Coronavirus Disease-19 and Liver Injury

Gontar Alamsyah Siregar; Ginanda Putra Siregar; Darmadi Darmadi; Riska Habriel Ruslie

doi:10.3889/oamjms.2020.5028

Authors

Gontar Alamsyah Siregar Department of Internal Medicine, Division of Gastroenterohepatology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Ginanda Putra Siregar Department of Surgery, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Darmadi Darmadi Department of Internal Medicine, Division of Gastroenterohepatology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia
Riska Habriel Ruslie Department of Child Health, Faculty of Medicine, Universitas Prima Indonesia, Medan, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2020.5028

Keywords:

COVID-19, liver, SARS-CoV-2

Abstract

Coronavirus Disease (COVID)-19 is a pandemic since March 11, 2020. The total case is more than a half million worldwide. Liver injury is quite common in COVID-19 patients. Direct viral infection is possible due to the presence of angiotensin converting enzyme 2 in cholangiocytes and hepatocytes. Other proposed mechanisms are virus-induced cytopathic effects, inflammation process, hypoxia and shock, increased apoptotic activity, increased positive end expiratory effect, and drug-induced. The manifestation of liver injury is mild and transient with elevated liver enzymes, bilirubin, and gamma-glutamyl transferase levels. Deterioration of liver function can occur in subjects with COVID-19 and underlying liver injury. The management is principally supportive. Hepatoprotective drugs may be administered in severe cases.

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