T, Manasa PL, and Pande B performed the literature search and collected and assembled the data; HKV and BP analyzed the obtained articles; Sahu T, Manasa PL, Pande B, and Verma HK wrote the manuscript and revised it critically; all authors have read and agreed to the published version of the manuscript.
Conflict-of-interest statement: The authors declare that there is no potential conflict of interest to disclose.
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: Henu Kumar Verma, PhD, Research Scientist, Senior Researcher, Department of Immunopathology, Institute of Lungs Health and Immunity, Ingolstädter Landstrasse 1, Munich 85764, Bavaria, Germany. henu.verma@yahoo.com
Received: January 16, 2022
Peer-review started: January 16, 2022
First decision: February 8, 2022
Revised: February 13, 2022
Accepted: May 28, 2022
Article in press: May 28, 2022
Published online: June 27, 2022
Processing time: 158 Days and 2.4 Hours
Abstract

In December 2019, a new strain of coronavirus was discovered in China, and the World Health Organization declared it a pandemic in March 2020. The majority of people with coronavirus disease 19 (COVID-19) exhibit no or only mild symptoms such as fever, cough, anosmia, and headache. Meanwhile, approximately 15% develop a severe lung infection over the course of 10 d, resulting in respiratory failure, which can lead to multi-organ failure, coagulopathy, and death. Since the beginning of the pandemic, it appears that there has been consideration that pre-existing chronic liver disease may predispose to deprived consequences in conjunction with COVID-19. Furthermore, extensive liver damage has been linked to immune dysfunction and coagulopathy, which leads to a more severe COVID-19 outcome. Besides that, people with COVID-19 frequently have abnormal liver function, with more significant elevations in alanine aminotransferase and aspartate aminotransferase in patients with severe COVID-19 compared to those with mild/moderate disease. This review focuses on the pathogenesis of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection in the liver, as well as the use of liver chemistry as a prognostic tool during COVID-19. We also evaluate the findings for viral infection of hepatocytes, and look into the potential mechanisms behind SARS-CoV-2-related liver damage.

Keywords: SARS-CoV-2; COVID-19; Liver function; Hepatic injury; Viral infection

Core Tip: Understanding the hepatic consequences of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection, as well as its molecular mechanism, has advanced significantly. Since the start of the pandemic, it appears that there has been thought that pre-existing chronic liver disease may predispose to deprived outcomes when combined with coronavirus disease 19 (COVID-19). Evidence suggests that COVID-19 patients have abnormal liver function more frequently, with more significant elevations in alanine aminotransferase and aspartate aminotransferase in severe COVID-19 patients than those with mild/moderate disease. In this review, we focus on the pathogenesis of SARS-CoV-2 infection in the liver, as well as the use of liver chemistry as a prognostic tool during COVID-19.