Outcomes in Patients with Liver Dysfunction Post SARS-CoV-2 Infection: What Should We Measure?
Nimy John,1 Brittney Ibrahim,2 Mark Ebaid,2 Sammy Saab1,2 1Department of Medicine, University of California, Los Angeles, CA, USA; 2Department of Surgery, University of California, Los Angeles, CA, USACorrespondence: Sammy Saab, Departments of Medicine and Surgery, 200 Medical Plaza, Suite 214, Los...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-10-01
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| Series: | Hepatic Medicine: Evidence and Research |
| Subjects: | |
| Online Access: | https://www.dovepress.com/outcomes-in-patients-with-liver-dysfunction-post-sars-cov-2-infection--peer-reviewed-fulltext-article-HMER |
| _version_ | 1797658948935876608 |
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| author | John N Ibrahim B Ebaid M Saab S |
| author_facet | John N Ibrahim B Ebaid M Saab S |
| author_sort | John N |
| collection | DOAJ |
| description | Nimy John,1 Brittney Ibrahim,2 Mark Ebaid,2 Sammy Saab1,2 1Department of Medicine, University of California, Los Angeles, CA, USA; 2Department of Surgery, University of California, Los Angeles, CA, USACorrespondence: Sammy Saab, Departments of Medicine and Surgery, 200 Medical Plaza, Suite 214, Los Angeles, CA, 90095, USA, Tel +1 310 206 6705, Fax +1 310-206-4197, Email Ssaab@mednet.ucla.eduAim: Since 2019, the COVID-19 pandemic wreaked havoc all over the world. Early in the course of the pandemic, multiple hepatic manifestations of COVID-19 were noted. We aim to categorize hepatic dysfunction and its outcome in COVID-19 infection.Methods: This is a review article based on a literature search in PubMed and Medline databases for articles detailing short-term and long-term outcomes of COVID-19 related liver dysfunction.Results: The most common hepatic manifestation of COVID-19 was aspartate amino transferase (AST) predominant transaminase elevation. Transaminases improve once the COVID-19 infection resolves. In addition, COVID-19 cholangiopathy, autoimmune hepatitis associated COVID-19, and splanchnic venous thrombosis triggered by COVID-19 are other manifestations. Patients with preexisting liver disease, especially those with cirrhosis, have poor prognosis with COVID-19 infections compared to the general population. Elevations in liver tests were associated with severe COVID-19 infections. Patients with chronic liver disease have a higher risk of morbidity and mortality from COVID-19 infection. Among patients with chronic liver disease, decompensated liver cirrhosis, hepatocellular carcinoma and alcohol-associated liver disease were associated with an increased risk of severity and mortality from COVID-19 infection. Interactions between antiviral therapy for COVID-19 and hepatitis B/hepatitis C medications must be considered in patients with chronic viral hepatitis and COVID-19 infection. COVID-19 vaccination-related hepatic dysfunction has been reported.Conclusion: COVID-19 is here to stay. Hepatic dysfunction in COVID-19 signals severe COVID-19 infections. Patients with chronic liver disease have higher mortality from COVID-19 than general population. It is important to remember the lessons learned throughout the covid pandemic to take care of patients with COVID-19 now and in the future. Further studies are needed to document long-term outcomes in patients with COVID-19 who developed hepatic dysfunction.Keywords: COVID-19, liver injury, cirrhosis, thrombosis, cholangiopathy |
| first_indexed | 2024-03-11T18:06:48Z |
| format | Article |
| id | doaj.art-0a2706600585466a92caa58903f32c00 |
| institution | Directory Open Access Journal |
| issn | 1179-1535 |
| language | English |
| last_indexed | 2024-03-11T18:06:48Z |
| publishDate | 2023-10-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Hepatic Medicine: Evidence and Research |
