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World J Virol. Nov 25, 2022; 11(6): 453-466
Published online Nov 25, 2022. doi: 10.5501/wjv.v11.i6.453
Hepatic manifestations of coronavirus disease 2019 infection: Clinical and laboratory perspective
Farina M Hanif, Zain Majid, Shoaib Ahmed, Nasir H Luck, Muhammed Mubarak
Farina M Hanif, Zain Majid, Shoaib Ahmed, Nasir H Luck, Department of Hepatogastroenterology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Muhammed Mubarak, Department of Pathology, Sindh Institute of Urology and Transplantation, Karachi 74200, Sindh, Pakistan
Author contributions: Mubarak M and Luck NL conceived the study; Mubarak M, Majid Z and Hanif FM designed the study; Hanif FM, Ahmed S and Majid Z performed the research; All authors participated in primary and final drafting; All authors read and approved the final manuscript.
Conflict-of-interest statement: None of the authors have any conflicts of interest related to this research.
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: Muhammed Mubarak, FCPS, Professor, Department of Pathology, Sindh Institute of Urology and Transplantation, Dewan Farooque Medical Complex, Chand Bibi Road, Karachi 74200, Sindh, Pakistan. drmubaraksiut@yahoo.com
Received: September 12, 2022
Peer-review started: September 12, 2022
First decision: September 29, 2022
Revised: October 17, 2022
Accepted: November 7, 2022
Article in press: November 7, 2022
Published online: November 25, 2022
Processing time: 71 Days and 23.4 Hours
Abstract

The novel coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2, has become a global challenge of unprecedented nature since December 2019. Although most patients with COVID-19 exhibit mild clinical manifestations and upper respiratory tract involvement, in approximately 5%-10% of patients, the disease is severe and involves multiple organs, leading to multi-organ dysfunction and failure. The liver and gastrointestinal tract are also frequently involved in COVID-19. In the context of liver involvement in patients with COVID-19, many key aspects need to be addressed in both native and transplanted organs. This review focuses on the clinical presentations and laboratory abnormalities of liver function tests in patients with COVID-19 with no prior liver disease, patients with pre-existing liver diseases and liver transplant recipients. A brief overview of the history of COVID-19 and etiopathogenesis of the liver injury will also be described as a prelude to better understanding the above aspects.

Keywords: COVID-19; Liver injury; SARS-CoV-2; Clinical manifestations; Liver function tests; Cirrhosis

Core Tip: The novel coronavirus disease 2019 (COVID-19) has affected the entire globe with devastating consequences on the health and economy of all countries. Primarily a disease of the upper respiratory tract, it may involve multiple organs in severe cases, which are fortunately rare. The liver and gastrointestinal tract are also frequently involved in COVID-19. Involvement of the liver is multifaceted and may be asymptomatic or may lead to acute liver failure. This review article focused on various clinical presentations and laboratory abnormalities of liver function tests in patients with COVID-19. This will help in creating awareness among the general physicians, gastroenterologists, hepatologists and infectious disease consultants regarding this important complication.