Characteristics and Mechanism of Liver Injury in 2019 Coronavirus Disease

Li, Jie; Fan, Jian-Gao

In December 2019, a novel coronavirus (2019-nCoV), named as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was discovered in Wuhan, Hubei Province, China. [1] [2] [3] The SARS-CoV-2 infection and related coronavirus disease 2019 (COVID- 19) , has aroused great concern worldwide. The global outbreak of this disease is significantly bigger than the prior pandemic of SARS and Middle East respiratory syndrome (MERS). Within 3 months, SARS-CoV-2 spread rapidly from Wuhan city to the entire country of China, and then into more than 120 countries worldwide. Up to March 14, 2020, a total of 81,021 cases of COVID-19 with 3194 deaths in China and 63,016 cases with 2212 deaths outside of China have been confirmed. Unfortunately, the global numbers of both infected patients and fatalities will continue to grow in the future months because no specific effective antiviral therapies nor vaccine have been identified. 4 With the number of cases increasing in China, abnormal liver function test results have been observed in some patients with COVID-19, making this organ the most frequently damaged outside of the respiratory system. [5] [6] [7] However, the clinical characteristics and outcomes of Chinese patients with COVID-19 might be changing with time, and the clinical-pathological manifestations and mechanism of the liver injury in COVID-19 remain largely unclear. 8 This review will summarize these important issues based on the recent developments in the field, for optimizing the management and treatment of COVID-19 patients with liver injury.