The novel Coronavirus SARS-CoV-2 disease (COVID-19) is a global pandemic, which poses a major threat to the general population and for patients with pre-existing chronic conditions. The authors showed data concerning SARS-CoV-2 infection in children with chronic liver disease (CLD).

The authors used a literature review from the online database PubMed to review available findings on the relationship between pre-existing liver disease and COVID-19 infection in children.

The outcome revealed that children with COVID-19 have maintained effector and immunosuppressive constituents which results in a milder disease in contrast to adults. The most frequently seen hepatic manifestation is an increase in hepatic transaminases. Liver injury may be directly mediated by viral infection of liver cells, by medications or by the chronic hypoxia, common in COVID-19 patients.

Thus, it can be summarized that although COVID-19-related liver injury shows mild elevation of transaminases, understanding its clinical significance requires further studies. Data do not show any increase in risk of severity of disease course of SARS-CoV-2 infection with little or no liver dysfunction in children with CLD, including those with AILD and post-LT. Therefore, it is essential to adopt normal standards of care while following national Covid-19 guidelines, and especially to maintain immunosuppressive medication to prevent relapse or rejection.

Source: Di Giorgio A, Hartleif S, Warner S, Kelly D. COVID-19 in Children With Liver Disease. Front Pediatr. 2021;9:616381. Published 2021 Mar 11.