OBJECTIVE: To comprehensively analyze that how liver injury in patients with metabolic syndrome is affected by coronavirus disease 2019 (COVID-19) and provide clinical reference to their prevention and treatment. BACKGROUND: The current COVID-19 pandemic poses a major threat to human life and health. Metabolic syndrome is also a major global health problem, and evidence suggests that patients with metabolic syndrome are at an increased risk of COVID-19 complications. Liver injury is one of the main manifestations of extra-pulmonary organ injury in patients with COVID-19. Currently, the effects of metabolic syndrome on liver injury in patients with COVID-19 are unclear. METHODS: In this study, we searched the PubMed, Embase, and China National Knowledge Infrastructure (CNKI) databases for articles on the latest developments of liver injury in COVID-19 patients with metabolic syndrome from 2019 to comprehensively analyze the current knowledge of how liver injury in patients with metabolic syndrome is affected by COVID-19. We used the free key words "metabolic syndrome" OR "hypertension" OR "obesity" OR "diabetes" OR "dyslipidemia" OR "liver injury" OR "SARS-CoV-2" OR "COVID-19" in all fields. We imposed no language restrictions. CONCLUSIONS: Both COVID-19 and metabolic syndrome and its components are closely related to liver injury, may induce liver injury through direct or indirect mechanisms. Therefore, when COVID-19 is combined with metabolic syndrome, it may increase the risk of liver injury, and it cannot be ruled out that the two diseases have a superimposed effect on liver injury.