COVID-19 and the Liver: A 2021 Update

Catherine W. Spearman; Alessio Aghemo; Luca Valenti; Mark W. Sonderup

Disclosures

Liver International. 2021;41(9):1988-1998. 

In This Article

Abstract and Introduction

Abstract

In December 2019, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified in Wuhan, China and has since resulted in a global pandemic in excess of 165 million reported infections and 3.4 million attributable deaths. COVID-19 is primarily a respiratory illness, which may be complicated by pneumonia and acute respiratory distress syndrome. SARS-CoV-2 is also responsible for numerous extrapulmonary manifestations involving the haematologic, cardiovascular, renal, gastrointestinal and hepatobiliary, endocrinologic, neurologic, ophthalmologic and dermatologic systems. This review will discuss the pathophysiology of COVID-19; focusing on the mechanisms and outcomes of liver injury associated with COVID-19; its impact on chronic liver disease (CLD); management of CLD during the COVID-19 pandemic and the long-term impact of COVID-19 on CLD.

Introduction

In December 2019, a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was identified in Wuhan, China.[1] Its genomic sequence is 79.6% homologous with human SARS-CoV and is responsible for the now-known coronavirus disease 2019 or COVID-19.[2] Globally, to date, excess of 165 million people have been infected with 3.4 million attributable deaths, and the incidence continues to increase.[3]

COVID-19 is primarily a respiratory illness that may be complicated by pneumonia and acute respiratory distress syndrome (ARDS). However, the disease has also several extra-pulmonary manifestations involving the haematological, cardiovascular, renal, gastrointestinal and hepatobiliary, endocrine, neurological, ophthalmological and dermatological systems.[4] Here, we shortly review the pathophysiology of COVID-19, with a special focus on the mechanisms and outcomes of liver injury and its potential impact on CLD. Furthermore, we discuss chronic CLD management during the COVID-19 pandemic and the long-term impact of COVID-19 on CLD.

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