{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T06:57:48Z","timestamp":1784357868021,"version":"3.55.0"},"reference-count":129,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T00:00:00Z","timestamp":1672185600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Ministry of Research and Innovation within PNCDI III, Program 1-Development of the National RD system, Subprogram 1.2-Institutional Performance-RDI excellence funding projects","award":["33PFE\/30.12.2021"],"award-info":[{"award-number":["33PFE\/30.12.2021"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) impacted the world and caused the 2019 coronavirus disease (COVID-19) pandemic. The clinical manifestations of the virus can vary from patient to patient, depending on their respective immune system and comorbidities. SARS-CoV-2 can affect patients through two mechanisms: directly by targeting specific receptors or by systemic mechanisms. We reviewed data in the latest literature in order to discuss and determine the risk of new-onset liver injuries due to COVID-19 in preexisting hepatic conditions. The particular expression of angiotensin-converting enzyme 2 (ACE2) receptors is an additional risk factor for patients with liver disease. COVID-19 causes more severe forms in patients with non-alcoholic fatty liver disease (NAFLD), increases the risk of cirrhosis decompensation, and doubles the mortality for these patients. The coinfection SARS-CoV-2\u2014viral hepatitis B or C might have different outcomes depending on the stage of the liver disease. Furthermore, the immunosuppressant treatment administered for COVID-19 might reactivate the hepatic virus. The high affinity of SARS-CoV-2 spike proteins for cholangiocytes results in a particular type of secondary sclerosing cholangitis. The impact of COVID-19 infection on chronic liver disease patients is significant, especially in cirrhosis, influencing the prognosis and outcome of these patients.<\/jats:p>","DOI":"10.3390\/medicina59010062","type":"journal-article","created":{"date-parts":[[2022,12,28]],"date-time":"2022-12-28T08:38:19Z","timestamp":1672216699000},"page":"62","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Risk of New-Onset Liver Injuries Due to COVID-19 in Preexisting Hepatic Conditions\u2014Review of the Literature"],"prefix":"10.3390","volume":"59","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8787-3829","authenticated-orcid":false,"given":"Sandica","family":"Bucurica","sequence":"first","affiliation":[{"name":"Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Gastroenterology, \u2018Dr. Carol Davila\u2019 Central Military Emergency University Hospital, 010242  Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florentina","family":"Ionita Radu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Gastroenterology, \u2018Dr. Carol Davila\u2019 Central Military Emergency University Hospital, 010242  Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana","family":"Bucurica","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7598-8998","authenticated-orcid":false,"given":"Calin","family":"Socol","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana","family":"Prodan","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Gastroenterology, \u2018Dr. Carol Davila\u2019 Central Military Emergency University Hospital, 010242  Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioana","family":"Tudor","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Gastroenterology, \u2018Dr. Carol Davila\u2019 Central Military Emergency University Hospital, 010242  Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1982-1066","authenticated-orcid":false,"given":"Carmen Adella","family":"Sirbu","sequence":"additional","affiliation":[{"name":"Department of Neurology, \u2018Dr. Carol Davila\u2019 Central Military Emergency University Hospital, 010242 Bucharest, Romania"},{"name":"Centre for Cognitive Research in Neuropsychiatric Pathology (Neuropsy-Cog), Department of Neurology, Faculty of Medicine, \u201cVictor Babe\u0219\u201d University of Medicine and Pharmacy, 300041 Timi\u0219oara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florentina Cristina","family":"Plesa","sequence":"additional","affiliation":[{"name":"Department of Neurology, \u2018Dr. Carol Davila\u2019 Central Military Emergency University Hospital, 010242 Bucharest, Romania"},{"name":"Department of Preclinical Disciplines, Titu Maiorescu University of Medicine, 031593 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariana","family":"Jinga","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania"},{"name":"Department of Gastroenterology, \u2018Dr. Carol Davila\u2019 Central Military Emergency University Hospital, 010242  Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1007\/s42399-020-00363-4","article-title":"Comorbidity and its Impact on Patients with COVID-19","volume":"2","author":"Sanyaolu","year":"2020","journal-title":"SN Compr. Clin. Med."