Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 21, 2023; 29(7): 1123-1130
Published online Feb 21, 2023. doi: 10.3748/wjg.v29.i7.1123
COVID-19-induced transaminitis and hyperbilirubinemia: Presentation and outcomes
Zeinab Nabil Ahmed Said, Safinaz Adel El Habashy, Samy Zaky, ESCMID Study Group for Viral Hepatitis
Zeinab Nabil Ahmed Said, Department of Medical Microbiology and Immunology, Faculty of Medicine (For Girls), Al-Azhar University, Cairo 11754, Nasr City, Egypt
Safinaz Adel El Habashy, Department of Pediatrics, Ain Shams University, Cairo 11391, Abbaseia, Egypt
Samy Zaky, Department of Hepato-gastroenterology and Infectious Diseases, Faculty of Medicine (For Girls), Al-Azhar University, Cairo 11754, Egypt
Author contributions: Said ZNA, El Habashy SA, and Zaky S contributed equally to this work; All authors have read and agreed to the published version of the manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
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: Zeinab Nabil Ahmed Said, PhD, Additional Professor, Medical Microbiology and Immunology, Faculty of Medicine (For Girls), Al-Azhar University, Elshenawy St., Cairo 11754, Nasr City, Egypt. znabil58@yahoo.com
Received: September 10, 2022
Peer-review started: September 10, 2022
First decision: November 17, 2022
Revised: December 29, 2022
Accepted: February 13, 2023
Article in press: February 13, 2023
Published online: February 21, 2023

The risk of liver injury in patients with coronavirus disease 2019 (COVID-19) infection is quite evident. Furthermore, liver function test abnormalities are still detected in COVID-19 patients despite the development of antivirals and the availability of several types of vaccines. This editorial describes liver involvement during COVID-19 infection in patients with or without preexisting liver injury, such as chronic liver disease, to elucidate COVID-19-induced liver function abnormalities and their severity, pathophysiology, clinical manifestations, and clinical and laboratory outcomes. We also discuss the effect of vaccination against COVID-19 to better understand host factors, such as age, gender, and race, on the incidence and severity of liver dysfunction at initial presentation and during the illness. Finally, we summarize the results of relevant meta-analyses published to date and highlight the importance of adequate liver function monitoring in the current climate of the overwhelming COVID-19 pandemic.

Keywords: COVID-19, SARS-CoV-2, Liver injury, Transaminases, Hyperbilirubinemia, Pathophysiology

Core Tip: Recent evidence confirmed coronavirus disease 2019-induced liver function test abnormalities in patients with or without preexisting liver injury. Understanding the mechanism and recognizing the clinical picture, as well as identifying the risk factors for developing such abnormalities, will pave the way for early diagnosis and better management of such cases.