Hepatic Medicine: Evidence and Research

Covid-19 and the liver

This Thematic Series examines the long association of liver damage with COVID-19. Research has attributed several factors responsible for this damage; including a direct cytopathic attack from SARS-CoV-2, acute inflammatory damage, drug toxicity associated with therapy and severe hypoxia related to the pneumonia. Numerous mechanisms have been associated with the cytopathic effect, and much more is yet to be understood. The virus is present on the surface of endothelial cells and hepatocytes as well as cholangiocytes and the hyper-inflammatory reaction suggestive of HLH (hemophagocytic lymphohistiocytosis) has been associated with liver failure. Endothelial damage and coagulation dysfunction could trigger liver damage, and evidence shows that drugs used in the treatment of Covid have hepatotoxic potential.