{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T09:47:03Z","timestamp":1790416023020,"version":"4.1.0"},"reference-count":141,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T00:00:00Z","timestamp":1594166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Aliment Pharmacol Ther"],"published-print":{"date-parts":[[2020,8]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The incidence of elevated liver chemistries and the presence of pre\u2010existing chronic liver disease (CLD) have been variably reported in COVID\u201019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess the prevalence of CLD, the incidence of elevated liver chemistries and the outcomes of patients with and without underlying CLD\/elevated liver chemistries in COVID\u201019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A comprehensive search of electronic databases from 1 December 2019 to 24 April 2020 was done. We included studies reporting underlying CLD or elevated liver chemistries and patient outcomes in COVID\u201019.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      107 articles (n\u00a0=\u00a020\u00a0874 patients) were included for the systematic review. The pooled prevalence of underlying CLD was 3.6% (95% CI, 2.5\u20105.1) among the 15\u00a0407 COVID\u201019 patients. The pooled incidence of elevated liver chemistries in COVID\u201019 was 23.1% (19.3\u201027.3) at initial presentation. Additionally, 24.4% (13.5\u201040) developed elevated liver chemistries during the illness. The pooled incidence of drug\u2010induced liver injury was 25.4% (14.2\u201041.4). The pooled prevalence of CLD among 1587 severely infected patients was 3.9% (3%\u20105.2%). The odds of developing severe COVID\u201019 in CLD patients was 0.81 (0.31\u20102.09;\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a00.67) compared to non\u2010CLD patients. COVID\u201019 patients with elevated liver chemistries had increased risk of mortality (OR\u20103.46 [2.42\u20104.95,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001]) and severe disease (OR\u20102.87 [95% CI, 2.29\u20103.6,\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a00.001]) compared to patients without elevated liver chemistries.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Elevated liver chemistries are common at presentation and during COVID\u201019. The severity of elevated liver chemistries correlates with the outcome of COVID\u201019. The presence of CLD does not alter the outcome of COVID\u201019. Further studies are needed to analyse the outcomes of compensated and decompensated liver disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/apt.15916","type":"journal-article","created":{"date-parts":[[2020,7,8]],"date-time":"2020-07-08T04:37:14Z","timestamp":1594183034000},"page":"584-599","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":210,"title":["Systematic review with meta\u2010analysis: liver manifestations and outcomes in COVID\u201019"],"prefix":"10.1111","volume":"52","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1240-1675","authenticated-orcid":false,"given":"Anand V.","family":"Kulkarni","sequence":"first","affiliation":[{"name":"Department of Hepatology Asian Institute of Gastroenterology Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pramod","family":"Kumar","sequence":"additional","affiliation":[{"name":"Department of Hepatology Asian Institute of Gastroenterology Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harsh Vardhan","family":"Tevethia","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Asian Institute of Gastroenterology Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2961-4148","authenticated-orcid":false,"given":"Madhumita","family":"Premkumar","sequence":"additional","affiliation":[{"name":"Department of Hepatology PGIMER Chandigarh India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan Pablo","family":"Arab","sequence":"additional","affiliation":[{"name":"Departamento de Gastroenterologia Escuela de Medicina Pontificia Universidad Catolica de Chile Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberto","family":"Candia","sequence":"additional","affiliation":[{"name":"Departamento de Gastroenterologia Escuela de Medicina Pontificia Universidad Catolica de Chile Santiago Chile"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rupjyoti","family":"Talukdar","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Asian Institute of Gastroenterology Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mithun","family":"Sharma","sequence":"additional","affiliation":[{"name":"Department of Hepatology Asian Institute of Gastroenterology Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3559-5855","authenticated-orcid":false,"given":"Xiaolong","family":"Qi","sequence":"additional","affiliation":[{"name":"CHESS Center Institute of Portal Hypertension The First Hospital of Lanzhou University Lanzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Padaki Nagaraja","family":"Rao","sequence":"additional","affiliation":[{"name":"Department of Hepatology Asian Institute of Gastroenterology Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duvvuru Nageshwar","family":"Reddy","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Asian Institute of Gastroenterology Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,8]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijid.2020.03.017"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2020.03.005"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.03.024"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.14465"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2020.04.021"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.283.15.2008"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2020.04.006"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000000819"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201908-1581ST"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-011458"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2015.07.010"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5928"},{"key":"e_1_2_7_14_1","unstructured":"WellsGA SheaB O'connellD et al.The Newcastle\u2010Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta\u2010analyses.2013.http:\/\/www.ohri.ca\/programs\/clinical_epidemiology\/oxford.asp. 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