Tweet
J Clin Gastroenterol
. 2020 Sep 23.
doi: 10.1097/MCG.0000000000001432. Online ahead of print.
Hepatic Injury in Patients With COVID-19
Ravina Kullar 1 , Ankur P Patel 2 , Sammy Saab 1 2
Affiliations
- PMID: 32976196
- DOI: 10.1097/MCG.0000000000001432
Abstract
Background: Coronavirus disease 2019 (COVID-19) has infected over 2 million people worldwide over the course of just several months. Various studies have highlighted that patients infected with COVID-19 may develop various degrees of liver injury. Here, we discuss the impact of underlying liver disease and manifestations of hepatic injury with COVID-19. We also review mechanisms of hepatic injury.
Methods: We searched the database PubMed for all studies focused on hepatic injury in COVID-19.
Results: We identified 13 studies that assessed the impact of underlying liver disease in patients infected with COVID-19 (N=3046). Underlying liver disease was one of the most common known comorbid categories in patients infected with COVID-19. Overall, 25% of the patients identified from the 13 studies had hepatic injury. Twenty-one percent and 24% had elevated alanine transaminase and aspartate transaminase values, respectively. Nine percent of the patients had elevated total bilirubin values. Ten of the 13 studies assessed COVID-19 acuity with severity of hepatic injury. In 9 of the 10 studies, clinical outcomes were worse with hepatic injury.
Conclusions: Liver injury is highly prevalent in patients that present with COVID-19. Since the liver is one of the most affected organs outside of the respiratory system in COVID-19, more intensive surveillance is warranted for severe cases, particularly among those with pre-existing advanced liver disease.