Systematic Reviews
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2023; 29(6): 1109-1122
Published online Feb 14, 2023. doi: 10.3748/wjg.v29.i6.1109
Relation of COVID-19 with liver diseases and their impact on healthcare systems: The Portuguese case
Sara Fernandes, Milaydis Sosa-Napolskij, Graça Lobo, Isabel Silva
Sara Fernandes, Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto (ICBAS-UP), Porto 4050-313, Portugal
Milaydis Sosa-Napolskij, CINTESIS@RISE, Center for Health Technology and Services Research at The Associate Laboratory RISE–Health Research Network, Faculty of Medicine of The University of Porto, Porto 4200-219, Portugal
Graça Lobo, Isabel Silva, Laboratory of Pharmacology and Neurobiology–Department of Immuno-physiology and Pharmacology, Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto (ICBAS-UP), Porto 4050-313, Portugal
Graça Lobo, Isabel Silva, Center for Drug Discovery and Innovative Medicines (MedInUP), Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto (ICBAS-UP), Porto 4050-313, Portugal
Author contributions: Fernandes S and Sosa-Napolskij M contributed equally to this work; Fernandes S, Sosa-Napolskij M, Lobo G, and Silva I designed the research study, performed the research, analyzed the data, and wrote the manuscript; 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.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: Isabel Silva, Doctor, PhD, Researcher, Laboratory of Pharmacology and Neurobiology–Department of Immuno-physiology and Pharmacology, Instituto de Ciências Biomédicas Abel Salazar da Universidade do Porto (ICBAS-UP), Rua Jorge Viterbo Ferreira, nº228, Porto 4050-313, Portugal. isabel.silva@ibmc.up.pt
Received: September 13, 2022
Peer-review started: September 13, 2022
First decision: November 5, 2022
Revised: November 18, 2022
Accepted: December 30, 2022
Article in press: December 30, 2022
Published online: February 14, 2023
Processing time: 149 Days and 12.6 Hours
Abstract
BACKGROUND

The impact caused by the coronavirus disease 2019 (COVID-19) on the Portuguese population has been addressed in areas such as clinical manifestations, frequent comorbidities, and alterations in consumption habits. However, comorbidities like liver conditions and changes concerning the Portuguese population's access to healthcare-related services have received less attention.

AIM

To (1) Review the impact of COVID-19 on the healthcare system; (2) examine the relationship between liver diseases and COVID-19 in infected individuals; and (3) investigate the situation in the Portuguese population concerning these topics.

METHODS

For our purposes, we conducted a literature review using specific keywords.

RESULTS

COVID-19 is frequently associated with liver damage. However, liver injury in COVID-19 individuals is a multifactor-mediated effect. Therefore, it remains unclear whether changes in liver laboratory tests are associated with a worse prognosis in Portuguese individuals with COVID-19.

CONCLUSION

COVID-19 has impacted healthcare systems in Portugal and other countries; the combination of COVID-19 with liver injury is common. Previous liver damage may represent a risk factor that worsens the prognosis in individuals with COVID-19.

Keywords: COVID-19; Healthcare systems; Liver; Portuguese individuals; Comorbidities; Clinical outcomes

Core Tip: This review analyzes how the coronavirus disease 2019 (COVID-19) affects health care and clinical practice in Portugal and the possible causes of liver injury in COVID-19 individuals, including the direct effect of severe acute respiratory syndrome coronavirus 2 on the liver and drug-induced liver injury, and how preexisting liver diseases affect the treatment of COVID-19.