Minireviews
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 14, 2021; 27(22): 3022-3036
Published online Jun 14, 2021. doi: 10.3748/wjg.v27.i22.3022
Liver injury in COVID-19: Detection, pathogenesis, and treatment
Yue Cai, Li-Ping Ye, Ya-Qi Song, Xin-Li Mao, Li Wang, Yan-Zhi Jiang, Wei-Tao Que, Shao-Wei Li
Yue Cai, Li-Ping Ye, Xin-Li Mao, Shao-Wei Li, Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
Yue Cai, Li-Ping Ye, Xin-Li Mao, Shao-Wei Li, Department of Gastroenterology, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, Linhai 317000, Zhejiang Province, China
Li-Ping Ye, Ya-Qi Song, School of Medicine, Zhejiang University, Hangzhou 310000, Zhejiang Province, China
Li Wang, College of Basic Medicine, Inner Mongolia Medical University, Hohhot 010000, Inner Mongolia Autonomous Region, China
Yan-Zhi Jiang, Department of Gastroenterology and Hepatology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China
Wei-Tao Que, Department of Surgery, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200000, China
Author contributions: All authors drafted the manuscript and contributed to the writing and editing of the manuscript; all authors contributed to the article and approved the submitted version.
Supported by Program of Taizhou Science and Technology Grant, No. 20ywb29; Medical Health Science and Technology Project of Zhejiang Province, No. 2021PY083, and No. 2019KY239; Key Technology Research and Development Program of Zhejiang Province, No. 2019C03040; and Major Research Program of Taizhou Enze Medical Center Grant, No. 19EZZDA2.
Conflict-of-interest statement: The authors declare no conflict of interest related to this manuscript.
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: Shao-Wei Li, PhD, Academic Fellow, Assistant Professor, Associate Research Scientist, Instructor, Key Laboratory of Minimally Invasive Techniques & Rapid Rehabilitation of Digestive System Tumor of Zhejiang Province, Taizhou Hospital of Zhejiang Province Affiliated to Wenzhou Medical University, No. 150 Xinmen Street, Linhai 317000, Zhejiang Province, China. li_shaowei81@hotmail.com
Received: January 24, 2021
Peer-review started: January 24, 2021
First decision: March 7, 2021
Revised: March 24, 2021
Accepted: April 21, 2021
Article in press: April 21, 2021
Published online: June 14, 2021
Abstract

In the early December 2019, a novel coronavirus named severe acute respiratory syndrome coronavirus 2 was first reported in Wuhan, China, followed by an outbreak that spread around the world. Numerous studies have shown that liver injury is common in patients with coronavirus disease 2019 (COVID-19), and may aggravate the severity of the disease. However, the exact cause and specific mechanism of COVID-associated liver injury needs to be elucidated further. In this review, we present an analysis of the clinical features, potential mechanisms, and treatment strategies for liver injury associated with COVID-19. We hope that this review would benefit clinicians in devising better strategies for management of such patients.

Keywords: COVID-19, Liver injury, Clinical features, Potential mechanism, Treatment

Core Tip: Coronavirus disease 2019 (COVID-19) has assumed pandemic proportions, and has resulted in several hundred thousand deaths globally. Although the lung is the main organ that is damaged in COVID-19, approximately 60% of the patients have been reported to develop various degrees of liver injury in several studies. Accumulating clinical data show that liver damage is related to the severity of COVID-19 and is a major cause of death from COVID-19, especially in the presence of hepatic failure. The exact cause of liver injury in patients with COVID-19 remains unclear and the specific underlying mechanism(s) need to be elucidated.