**1. Introduction**

The 2010 Global Burden of Disease reported that liver diseases were responsible for about 2 million deaths annually, with 50% of these associated with complications due to liver cirrhosis and the other half linked to hepatocellular carcinoma and viral hepatitis [1]. Cirrhosis is an end stage of chronic liver disease often preceded by hepatocellular necrosis and progressive fibrosis triggered by various agents including viral infections and chronic alcohol use [2]. Alcohol-related liver disease, nonalcoholic steatohepatitis and hepatitis B and C have been reported to be the main aetiologies of liver cirrhosis, with an up to 80% mortality rate recorded 1-year after decompensation [3,4]. Aside from mortality, the economic impact of liver-associated morbidity is also high, with associated disease-adjusted life years loss at over 41 million years globally. According to the World Health Organization (WHO) global health estimate of 2015, chronic liver disease ranks as the 16th highest cause of morbidity globally [5,6]. Despite the availability of vaccines for hepatitis B and the advances in clinical understanding and the managemen<sup>t</sup> of chronic liver diseases, the global health burden of the disease increased between 1990 and 2017. This rise in health burden was attributed to ageing and an overall increase in the global population [4].

According to Kidney Disease Improving Global Outcome (KDIGO), chronic kidney disease (CKD) is a dysfunction of the kidney characterised by established histological damage or a suboptimal (<60 mL/min/1.73 m2) glomerular filtration rate (GFR) persisting for at least 3 months [7]. Although the majority of CKD cases are linked to diabetes and hypertension [8], other risk factors, including genetics [9], recreational drugs and alcohol consumption [10], obesity [11], gender [12,13], age [12], lower birth weight [14], smoking status [15,16], ethnicity [17], family history of CKD [18] and acute kidney injury, have been studied [19,20]. In 2017, the number of deaths associated with CKD or CDK-related complications was estimated to be 1.2 million, accounting for 4.6% of global deaths [21]. Between 1990 and 2017, CKD rose as a cause of global mortality from the 17th to the 12th leading cause of death, with a 46% increase in the total number of deaths caused directly or indirectly by cardiovascular disease linked to kidney dysfunction [22]. While the relationship between COVID-19-induced acute kidney injury has been investigated previously [23], to the best of our knowledge, no studies have looked at the risk of COVID-19 in patients with all-form renal disease.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a viral pathogen which is responsible for the coronavirus disease 2019 (COVID-19) [24]. Symptoms of COVID-19 include fever, fatigue, dry cough, dyspnoea and sore throat, with patients presenting with abnormal chest CT (Computed Tomography) scans in the form of pulmonary ground glass opacity changes [25,26]. COVID-19 was first reported in December 2019, with its possible origin linked to the Wuhan seafood market in China [27]. Since first being reported, SARS-CoV-2 has infected, as of 2nd of April, 2020, 896,450 people and caused 45,525 deaths worldwide, with these numbers rising daily [28]. So far, the risk factors associated with poor clinical outcomes (death or admission to an intensive care unit (ICU)) have been reported to be old age and several comorbidities associated with compromised immune system to help the patient fight the infection. The most common of these comorbidities are hypertension, diabetes, cardiovascular diseases and malignancies. These comorbidities, individually or in combination with age, were reported to be linked with poor prognoses [29]. Several studies have looked at the risk posed to patients with various chronic diseases by COVID-19. For instance, Alqahtani et al. 2020 looked at the risk of smoking status and chronic obstructive pulmonary disease (COPD) in COVID-19 patients, establishing an increased risk of death or admission to ICU for patients with COPD or smoking history infected with SARS-CoV-2 [30].

While COVID-19-induced liver and kidney injuries have been documented, to the best of our knowledge, there has been no report on the risk posed by COVID-19 infection in patients with a history of liver or renal disease. Understanding the risk to this subpopulation of patients will facilitate e ffective prevention decisions and clinical management. We aim here to understand the risks by looking at reported cases since the outbreak of COVID-19.
