Correspondence (letters to the editor): Liver Involvement

In the article (1), we noticed that significant differences were reported between patients with acute respiratory distress syndrome (ARDS) and those with non-ARDS for laboratory parameters such as CRP, IL-6, LDH, CK, and D-dimer, but that no increases in serum levels of liver function markers and/or of liver function impairment were observed. However, a number of scientific studies have already shown that, in the context of COVID-19, liver can be involved in 16%–53% of cases, especially if there is a severe SARS-Cov-2 infection (2, 3). For a large number of these cases, only an asymptomatic increase in transaminases, but no significant increase in bilirubin or liver function impairment, was described. However, there have also been reports of severe liver damage during SARS-CoV-2 infection (4). We therefore recommend that, in addition to the laboratory parameters proposed by Dreher et al., the serum levels of liver enzymes are also closely monitored, especially in the case of a severe course with ARDS.