},{"key":"ref_2","unstructured":"(2022, October 09). WHO Coronavirus (COVID-19) Dashboard. Available online: https:\/\/covid19.who.int."},{"key":"ref_3","first-page":"30","article-title":"Clinical and Paraclinical Characteristics of COVID-19 patients: A Systematic Review and Meta-Analysis","volume":"4","author":"Heydari","year":"2022","journal-title":"Tabari Biomed. Stud. Res. J."},{"key":"ref_4","first-page":"237","article-title":"The Interrelationship between Liver Function Test and the Coronavirus Disease 2019: A Systematic Review and Meta-Analysis","volume":"46","author":"Zahedi","year":"2021","journal-title":"Iran. J. Med. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1002\/cld.1061","article-title":"Global Epidemiology of Chronic Liver Disease","volume":"17","author":"Cheemerla","year":"2021","journal-title":"Clin. Liver Dis."},{"key":"ref_6","unstructured":"(2022, October 09). Global Progress Report on HIV, Viral Hepatitis and Sexually Transmitted Infections. Available online: https:\/\/www.who.int\/publications-detail-redirect\/9789240027077."},{"key":"ref_7","unstructured":"Hepatitis, C. (2022, October 09). Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/hepatitis-c."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1111\/j.1365-2036.2011.04724.x","article-title":"Systematic review: The epidemiology and natural history of non-alcoholic fatty liver disease and non-alcoholic steatohepatitis in adults","volume":"34","author":"Vernon","year":"2011","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"m1091","DOI":"10.1136\/bmj.m1091","article-title":"Clinical characteristics of 113 deceased patients with coronavirus disease 2019: Retrospective study","volume":"368","author":"Chen","year":"2020","journal-title":"BMJ"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1007","DOI":"10.1038\/s41379-020-0536-x","article-title":"Pathological study of the 2019 novel coronavirus disease (COVID-19) through postmortem core biopsies","volume":"33","author":"Tian","year":"2020","journal-title":"Mod. Pathol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2407","DOI":"10.1007\/s42399-021-01029-5","article-title":"COVID-19: A Disease with a Potpourri of Histopathologic Findings-a Literature Review and Comparison to the Closely Related SARS and MERS","volume":"3","author":"Malik","year":"2021","journal-title":"SN Compr. Clin. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"320","DOI":"10.1016\/S0140-6736(20)31305-2","article-title":"Histopathology and ultrastructural findings of fatal COVID-19 infections in Washington State: A case series","volume":"396","author":"Bradley","year":"2020","journal-title":"Lancet"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1417","DOI":"10.1016\/S0140-6736(20)30937-5","article-title":"Endothelial cell infection and endotheliitis in COVID-19","volume":"395","author":"Varga","year":"2020","journal-title":"Lancet"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"807","DOI":"10.1016\/j.jhep.2020.05.002","article-title":"SARS-CoV-2 infection of the liver directly contributes to hepatic impairment in patients with COVID-19","volume":"73","author":"Wang","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1726","DOI":"10.1016\/j.cgh.2021.01.044","article-title":"Hepatic Vasculopathy and Regenerative Responses of the Liver in Fatal Cases of COVID-19","volume":"19","author":"Kaltschmidt","year":"2021","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1136\/gutjnl-2021-324280","article-title":"Residual SARS-CoV-2 viral antigens detected in GI and hepatic tissues from five recovered patients with COVID-19","volume":"71","author":"Cheung","year":"2022","journal-title":"Gut"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1016\/j.jhep.2020.08.020","article-title":"COVID-19 can mimic acute cholecystitis and is associated with the presence of viral RNA in the gallbladder wall","volume":"73","author":"Balaphas","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1038\/s41586-021-03570-8","article-title":"COVID-19 tissue atlases reveal SARS-CoV-2 pathology and cellular targets","volume":"595","author":"Delorey","year":"2021","journal-title":"Nature"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"2202","DOI":"10.1172\/JCI137647","article-title":"SARS-CoV-2: A storm is raging","volume":"130","author":"Pedersen","year":"2020","journal-title":"J. Clin. Investig."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.1111\/liv.14500","article-title":"SARS-CoV-2 virus and liver expression of host receptors: Putative mechanisms of liver involvement in COVID-19","volume":"40","author":"Pirola","year":"2020","journal-title":"Liver Int."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1007\/s12041-021-01262-w","article-title":"Contributions of human ACE2 and TMPRSS2 in determining host-pathogen interaction of COVID-19","volume":"100","author":"Senapati","year":"2021","journal-title":"J. Genet."