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World J Virol. Nov 25, 2022; 11(6): 443-452
Published online Nov 25, 2022. doi: 10.5501/wjv.v11.i6.443
COVID-19-induced liver injury in adult patients: A brief overview
Martina Grando, Massimiliano Balbi, Marco Zeppieri
Martina Grando, Massimiliano Balbi, Department of Internal Medicine, Azienda Sanitaria Friuli Occidentale, San Vito al Tagliamento 33078, Italy
Marco Zeppieri, Department of Ophthalmology, University Hospital of Udine, Udine 33100, Italy
Author contributions: Grando M, Balbi M and Zeppieri M wrote the outline and the paper, assisted in the editing and making critical revisions of the manuscript; Grando M did the research and writing of the manuscript; Zeppieri M was responsible for the conception and design of the study and completed the English and scientific editing (a native English speaking MD, PhD); All authors provided the final approval of the article.
Conflict-of-interest statement: All authors declare no conflict of interests 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: Marco Zeppieri, BSc, MD, PhD, Doctor, Department of Ophthalmology, University Hospital of Udine, p.le SM Misericordia, Udine 33100, Italy. markzeppieri@hotmail.com
Received: August 17, 2022
Peer-review started: August 17, 2022
First decision: September 2, 2022
Revised: September 7, 2022
Accepted: October 12, 2022
Article in press: October 12, 2022
Published online: November 25, 2022
Abstract

Coronavirus disease has spread worldwide since 2019, causing important pandemic issues and various social health problems to date. Little is known about the origin of this virus and the effects it has on extra-pulmonary organs. The different mechanisms of the virus and the influence it has on humans are still being studied, with hopes of finding a cure for the disease and the pathologies associated with the infection. Liver damage caused by coronavirus disease 2019 (COVID-19) is sometimes underestimated and has been of important clinical interest in the past few years. Hepatic dysfunctions can manifest in different forms which can sometimes be mild and without specific signs and symptoms or be severe with important clinical implications. There are several studies that have tried to explain the mechanism of entry (hepatotropism) of the virus into hepatocytes and the effects the virus has on this important organ. What clearly emerges from the current literature is that hepatic injury represents an important clinical aspect in the management of patients infected with COVID-19, especially in frail patients and those with comorbidities. The aim of our brief overview is to summarize the current literature regarding the forms of hepatic damage, complications, mechanisms of pathology, clinical features of liver injury, influence of comorbidities and clinical management in patients with COVID-19 infection.

Keywords: COVID-19, SARS-CoV-2, Hepatotropism, Hepatic injury, Cirrhosis, Cytokine storm, Angiotensin-converting enzyme 2

Core Tip: Liver damage can occur in patients infected by coronavirus disease 2019 (COVID-19). The organ damage can be due to various mechanisms such as direct infection, immune injury, drug-induced damage, hypoxia or inflammation response. It is of clinical importance to manage hepatic damage in COVID-19-positive patients. Patient outcomes, the success of therapy, prevention of life-threatening complications and management of existing comorbidities depend on proper organ functioning.