Liver Injuries Associated with Coronavirus Disease 2019: View on the Problem

Abstract

Introduction. Major cardiovascular and pulmonary comorbidities, as well as diabetes mellitus and certain cancers, are associated with worse clinical outcomes of coronavirus disease-2019 (COVID-19). Meanwhile, the impact of concomitant liver diseases on the COVID-19 natural course together with the influence of the COVID-19 on the hepatic tissues have been rarely investigated. The aim of the study was to analyse the available data regarding impact of liver pathologies on COVID-19 natural course and outcome, and, reciprocally, hepatic injuries development induced by COVID-19. Materials and methods. Content analysis, systematic and comparative analysis, bibliosemantic method of investigation of current scientific research results on liver damage associated with COVID-19 were used. Results. The potential mechanism of liver injury in COVID-19 is complex and includes direct cytopathic viral injury, proinflammatory cytokine outbreak, hypoxia/reperfusion damage and potential drug induced liver injury. Among the medications used for the treatment of COVID-19 patients, there are certain that could potentially cause drug-induced liver injury. Treatment of liver transplant patients can be challenging taking into consideration the possible necessity of immunosuppressive therapy correction combined with the needs to find a balance between the risk of graft rejection and effective elimination of the virus. Conclusions. Current review of the available database revealed that liver diseases are among substantive comorbidities in COVID-19 patients alongside with liver injuries which are rather frequent complications of COVID-19 treatment. Potential drug-induced liver injuries in patients subjected tocertain antiviral agents in combination with supportive therapy drugs should be taken into consideration. Special precautions are required to prevent potential drug-to-drug interactions in case of COVID-19 treatment in liver transplant patients.