Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Virol. Jan 25, 2023; 12(1): 53-67
Published online Jan 25, 2023. doi: 10.5501/wjv.v12.i1.53
COVID-19-related liver injury: Focus on genetic and drug-induced perspectives
Deepak Parchwani, Amit D Sonagra, Sagar Dholariya, Anita Motiani, Ragini Singh
Deepak Parchwani, Amit D Sonagra, Sagar Dholariya, Anita Motiani, Ragini Singh, Department of Biochemistry, All India Institute of Medical Sciences, Rajkot 360001, India
Author contributions: Sonagra AD, Dholariya S and Motiani A contributed to the search and examination of articles, analysis, manuscript writing and proof reading; Parchwani D designed the research study, examined articles and wrote the manuscript; Singh R contributed to literature search and analysis; and all authors have read and approved the final manuscript.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2020 Checklist, and the manuscript was prepared and revised according to the PRISMA 2020 guidelines.
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 Non Commercial (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: Sagar Dholariya, MD, Assistant Professor, Department of Biochemistry, All India Institute of Medical Sciences, Jamnagar Road, Khandheri, Rajkot 360001, India. drsagar.dholariya@gmail.com
Received: September 13, 2022
Peer-review started: September 13, 2022
First decision: October 3, 2022
Revised: October 15, 2022
Accepted: December 1, 2022
Article in press: December 1, 2022
Published online: January 25, 2023
Processing time: 126 Days and 16.1 Hours
Abstract
BACKGROUND

Empirical use of potentially hepatotoxic drugs in the management of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is considered as one of the major etiopathogenetic factors for liver injury. Recent evidence has shown that an underlying genetic factor may also occur. Hence, it is important to understand the host genetics and iatrogenic-based mechanisms for liver dysfunction to make timely remedial measures.

AIM

To investigate drug-induced and genetic perspectives for the development of coronavirus disease 2019 (COVID-19)-related liver injury.

METHODS

Reference Citation Analysis, PubMed, Google Scholar and China National Knowledge Infrastructure were searched by employing the relevant MeSH keywords and pertaining data of the duration, site and type of study, sample size with any subgroups and drug-induced liver injury outcome. Genetic aspects were extracted from the most current pertinent publications.

RESULTS

In all studies, the hepatic specific aminotransferase and other biochemical indices were more than their prescribed upper normal limit in COVID-19 patients and were found to be significantly related with the gravity of disease, hospital stay, number of COVID-19 treatment drugs and worse clinical outcomes. In addition, membrane bound O-acyltransferase domain containing 7 rs641738, rs11385942 G>GA at chromosome 3 gene cluster and rs657152 C>A at ABO blood locus was significantly associated with severity of livery injury in admitted SARS-CoV-2 patients.

CONCLUSION

Hepatic dysfunction in SARS-CoV-2 infection could be the result of individual drugs or due to drug-drug interactions and may be in a subset of patients with a genetic propensity. Thus, serial estimation of hepatic indices in hospitalized SARS-CoV-2 patients should be done to make timely corrective actions for iatrogenic causes to avoid clinical deterioration. Additional molecular and translational research is warranted in this regard.

Keywords: SARS-CoV-2; Liver injury; Genetic prospective; Drug-induced liver injury; Prognosis; COVID-19

Core Tip: Evidence highlights the multisystemic nature of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Hepatic dysfunction is the primary extrapulmonary manifestation. In addition to the direct cytopathic effect of the virus, iatrogenic causes and genetic susceptibility are also postulated in the pathogenesis of hepatic damage in SARS-CoV-2 infection. Degree of liver toxicity in terms of altered biochemical indices were consistent with severity of coronavirus disease 2019 (COVID-19) illness and hospital stay. Hence, serial monitoring of hepatic indices in COVID-19 hospitalized patients may provide useful prognostic value to make timely corrective actions to avoid clinical deterioration.