Semin Liver Dis 2023; 43(03): 351-366
DOI: 10.1055/a-2157-3318
Review Article

COVID-19 and Liver Disease: An Evolving Landscape

Kai Zhu
1   Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Olivia Tsai
1   Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
Daljeet Chahal
2   Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada
3   BC Liver Transplant Program, Vancouver, British Columbia, Canada
Trana Hussaini
3   BC Liver Transplant Program, Vancouver, British Columbia, Canada
4   Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada
Eric M. Yoshida
2   Division of Gastroenterology, University of British Columbia, Vancouver, British Columbia, Canada
3   BC Liver Transplant Program, Vancouver, British Columbia, Canada
› Author Affiliations
Funding None.


The COVID-19 pandemic has resulted in significant worldwide morbidity and mortality. In this review, we examine the intricate relationships between COVID-19 and liver diseases. While respiratory manifestations of COVID-19 are well known, its impact and consequences in patients with liver diseases remain an area of ongoing investigation. COVID-19 can induce liver injury through various mechanisms and is associated with higher mortality in individuals with preexisting chronic liver disease. Mortality increases with the severity of chronic liver disease and the level of care required. The outcomes in patients with autoimmune hepatitis remain unclear, whereas liver transplant recipients are more likely to experience symptomatic COVID-19 but have comparable outcomes to the general population. Despite suboptimal immunological response, COVID-19 vaccinations are safe and effective in liver disease, although cases of autoimmune hepatitis-like syndrome have been reported. In conclusion, COVID-19 has significant implications in liver diseases; early recognition and treatments are important for improving patient outcomes.

Publication History

Accepted Manuscript online:
21 August 2023

Article published online:
29 September 2023

© 2023. Thieme. All rights reserved.

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