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1038\/s41580-021-00418-x","article-title":"Mechanisms of SARS-CoV-2 entry into cells","volume":"23","author":"Jackson","year":"2022","journal-title":"Nat. Rev. Mol. Cell Biol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1988","DOI":"10.1111\/liv.14984","article-title":"COVID-19 and the liver: A 2021 update","volume":"41","author":"Spearman","year":"2021","journal-title":"Liver Int."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"eabg0833","DOI":"10.1126\/sciimmunol.abg0833","article-title":"SARS-CoV-2 drives JAK1\/2-dependent local complement hyperactivation","volume":"6","author":"Yan","year":"2021","journal-title":"Sci. Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"158","DOI":"10.1016\/j.dld.2020.08.004","article-title":"Systemic inflammation as fuel for acute liver injury in COVID-19","volume":"53","author":"Effenberger","year":"2021","journal-title":"Dig. Liver Dis."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1122","DOI":"10.1126\/science.abm8108","article-title":"The immunology and immunopathology of COVID-19","volume":"375","author":"Merad","year":"2022","journal-title":"Science"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1111\/jvh.13590","article-title":"COVID-19 and the Liver: Lessons Learnt from the EAST and the WEST, A Year Later","volume":"29","author":"Ekpanyapong","year":"2022","journal-title":"J. Viral Hepat."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1491","DOI":"10.1002\/jmv.25973","article-title":"Hepatic involvement in COVID-19 patients: Pathology, pathogenesis, and clinical implications","volume":"92","author":"Li","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1097\/MEG.0000000000001808","article-title":"COVID-19 and the liver: Overview","volume":"33","author":"Amin","year":"2021","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1016\/j.jemermed.2020.04.004","article-title":"Clinical Characteristics of Coronavirus Disease 2019 in China","volume":"58","author":"Eastin","year":"2020","journal-title":"J. Emerg. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"497","DOI":"10.1016\/S0140-6736(20)30183-5","article-title":"Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China","volume":"395","author":"Huang","year":"2020","journal-title":"Lancet"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1239","DOI":"10.1001\/jama.2020.2648","article-title":"Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China: Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention","volume":"323","author":"Wu","year":"2020","journal-title":"JAMA"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2152","DOI":"10.1002\/jmv.26003","article-title":"Hypoalbuminemia predicts the outcome of COVID-19 independent of age and co-morbidity","volume":"92","author":"Huang","year":"2020","journal-title":"J. Med. Virol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2785","DOI":"10.2147\/IJGM.S312521","article-title":"Serum Albumin Levels are a Predictor of COVID-19 Patient Prognosis: Evidence from a Single Cohort in Chongqing, China","volume":"14","author":"Xu","year":"2021","journal-title":"Int. J. Gen. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1207","DOI":"10.1002\/jmv.26542","article-title":"Biochemical rationale for hypoalbuminemia in COVID-19 patients","volume":"93","author":"Ambade","year":"2021","journal-title":"J. Med. Virol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"153","DOI":"10.3389\/fcvm.2020.00153","article-title":"SARS-CoV-2 Bound Human Serum Albumin and Systemic Septic Shock","volume":"7","author":"Johnson","year":"2020","journal-title":"Front. Cardiovasc. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/j.livres.2021.09.001","article-title":"The clinical implication of gamma-glutamyl transpeptidase in COVID-19","volume":"5","author":"Liu","year":"2021","journal-title":"Liver Res."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1002\/hep4.1576","article-title":"Gamma-Glutamyltransferase Elevation Is Frequent in Patients With COVID-19: A Clinical Epidemiologic Study","volume":"4","author":"Shao","year":"2020","journal-title":"Hepatol. Commun."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1857","DOI":"10.2147\/IDR.S356181","article-title":"Changes in Serum Liver Function for Patients with COVID-19: A 1-Year Follow-Up Study","volume":"15","author":"Zhu","year":"2022","journal-title":"Infect. Drug Resist."},{"key":"ref_40","unstructured":"Sharma, A., and Nagalli, S. (2022). Chronic Liver Disease, StatPearls Publishing."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1138","DOI":"10.1002\/hep4.1745","article-title":"Impact of COVID-19 in Liver Disease Progression","volume":"5","author":"Martinez","year":"2021","journal-title":"Hepatol. Commun."