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In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess...
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Chronic liver disease significantly impacts drug metabolism due to alterations in hepatic blood flow and enzyme accessibility. This disruption affects the body's pharmacokinetics—the movement and processing of drugs within the system. Key enzymes crucial for metabolizing medications become less accessible, changing how drugs are processed and utilized. Furthermore, liver disease influences the synthesis of plasma proteins, such as albumin and globulins, which play critical roles in drug...
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Hepatic impairment, characterized by decreased liver function, does not uniformly mandate adjustments in drug dosage. Whether dosage modifications are necessary depends on various factors related to the drug's metabolism and elimination pathways. If a drug is primarily excreted via the kidneys and bypasses significant hepatic processing, if it undergoes minimal metabolic transformation in the liver, or if it is volatile and primarily expelled through the lungs, dose adjustments may not be...
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Geriatric patients show significant variation in how their bodies process medications, which can change how effective and safe treatments are. The liver is the primary organ where drug metabolism occurs, involving two main types of chemical reactions: phase I and II. Phase I metabolism is driven by the cytochrome P450 enzyme system, which includes key types such as CYP3A, CYP2D6, and CYP2C9. Research indicates that while aging doesn't notably alter the levels or activity of these enzymes, it...
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In geriatric patients, renal physiology undergoes significant changes, including diminished renal blood flow and a lower glomerular filtration rate (GFR), leading to alterations in medication clearance. Drugs such as aminoglycoside antibiotics, lithium, and digoxin, which rely on glomerular filtration for removal from the body, particularly impact pharmacokinetics. These drugs tend to have slower clearance rates in older adults, necessitating careful dosage considerations.Evaluation of renal...
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COVID-19 induced liver function abnormality associates with age.

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Coronavirus disease 2019 (COVID-19) is a novel infectious disease.
  • The impact of COVID-19 on liver function remains incompletely understood.
  • Liver function test (LFT) abnormalities are a potential complication of COVID-19.

Purpose of the Study:

  • To investigate the incidence of liver function test (LFT) abnormalities in patients with COVID-19.
  • To compare LFT abnormalities between mild/moderate and severe/critical COVID-19 cases.
  • To identify risk factors associated with LFT abnormalities in COVID-19 patients.

Main Methods:

  • Retrospective analysis of 159 COVID-19 patients admitted between January and March 2020.
  • Assessment of liver function tests (LFTs) including liver enzymes and bilirubin.
  • Comparison of LFT abnormality rates between different severity groups (mild/moderate vs. severe/critical).

Main Results:

  • Overall LFT abnormality observed in 17.6% of COVID-19 patients.
  • Significantly higher frequency of LFT abnormality in severe/critical COVID-19 cases (32.4%) compared to mild/moderate cases (11.6%).
  • Older age was associated with LFT abnormalities in severe/critical COVID-19 patients (median age 52 vs. 39 years).

Conclusions:

  • COVID-19 is associated with mild liver function abnormalities, particularly in severe cases.
  • Older patients with severe/critical COVID-19 are at higher risk for liver function impairment.
  • Close liver function monitoring and avoidance of hepatotoxic agents/hypotension are recommended for COVID-19 patients, especially the elderly.