Management of COVID-19 patients with chronic liver diseases and liver transplants |
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Authors: | Xinyu Hu Longyan Sun Zhaoyang Guo Chao Wu Xin Yu Jie Li |
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Institution: | 1. Department of Infectious Disease, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Ji''nan, Shandong, China;2. Queen Mary School of Nanchang University, Nanchang, Jiangxi, China;3. Department of HPB surgery, Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China;4. Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, Jiangsu, China |
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Abstract: | The epidemic of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has increasingly attracted worldwide concern. Liver damage or dysfunction occurred in patients with COVID-19 (mainly characterized by moderately elevated serum aspartate aminotransferase levels). However, it is not yet clear whether the COVID-19-related liver injury is mainly caused by the virus infection, potentially hepatotoxic drugs, or other coexisting conditions. Progression of pre-existing chronic liver disease (CLD) may be the underlying mechanism of liver injury. Although COVID-19 patients with CLD, such as nonalcoholic fatty liver disease, liver cirrhosis, and liver cancer, have been deemed at increased risk for serious illness in many studies, little is known about the impact of CLD on the natural history and outcome of COVID-19 patients. Thereby, based on the latest evidence from case reports and case series, this paper discusses the clinical manifestations, treatment, prognosis, and management of the COVID-19 patients with different CLD. This article also reviews the effect of COVID-19 on liver transplantation patients (LT), hoping to work for future prevention, management, and control measures of COVID-19. However, due to the lack of relevant research, most of them are still limited to the theoretical stage, further study of COVID-19 and CLD needs to be improved in the future. |
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Keywords: | Corresponding author at: Department of HPB surgery Second Affiliated Hospital of Nanchang University Nanchang Jiangxi China COVID-19 SARS-CoV-2 Chronic liver disease Liver injury Prognosis AASLD American Association for the Study of Liver Diseases ACE2 Angiotensin I converting enzyme 2 ACLF Acute on chronic liver failure AIFA Italian Medical Agency AIH Autoimmune hepatitis ALD Alcohol-associated liver disease APASL Asian-Pacific Association for the Study of Liver Diseases CLD Chronic liver disease COVID-19 Coronavirus disease 2019 EASL European Association for the Study of the Liver HCC Hepatocellular carcinoma LT Liver transplantation MAFLD Metabolic dysfunction-associated fatty liver disease NAFLD Non-alcoholic fatty liver disease SARS-CoV-2 Severe acute respiratory syndrome coronavirus 2 |
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