Review
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Meta-Anal. Apr 28, 2021; 9(2): 108-127
Published online Apr 28, 2021. doi: 10.13105/wjma.v9.i2.108
Is COVID-19-induced liver injury different from other RNA viruses?‎
Marwan SM Al-Nimer
Marwan SM Al-Nimer, Department of Clinical Pharmacy, Hawler Medical University, Erbil 44001, Iraq
Marwan SM Al-Nimer, College of Medicine, University of Diyala, Baqubah 32001, Iraq
Author contributions: Al-Nimer MS contributed to the concept, data collection, editing and revision of this manuscript.
Conflict-of-interest statement: Authors declare no conflict 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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Marwan SM Al-Nimer, MBChB, MD, PhD, Academic Research, Doctor, Emeritus Professor, Department of Clinical Pharmacy, Hawler Medical University, Kurdistan Region, Erbil 44001, Iraq. alnimermarwan@ymail.com
Received: January 23, 2021
Peer-review started: January 23, 2021
First decision: February 28, 2021
Revised: March 12, 2021
Accepted: April 23, 2021
Article in press: April 23, 2021
Published online: April 28, 2021
Processing time: 94 Days and 20.6 Hours
Abstract

Coronavirus disease 2019 is a pandemic disease caused by a novel RNA coronavirus, SARS coronavirus 2 (SARS-CoV-2), which is implicated in the respiratory system. SARS-CoV-2 also targets extrapulmonary systems, including the gastrointestinal tract, liver, central nervous system and others. SARS-CoV-2, like other RNA viruses, targets the liver and produces liver injury. This literature review showed that SARS-CoV-2-induced liver injury is different from other RNA viruses by a transient elevation of hepatic enzymes and does not progress to liver fibrosis or other unfavorable events. Moreover, SARS-CoV-2-induced liver injury usually occurs in the presence of risk factors, such as nonalcoholic liver fatty disease. This review highlights the important differences between RNA viruses inducing liver injury taking into consideration the clinical, biochemical, histopathological, postmortem findings and the chronicity of liver injury that ultimately leads to liver fibrosis and hepatocellular carcinoma.

Keywords: Liver injury; COVID-19; RNA-viruses; Risk factors; Liver enzymes; Liver fibrosis

Core Tip: Coronavirus-induced liver injury is rare, and it may be passed without a definite diagnosis. Liver ‎function tests are simple, inexpensive and rapid and can detect acute liver injury, particularly ‎in infected patients who have evidence of comorbidities. This review discusses the differences ‎between RNA virus-induced liver injury focusing on the coronavirus targeting the liver as an ‎extrapulmonary site of infection or as a part of multiple organ dysfunction‎