Liver injury in COVID – 19: literature review

Roberta Buginytė1, Deimantė Bajoriūnaitė1, Viktorija Kenstavičiūtė1

1Lithuanian University of Health Sciences, Academy of Medicine, Kaunas, Lithuania


Background: In 2020 March the World Health organization (WHO) declared the COVID – 19 as pandemic. This disease is caused by the SARS-CoV-2 virus, which belongs to the Coronaviriadae virus family. Upon infection the SARS-CoV- 2 virus binds to the receptors of specific angiotensin-converting enzyme 2 (ACE2). Because ACE2 receptors have a wide expression COVID-19 can manifest in various levels of severity. In most cases the virus damages the upper and the lower airways, however information about possible liver injury is increasing.

Aim: to evaluate the possible liver injury mechanisms, symptoms, laboratory tests changes, the influence of patient injuries to survivability as well as the possibilities of treatment and liver injury preventions in patients with COVID-19.

Methods: review of literature was conducted using the PubMed, Cochrane, UpToDate and Medline electronic databases. Randomized trial studies published in English between 2020 and 2021 were selected for the analysis. Search of literature was conducted using predetermined keywords. More than 30 publications were analyzed related to COVID-19 caused liver injury.

Results: hepatic injury may be caused to healthy patients and to patients with chronic hepatic diseases alike. Most common laboratory findings are an increase of alanine transaminase (ALT) and aspartate transaminase (AST) enzymes, which is related to the severity of disease. Because of the worse outcomes of COVID-19, patients with liver injury must be diagnosed early and get appropriate treatment.

Keywords: COVID-19, liver injury, SARS-CoV-2, hepatoprotection, liver protection.