Cytokine-induced liver injury in coronavirus disease-2019 (COVID-19): untangling the knots

Prajna Anirvan; Sonali Narain; Negin Hajizadeh; Fuad Z Aloor; Shivaram P Singh; Sanjaya K Satapathy

doi:10.1097/MEG.0000000000002034

Cytokine-induced liver injury in coronavirus disease-2019 (COVID-19): untangling the knots

Eur J Gastroenterol Hepatol. 2021 Dec 1;33(1S Suppl 1):e42-e49. doi: 10.1097/MEG.0000000000002034.

Authors

Prajna Anirvan¹, Sonali Narain^{2

3}, Negin Hajizadeh^{3

4

5}, Fuad Z Aloor³, Shivaram P Singh¹, Sanjaya K Satapathy⁶

Affiliations

¹ Department of Gastroenterology, S.C.B. Medical College, Cuttack, India.
² Department of Medicine, Division of Rheumatology, Northwell Health, Manhasset.
³ Department of Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead.
⁴ Department of Information Services, Institute of Health, Innovations and Outcomes Research, Feinstein Institutes for Medical Research, Northwell Health, New Hyde Park.
⁵ Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine, Northwell Health, Manhasset, New York, USA.
⁶ Division of Hepatology at Sandra Atlas Bass Centre for Liver Diseases and Transplantation, Barbara and Zucker School of Medicine/Northwell Health, Manhasset, New York, USA.

PMID: 33405427
DOI: 10.1097/MEG.0000000000002034

Abstract

Liver dysfunction manifesting as elevated aminotransferase levels has been a common feature of coronavirus disease-2019 (COVID-19) infection. The mechanism of liver injury in COVID-19 infection is unclear. However, it has been hypothesized to be a result of direct cytopathic effects of the virus, immune dysfunction and cytokine storm-related multiorgan damage, hypoxia-reperfusion injury and idiosyncratic drug-induced liver injury due to medications used in the management of COVID-19. The favored hypothesis regarding the pathophysiology of liver injury in the setting of COVID-19 is cytokine storm, an aberrant and unabated inflammatory response leading to hyperproduction of cytokines. In the current review, we have summarized the potential pathophysiologic mechanisms of cytokine-induced liver injury based on the reported literature.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

COVID-19* / complications
Cytokine Release Syndrome* / complications
Cytokine Release Syndrome* / virology
Cytokines
Humans
Liver Diseases / virology*

Substances

Cytokines