Spectrum of COVID-19-induced liver injury in children

Deranged liver functions, which mainly raised alanine aminotransferase (ALT) and aspartate aminotransferase (AST), have been reported in 14%–53% of coronavirus disease 2019 (COVID-19) patients without known liver disease. Patients with the severe disease showed higher frequency and degree of liver dysfunction, while in milder cases the liver injury was transient. The mechanisms of hepatic injury include immune-mediated inflammation and hypoxic injury due to severe pneumonia and drug usage. It is also postulated that expression of the ACE2 receptor on cholangiocytes may predispose to cholestatic injury. In this study, it was aimed to review the spectrum of COVID-19-induced liver injury in children.