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World J Clin Cases. Dec 26, 2022; 10(36): 13167-13178
Published online Dec 26, 2022. doi: 10.12998/wjcc.v10.i36.13167
Living with liver disease in the era of COVID-19-the impact of the epidemic and the threat to high-risk populations
Pranav Barve, Prithi Choday, Anphong Nguyen, Tri Ly, Isha Samreen, Sukhwinder Jhooty, Chukwuemeka A Umeh, Sumanta Chaudhuri
Pranav Barve, Department of Internal Medicine, Hemet Global Medical Center, Menifee, CA 92585, United States
Prithi Choday, Anphong Nguyen, Tri Ly, Isha Samreen, Chukwuemeka A Umeh, Sumanta Chaudhuri, Department of Internal Medicine, Hemet Global Medical Center, Hemet, CA 92543, United States
Sukhwinder Jhooty, College of Medicine, American University of Antigua, Manipal Education America’s, New York, NY 10005, United States
Author contributions: Each author was involved substantially in the creation, review and revision of this manuscript; The order sequence represents the degree of involvement for each author; Barve P contributed to the editing, guidance, supervision; Choday P contributed to the data collection, writing, editing, organizing; Nguyen A contributed to the data collection, writing, editing; Ly T and Samreen I contributed to the data collection, writing; Jhooty S contributed to the data collection, writing, illustration; Umeh C contributed to the data collection, editing, guidance; Chaudhuri S contributed to the editing, guidance, supervision.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Pranav Barve, MD, Researcher, Department of Internal Medicine, Hemet Global Medical Center, 28400 Mccall Blvd, Ste B10, Menifee, CA 92585, United States. barve.md@sevenstar.health
Received: September 11, 2022
Peer-review started: September 11, 2022
First decision: October 30, 2022
Revised: November 15, 2022
Accepted: December 5, 2022
Article in press: December 5, 2022
Published online: December 26, 2022
Processing time: 105 Days and 22 Hours
Abstract

The cardinal symptoms of severe acute respiratory syndrome coronavirus 2 infection as the pandemic began in 2020 were cough, fever, and dyspnea, thus characterizing the virus as a predominantly pulmonary disease. While it is apparent that many patients presenting acutely to the hospital with coronavirus disease 2019 (COVID-19) infection have complaints of respiratory symptoms, other vital organs and systems are also being affected. In fact, almost half of COVID-19 hospitalized patients were found to have evidence of some degree of liver injury. Incidence and severity of liver injury in patients with underlying liver disease were even greater. According to the Centers of Disease Control and Prevention, from August 1, 2020 to May 31, 2022 there have been a total of 4745738 COVID-19 hospital admissions. Considering the gravity of the COVID-19 pandemic and the incidence of liver injury in COVID-19 patients, it is imperative that we as clinicians understand the effects of the virus on the liver and conversely, the effect of underlying hepatobiliary conditions on the severity of the viral course itself. In this article, we review the spectrum of novel studies regarding COVID-19 induced liver injury, compiling data on the effects of the virus in various age and high-risk groups, especially those with preexisting liver disease, in order to obtain a comprehensive understanding of this disease process. We also provide an update of the impact of the new Omicron variant and the changing nature of COVID-19 pathogenesis.

Keywords: Liver injury; Hepatobiliary injury; COVID-19; SARS-CoV-2; High-risk populations; Liver disease

Core Tip: The severe acute respiratory syndrome coronavirus 2 virus primarily produced respiratory symptoms in patients; subsequently, its effects on the hepatobiliary system were previously overlooked. New emerging studies on the effects of coronavirus disease 2019 (COVID-19) on the hepatobiliary system show that the association is significant and warrants further review. In this article, we review the existing data and present a comprehensive understanding of hepatobiliary injury in COVID-19 in those with underlying liver disease and in special populations, such as pregnancy, obesity, diabetes, and racial minority groups. Most of our reviewed populations are at increased risk of liver injury and mortality from COVID-19.