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"348","DOI":"10.1038\/s41575-021-00426-4","article-title":"COVID-19 and liver disease: Mechanistic and clinical perspectives","volume":"18","author":"Marjot","year":"2021","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1016\/j.ejim.2020.05.035","article-title":"Hepatic consequences of COVID-19 infection. Lapping or biting?","volume":"77","author":"Portincasa","year":"2020","journal-title":"Eur. J. Intern. Med."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1016\/j.jhep.2020.09.024","article-title":"Outcomes following SARS-CoV-2 infection in patients with chronic liver disease: An international registry study","volume":"74","author":"Marjot","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"705","DOI":"10.1016\/j.jhep.2020.05.013","article-title":"High mortality rates for SARS-CoV-2 infection in patients with pre-existing chronic liver disease and cirrhosis: Preliminary results from an international registry","volume":"73","author":"Moon","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1007\/s12072-020-10072-8","article-title":"APASL COVID Task Force, APASL COVID Liver Injury Spectrum Study (APCOLIS Study-NCT 04345640). Pre-existing liver disease is associated with poor outcome in patients with SARS CoV2 infection; The APCOLIS Study (APASL COVID-19 Liver Injury Spectrum Study)","volume":"14","author":"Sarin","year":"2020","journal-title":"Hepatol. Int."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"531","DOI":"10.1136\/gutjnl-2020-322118","article-title":"Comparison of mortality risk in patients with cirrhosis and COVID-19 compared with patients with cirrhosis alone and COVID-19 alone: Multicentre matched cohort","volume":"70","author":"Bajaj","year":"2021","journal-title":"Gut"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1063","DOI":"10.1016\/j.jhep.2020.06.001","article-title":"High rates of 30-day mortality in patients with cirrhosis and COVID-19","volume":"73","author":"Iavarone","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.1016\/j.cgh.2020.09.027","article-title":"Predictors of Outcomes of COVID-19 in Patients With Chronic Liver Disease: US Multi-center Study","volume":"19","author":"Kim","year":"2021","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1016\/j.jhep.2021.04.052","article-title":"Demosthenes research group Prognosis of French COVID-19 patients with chronic liver disease: A national retrospective cohort study for 2020","volume":"75","author":"Mallet","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Simon, T.G., Hagstr\u00f6m, H., Sharma, R., S\u00f6derling, J., Roelstraete, B., Larsson, E., and Ludvigsson, J.F. (2021). Risk of severe COVID-19 and mortality in patients with established chronic liver disease: A nationwide matched cohort study. BMC Gastroenterol., 21.","DOI":"10.1186\/s12876-021-02017-8"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"E53","DOI":"10.5888\/pcd19.210228","article-title":"COVID-19 Severity and Mortality Among Chronic Liver Disease Patients: A Systematic Review and Meta-Analysis","volume":"19","author":"Nagarajan","year":"2022","journal-title":"Prev. Chronic Dis."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"100350","DOI":"10.1016\/j.aohep.2021.100350","article-title":"Comparison of different prognostic scores for patients with cirrhosis hospitalized with SARS-CoV-2 infection","volume":"25","author":"Mendizabal","year":"2021","journal-title":"Ann. Hepatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1136\/gutjnl-2020-322561","article-title":"COVID-19 in patients with cirrhosis: Understanding adverse impact","volume":"70","author":"Sharma","year":"2021","journal-title":"Gut"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1007\/s12664-020-01074-3","article-title":"Poor outcomes in patients with cirrhosis and Corona Virus Disease-19","volume":"39","author":"Shalimar","year":"2020","journal-title":"Indian J. Gastroenterol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"3137","DOI":"10.1042\/CS20201268","article-title":"ACE2: From protection of liver disease to propagation of COVID-19","volume":"134","author":"Warner","year":"2020","journal-title":"Clin. Sci."},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Chai, X., Hu, L., Zhang, Y., Han, W., Lu, Z., Ke, A., Zhou, J., Shi, G., Fang, N., and Fan, J. (2020). Specific ACE2 Expression in Cholangiocytes May Cause Liver Damage After 2019-nCoV Infection. bioRxiv.","DOI":"10.1101\/2020.02.03.931766"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.14309\/ajg.0000000000000780","article-title":"ACE2: A Linkage for the Interplay Between COVID-19 and Decompensated Cirrhosis","volume":"115","author":"Gao","year":"2020","journal-title":"Am. J. Gastroenterol."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"218","DOI":"10.1007\/s00535-021-01760-9","article-title":"COVID-19-associated liver injury: From bedside to bench","volume":"56","author":"Li","year":"2021","journal-title":"J. Gastroenterol."