| spelling | doaj.art-0a2706600585466a92caa58903f32c002023-10-17T02:44:54ZengDove Medical PressHepatic Medicine: Evidence and Research1179-15352023-10-01Volume 1518519387336Outcomes in Patients with Liver Dysfunction Post SARS-CoV-2 Infection: What Should We Measure?John NIbrahim BEbaid MSaab SNimy John,1 Brittney Ibrahim,2 Mark Ebaid,2 Sammy Saab1,2 1Department of Medicine, University of California, Los Angeles, CA, USA; 2Department of Surgery, University of California, Los Angeles, CA, USACorrespondence: Sammy Saab, Departments of Medicine and Surgery, 200 Medical Plaza, Suite 214, Los Angeles, CA, 90095, USA, Tel +1 310 206 6705, Fax +1 310-206-4197, Email Ssaab@mednet.ucla.eduAim: Since 2019, the COVID-19 pandemic wreaked havoc all over the world. Early in the course of the pandemic, multiple hepatic manifestations of COVID-19 were noted. We aim to categorize hepatic dysfunction and its outcome in COVID-19 infection.Methods: This is a review article based on a literature search in PubMed and Medline databases for articles detailing short-term and long-term outcomes of COVID-19 related liver dysfunction.Results: The most common hepatic manifestation of COVID-19 was aspartate amino transferase (AST) predominant transaminase elevation. Transaminases improve once the COVID-19 infection resolves. In addition, COVID-19 cholangiopathy, autoimmune hepatitis associated COVID-19, and splanchnic venous thrombosis triggered by COVID-19 are other manifestations. Patients with preexisting liver disease, especially those with cirrhosis, have poor prognosis with COVID-19 infections compared to the general population. Elevations in liver tests were associated with severe COVID-19 infections. Patients with chronic liver disease have a higher risk of morbidity and mortality from COVID-19 infection. Among patients with chronic liver disease, decompensated liver cirrhosis, hepatocellular carcinoma and alcohol-associated liver disease were associated with an increased risk of severity and mortality from COVID-19 infection. Interactions between antiviral therapy for COVID-19 and hepatitis B/hepatitis C medications must be considered in patients with chronic viral hepatitis and COVID-19 infection. COVID-19 vaccination-related hepatic dysfunction has been reported.Conclusion: COVID-19 is here to stay. Hepatic dysfunction in COVID-19 signals severe COVID-19 infections. Patients with chronic liver disease have higher mortality from COVID-19 than general population. It is important to remember the lessons learned throughout the covid pandemic to take care of patients with COVID-19 now and in the future. Further studies are needed to document long-term outcomes in patients with COVID-19 who developed hepatic dysfunction.Keywords: COVID-19, liver injury, cirrhosis, thrombosis, cholangiopathyhttps://www.dovepress.com/outcomes-in-patients-with-liver-dysfunction-post-sars-cov-2-infection--peer-reviewed-fulltext-article-HMERcovid 19liver injurycirrhosisthrombosischolangiopathy |
| spellingShingle | John N Ibrahim B Ebaid M Saab S Outcomes in Patients with Liver Dysfunction Post SARS-CoV-2 Infection: What Should We Measure? Hepatic Medicine: Evidence and Research covid 19 liver injury cirrhosis thrombosis cholangiopathy |
| title | Outcomes in Patients with Liver Dysfunction Post SARS-CoV-2 Infection: What Should We Measure? |
| title_full | Outcomes in Patients with Liver Dysfunction Post SARS-CoV-2 Infection: What Should We Measure? |
| title_fullStr | Outcomes in Patients with Liver Dysfunction Post SARS-CoV-2 Infection: What Should We Measure? |
| title_full_unstemmed | Outcomes in Patients with Liver Dysfunction Post SARS-CoV-2 Infection: What Should We Measure? |
| title_short | Outcomes in Patients with Liver Dysfunction Post SARS-CoV-2 Infection: What Should We Measure? |
| title_sort | outcomes in patients with liver dysfunction post sars cov 2 infection what should we measure |
| topic | covid 19 liver injury cirrhosis thrombosis cholangiopathy |
| url | https://www.dovepress.com/outcomes-in-patients-with-liver-dysfunction-post-sars-cov-2-infection--peer-reviewed-fulltext-article-HMER |
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