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World J Clin Cases. Jan 26, 2021; 9(3): 528-539
Published online Jan 26, 2021. doi: 10.12998/wjcc.v9.i3.528
Clinical features and potential mechanism of coronavirus disease 2019-associated liver injury
Mei-Wen Han, Ming Wang, Meng-Ying Xu, Wei-Peng Qi, Peng Wang, Dong Xi
Mei-Wen Han, Ming Wang, Meng-Ying Xu, Wei-Peng Qi, Peng Wang, Dong Xi, Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Author contributions: Han MW performed most of the writing and prepared the figures and tables; Wang M and Xu MY collected the data; Qi WP and Wang P coordinated the writing of the paper; Xi D designed the outline.
Conflict-of-interest statement: There is no conflict of interest.
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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong Xi, PhD, Associate Professor, Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Dadao, Wuhan 430030, Hubei Province, China. xidong@tjh.tjmu.edu.cn
Supported by The National Major Science and Technology Special Project on Major New Drug Innovation, No. 2018ZX09733001-002-006; and Natural Science Foundation of Hubei Province, No. 2019CFB328.
Received: September 19, 2020
Peer-review started: September 19, 2020
First decision: November 26, 2020
Revised: December 10, 2020
Accepted: December 23, 2020
Article in press: December 23, 2020
Published online: January 26, 2021
Processing time: 116 Days and 21.6 Hours
Abstract

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has posed a serious threat to global public health security. With the increase in the number of confirmed cases globally, the World Health Organization has declared the outbreak of COVID-19 an international public health emergency. Despite atypical pneumonia as the primary symptom, liver dysfunction has also been observed in many clinical cases and is associated with the mortality risk in patients with COVID-19, like severe acute respiratory syndrome and Middle East respiratory syndrome. Here we will provide a schematic overview of the clinical characteristics and the possible mechanisms of liver injury caused by severe acute respiratory syndrome coronavirus 2 infection, which may provide help for optimizing the management of liver injury and reducing mortality in COVID-19 patients.

Keywords: COVID-19; Novel coronavirus; SARS-CoV-2; Liver injury

Core Tip: With the number of confirmed cases increasing worldwide, abnormal liver function has been observed in many patients with coronavirus disease 2019 (COVID-19). COVID-19-associated liver injury refers to any hepatic damage that occurs during disease progression and treatment in COVID-19 patients with or without underlying liver diseases. Underlying mechanisms may be viral infection in liver cells, systemic inflammation induced by cytokine storm, drug induced liver injury or pneumonia-associated hypoxia. A close monitor of liver function is recommended in COVID-19 patients, especially in critical individuals.