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World J Gastroenterol. Aug 28, 2020; 26(32): 4753-4762
Published online Aug 28, 2020. doi: 10.3748/wjg.v26.i32.4753
Etiology and management of liver injury in patients with COVID-19
Rui-Xu Yang, Rui-Dan Zheng, Jian-Gao Fan
Rui-Xu Yang, Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China
Rui-Dan Zheng, Diagnosis and Treatment Center for Liver Diseases, Zhengxing Hospital, Zhangzhou 363000, Fujian Province, China
Jian-Gao Fan, Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, Shanghai 200092, China
Author contributions: Yang RX wrote the paper; Zheng RD contributed to the preparation of the tables and figure; and Fan JG critically revised the manuscript.
Supported by the National Key Research and Development Program, No. 2017YFC0908903; National Natural Science Foundation of China, No. 81873565 and No. 81900507; and Hospital Funded Clinical Research, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, No. 17CSK04.
Conflict-of-interest statement: The authors declare no 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: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jian-Gao Fan, MD, PhD, Chief Doctor, Professor, Center for Fatty Liver, Department of Gastroenterology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai Key Lab of Pediatric Gastroenterology and Nutrition, No. 1665 Kongjiang Road, Shanghai 200092, China. fanjiangao@xinhuamed.com.cn
Received: May 8, 2020
Peer-review started: May 8, 2020
First decision: May 15, 2020
Revised: May 23, 2020
Accepted: August 12, 2020
Article in press: August 12, 2020
Published online: August 28, 2020
Processing time: 111 Days and 23.6 Hours
Core Tip

Core tip: The pandemic of coronavirus disease 2019 (COVID-19) has aroused a global threat to human health. With the deepening of related research, it was found that in addition to respiratory symptoms, digestive involvements and liver injury were reported in COVID-19. Viral immunologic injury, drug-induced liver injury, secondary liver injury induced by systemic inflammatory response or hypoxia, and the exacerbation of pre-existing liver disease might be the etiologic factors for liver injury in COVID-19. Health workers need to pay attention to the management of pre-existing liver disease, monitor the liver function and strengthen supportive treatment, and reduce the chance of drug-induced liver injury with COVID-19.