Published online Sep 25, 2022. doi: 10.5501/wjv.v11.i5.237
Peer-review started: March 13, 2022
First decision: April 13, 2022
Revised: April 25, 2022
Accepted: June 20, 2022
Article in press: June 20, 2022
Published online: September 25, 2022
Processing time: 195 Days and 0.9 Hours
The coronavirus disease 2019 (COVID-19) pandemic continues to be a global problem with over 438 million cases reported so far. Although it mostly affects the respiratory system, the involvement of extrapulmonary organs, including the liver, is not uncommon. Since the beginning of the pandemic, metabolic com-orbidities, such as obesity, diabetes, hypertension, and dyslipidemia, have been identified as poor prognostic indicators. Subsequent metabolic and lipidomic studies have identified several metabolic dysfunctions in patients with COVID-19. The metabolic alterations appear to be linked to the course of the disease and inflammatory reaction in the body. The liver is an important organ with high metabolic activity, and a significant proportion of COVID-19 patients have metabolic comorbidities; thus, this factor could play a key role in orchestrating systemic metabolic changes during infection. Evidence suggests that metabolic dysregulation in COVID-19 has both short- and long-term metabolic implications. Furthermore, COVID-19 has adverse associations with metabolic-associated fatty liver disease. Due to the ensuing effects on the renin-angiotensin-aldosterone system and ammonia metabolism, COVID-19 can have significant implications in patients with advanced chronic liver disease. A thorough understanding of COVID-19-associated metabolic dysfunction could lead to the identification of important plasma biomarkers and novel treatment targets. In this review, we discuss the current understanding of metabolic dysfunction in COVID-19, focusing on the liver and exploring the underlying mechanistic pathogenesis and clinical implications.
Core Tip: In coronavirus disease 2019 (COVID-19) patients, the virus induces a complex viral-host interaction that leads to metabolic reprogramming, altered immunological responses, and a variety of clinical consequences. In metabolomic and lipidomic studies, a variety of alterations in amino acids, lipids, carbohydrates, and energy metabolism have been identified in such patients. The liver is the primary metabolic organ; thus, these metabolic alterations may have a major impact on patients with liver diseases and metabolic comorbidities that are common in COVID-19 patients. Therefore, this review article discusses the pathophysiological aspects and clinical implications of metabolic dysfunction in COVID-19 patients with a focus on the liver.