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Roadmap to resuming care for liver diseases after coronavirus disease-2019

Devika Kapuria1, Steven Bollipo2,3, Atoosa Rabiee4

  • 1Division of Gastroenterology and Hepatology, University of New Mexico, Albuquerque, New Mexico, USA.

Journal of Gastroenterology and Hepatology
|July 14, 2020
PubMed

Insights

Patients with chronic liver disease face risks from COVID-19 disruptions. This guide offers a roadmap for safely resuming liver care, focusing on outpatient services, transplantation, cancer care, and endoscopy.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Public Health

Background:

  • The COVID-19 pandemic significantly disrupted healthcare, particularly for vulnerable chronic liver disease patients.
  • Chronic liver disease is an independent risk factor for COVID-19 related hospital mortality.
  • Interim management changes, including telehealth and postponed procedures, were recommended for liver disease patients.

Purpose of the Study:

  • To provide a roadmap for the safe resumption of clinical operations for patients with chronic liver disease.
  • To minimize exposure risks for patients and healthcare professionals during the pandemic.
  • To address specific care areas including outpatient services, liver transplantation, liver cancer, and endoscopy.

Main Methods:

  • Review and synthesis of recommendations from national and international societies.
  • Development of a phased approach for resuming clinical services.
  • Emphasis on risk mitigation strategies for patient and provider safety.

Main Results:

  • Concern exists regarding increased morbidity from delayed diagnosis and treatment.
  • A potential delayed surge in decompensated liver disease hospitalizations is anticipated post-pandemic.
  • The roadmap outlines strategies for safe outpatient care, transplantation, cancer management, and endoscopy.

Conclusions:

  • Safe resumption of liver care requires a comprehensive, phased plan.
  • Proactive planning is essential to mitigate risks associated with pandemic-related healthcare disruptions.
  • Prioritizing patient and healthcare professional safety is paramount during service resumption.

Keywords:
COVID-19Chronic liver diseaseEndoscopyHepatocellular carcinomaHepatologyLiver transplantationOutpatientPost-pandemicSARS-CoV-2

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