},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1371","DOI":"10.1053\/j.gastro.2021.08.037","article-title":"COVID-19 and Cirrhosis: A Combination We Must Strive to Prevent","volume":"161","author":"Su","year":"2021","journal-title":"Gastroenterology"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"2350","DOI":"10.1136\/gutjnl-2021-326792","article-title":"COVID-19 and liver disease","volume":"71","author":"Dufour","year":"2022","journal-title":"Gut"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1038\/nrgastro.2009.46","article-title":"Secondary sclerosing cholangitis","volume":"6","author":"Ruemmele","year":"2009","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"2404","DOI":"10.1111\/liv.14971","article-title":"Secondary sclerosing cholangitis as cause of persistent jaundice in patients with severe COVID-19","volume":"41","author":"Lenggenhager","year":"2021","journal-title":"Liver Int."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1186\/s13244-022-01266-9","article-title":"Imaging features of COVID-19-associated secondary sclerosing cholangitis on magnetic resonance cholangiopancreatography: A retrospective analysis","volume":"13","author":"Ghafoor","year":"2022","journal-title":"Insights Imaging"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1186\/s13054-015-0861-5","article-title":"Trigger mechanisms of secondary sclerosing cholangitis in critically ill patients","volume":"19","author":"Leonhardt","year":"2015","journal-title":"Crit. Care"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Hunyady, P., Streller, L., R\u00fcther, D.F., Groba, S.R., Bettinger, D., Fitting, D., Hamesch, K., Marquardt, J.U., M\u00fccke, V.T., and Finkelmeier, F. (2022). Secondary sclerosing cholangitis following COVID-19 disease: A multicenter retrospective study. Clin. Infect. Dis., ciac565.","DOI":"10.1016\/S0168-8278(22)00993-X"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1038\/s42255-022-00552-6","article-title":"Molecular consequences of SARS-CoV-2 liver tropism","volume":"4","author":"Wanner","year":"2022","journal-title":"Nat. Metab."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"590","DOI":"10.1056\/NEJMc2011400","article-title":"Multiorgan and Renal Tropism of SARS-CoV-2","volume":"383","author":"Puelles","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1007\/s13238-020-00718-6","article-title":"Recapitulation of SARS-CoV-2 infection and cholangiocyte damage with human liver ductal organoids","volume":"11","author":"Zhao","year":"2020","journal-title":"Protein Cell"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/S2213-2600(20)30076-X","article-title":"Pathological findings of COVID-19 associated with acute respiratory distress syndrome","volume":"8","author":"Xu","year":"2020","journal-title":"Lancet Respir. Med."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/j.clinimag.2021.07.017","article-title":"A case of secondary sclerosing cholangitis due to COVID-19","volume":"80","author":"Tafreshi","year":"2021","journal-title":"Clin. Imaging"},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"1563","DOI":"10.1002\/hep.32582","article-title":"Progressive cholestasis and associated sclerosing cholangitis are frequent complications of COVID-19 in patients with chronic liver disease","volume":"76","author":"Hartl","year":"2022","journal-title":"Hepatology"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e244168","DOI":"10.1136\/bcr-2021-244168","article-title":"Liver transplantation for post-COVID-19 sclerosing cholangitis","volume":"14","author":"Lee","year":"2021","journal-title":"BMJ Case Rep."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1077","DOI":"10.14309\/ajg.0000000000001154","article-title":"Post-COVID-19 Cholangiopathy: A Novel Entity","volume":"116","author":"Roth","year":"2021","journal-title":"Am. J. Gastroenterol."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"S741","DOI":"10.14309\/01.ajg.0000780152.04292.21","article-title":"S1655 COVID-19-Induced Persistent Jaundice With Secondary Sclerosing Cholangitis","volume":"116","author":"Kobeszko","year":"2021","journal-title":"Off. J. Am. Coll. Gastroenterol. ACG"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"1124","DOI":"10.1007\/s12328-022-01687-5","article-title":"Secondary sclerosing cholangitis after COVID-19 pneumonia: A report of two cases and review of the literature","volume":"15","author":"Bauer","year":"2022","journal-title":"Clin. J. Gastroenterol."},{"key":"ref_77","first-page":"e936250","article-title":"Post-COVID-19 Secondary Sclerosing Cholangitis: A Rare but Severe Condition with no Treatment Besides Liver Transplantation","volume":"23","author":"Machado","year":"2022","journal-title":"Am. J. Case Rep."},{"key":"ref_78","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1111\/j.1572-0241.2004.04059.x","article-title":"Ethnic differences in the prevalence of cryptogenic cirrhosis","volume":"99","author":"Browning","year":"2004","journal-title":"Am. J. Gastroenterol."