Liver damage in patients with COVID-19

About authors

1 City Clinical Hospital No. 40 of the Kurortny District, Saint Petersburg, Russia

2 Saint Petersburg State University, St Petersburg, Russia

Correspondence should be addressed: Aleksandr S. Golota
Borisova, 9, lit. B, 197706, Saint Petersburg, Russia; moc.oohay@aatolog

About paper

Author contribution: Golota AS, Kamilova TA — data search and analysis, manuscript writing; Vologzhanin DA, Makarenko SV, Sсherbak SG — manuscript discussion and editing.

Received: 2022-03-14 Accepted: 2022-03-27 Published online: 2022-03-31

The clinical spectrum of SARS-CoV-2 infection continues to expand, raising  important fundamental issues regarding the SARS-CoV-2 cellular tropism and pathogenic mechanisms. Liver damage is observed in patients with all forms of  COVID-19, especially severe and critical forms, which could be due to the direct viral damage, immune dysregulation (systemic inflammatory response and cytokine storm), hypoxia-ischemia, drug-induced hepatotoxicity, and concomitant chronic disorders. Liver damage, defined primarily by elevated transaminase levels, is often observed in patients with COVID-19 and correlates with clinical outcomes, including mortality. Diagnostic criteria, pathogenesis, clinical characteristics, treatment, and prognosis of liver injury in COVID-19 should be clarified in further clinical trials. Currently, there is a critical shortage of proven treatment options for patients with COVID-19, resulting in an urgent need to study the multiple organ failure and liver damage pathogenesis in patients with this disease. The review provides information about the pathophysiological mechanisms of the SARS-CoV-2-induced liver damage and the development of liver failure in COVID-19. Information sources were searched in the PubMed database using the keywords “liver damage in COVID-19” and “immune liver damage in COVID-19”.

Keywords: COVID-19, coronavirus SARS-CoV-2, liver damage, сsystemic hepatotoxicity, immune liver damage, drug-induced hepatotoxicity, concomitant chronic liver disease