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Liver and Kidney Injuries in COVID-19 and Their Effects on Drug Therapy; a Letter to Editor

Ali Rismanbaf, Sara Zarei



Dear Editor,

COVID-19 is a newly emerging human infectious disease of SARS-CoV-2 origin that has affected many countries around the world. COVID-19 is now rapidly spreading worldwide, and this letter is written as the World Health Organization (WHO) has declared a global emergency on January 31st amid concerns about a growing outbreak of SARS-CoV-2. Most of the published articles on COVID-19 have highlighted lungs as the main organ involved in the disease, while few articles have reported SARS-CoV-2 involvement in other organs, including liver and kidneys, which can impair the metabolism and excretion of the medications taken to treat the disease.

According to Zhang et al. the incidence of hepatic abnormalities significantly increases after infection with COVID-19 and during the course of the disease, which may indicate the effect of SARS-CoV-2 on the liver or side effects of the medications used by patients (1). Also, Xu et al. have reported steatosis and liver injury in the liver biopsy of a patient with COVID-19 (2). In addition to liver injuries, some articles have also reported an increased incidence of acute renal injury following COVID-19, which could be due to the presence of SARS-CoV-2, the inflammation induced by the disease, or a synergistic effect of both on kidneys (3, 4). Additionally, Cheng et al. have reported that patients with acute renal injury have a higher mortality rate compared to other patients (3).


Coronavirus; Acute kidney injury; Liver Failure; Drug therapy


Zhang C, Shi L, Wang F-S. Liver injury in COVID-19: management and challenges. The Lancet Gastroenterology & Hepatology.

Xu Z, Shi L, Wang Y, Zhang J, Huang L, Zhang C, et al. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. The Lancet Respiratory Medicine. 2020.

Cheng Y, Luo R, Wang K, Zhang M, Wang Z, Dong L, et al. Kidney impairment is associated with in-hospital death of COVID-19 patients. medRxiv. 2020.

Xu D, Zhang H, Gong H-y, Chen J-x, Ye J-q, Meng T, et al. Identification of a Potential Mechanism of Acute Kidney Injury During the Covid-19 Outbreak: A Study Based on Single-Cell Transcriptome Analysis. 2020.

DOI: https://doi.org/10.22037/aaem.v8i1.590

DOI (PDF): https://doi.org/10.22037/aaem.v8i1.590.g710

DOI (HTML): https://doi.org/10.22037/aaem.v8i1.590.g718