},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.1053\/j.gastro.2016.02.066","article-title":"Pathogenesis of Nonalcoholic Steatohepatitis","volume":"150","author":"Machado","year":"2016","journal-title":"Gastroenterology"},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"245","DOI":"10.7861\/clinmedicine.18-3-245","article-title":"Non-alcoholic fatty liver disease","volume":"18","author":"Maurice","year":"2018","journal-title":"Clin. Med."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"813","DOI":"10.1016\/j.dsx.2021.03.019","article-title":"Non-alcoholic fatty liver disease and clinical outcomes in patients with COVID-19: A comprehensive systematic review and meta-analysis","volume":"15","author":"Singh","year":"2021","journal-title":"Diabetes Metab. Syndr."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"2726","DOI":"10.1007\/s42399-020-00631-3","article-title":"NAFLD and COVID-19: A Pooled Analysis","volume":"2","author":"Sachdeva","year":"2020","journal-title":"SN Compr. Clin. Med."},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Forlano, R., Mullish, B.H., Mukherjee, S.K., Nathwani, R., Harlow, C., Crook, P., Judge, R., Soubieres, A., Middleton, P., and Daunt, A. (2020). In-hospital mortality is associated with inflammatory response in NAFLD patients admitted for COVID-19. PloS ONE, 15.","DOI":"10.1371\/journal.pone.0240400"},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"3062","DOI":"10.1002\/hep4.1802","article-title":"Independent Predictors of Mortality Among Patients with Non-alcoholic Fatty Liver Disease (NAFLD) Hospitalized with COVID-19 Infection","volume":"6","author":"Younossi","year":"2021","journal-title":"Hepatol. Commun."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1016\/j.jhep.2020.09.006","article-title":"NAFLD is a predictor of liver injury in COVID-19 hospitalized patients but not of mortality, disease severity on the presentation or progression\u2014The debate continues","volume":"74","author":"Mushtaq","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1578","DOI":"10.1097\/MEG.0000000000001902","article-title":"Nonalcoholic fatty liver disease is associated with COVID-19 severity independently of metabolic syndrome: A retrospective case-control study","volume":"33","author":"Mahamid","year":"2021","journal-title":"Eur. J. Gastroenterol. Hepatol."},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Bramante, C.T., Tignanelli, C.J., Dutta, N., Jones, E., Tamaritz, L., Clark, J., Melton-Meaux, G., Usher, M., and Ikramuddin, S. (2020). Non-alcoholic fatty liver disease (NAFLD) and risk of hospitalization for Covid-19. medRxiv.","DOI":"10.1101\/2020.09.01.20185850"},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"2568","DOI":"10.1111\/liv.14484","article-title":"Potential implications of COVID-19 in non-alcoholic fatty liver disease","volume":"40","author":"Prins","year":"2020","journal-title":"Liver Int."},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"215","DOI":"10.3390\/obesities2020017","article-title":"Gut Microbiota, NAFLD and COVID-19: A Possible Interaction","volume":"2","author":"Finelli","year":"2022","journal-title":"Obesities"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"5556354","DOI":"10.1155\/2021\/5556354","article-title":"NAFLD and Infection, a Nuanced Relationship","volume":"2021","author":"Adenote","year":"2021","journal-title":"Can. J. Gastroenterol. Hepatol."},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"L\u00f3pez-Gonz\u00e1lez, \u00c1.A., Altisench Jan\u00e9, B., Masmiquel Comas, L., Arroyo Bote, S., Gonz\u00e1lez San Miguel, H.M., and Ram\u00edrez Manent, J.I. (2022). Impact of COVID-19 Lockdown on Non-Alcoholic Fatty Liver Disease and Insulin Resistance in Adults: A before and after Pandemic Lockdown Longitudinal Study. Nutrients, 14.","DOI":"10.3390\/nu14142795"},{"key":"ref_92","doi-asserted-by":"crossref","unstructured":"Chang, Y., Jeon, J., Song, T.-J., and Kim, J. (2022). Association between the fatty liver index and the risk of severe complications in COVID-19 patients: A nationwide retrospective cohort study. BMC Infect. Dis., 22.","DOI":"10.1186\/s12879-022-07370-x"},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.jhep.2020.03.044","article-title":"Non-alcoholic fatty liver diseases in patients with COVID-19: A retrospective study","volume":"73","author":"Ji","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1016\/j.jhep.2020.09.027","article-title":"Obese patients with NASH have increased hepatic expression of SARS-CoV-2 critical entry points","volume":"74","author":"Fondevila","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_95","doi-asserted-by":"crossref","first-page":"484","DOI":"10.1016\/j.jceh.2020.12.006","article-title":"Effect of COVID-19 on Pre-existing Liver disease: What Hepatologist Should Know?","volume":"11","author":"Sharma","year":"2021","journal-title":"J. Clin. Exp. Hepatol."