Background and Aims: COVID-19 is a dominant pulmonary disease MESHD, with multisystem involvement, depending upon co morbidities. Its profile in patients with pre-existing chronic liver disease MESHD (CLD) is largely unknown. We studied the liver injury patterns of SARS-Cov-2 in CLD patients, with or without cirrhosis HP. Methods: Data was collected from 13 Asian countries on patients with CLD, known or newly diagnosed, with confirmed COVID-19. Result: Altogether, 228 patients [185 CLD without cirrhosis HP and 43 with cirrhosis HP] were enrolled, with comorbidities in nearly 80%. Metabolism associated fatty liver MESHD disease MESHD (113, 61%) and viral etiology (26, 60%) were common. In CLD without cirrhosis HP, diabetes [57.7% vs 39.7%, OR=2.1(1.1-3.7), p=0.01] and in cirrhotics, obesity MESHD obesity HP, [64.3% vs. 17.2%, OR=8.1(1.9-38.8), p=0.002) predisposed more to liver injury than those without these. Forty three percent of CLD without cirrhosis HP presented as acute liver injury and 20% cirrhotics presented with either acute-on-chronic liver failure MESHD [5(11.6%)] or acute decompensation [4(9%)]. Liver related complications increased (p<0.05) with stage of liver disease MESHD; a Child TRANS-Turcotte Pugh score of 9 or more at presentation predicted high mortality [AUROC-0.94, HR=19.2(95CI 2.3-163.3), p<0.001, sensitivity SERO 85.7% and specificity 94.4%). In decompensated cirrhotics, the liver injury was progressive in 57% patients, with 43% mortality. Rising bilirubin and AST/ALT ratio predicted mortality among cirrhosis HP. Conclusions: SARS-Cov-2 infection MESHD causes significant liver injury in CLD patients, decompensating one fifth of cirrhosis HP, and worsening the clinical status of the already decompensated. The CLD patients with diabetes and obesity MESHD obesity HP are more vulnerable and should be closely monitored.