Newer developments in viral hepatitis: Looking beyond hepatotropic viruses

Table 3 Studies studying coronavirus disease 2019 infection and liver disease

Ref.	Patients	Type	Study highlight with regards to liver disease
Xie et al[148]	79	Retrospective study	Liver injury maybe related to systemic inflammation and liver function should be monitored in patients with severe pulmonary lesions on imaging
Zhang et al[149]	115	Retrospective study	Liver enzymes as well as INR significantly elevated in patients with severe COVID-19; Albumin low in severe cases
Huang et al[145]	41	Prospective case series	Two percent patients had chronic liver disease; 37% patients had elevated AST which was more pronounced in ICU patients
Fan et al[141]	148	Retrospective case series	In patients with abnormal liver function, more received treatment with lopinavir/ritonavir as compared to those with normal liver function
Wang et al[150]	138	Retrospective study	Of 2.9% patients had chronic liver disease, AST elevation > ALT and seen more in ICU patients
Xu et al[151]	62	Retrospective study	Of 12% patients had underlying liver disease; 16% patients had elevated AST
Shi et al[152]	81	Retrospective study	AST more elevated in patients with increasing pulmonary lesions on imaging; 9% patients had hepatitis or cirrhosis on imaging
Zhang et al[153]	82	Retrospective study; Jul 2020	Of 2.4% patients had underlying liver disease; 1.2% patients died due to liver disease; 30.6%, 61.1% and 30.6% had elevated levels of ALT, AST and Total bilirubin respectively
Guan et al[135]	1099	Retrospective study	There are 2.1% patients had hepatitis B; AST, ALT and Total bilirubin were elevated in 22.2%, 21.3% and 10.5% patients respectively
Ji et al[147]	202	Retrospective study	Liver injury frequent but mild in nature with mostly hepatocellular pattern; Patients with NAFLD and BMI had higher risk for persistent liver injury. Patients with NAFLD had higher risk for severe COVID-19 and longer viral shedding.
Mao et al[154]	6686	Systematic Review and Meta-analysis	Pooled prevalence of liver comorbidities was 3%. Pooled prevalence of liver injury was 19%; Patients with severe COVID-19 had higher risk for abnormal liver enzymes.
Singh et al[155]	2780	Multicenter research network study	Patients with cirrhosis and pre-existing liver disease are at increased risk for hospitalization and death
Bloom et al[143]	60	Prospective cohort study	Predominant AST elevation commonly seen in COVID-19 and correlates with disease severity
Wang et al[156]	105	Retrospective study	Elevated liver enzymes more likely in patients with severe COVID-19
Cai et al[157]	417	Cross sectional study	Of 76.3% patients had abnormal liver enzymes and 21.5% had liver injury during hospitalization; Patients who received lopinavir/ritonavir had higher odds of liver injury. Patients with abnormal liver tests had higher chance of severe COVID-19

INR: International normalized ratio; COVID-19: Coronavirus disease-2019; AST: Aspartate aminotransferase; ALT: Alanine aminotransferase; ICU: Intensive Care Unit; NAFLD: Non-alcoholic fatty liver disease; BMI: Body mass index.