},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"619","DOI":"10.4254\/wjh.v12.i9.619","article-title":"Transaminitis is an indicator of mortality in patients with COVID-19: A retrospective cohort study","volume":"12","author":"Harne","year":"2020","journal-title":"World J. Hepatol."},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1002\/cld.1169","article-title":"The Impact of Nonalcoholic Fatty Liver Disease on the Outcomes of Coronavirus Disease 2019 Infection","volume":"19","author":"Asemota","year":"2022","journal-title":"Clin. Liver Dis."},{"key":"ref_98","doi-asserted-by":"crossref","unstructured":"Backer-Meurke, S.L., and Khanna, D. (2022). The Lasting Effects of COVID-19 on The Progression of Non-Alcoholic Fatty Liver Disease. FASEB J., 36.","DOI":"10.1096\/fasebj.2022.36.S1.L8005"},{"key":"ref_99","first-page":"1","article-title":"The interrelationship among non-alcoholic fatty liver disease, colonic diverticulosis and metabolic syndrome","volume":"30","author":"Milovanovic","year":"2021","journal-title":"J. Gastrointestin. Liver Dis."},{"key":"ref_100","first-page":"314","article-title":"Hepatitis B: Screening, Prevention, Diagnosis, and Treatment","volume":"99","author":"Wilkins","year":"2019","journal-title":"Am. Fam. Physician"},{"key":"ref_101","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1038\/s41575-022-00608-8","article-title":"Breakthroughs in hepatitis C research: From discovery to cure","volume":"19","author":"Manns","year":"2022","journal-title":"Nat. Rev. Gastroenterol. Hepatol."},{"key":"ref_102","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1053\/j.gastro.2018.08.060","article-title":"Approaches, Progress, and Challenges to Hepatitis C Vaccine Development","volume":"156","author":"Bailey","year":"2019","journal-title":"Gastroenterology"},{"key":"ref_103","unstructured":"(2022, September 10). Global Hepatitis Report. Available online: https:\/\/www.who.int\/publications-detail-redirect\/9789241565455."},{"key":"ref_104","unstructured":"(2022, September 10). Global Health Sector Strategies on, Respectively, HIV, Viral Hepatitis and Sexually Transmitted Infections for the Period 2022\u20132030. Available online: https:\/\/www.who.int\/publications-detail-redirect\/9789240053779."},{"key":"ref_105","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1007\/s12072-022-10306-x","article-title":"Management of hepatitis B virus reactivation due to treatment of COVID-19","volume":"16","author":"Yip","year":"2022","journal-title":"Hepatol. Int."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"e29","DOI":"10.3346\/jkms.2022.37.e29","article-title":"Clinical Effect of Hepatitis B Virus on COVID-19 Infected Patients: A Nationwide Population-Based Study Using the Health Insurance Review & Assessment Service Database","volume":"37","author":"Choe","year":"2022","journal-title":"J. Korean Med. Sci."},{"key":"ref_107","doi-asserted-by":"crossref","first-page":"389","DOI":"10.3851\/IMP3382","article-title":"COVID-19 and hepatitis B infection","volume":"25","author":"Alqahtani","year":"2020","journal-title":"Antivir. Ther."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"651658","DOI":"10.3389\/fmed.2021.651658","article-title":"Potential Effects of Coronaviruses on the Liver: An Update","volume":"8","author":"Wang","year":"2021","journal-title":"Front. Med."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"1229","DOI":"10.1007\/s40121-022-00638-4","article-title":"Patients with COVID-19 and HBV Coinfection are at Risk of Poor Prognosis","volume":"11","author":"Yang","year":"2022","journal-title":"Infect. Dis. Ther."},{"key":"ref_110","doi-asserted-by":"crossref","first-page":"1504","DOI":"10.1111\/jvh.13362","article-title":"Clinical characteristics in patients with SARS-CoV-2\/HBV co-infection","volume":"27","author":"Chen","year":"2020","journal-title":"J. Viral Hepat."},{"key":"ref_111","doi-asserted-by":"crossref","first-page":"420","DOI":"10.14309\/ajg.0000000000000924","article-title":"Clinical Characteristics of COVID-19 Patients With Pre-existing Hepatitis B Virus Infection: A Multicenter Report","volume":"116","author":"He","year":"2021","journal-title":"Am. J. Gastroenterol."},{"key":"ref_112","doi-asserted-by":"crossref","first-page":"1295","DOI":"10.1016\/j.jhep.2020.12.012","article-title":"Association of liver abnormalities with in-hospital mortality in patients with COVID-19","volume":"74","author":"Ding","year":"2021","journal-title":"J. Hepatol."},{"key":"ref_113","doi-asserted-by":"crossref","first-page":"1357","DOI":"10.14309\/ajg.0000000000001034","article-title":"COVID-19 Patients With Hepatitis B Virus Infection","volume":"116","author":"Lv","year":"2021","journal-title":"Am. J. Gastroenterol."},{"key":"ref_114","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1016\/j.amepre.2021.03.011","article-title":"Decreases in Hepatitis C Testing and Treatment During the COVID-19 Pandemic","volume":"61","author":"Kaufman","year":"2021","journal-title":"Am. J. Prev. Med."