Background: COVID-19 is a respiratory infection that may affect other organs, including the liver. Aim of work: We investigated hepatic involvement in COVID-19 patients to identify the risk factors and consequences of COVID-19-related hepatitis. We also assessed the association of hepatic steatosis with disease severity and outcomes, as well as the risk factors and consequences of hepatitis during the infection. Methods: This prospective cohort study included 246 Egyptian patients with COVID-19 infection, divided into two groups: Group A (n=119) had normal transaminases, and Group B (n=127) had elevated levels of at least one transaminase at diagnosis. We collected data at baseline and after six months. We used vibration-controlled transient elastography (VCTE) and controlled attenuated parameter (CAP) to measure liver fibrosis and steatosis scores.