Acute-on-chronic liver failure by SARS-CoV-2 in active alcohol use disorder cirrhotic patient.
Minerva Gastroenterol (Torino)
; 67(3): 283-288, 2021 Sep.
Article
in English
| MEDLINE | ID: covidwho-1485664
ABSTRACT
World Gastroenterology Organization define acute on chronic liver failure (ACLF) a syndrome in patients with chronic liver disease with or without previously diagnosed cirrhosis, characterized by acute hepatic decompensation resulting in liver failure and one or more extrahepatic organ failures, associated with increased mortality up to three months. A-56-year-old gentleman with alcohol related liver cirrhosis (ARLC) and history of variceal bleeding with insertion of transjugular intrahepatic porto-systemic stent shunt presented with two days history of fever, dry cough and worsening of the sensory. The severe acute respiratory coronavirus-2 (SARS-CoV-2) nasopharingeal C-reactive protein test was positive. X-ray showed multiple patchy ground glass opacities in both lungs. Despite the therapy, the clinical and laboratory picture deteriorated rapidly. The patient succumbed on day 14 with multi-organ-failure. SARS-Cov-2 infection can overlap with pre-existing chronic liver disease or induce liver damage directly or indirectly. From the data of the literature and from what is inferred from the case report it clearly emerges that alcohol related liver disease (ALD) patients are particularly vulnerable to SARS-Cov-2 infection. Thereafter, some considerations can be deduced from the analysis of the case report. In subjects with pre-existing cirrhosis hepatologists should play more attention to hepatic injury and monitor risk of hepatic failure caused by coronavirus disease 2019 (COVID-19). It is appropriate to promptly define the alcoholic etiology and investigate whether the patient is actively consuming. In fact, withdrawal symptoms may be present, and the prognosis of these patients is also worse. Physicians should be alerted to the possibility of the development of ACLF in this population, hepatotoxic drugs should be avoided, it is recommended to use of hepatoprotective therapy to mitigate the negative impact of COVID-19, and it is mandatory to administer anti COVID-19 vaccine to patients with alcohol related liver cirrhosis.
Full text:
Available
Collection:
International databases
Database:
MEDLINE
Main subject:
Alcoholism
/
Acute-On-Chronic Liver Failure
/
COVID-19
/
Liver Cirrhosis
Type of study:
Case report
/
Etiology study
/
Prognostic study
Topics:
Long Covid
/
Vaccines
Limits:
Humans
/
Male
/
Middle aged
Language:
English
Journal:
Minerva Gastroenterol (Torino)
Year:
2021
Document Type:
Article
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