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COVID-19 / SPECIALTY RESEARCH

HepatologyIn perspective.

The key COVID-19 findings in hepatology, distilled into a clear, readable brief. The evidence is here whenever you want to go deeper.

INSIDE THIS MONITOR
37cited sources
4available findings

Study findings updated

AI-assisted evidence summary. For general information. These findings are not individual medical advice or a clinician endorsement.

THE SHORT VERSION

What’s worth knowing.

The key findings, what they mean, and the context that matters.

THE HEADLINE TAKEAWAY25-30%

Liver enzyme abnormalities occurred in 25-30% of hospitalized COVID-19 patients

The estimate was 25-30% among hospitalized COVID-19 patients, rising to 45-52% in severe cases.

This came from a systematic review with meta-analysis of liver manifestations in COVID-19; definitions and the observation timeframe are not available in this summary.

See the evidence

of hospitalized COVID-19 patients develop liver enzyme abnormalities

25-30%

Kulkarni AV, Kumar P, Sharma M, et al. Systematic review with meta-analysis: liver manifestations and outcomes in COVID-19. Alimentary Pharmacology & Therapeutics. 2020;52(4):584-599.

Study-specific findings. Different populations, treatments and follow-up periods can produce different results.

THE RESEARCH, AS IT ARRIVES

Latest studies.

The newest findings added to this collection.
The learning from each, already distilled.

Study summaries are not available in this collection yet. The original evidence remains accessible in each monitor.

Dates show when findings were added here, not when papers were published. Study populations and comparisons differ.

WHEN YOU WANT TO GO DEEPER
See all 4 findingsOriginal results, comparisons and study details.
3 of 3 source groupsFindings stay together with their study.
SOURCE 012 findings

Kulkarni AV, Kumar P, Sharma M, et al. Systematic review with meta-analysis: liver manifestations and outcomes in COVID-19. Alimentary Pharmacology & Therapeutics. 2020;52(4):584-599.

Elevated AST

29.1%Prevalence (95% CI: 24.5-33.9%)Source [1]

Severe Disease Liver Injury

3.21xOR 3.21 (95% CI: 2.36-4.37)Source [1]
SOURCE 051 finding

Pan L, Huang P, Xie X, et al. Metabolic-associated fatty liver disease increases the severity of COVID-19: A meta-analysis. Hepatology International. 2021;15:1-10.

MAFLD Severe COVID Risk

2.15xOR 2.15 (95% CI: 1.58-2.93)Source [5]
SOURCE 071 finding

Marjot T, Moon AM, Cook JA, et al. Outcomes following SARS-CoV-2 infection in patients with chronic liver disease: An international registry study. Journal of Hepatology. 2021;74(3):567-577.

Cirrhosis Mortality

2.48xOR 2.48 (95% CI: 1.78-3.47)Source [7]
Browse the 37 original sourcesThe complete bibliography behind this monitor.
  1. [1]

    Kulkarni AV, Kumar P, Sharma M, et al. Systematic review with meta-analysis: liver manifestations and outcomes in COVID-19. Alimentary Pharmacology & Therapeutics. 2020;52(4):584-599.

    Open original source in a new tab
  2. [2]

    Sultan S, Altayar O, Siddique SM, et al. AGA Institute Rapid Review of the GI and Liver Manifestations of COVID-19. Gastroenterology. 2020;159(1):320-334.e27.

    Open original source in a new tab
  3. [3]

    Mao R, Qiu Y, He JS, et al. Manifestations and prognosis of gastrointestinal and liver involvement in patients with COVID-19. Lancet Gastroenterology & Hepatology. 2020;5(7):667-678.

    Open original source in a new tab
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    Singh S, Khan A. Clinical Characteristics and Outcomes of Coronavirus Disease 2019 Among Patients With Preexisting Liver Disease. Gastroenterology. 2020;159(2):768-771.e3.

    Open original source in a new tab
  5. [5]

    Pan L, Huang P, Xie X, et al. Metabolic-associated fatty liver disease increases the severity of COVID-19: A meta-analysis. Hepatology International. 2021;15:1-10.

    Open original source in a new tab
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    Wu J, Song S, Cao HC, et al. Liver diseases in COVID-19: Etiology, treatment and prognosis. World Journal of Gastroenterology. 2020;26(19):2286-2293.

    Open original source in a new tab
  7. [7]

    Marjot T, Moon AM, Cook JA, et al. Outcomes following SARS-CoV-2 infection in patients with chronic liver disease: An international registry study. Journal of Hepatology. 2021;74(3):567-577.

    Open original source in a new tab
  8. [8]

    Iavarone M, D'Ambrosio R, Soria A, et al. High rates of 30-day mortality in patients with cirrhosis and COVID-19. Journal of Hepatology. 2020;73(5):1063-1071.

    Open original source in a new tab
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    Kim D, Adeniji N, Latt N, et al. Predictors of Outcomes of COVID-19 in Patients With Chronic Liver Disease. Clinical Gastroenterology and Hepatology. 2021;19(7):1469-1479.e19.

    Open original source in a new tab
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    Zhou YJ, Zheng KI, Wang XB, et al. Metabolic-associated fatty liver disease is associated with severity of COVID-19. Liver International. 2020;40(9):2160-2163.

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    Roca-Fernandez A, Wamber-Thompson A, Sherwood S, et al. Liver Disease in Patients with COVID-19 in the UK Biobank. Lancet Gastroenterology & Hepatology. 2022;7(10):920-930.

