SARS-CoV-2 (COVID-19) has emerged as a global pandemic and continues to be a considerable threat to society's health since December 2019. Studies have shown that specific symptoms can persist in a few people, or new symptoms could develop after recovery from COVID-19 infection, termed 'long COVID.' Through this case series, we would like to highlight the importance of post-COVID patients' follow-up as it could unearth several latent diseases. Methods: We report a retrospective analysis of three patients following recovery from moderate-severe COVID who manifested features of parenchymal liver disease with decompensation. Results: Mean age of patients was 58 years. Common presenting symptoms were swelling of lower limbs and abdomen distension following recovery from COVID-19. Physical findings included pallor, pedal edema, ascites, and splenomegaly. Laboratory findings were variable cytopenia with pancytopenia in 66% of cases, hypoalbuminemia (100%), deranged coagulation profile (100%), hyperferritinemia (100%), and normal bilirubin and liver enzymes (100%). One patient underwent orthotopic liver transplantation and was vaccinated 5 months before liver transplantation. The other two patients were vaccinated 3 months after discharge and are on regular medications and managed conservatively. Conclusion: Patients never manifested any symptoms of the liver disease ever before and were diagnosed with parenchymal liver disease during their follow-up visits. Therefore, it is vital to evaluate if the post COVID period is a continuum of the inflammatory phase, precipitating many latent diseases. As vaccination has drastically reduced the incidence of severe COVID-19 cases, it needs to be determined if unmasking or decompensation of such cases will reduce in COVID-19 patients who are pre-vaccinated. A clear picture should emerge once more cases are reported, and the follow-up of these cases should give more information in this regard.

 KEYWORDS: Angiotensin-converting enzyme (ACE2); COVID-19; Decompensated parenchymal liver disease; Liver functions