Hepatic Manifestations of Nonhepatotropic Infectious Agents Including Severe Acute Respiratory Syndrome Coronavirus-2, Adenovirus, Herpes Simplex Virus, and Coxiella burnetii

Nonhepatotropic viruses such as adenovirus , herpes simplex virus , flaviviruses, filoviruses , and human herpes virus, and bacteria such as Coxiella burnetii , can cause liver injury mimicking acute hepatitis. Most of these organisms cause a self-limited infection. However, in immunocompromised patients , they can cause severe hepatitis or in some cases fulminant hepatic failure requiring an urgent liver transplant . Hepatic dysfunction is also commonly seen in patients with severe acute respiratory syndrome coronavirus-2 infection. Patients with preexisting liver diseases are likely at risk for severe coronavirus disease 2019 (COVID-19) and may be associated with poor outcomes.