Sivandzadeh GR, Askari H, Safarpour AR, Ejtehadi F, Raeis-Abdollahi E, Vaez Lari A, Abazari MF, Tarkesh F, Bagheri Lankarani K. COVID-19 infection and liver injury: Clinical features, biomarkers, potential mechanisms, treatment, and management challenges. World J Clin Cases 2021; 9(22): 6178-6200 [PMID: 34434987 DOI: 10.12998/wjcc.v9.i22.6178]
Corresponding Author of This Article
Ali Reza Safarpour, MD, PhD, Assistant Professor, Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Nemazee Hospital, Shiraz 7193635899, Iran. safarpourar@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which 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: http://creativecommons.org/licenses/by-nc/4.0/
Gholam Reza Sivandzadeh, Hassan Askari, Ali Reza Safarpour, Fardad Ejtehadi, Firoozeh Tarkesh, Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz 7193635899, Iran
Ehsan Raeis-Abdollahi, Department of Medical Sciences, Qom Medical Branch, Islamic Azad University, Qom 1417613151, Iran
Armaghan Vaez Lari, Department of Physiology, School of Medicine, Ahvaz Jundishapur University of Medical Science, Ahvaz 6135715794, Iran
Mohammad Foad Abazari, Research Center for Clinical Virology, Tehran University of Medical Sciences, Tehran 1417653761, Iran
Kamran Bagheri Lankarani, Health Policy Research Center, Shiraz University of Medical Sciences, Shiraz 71348-45794, Iran
Author contributions: Safarpour AR, Raeis-Abdollahi E, Vaez Lari A, Abazari MF, Ejtehadi F, and Tarkesh F collected data; Sivandzadeh GR, Askari H, and Safarpour AR collected data and partly drafted the paper's first version; Sivandzadeh GR, Askari H, Safarpour AR and Bagheri Lankarani K designed, revised, and finalized the manuscript.
Conflict-of-interest statement: The authors declare that they have no competing interests.
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: Ali Reza Safarpour, MD, PhD, Assistant Professor, Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Nemazee Hospital, Shiraz 7193635899, Iran. safarpourar@gmail.com
Received: January 18, 2021 Peer-review started: January 18, 2021 First decision: May 2, 2021 Revised: May 7, 2021 Accepted: June 25, 2021 Article in press: June 25, 2021 Published online: August 6, 2021 Processing time: 190 Days and 21 Hours
Core Tip
Core Tip: Coronavirus disease 2019 (COVID-19) is associated with respiratory symptoms, digestive complications, and liver injury. Severe inflammatory response, anoxia, drug-induced liver injury, direct cytotoxicity, as well as reactivation of pre-existing liver disease might be the etiologic mechanisms behind liver injury in COVID-19 patients. In this review, we study the clinical manifestations and liver-related events seen in COVID-19 patients, including the pathophysiology, etiology, biomarkers, diagnosis, treatment, and management strategies for liver injury. We aim to increase the awareness of healthcare workers about liver injury and to provide information for hepatic management in COVID-19 patients. Physicians should (1) pay special attention to the management of concurrent liver disorders; (2) boost hepatic function by strengthening supportive therapy; and (3) minimize the risk of drug-induced liver injury.
