Background To investigate the liver function indexes and dynamic changes in patients with different clinical types of new coronavirus pneumonia (COVID-19). Methods A retrospective analysis of 170 COVID-19 patients hospitalized in the Wuxi Fifth People’s Hospital was divided into asymptomatic group (13 cases), mild-common group (142 cases) and seriously-critically ill group (15 cases), the clinical data and liver function indexes of the three groups were compared. Results A total of 170 patients included 94 males and 76 females, with an average age of 44.7 ± 17.8 years. Seriously-critically ill group was older, and the proportion of patients with diabetes and liver injury at admission was also higher. As the hospitalization time increased, the changes of alanine aminotransferase (ALT) levels in asymptomatic group and mild-common group were not significant (all P > 0.05), while the ALT levels of seriously-critically ill group showed a curve that first flattened and then decreased (degree of freedom: 1.809, P = 0.002). Compared with the mild-common group, the daily decrease of ALT was 1.220U/L more in the seriously-critically ill group (P<0.001). The aspartate aminotransferase (AST) in asymptomatic group and seriously-critically ill group did not decrease significantly (all P > 0.05), while the AST in mild-common group decreased significantly (regression coefficient: −10.507, P = 0.008). There was no significant difference in AST changes between the three groups (P = 0.250–0.904). Conclusion Liver injury is common in COVID-19 patients, especially for severe patients; the dynamic change pattern of liver function indicators may be helpful to judge liver injury and evaluate treatment effects in patients with different clinical types.

The COVID-19 outbreak triggered a serious and potentially lethal pandemic, resulting in massive health and economic losses worldwide. The most common clinical manifestations of COVID-19 patients are pneumonia and acute respiratory distress syndrome, with a variety of complications. Multiple organ failure and damage, ultimately leading to patient death, are possible as a result of medication combinations, and this is exemplified by DILI. We hope to summarize DILI caused by the antiviral drugs favipiravir, remdesivir, lopinavir/ritonavir, and hydroxychloroquine in COVID-19 patients in this review. The incidence of liver injury in the treatment of COVID-19 patients was searched on PubMed to investigate DILI cases. The cumulative prevalence of acute liver injury was 23.7% (16.1%–33.1%). We discuss the frequency of these events, potential mechanisms, and new insights into surveillance strategies. Furthermore, we also describe medication recommendations aimed at preserving DILI caused by treatment in COVID-19 patients.