COVID-19
The few available studies show that as many as 51% of patients with COVID-19 have abnormal liver function on admission (elevated liver enzymes, bilirubin and lactate dehydrogenase levels) 66 (Table 2). Patients with abnormal LFTs present with a high degree of fever, and their degree of hepatic dysfunction correlates with length of hospitalization.66 New reports suggest that the liver dysfunction in patients with COVID-19 may be related to damage to the cholangiocytes lining the biliary epithelium, likely due to the higher expression of ACE2 receptors on those cells.67 Patients with preexisting metabolic fatty liver disease have been seen to have an about 6-fold higher chance of severe disease in the presence of coexisting obesity.21