COVID-19, Anesthesia and Liver: Traditional Review

Abstract

In the coronavirus disease-2019 (COVID-19) pandemic, which started in 2019 and was caused by the severe acute respiratory syndrome-coronavirus-2 virus, the clinical course of the infection was observed in a wide range from very mild symptoms to death. Although the respiratory system and lungs are mostly affected in COVID-19 infection, other organs and systems are also affected. The most common symptoms in COVID-19 are fever, cough, fatigue, difficulty breathing, anosmia, and loss of taste. In cases where clinical symptoms are more severe, acute respiratory distress syndrome, cytokine storms, multiple organ failure, sepsis and thrombosis are seen. Liver involvement has an important place in the course of COVID-19 apart from lung involvement, some patients with COVID-19 infection and cooperation difficulties require general anesthesia during computed tomography imaging procedures or intensive care treatments. Again, the need for urgent surgical intervention during infection causes them to be exposed to general anesthetics. The negative effects of general anesthesia agents on organ systems, especially on the liver, is an important issue that is frequently emphasized in the literature. Liver enzymes should be monitored in the clinical follow-up and estimation of mortality in patients with a diagnosis of COVID-19. Non-emergency surgeries of patients with a diagnosis of COVID-19 should be postponed or if anesthesia applications are necessary, non-hepatotoxic or minimally hepatotoxic methods should be performed. In this review, it is aimed to share information on anesthesia applications in terms of COVID-19 and liver functions by examining the relationship of COVID-19 with the liver.