COVID-19 and liver diseases

Area of Science:

• Hepatology
• Infectious Diseases
• Oncology

Background:

• Coronavirus disease 2019 (COVID-19) is a global pandemic causing viral pneumonia.
• Liver injury, including hepatitis with elevated ALT, is increasingly recognized in COVID-19 patients.
• Pre-existing chronic liver disease (CLD) elevates risks for severe COVID-19 outcomes.

Purpose of the Study:

• To review the impact of COVID-19 on various liver conditions.
• To provide recommendations for managing patients with liver disease during the pandemic.
• To assess risks associated with specific liver diseases and cancer in COVID-19 patients.

Main Methods:

• Literature review and synthesis of current evidence.
• Analysis of reported cases and clinical outcomes.
• Formulation of expert recommendations based on available data.

Main Results:

• Acute liver injury (ALI) occurs in 5-28% of COVID-19 patients.
• COVID-19 poses a threat to hepatitis C virus (HCV) elimination goals.
• Patients with CLD, MAFLD, and cancer face higher risks of severe COVID-19.
• Autoimmune hepatitis (AIH) patients show no increased risk of adverse outcomes.
• Immunosuppressant modifications are generally not advised for mild COVID-19, but may be considered in severe cases.

Conclusions:

• Continued treatment for chronic HCV and HBV is recommended.
• Antiviral therapy may be considered for specific HBV reactivation risks.
• Careful management of immunosuppression is necessary for cancer patients and those with severe COVID-19.
• Understanding COVID-19's multifaceted effects on liver health is critical for patient care.