本综述探讨了 COVID-19 引起的肝损伤的机制、诊断方法和治疗策略，重点关注其对已有肝脏疾病、肝癌和接受肝移植患者的影响。综合文献综述包括COVID-19引起的肝损伤临床表现的研究。研究的关键领域包括直接病毒效应、药物引起的肝损伤、细胞因子风暴以及对慢性肝病患者的影响、肝移植和疫苗接种的作用。数据收集自临床试验、观察性研究、病例报告和文献综述。COVID-19 可引起一系列肝损伤，从轻度酶升高到严重肝功能障碍。损伤机制包括直接病毒入侵、免疫反应改变、药物毒性和缺氧再灌注损伤。患有慢性肝病（例如酒精相关性肝病、非酒精性脂肪肝、肝硬化和肝细胞癌）的患者面临严重后果的风险增加。这场大流行使原有的肝脏状况恶化，扰乱了癌症治疗，并使肝移植变得复杂。疫苗接种对于减少严重疾病仍然至关重要，特别是对于慢性肝病患者和移植受者。远程医疗有利于管理患者和减少交叉感染风险。这篇综述讨论了改进诊断方法和管理策略对 COVID-19 引起的肝损伤的重要性。它强调需要对高危人群进行密切监测和定制治疗，倡导未来研究探索长期效果、新疗法和循证方法，以改善大流行期间和之后的肝脏健康。版权所有 © 2024。已发布由爱思唯尔公司

This review explores the mechanisms, diagnostic approaches, and management strategies for COVID-19-induced liver injury, with a focus on its impact on patients with pre-existing liver conditions, liver cancer, and those undergoing liver transplantation.A comprehensive literature review included studies on clinical manifestations of liver injury due to COVID-19. Key areas examined were direct viral effects, drug-induced liver injury, cytokine storms, and impacts on individuals with chronic liver diseases, liver transplants, and the role of vaccination. Data were collected from clinical trials, observational studies, case reports, and review literature.COVID-19 can cause a spectrum of liver injuries, from mild enzyme elevations to severe hepatic dysfunction. Injury mechanisms include direct viral invasion, immune response alterations, drug toxicity, and hypoxia-reperfusion injury. Patients with chronic liver conditions (such as alcohol-related liver disease, nonalcoholic fatty liver disease, cirrhosis, and hepatocellular carcinoma) face increased risks of severe outcomes. The pandemic has worsened pre-existing liver conditions, disrupted cancer treatments, and complicated liver transplantation. Vaccination remains crucial for reducing severe disease, particularly in chronic liver patients and transplant recipients. Telemedicine has been beneficial in managing patients and reducing cross-infection risks.This review discusses the importance of improved diagnostic methods and management strategies for liver injury caused by COVID-19. It emphasizes the need for close monitoring and customized treatment for high-risk groups, advocating for future research to explore long-term effects, novel therapies, and evidence-based approaches to improve liver health during and after the pandemic.Copyright © 2024. Published by Elsevier Inc.