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Alcoholic Hepatitis and COVID-19: The Question of Steroids

Sara Zelman1, Erik Holzwanger1, Raza Malik1

  • 1Department of Gastroenterology and Hepatology, Tufts Medical Center, Boston, MA.

ACG Case Reports Journal
|October 4, 2021
PubMed

Insights

Corticosteroids may be safely used in severe acute alcoholic hepatitis patients with COVID-19. This case study shows no worsening of infection, suggesting careful corticosteroid use is possible during the pandemic.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Gastroenterology

Background:

  • The COVID-19 pandemic presents unique challenges in managing co-existing gastrointestinal disorders.
  • Severe acute alcoholic hepatitis (AH) often requires corticosteroid treatment, primarily prednisolone.
  • Corticosteroids carry a risk of exacerbating underlying infections, a concern amplified in COVID-19 patients.

Observation:

  • A case of severe acute AH co-infected with COVID-19 was managed.
  • The patient received standard corticosteroid therapy (prednisolone).

Findings:

  • The patient with severe acute AH and COVID-19 tolerated corticosteroid treatment.
  • No evidence of infection worsening was observed during prednisolone therapy.

Implications:

  • Corticosteroids may be a viable treatment option for severe acute AH even in the presence of COVID-19.
  • Careful monitoring is essential, but the risk of worsening infection may not preclude corticosteroid use.
  • This finding could inform treatment guidelines for patients with overlapping conditions.

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