Liver Damage and COVID-19: At Least a “Two-Hit” Story in Systematic Review

Round 1

Reviewer 1 Report

Abstract

21

Acute liver damage

27

In the frame

Many other similar minor problems of spelling

214, 214

Making an example tamoxifen, an estrogen antagonist has been found in hepatocellular (?) carriers beacause of hepatotoxicity mechanisms

Table 1

Corticosteroids

…administration use can … B and C chronic viral hepatitis

313, 314

liver transplantation being the world’s second most prevalent intervention

The correct sentence would be:

…liver transplantation is the world’s second most prevalent solid organ transplant

Author Response

REPLY POINT BY POINT TO REVIEWERS’:

REVIEWER 1

Abstract

21 

Acute liver damage

27 

In the frame

Many other similar minor problems of spelling

214, 214 

Making an example tamoxifen, an estrogen antagonist has been found in hepatocellular (?)carriers beacause of hepatotoxicity mechanisms

Table 1

Corticosteroids 

…administration use can … B and C chronic viral hepatitis

313, 314

liver transplantation being the world’s second most prevalent intervention

The correct sentence would be:

…liver transplantation is the world’s second most prevalent solid organ transplant.

We thank the reviewer for all these observations and suggestions. We have accurately revised and corrected the typos, errors throughout the manuscript.

Reviewer 2 Report

In this paper, the authors sought to review literature data regarding liver damage during COVID-19.

To this end, the authors conducted a search on the main medical databases for original articles, reviews, meta-analyses, randomized clinical trials and case series using the following keywords and acronyms and their associations: liver disease, COVID-19, acute liver damage, drug induced liver injury, antivirals.

The authors found acute liver damage due to SARS-CoV 2 infection to be common among COVID-19 patients and to be generally self-limiting. However, chronic hepatic disease such as metabolic associated fatty liver disease (MAFLD) were associated with a less favorable prognosis. Early recognition, monitoring and treatment of liver damage is crucial in these patients.

The authors conclude that in the frame of a not-ending pandemic sustained by SARS-CoV 2, it is crucial to recognize acute hepatic decompensation due to virus and/or drugs used for COVID-19 treatment.

Overall, this is an interesting review on a topic of great interest. I congratulate the authors on this interesting paper.

Author Response

REPLY POINT BY POINT TO REVIEWERS’:

REVIEWER 2:

In this paper, the authors sought to review literature data regarding liver damage during COVID-19. 

To this end, the authors conducted a search on the main medical databases for original articles, reviews, meta-analyses, randomized clinical trials and case series using the following keywords and acronyms and their associations: liver disease, COVID-19, acute liver damage, drug induced liver injury, antivirals. 

The authors found acute liver damage due to SARS-CoV 2 infection to be common among COVID-19 patients and to be generally self-limiting. However, chronic hepatic disease such as metabolic associated fatty liver disease (MAFLD) were associated with a less favorable prognosis. Early recognition, monitoring and treatment of liver damage is crucial in these patients. 

The authors conclude that in the frame of a not-ending pandemic sustained by SARS-CoV 2, it is crucial to recognize acute hepatic decompensation due to virus and/or drugs used for COVID-19 treatment.

Overall, this is an interesting review on a topic of great interest. I congratulate the authors on this interesting paper.

We thank the reviewer for this encouraging and positive comment.