Effect of COVID-19 on Pre-existing Liver disease: What Hepatologist Should Know?
J Clin Exp Hepatol
; 11(4): 484-493, 2021.
Article
in English
| MEDLINE | ID: covidwho-1002704
ABSTRACT
COVID-19 is characterized by predominant respiratory and gastrointestinal symptoms. Liver enzymes derangement is seen in 15-55% of the patients. Advanced age, hypertension, diabetes, obesity, malignancy, and cardiovascular disease predispose them to severe disease and the need for hospitalization. Data on pre-existing liver disease in patients with COVID-19 is limited, and most studies had only 3-8% of these patients. Patients with metabolic dysfunction-associated fatty liver (MAFLD) had shown a 4-6 fold increase in severity of COVID-19, and its severity and mortality increased in patients with higher fibrosis scores. Patients with chronic liver disease had shown that cirrhosis is an independent predictor of severity of COVID-19 with increased hospitalization and mortality. Increase in Child Turcotte Pugh (CTP) score and model for end-stage liver disease (MELD) score increases the mortality in these patients. Few case reports had shown SARS-CoV-2 as an acute event in the decompensation of underlying chronic liver disease. Immunosuppression should be reduced prophylactically in patients with autoimmune liver disease and post-transplantation with no COVID-19. Hydroxychloroquine and remdesivir is found to be safe in limited studies in a patient with cirrhosis and COVID-19. For hepatologists, cirrhosis with COVID-19 is a pertinent issue as the present pandemic will have severe disease in patients with chronic liver disease leading to more hospitalization and decompensation.
AASLD, American Association for the Study of Liver Diseases; ACE2, Angiotensin-Converting Enzyme 2; AIH, Autoimmune Hepatitis; ALP, Alkaline Phosphatase; AST/ALT, Aspartate and Alanine Aminotransferase; CHF, Congestive Heart Failure; CKD, Chronic Kidney Disease; CLD, Chronic Liver Disease; CLIF-OC, Chronic Liver Failure Organ Cirrhosis; CLIF-OF, Chronic Liver Failure Organ Failure; COVID-19; CRP, C Reactive Protein; CTP, Child Turcotte Pugh; Cirrhosis; DILI, Drug-Induced Liver Injury; EASL, European Association for the Study of Liver; HBC, Hepatitis C; HBV, Hepatitis B; HCC, Hepatocellular Carcinoma; HCQ, Hydoxycholoroquine; LT, Liver Transplantation; Liver disease; MAFLD, Metabolic Associated Fatty Liver Disease; MELD, Model for End-stage Liver Disease; NAFLD, Nonalcoholic Fatty Liver Disease; PPE, Personal Protection Kit; RR, Relative Risk; RTPCR, Reverse Transcription-Polymerase Chain Reaction; Severity
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Type of study:
Experimental Studies
/
Prognostic study
Language:
English
Journal:
J Clin Exp Hepatol
Year:
2021
Document Type:
Article
Affiliation country:
J.jceh.2020.12.006
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