},{"key":"ref_115","doi-asserted-by":"crossref","first-page":"2689","DOI":"10.2169\/internalmedicine.53.3194","article-title":"Hepatitis C virus (HCV) reactivation caused by steroid therapy for dermatomyositis","volume":"53","author":"Mori","year":"2014","journal-title":"Intern. Med."},{"key":"ref_116","doi-asserted-by":"crossref","first-page":"870","DOI":"10.5009\/gnl16434","article-title":"Reactivation of Hepatitis C Virus and Its Clinical Outcomes in Patients Treated with Systemic Chemotherapy or Immunosuppressive Therapy","volume":"11","author":"Lee","year":"2017","journal-title":"Gut Liver"},{"key":"ref_117","doi-asserted-by":"crossref","first-page":"100704","DOI":"10.1016\/j.aohep.2022.100704","article-title":"The possibility of hepatitis C reactivation in COVID-19 patients treated with corticosteroids","volume":"27","author":"Shokri","year":"2022","journal-title":"Ann. Hepatol."},{"key":"ref_118","doi-asserted-by":"crossref","first-page":"7362","DOI":"10.3748\/wjg.v27.i42.7362","article-title":"Survival and outcomes for co-infection of chronic hepatitis C with and without cirrhosis and COVID-19: A multicenter retrospective study","volume":"27","author":"Afify","year":"2021","journal-title":"World J. Gastroenterol."},{"key":"ref_119","doi-asserted-by":"crossref","first-page":"8749","DOI":"10.12998\/wjcc.v9.i29.8749","article-title":"Chronic hepatitis-C infection in COVID-19 patients is associated with in-hospital mortality","volume":"9","author":"Ronderos","year":"2021","journal-title":"World J. Clin. Cases"},{"key":"ref_120","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/MCG.0000000000001459","article-title":"WGO Guidance for the Care of Patients With COVID-19 and Liver Disease","volume":"55","author":"Hamid","year":"2021","journal-title":"J. Clin. Gastroenterol."},{"key":"ref_121","doi-asserted-by":"crossref","first-page":"117592","DOI":"10.1016\/j.lfs.2020.117592","article-title":"Ribavirin, Remdesivir, Sofosbuvir, Galidesivir, and Tenofovir against SARS-CoV-2 RNA dependent RNA polymerase (RdRp): A molecular docking study","volume":"253","author":"Elfiky","year":"2020","journal-title":"Life Sci."},{"key":"ref_122","first-page":"A22","article-title":"P31 Covid-19 induced hepatitis (CIH), definition and diagnostic criteria of a poorly understood new clinical syndrome","volume":"69","author":"Gadour","year":"2020","journal-title":"Gut"},{"key":"ref_123","first-page":"e16359","article-title":"COVID-19 Presenting as Acute Icteric Hepatitis","volume":"13","author":"Balaja","year":"2021","journal-title":"Cureus"},{"key":"ref_124","first-page":"e21360","article-title":"A small molecule compound berberine as an orally active therapeutic candidate against COVID-19 and SARS: A computational and mechanistic study","volume":"35","author":"Wang","year":"2021","journal-title":"FASEB J."},{"key":"ref_125","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1007\/s40005-021-00544-w","article-title":"Nanoparticles of ZnO\/Berberine complex contract COVID-19 and respiratory co-bacterial infection in addition to elimination of hydroxychloroquine toxicity","volume":"51","author":"Ghareeb","year":"2021","journal-title":"J. Pharm. Investig."},{"key":"ref_126","doi-asserted-by":"crossref","first-page":"1935","DOI":"10.1007\/s00705-020-04706-3","article-title":"Antiviral activity of berberine","volume":"165","author":"Warowicka","year":"2020","journal-title":"Arch. Virol."},{"key":"ref_127","doi-asserted-by":"crossref","first-page":"62","DOI":"10.1016\/j.phymed.2018.09.025","article-title":"Berberine inhibits hepatitis C virus entry by targeting the viral E2 glycoprotein","volume":"53","author":"Hung","year":"2019","journal-title":"Phytomedicine"},{"key":"ref_128","doi-asserted-by":"crossref","first-page":"e00214-17","DOI":"10.1128\/AAC.00214-17","article-title":"An Effective Antiviral Approach Targeting Hepatitis B Virus with NJK14047, a Novel and Selective Biphenyl Amide p38 Mitogen-Activated Protein Kinase Inhibitor","volume":"61","author":"Kim","year":"2017","journal-title":"Antimicrob. Agents Chemother."},{"key":"ref_129","doi-asserted-by":"crossref","first-page":"e202200266","DOI":"10.1002\/cbdv.202200266","article-title":"A Computational Insight on the Inhibitory Potential of 8-Hydroxydihydrosanguinarine (8-HDS), a Pyridone Containing Analog of Sanguinarine, against SARS CoV2","volume":"19","author":"Jena","year":"2022","journal-title":"Chem. Biodivers."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/1\/62\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:53:51Z","timestamp":1760147631000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/59\/1\/62"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,28]]},"references-count":129,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,1]]}},"alternative-id":["medicina59010062"],"URL":"https:\/\/doi.org\/10.3390\/medicina59010062","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,28]]}}}