COVID-19 Hepatic Illness

The hepatic effects of COVID-19 are relatively mild when compared to other organs such as the lungs and heart. Mild transaminase elevations are commonly seen in greater than 50% of patients with moderate to severe disease. Based on current data, it is unclear if patients with preexisting liver disease (NASH/NAFLD) are at higher risk of mortality due to COVID-19. It does appear, however, that those with cirrhosis have an increased risk of severe disease and tend to have a more complicated hospital course. Patients with previous liver transplantation should continue their immunosuppressive medications and see their doctor regularly. Current therapies aimed at the treatment of COVID-19 have been associated with hepatotoxicity including tocilizumab, lopinavir-ritonavir, and remdesivir and require monitoring for such side effects.