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Drug-induced liver injury in COVID-19 patients during hospitalization

Ying Chen1, Cai Shi1, Haiyan Zhan2

  • 1Department of Pharmacy, Renmin Hospital of Wuhan University, Wuhan, China.

Medicine
|March 17, 2023
PubMed

Insights

Drug-induced liver injury (DILI) in COVID-19 patients is common, with over half showing abnormal liver tests. Methylprednisolone use increased DILI risk, while Chinese herbal medicine showed a protective effect.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Clinical Pharmacology

Background:

  • Coronavirus disease 2019 (COVID-19) outbreaks have raised concerns about potential drug-induced liver injury (DILI).
  • Systematic descriptions of DILI in COVID-19 patients are scarce.
  • Understanding liver test abnormalities and DILI is crucial for managing COVID-19 patients.

Purpose of the Study:

  • To assess liver test abnormalities and liver injury characteristics in COVID-19 patients.
  • To investigate the incidence and risk factors of DILI during hospitalization for COVID-19.
  • To identify specific medications associated with DILI in this patient population.

Main Methods:

  • Single-center retrospective analysis of 303 confirmed severe acute respiratory syndrome coronavirus 2 infected patients.
  • Univariate and multivariate logistic regression analyses were employed.
  • Risk factors for liver test abnormality or liver injury were assessed, with a focus on DILI development during hospitalization.

Main Results:

  • At admission, 48.8% of patients had abnormal liver tests and 2.4% had liver injury.
  • During hospitalization, 64.4% had abnormal liver tests and 5.6% had liver injury.
  • Of 135 patients without pre-existing liver issues, 11.1% developed DILI; methylprednisolone was significantly associated with DILI (OR=4.177, P=.035), while Chinese herbal medicine showed a protective effect.

Conclusions:

  • Abnormal liver function is frequent in COVID-19 patients, potentially due to viral infection and medications.
  • Methylprednisolone is a significant risk factor for DILI in hospitalized COVID-19 patients.
  • Chinese herbal medicine may offer protection against liver injury in COVID-19 patients.

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