COVID-19 combined with liver injury: Current challenges and management

Abstract

Coronavirus disease 2019 (COVID-19) combined with liver injury has become a very prominent clinical problem. Due to the lack of a clear definition of liver injury in patients with COVID-19, the different selection of evaluation parameters and statistical time points, there are the conflicting conclusions about the incidence rate in different studies. The mechanism of COVID-19 combined with liver injury is complicated, including the direct injury of liver cells caused by severe acute respiratory syndrome coronavirus 2 replication and liver injury caused by cytokines, ischemia and hypoxia, and drugs. In addition, underlying diseases, especially chronic liver disease, can aggravate COVID-19 liver injury. In the treatment of COVID-19 combined with liver injury, the primary and basic treatment is to treat the etiology and pathogenesis, followed by support, liver protection, and symptomatic treatment according to the clinical classification and severity of liver injury. This article evaluates the incidence, pathogenesis and prevention and treatment of COVID-19 combined with liver injury, and aims to provide countermeasures for the prevention and treatment of COVID-19 combined with liver injury.

Keywords: SARS-CoV-2; COVID-19; Liver function; Liver injury; Pathogenesis; Treatment

Core Tip: The prevention and treatment of coronavirus disease 2019 (COVID-19) combined with liver injury face many challenges. First, the definition of COVID-19 combined with liver injury is not clear, the selected parameters and the time of statistics are inconsistent, and the conclusions about the incidence rate are consistent. Second, the etiology and mechanism of COVID-19 combined liver injury are not clear and need to be studied in depth. Third, there is a lack of effective treatment methods. This article provides and additional view of the incidence of COVID-19-associated liver injury and explores the contemporary management modalities.