Clinical implications of COVID-19 in patients with metabolic-associated fatty liver disease

Table 2 Analysis of liver test results in coronavirus disease 2019 patients

Test	Comments
Prolonged INR or thrombocytopenia	In one-third of sick patients
	Spontaneous coagulopathy/DIC may be present
	Thromboembolic incidents are probably frequent
	There may be a chance of ACLF
Imaging	Where chest-CT is frequently performed: Assessing liver/biliary tract disease might be helpful
	Do US, if necessary, but refrain from using US for superfluous imaging (not formally investigated)
Hypoalbuminemia	Common in people with systemic inflammatory response
	May also be a sign of acute hepatic decompensation or acute liver failure in people with pre-existing liver cirrhosis
High transaminases or bilirubin (> 3 × ULN)	Although not typical for COVID-19, ACLF may be present in patients with cirrhosis who already have liver disease
Dyselectrolytemia	Diarrhea and other GI problems might result in numerous electrolyte abnormalities
Anemia	Consider bleeding due to variceal hemorrhage in the context of MAFLD cirrhosis, portal hypertensive gastropathy or stress mucosal GI ulcer

ACLF: Acute on chronic liver failure; CT: Computed tomography; DIC: Disseminated intravascular coagulation; GI: Gastrointestinal; ULN: Upper limit of normal; US: Ultrasonography; COVID-19: Coronavirus disease 2019; MAFLD: Metabolic-associated fatty liver disease.