Al-Rawi TSS, Al-Ani RM. Liver dysfunction-related COVID-19: A narrative review. World J Meta-Anal 2023; 11(1): 5-17 [DOI: 10.13105/wjma.v11.i1.5]
Corresponding Author of This Article
Raid M Al-Ani, MBChB, Academic Research, Full Professor, Senior Editor, Surgeon, Department of Surgery/Otolaryngology, University of Anbar College of Medicine, Al-Thaela, Ramadi City 31001, Anbar, Iraq. med.raed.alani2003@uoanbar.edu.iq
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/
World J Meta-Anal. Jan 12, 2023; 11(1): 5-17 Published online Jan 12, 2023. doi: 10.13105/wjma.v11.i1.5
Liver dysfunction-related COVID-19: A narrative review
Taghreed S Saeed Al-Rawi, Raid M Al-Ani
Taghreed S Saeed Al-Rawi, Department of Biochemistry, University of Anbar College of Medicine, Ramadi City 31001, Anbar, Iraq
Raid M Al-Ani, Department of Surgery/Otolaryngology, University of Anbar College of Medicine, Ramadi City 31001, Anbar, Iraq
Author contributions: Al-Ani RM designed the study, wrote the abstract, core tip, introduction, and conclusion, formatted the references, edited the draft, and prepared the final version of the manuscript; Al-Rawi TSS collected the references and wrote the majority of the manuscript; both authors revised and approved the final version of the manuscript.
Conflict-of-interest statement: All the authors declare that there is no conflict of interest to disclose.
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: Raid M Al-Ani, MBChB, Academic Research, Full Professor, Senior Editor, Surgeon, Department of Surgery/Otolaryngology, University of Anbar College of Medicine, Al-Thaela, Ramadi City 31001, Anbar, Iraq. med.raed.alani2003@uoanbar.edu.iq
Received: September 9, 2022 Peer-review started: September 9, 2022 First decision: November 17, 2022 Revised: November 25, 2022 Accepted: December 13, 2022 Article in press: December 13, 2022 Published online: January 12, 2023 Processing time: 123 Days and 21.5 Hours
Abstract
The coronavirus 2019 disease (COVID-19) is caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2. This disease was designated by the World Health Organization as a pandemic on March 11, 2020, which is not seen before. There are no classical features among the cases of the disease owing to the involvement of nearly all body tissues by the virus. Hepatic involvement is one of the characteristics of the COVID-19 course. There are six possible mechanisms of such involvement: Direct virus injury, drug-induced effect, inflammatory cytokine storm, hypoxia-ischemic destruction, abnormalities in liver function tests, and pre-existing chronic liver diseases. Liver abnormalities are seen commonly in the severe or critical stage of COVID-19. Therefore, these abnormalities determine the COVID-19 severity and carry a high rate of morbidity and mortality. The elderly and patients with comorbidities like diabetes mellitus and hypertension are more vulnerable to liver involvement. Another issue that needs to be disclosed is the liver manifestations following the COVID-19 vaccination, such as autoimmune hepatitis. Of note, complete vaccination with third and fourth booster doses is necessary for patients with previous chronic liver diseases or those who have been subjected to liver transplantation. This review aims to explore the various aspects of liver dysfunction during the COVID-19 course regarding the epidemiological features, predisposing factors, pathophysiological mechanisms, hepatic manifestations due to COVID-19 or following vaccination, role of liver function tests in the assessment of COVID-19 severity, adverse effects of the therapeutic agents for the disease, and prognosis.
Core Tip: There is a diversity of clinical manifestations of the coronavirus 2019 disease (COVID-19), ranging from classical presentations like fever, cough, and dyspnea to non-classical presentations like liver involvement. Direct injury, drug-induced hypoxia, abnormal liver function tests, cytokine storm, and a history of chronic hepatic diseases are the proposed mechanisms of liver involvement during the COVID-19 course. Liver involvement can determine the severity of the disease. Old age and a history of chronic diseases like diabetes mellitus are recognized risk factors for this involvement. Autoimmune hepatitis is an example of liver involvement following COVID-19 vaccination. However, complete vaccination with 3rd and 4th booster doses is required in patients with chronic liver diseases. We aim to summarize the various aspects of hepatic involvement during the COVID-19 course or following its vaccination.
