Minireviews
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2022; 28(39): 5723-5730
Published online Oct 21, 2022. doi: 10.3748/wjg.v28.i39.5723
SARS-CoV-2-induced liver injury: A review article on the high-risk populations, manifestations, mechanisms, pathological changes, management, and outcomes
Alvin Oliver Payus, Malehah Mohd Noh, Nornazirah Azizan, Raman Muthukaruppan Chettiar
Alvin Oliver Payus, Malehah Mohd Noh, Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Sabah, Malaysia
Nornazirah Azizan, Department of Pathobiology and Medical Diagnostic, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
Raman Muthukaruppan Chettiar, Department of Medicine, Hospital Queen Elizabeth I, 13a, Jalan Penampang, Kota Kinabalu 88200, Malaysia
Author contributions: Payus AO designed the study, prepared the figure, and performed the majority of the writing; Azizan N provided input for the article and contributed to writing; Mohd Noh M and Muthukaruppan Chettiar R were both supervisors and contributed to the final revision of the manuscript; and all authors have read and approved the final 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: Alvin Oliver Payus, MD, MRCP, Senior Lecturer, Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Jalan UMS, Kota Kinabalu 88400, Sabah, Malaysia. dralvinpayus@ums.edu.my
Received: July 16, 2022
Peer-review started: July 16, 2022
First decision: August 19, 2022
Revised: August 24, 2022
Accepted: October 10, 2022
Article in press: October 10, 2022
Published online: October 21, 2022
Processing time: 94 Days and 4.4 Hours
Abstract

The novel coronavirus disease 2019 is an infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and was declared a global pandemic with more than 500 million reported cases and more than 6 million deaths worldwide to date. Although it has transitioned into the endemic phase in many countries, the mortality rate and overall prognosis of the disease are still abysmal and need further improvement. There has been evidence that shows the significance of SARS-CoV-2-related liver injury. Here, we review the literature on the various spectrum of SARS-CoV-2 infection-induced liver injury and the possible mechanisms of damage to the hepatobiliary system. This review aimed to illustrate the latest understanding regarding SARS-CoV-2-induced liver injury including the high-risk populations, the characteristic clinical manifestations, the possible pathogenic mechanism, the pathological changes, the current suggestions for clinical treatment for various spectrum of populations, and the prognosis of the condition. In conclusion, SARS-CoV-2 patients with a liver injury warrant close monitoring as it is associated with the more severe and poorer outcome of the infection.

Keywords: COVID-19; SARS-CoV-2; Pandemic; Liver injury; Pandemics; Prognosis

Core Tip: There are several reviews in the literature that discuss the pathophysiology, management, and outcomes of liver injury in coronavirus disease 2019 (COVID-19). Here, we reviewed the current understanding on various aspects of COVID-19-related liver injury, including the high-risk populations, the characteristic clinical manifestations, the possible pathogenic mechanism, the pathological changes, the current suggestions for clinical treatment for the spectrum of populations, and the prognosis of the condition.