COVID-19 Liver Manifestations. What should we know? A Literature Review.

Background: Coronavirus disease 2019 (COVID-19), caused by the coronavirus of severe acute respiratory syndrome, has become a threat to global health due to the high rates of morbidity and mortality. Predominantly, the infection is related to respiratory symptoms, but gastrointestinal manifestations, including hepatic, have also been reported. Objectives: This literature review addresses the new coronavirus pathogenic mechanism in the liver and its consequences. The repercussions of liver damage are mild to moderate elevations in serum levels of transaminases, gamma-glutamyl transferase, alkaline phosphatase and hypoalbuminemia. Design and Setting: In this literature review we searched PubMed for studies published between March, 2020 and June, 2020. Methods: The search terms included “COVID 19”, “Gastrointestinal”, “Liver”. The eligible studies were those that focused on liver manifestations caused by the new coronavirus and infected patients who already had liver comorbidities. Results: The liver damages result both from the direct virus aggression in the cells, as well as secondary to the patient's evolution and possible pre-existing morbidities, explaining the alterations in liver enzymes. Conclusions: This literature review helps to understand the hepatic involvement, although further studies are needed to elucidate the course and prognosis of the disease. The most severe enzymatic changes are strongly related to a worse prognosis. Therefore, doctors must pay attention to the evolution of the infection.