Published online Apr 21, 2021. doi: 10.3748/wjg.v27.i15.1531
Peer-review started: January 27, 2021
First decision: February 10, 2021
Revised: February 17, 2021
Accepted: March 29, 2021
Article in press: March 29, 2021
Published online: April 21, 2021
Coronavirus disease 2019 (COVID-19) is a devastating worldwide pandemic infection caused by a severe acute respiratory syndrome namely coronavirus 2 (SARS-CoV-2) that is associated with a high spreading and mortality rate. On the date this review was written, SARS-CoV-2 infected about 96 million people and killed about 2 million people. Several arguments disclosed the high mortality of COVID-19 due to acute respiratory distress syndrome or change in the amount of angiotensin-converting enzyme 2 (ACE2) receptor expression or cytokine storm strength production. In a similar pattern, hepatic impairment patients co-infected with SARS-CoV-2 exhibited overexpression of ACE2 receptors and cytokine storm overwhelming, which worsens the hepatic impairment and increases the mortality rate. In this review, the impact of SARS-CoV-2 on hepatic impairment conditions we overviewed. Besides, we focused on the recent studies that indicated cytokine storm as well as ACE2 as the main factors for high COVID-19 spreading and mortality while hinting at the potential therapeutic strategies.
Core Tip: Implications of fast coronavirus disease 2019 (COVID-19) outbreak are huge annoying problems that affected countries' health and economies around the world. Patients associated with hepatic impairment are considered at a high-risk target for severe acute respiratory syndrome namely coronavirus 2 severity and mortality. A good understanding of virus machinery provides excellent ideas about how to combat this monster. We provide detailed information about the recent mechanisms of COVID-19 pathogenesis, implications on several hepatic disorders, and potential therapeutic strategies.