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Critical Update on the Diagnosis and Management of COVID-19 in Advanced Cirrhosis and Liver Transplant Recipients

Cyriac Abby Philips1, Mohamed Rela2, Arvinder Singh Soin3

  • 1Department of Clinical and Translational Hepatology and The Monarch Liver Laboratory, The Liver Institute, Center of Excellence in Gastrointestinal Sciences, Rajagiri Hospital, Aluva, Kerala, India.

Journal of Clinical and Translational Hepatology
|December 30, 2021
PubMed

Insights

COVID-19 poses risks for patients with advanced cirrhosis, potentially leading to acute-on-chronic liver failure. Immunosuppression in liver transplant recipients may alter COVID-19 outcomes.

Area of Science:

  • * Immunology
  • * Hepatology
  • * Infectious Diseases

Background:

  • * The COVID-19 pandemic presents unique challenges for vulnerable patient groups.
  • * Patients with decompensated cirrhosis are at increased risk for severe COVID-19 progression and acute-on-chronic liver failure.
  • * Liver transplant recipients have altered immune profiles due to immunosuppression, potentially influencing COVID-19 responses.

Purpose of the Study:

  • * To review COVID-19 outcomes in patients with advanced cirrhosis.
  • * To examine the impact of COVID-19 on liver transplant recipients.
  • * To explore the immunopathogenesis of COVID-19 in relation to liver disease and immunosuppression.

Main Methods:

  • * Comprehensive literature review.
  • * Analysis of immunopathogenesis of COVID-19.
  • * Correlation of COVID-19 with advanced liver disease and immunosuppression.

Main Results:

  • * Patients with decompensated cirrhosis face higher risks of severe COVID-19 and complications like acute-on-chronic liver failure.
  • * Immunosuppression in liver transplant recipients may modulate inflammatory responses to COVID-19.
  • * The review synthesizes current knowledge on COVID-19's effects in these specific populations.

Conclusions:

  • * Advanced cirrhosis is a significant risk factor for severe COVID-19 outcomes.
  • * Immunosuppression in liver transplant recipients warrants further investigation regarding COVID-19 susceptibility and severity.
  • * Understanding these interactions is crucial for managing COVID-19 in patients with liver disease and transplant recipients.

Keywords:
Acute-on-chronic liver failureCirrhosisCoronavirusCritical careHepatic encephalopathyMultiple-organ failurePortal hypertensionSepsis

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