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Effect of COVID-19 on Pre-existing Liver disease: What Hepatologist Should Know?
J Clin Exp Hepatol. 2021 Jul-Aug; 11(4):484-493.JC

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.

Authors+Show Affiliations

Department of Gastroenterology Sir Ganga Ram Hospital New Delhi, India.Department of Gastroenterology Sir Ganga Ram Hospital New Delhi, India.Department of Gastroenterology Sir Ganga Ram Hospital New Delhi, India.Department of Gastroenterology Sir Ganga Ram Hospital New Delhi, India.Department of Gastroenterology Sir Ganga Ram Hospital New Delhi, India.Department of Gastroenterology Sir Ganga Ram Hospital New Delhi, India.Department of Gastroenterology Sir Ganga Ram Hospital New Delhi, India.

Pub Type(s)

Journal Article
Review

Language

eng

PubMed ID

33398223

Citation

Sharma, Praveen, et al. "Effect of COVID-19 On Pre-existing Liver Disease: what Hepatologist Should Know?" Journal of Clinical and Experimental Hepatology, vol. 11, no. 4, 2021, pp. 484-493.
Sharma P, Kumar A, Anikhindi S, et al. Effect of COVID-19 on Pre-existing Liver disease: What Hepatologist Should Know? J Clin Exp Hepatol. 2021;11(4):484-493.
Sharma, P., Kumar, A., Anikhindi, S., Bansal, N., Singla, V., Shivam, K., & Arora, A. (2021). Effect of COVID-19 on Pre-existing Liver disease: What Hepatologist Should Know? Journal of Clinical and Experimental Hepatology, 11(4), 484-493. https://doi.org/10.1016/j.jceh.2020.12.006
Sharma P, et al. Effect of COVID-19 On Pre-existing Liver Disease: what Hepatologist Should Know. J Clin Exp Hepatol. 2021 Jul-Aug;11(4):484-493. PubMed PMID: 33398223.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Effect of COVID-19 on Pre-existing Liver disease: What Hepatologist Should Know? AU - Sharma,Praveen, AU - Kumar,Ashish, AU - Anikhindi,ShriHari, AU - Bansal,Naresh, AU - Singla,Vikas, AU - Shivam,Khare, AU - Arora,Anil, Y1 - 2020/12/31/ PY - 2020/06/02/received PY - 2020/12/24/accepted PY - 2021/1/6/pubmed PY - 2021/1/6/medline PY - 2021/1/5/entrez KW - AASLD, American Association for the Study of Liver Diseases KW - ACE2, Angiotensin-Converting Enzyme 2 KW - AIH, Autoimmune Hepatitis KW - ALP, Alkaline Phosphatase KW - AST/ALT, Aspartate and Alanine Aminotransferase KW - CHF, Congestive Heart Failure KW - CKD, Chronic Kidney Disease KW - CLD, Chronic Liver Disease KW - CLIF-OC, Chronic Liver Failure Organ Cirrhosis KW - CLIF-OF, Chronic Liver Failure Organ Failure KW - COVID-19 KW - CRP, C Reactive Protein KW - CTP, Child Turcotte Pugh KW - Cirrhosis KW - DILI, Drug-Induced Liver Injury KW - EASL, European Association for the Study of Liver KW - HBC, Hepatitis C KW - HBV, Hepatitis B KW - HCC, Hepatocellular Carcinoma KW - HCQ, Hydoxycholoroquine KW - LT, Liver Transplantation KW - Liver disease KW - MAFLD, Metabolic Associated Fatty Liver Disease KW - MELD, Model for End-stage Liver Disease KW - NAFLD, Nonalcoholic Fatty Liver Disease KW - PPE, Personal Protection Kit KW - RR, Relative Risk KW - RTPCR, Reverse Transcription-Polymerase Chain Reaction KW - Severity SP - 484 EP - 493 JF - Journal of clinical and experimental hepatology JO - J Clin Exp Hepatol VL - 11 IS - 4 N2 - 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. SN - 0973-6883 UR - https://www.unboundmedicine.com/medline/citation/33398223/Effect_of_COVID_19_on_Pre_existing_Liver_disease:_What_Hepatologist_Should_Know L2 - https://linkinghub.elsevier.com/retrieve/pii/S0973-6883(20)30186-9 DB - PRIME DP - Unbound Medicine ER -
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