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World J Clin Pediatr. Jun 9, 2023; 12(3): 57-67
Published online Jun 9, 2023. doi: 10.5409/wjcp.v12.i3.57
COVID-19-induced liver injury in infants, children, and adolescents
Rana Bitar, Ahmed A Elghoudi, David Rawat, Amer Azaz, Mohamad Miqdady, Hassib Narchi
Rana Bitar, David Rawat, Amer Azaz, Mohamad Miqdady, Division of Pediatric Gastroenterology, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
Rana Bitar, David Rawat, Amer Azaz, Mohamad Miqdady, College of Medicine and Health Sciences, Khalifa University, Abu Dhabi, United Arab Emirates
Ahmed A Elghoudi, Department of Pediatric, Sheikh Khalifa Medical City, Abu Dhabi, United Arab Emirates
Ahmed A Elghoudi, Hassib Narchi, Department of Pediatric, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
Author contributions: All the authors contributed equally to writing the manuscript and reviewing the final draft.
Conflict-of-interest statement: All authors have no conflicts 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: Ahmed A Elghoudi, MBChB, MSc, Adjunct Associate Professor, Doctor, Department of Pediatric, Sheikh Khalifa Medical City, Al Karama Street, Al Khalidya, Abu Dhabi, United Arab Emirates. aelghoudi@seha.ae
Received: September 27, 2022
Peer-review started: September 27, 2022
First decision: October 17, 2022
Revised: November 7, 2022
Accepted: March 17, 2023
Article in press: March 17, 2023
Published online: June 9, 2023
Processing time: 251 Days and 18.7 Hours
Core Tip

Core Tip: Liver injury presenting with elevated levels of alanine aminotransferase and aspartate aminotransferase is common in children infected with the coronavirus disease 2019 (COVID-19) virus. The mechanism of liver injury is not fully understood and is likely secondary to the viral invasion of the liver, hepato-toxic medications, and the patient’s own immune-mediated response. Liver injury in children is generally mild and resolves spontaneously but is usually seen in children with more severe illnesses. In addition, children with underlying non-alcoholic fatty liver disease or another chronic liver disease may have a higher risk of severe COVID-19 illness. Management of liver injury after COVID infection is supportive. Proactive vaccination may reduce the transmission of infection and the severity of the disease.