COVID-19 and Liver Disease: An Evolving Landscape

Semin Liver Dis. 2023 Aug;43(3):351-366. doi: 10.1055/a-2157-3318. Epub 2023 Aug 21.

Abstract

The COVID-19 pandemic has resulted in significant worldwide morbidity and mortality. In this review, we examine the intricate relationships between COVID-19 and liver diseases. While respiratory manifestations of COVID-19 are well known, its impact and consequences in patients with liver diseases remain an area of ongoing investigation. COVID-19 can induce liver injury through various mechanisms and is associated with higher mortality in individuals with preexisting chronic liver disease. Mortality increases with the severity of chronic liver disease and the level of care required. The outcomes in patients with autoimmune hepatitis remain unclear, whereas liver transplant recipients are more likely to experience symptomatic COVID-19 but have comparable outcomes to the general population. Despite suboptimal immunological response, COVID-19 vaccinations are safe and effective in liver disease, although cases of autoimmune hepatitis-like syndrome have been reported. In conclusion, COVID-19 has significant implications in liver diseases; early recognition and treatments are important for improving patient outcomes.

Publication types

  • Review

MeSH terms

  • COVID-19*
  • Hepatitis, Autoimmune*
  • Humans
  • Liver Diseases* / complications
  • Liver Diseases* / therapy
  • Pandemics
  • Syndrome