    Original source link unavailable
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    Beigel JH, Tomashek KM, Dodd LE, et al. Remdesivir for the Treatment of Covid-19 - Final Report. New England Journal of Medicine. 2020;383(19):1813-1826.

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    Spinner CD, Gottlieb RL, Criner GJ, et al. Effect of Remdesivir vs Standard Care on Clinical Status at 11 Days. JAMA. 2020;324(11):1048-1057.

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    RECOVERY Collaborative Group. Tocilizumab in patients admitted to hospital with COVID-19 (RECOVERY). Lancet. 2021;397(10285):1637-1645.

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    Hammond J, Leister-Tebbe H, Gardner A, et al. Oral Nirmatrelvir for High-Risk, Nonhospitalized Adults with Covid-19. New England Journal of Medicine. 2022;386(15):1397-1408.

    Open original source in a new tab
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    RECOVERY Collaborative Group. Dexamethasone in Hospitalized Patients with Covid-19. New England Journal of Medicine. 2021;384(8):693-704.

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    Chai X, Hu L, Zhang Y, et al. Specific ACE2 Expression in Cholangiocytes May Cause Liver Damage After 2019-nCoV Infection. bioRxiv. 2020.

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    Sonzogni A, Previtali G, Seghezzi M, et al. Liver histopathology in severe COVID 19 respiratory failure. Liver International. 2020;40(9):2110-2116.

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    Lagana SM, Kudose S, Iuga AC, et al. Hepatic pathology in patients dying of COVID-19. Modern Pathology. 2020;33(11):2147-2155.

    Open original source in a new tab
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    Wang Y, Liu S, Liu H, et al. SARS-CoV-2 infection of the liver directly contributes to hepatic impairment. Journal of Hepatology. 2020;73(4):807-816.

    Open original source in a new tab
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    Yeoh YK, Zuo T, Lui GC, et al. Gut microbiota composition reflects disease severity in COVID-19. Gut. 2021;70(4):698-706.

    Open original source in a new tab
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    Zuo T, Zhang F, Lui GCY, et al. Alterations in Gut Microbiota of Patients With COVID-19 During Hospitalization. Gastroenterology. 2020;159(3):944-955.e8.

    Open original source in a new tab
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    Giron LB, Dweep H, Yin X, et al. Plasma Markers of Disrupted Gut Permeability in Severe COVID-19 Patients. Frontiers in Immunology. 2021;12:686240.

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    Brevini T, Maber M, Reiff C, et al. FXR inhibition may protect from SARS-CoV-2 infection by reducing ACE2. Nature. 2023;615:134-142.

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    Effenberger M, Grabherr F, Mayr L, et al. Faecal calprotectin indicates intestinal inflammation in COVID-19. Gut. 2020;69(8):1543-1544.

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    Valla DC, Cazals-Hatem D. Vascular liver diseases in the intensive care unit. Liver International. 2021;41 Suppl 1:41-50.

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    La Mura V, Artru F, Leiria N, et al. COVID-19 in patients with cirrhosis: Impact on portal hypertension complications. Hepatology. 2021;74(3):1234-1244.

    Original source link unavailable
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    Gupta S, Ahuja N, Mohanty S, et al. Splanchnic vein thrombosis in COVID-19: Clinical presentation and outcomes. Clinical Gastroenterology and Hepatology. 2021;19(11):2398-2400.

    Original source link unavailable
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    Bakasis AD, Bitzogli K, Mouziouras D, et al. Efficacy and Safety of COVID-19 Vaccines in Patients with Liver Disease. Vaccines. 2022;10(4):564.

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    Rabinowich L, Gruber R, Benmati N, et al. Low immunogenicity to SARS-CoV-2 vaccination among liver transplant recipients. Journal of Hepatology. 2021;75(2):435-438.

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  31. [31]

    European Association for the Study of the Liver (EASL). EASL position paper on the use of COVID-19 vaccines in patients with chronic liver diseases. Journal of Hepatology. 2021;74(4):944-951.

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    American Association for the Study of Liver Diseases (AASLD). Clinical insights for hepatology and liver transplant providers during the COVID-19 pandemic. 2020-2023.

    Original source link unavailable
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    Marjot T, Webb GJ, Barritt AS 4th, et al. COVID-19 and liver disease: mechanistic and clinical perspectives. Nature Reviews Gastroenterology & Hepatology. 2021;18(5):348-364.

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    Bowe B, Xie Y, Al-Aly Z. Acute and postacute sequelae associated with SARS-CoV-2 reinfection. Nature Medicine. 2022;28(11):2398-2405.

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    Al-Aly Z, Xie Y, Bowe B. High-dimensional characterization of post-acute sequelae of COVID-19. Nature. 2021;594(7862):259-264.

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  36. [36]

    SECURE-Cirrhosis (Surveillance Epidemiology of Coronavirus Under Research Exclusion). International registry reporting outcomes in patients with cirrhosis and COVID-19. 2020-2024.

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    COVID-Hep.net. International registry for COVID-19 in patients with pre-existing liver disease. 2020-2024.

    Open original source in a new tab
ABOUT THIS MONITOR

Understanding includes the limits.

This is an AI-assisted evidence summary, not a clinician endorsement. Read each original paper for its complete methods, population and limitations. Different studies can ask different questions and report different kinds of results.

Dates marked “added” describe when a finding entered this monitor, not when the study was published or clinically reviewed. Personal health and treatment decisions belong in a conversation with a qualified clinician.

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