Correlation of SARS-CoV-2 Infection with Hepatitis and Liver Disorders

The coronavirus infectious disease-2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become a severe global health challenge. The primary target for this virus is the lung. However, SARS-CoV-2 can also attack other organs, including the kidney and liver.  Some COVID-19 case reports demonstrated elevated liver enzymes such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), and total bilirubin. Indeed, higher levels of liver enzymes occur in severe cases compared with mild to moderate cases. The relationship between liver injury and COVID-19 might be due to various possible reasons such as reactivation of pre-existing liver disease, viral replication in hepatic cells causing direct cytotoxicity, liver ischemia and hypoxia, cytokine storm, and drug-induced liver injury (DILI). Thus, hepatitis prevention and care services are necessary during the COVID-19 pandemic. For instance, drugs that might reactivate hepatitis B should not be prescribed for treating COVID-19. Generally, the long-term effects of SARS-CoV-2 on human health and various organs are not well understood. This review briefly discusses the relationship between SARS-CoV-2 and liver injury (hepatitis), coinfection of hepatitis and COVID-19, and SARS-CoV-2 infection in autoimmune hepatitis.