COVID-19 in patients with liver disease and liver transplant: clinical implications, prevention, and management

Perreault, Gabriel; Ching, Charlotte; Nobel, Yael R.

doi:10.1177/17562848231188586

Cited by 3 publications

(3 citation statements)

References 109 publications

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“…As compared to individuals without CLD, the patients with CLD and cirrhosis may have more severe disease and a greater COVID-19-associated mortality rate. According to a system review, likelihood of COVD 19 associated severe diseases and death was 2.44 times greater in patients with CLD compared to those without underlying liver diseases 45,46 .…”

Section: Impact Of Covid-19 On Patients With Pre-existing Liver Disor...mentioning

confidence: 99%

Insight into COVID-19 associated liver injury: Mechanisms, evaluation, and clinical implications

Nasir

2024

Hepatology Forum

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COVID-19 has affected millions worldwide, causing significant morbidity and mortality. While predominantly involving the respiratory tract, SARS-CoV-2 has also caused systemic illnesses involving other sites. Liver injury due to COVID-19 has been variably reported in observational studies. It has been postulated that liver damage may be due to direct damage by SARS-CoV-2 virus or multifactorial secondary to hepatotoxic therapeutic options as well as cytokine release syndrome and sepsis-induced multiorgan dysfunction. The approach to a COVID-19 patient with liver injury requires a thorough evaluation of pattern of hepatocellular injury along with presence of underlying chronic liver disease and concurrent medications which may cause drug induced liver injury. While studies have shown uneventful recovery in the majority of mildly affected patients; severe COVID-19 associated liver injury has been associated with higher mortality, prolonged hospitalization, and greater morbidity in survivors. Furthermore, its impact on long term outcomes remains to be ascertained as recent studies report association with metabolic-fatty liver disease. This present review provides insight into the subject by describing the postulated mechanism of liver injury, its impact in the presence of pre-existing liver disease and its short-and long-term clinical implications.

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Section: Impact Of Covid-19 On Patients With Pre-existing Liver Disor...mentioning

confidence: 99%

Insight into COVID-19 associated liver injury: Mechanisms, evaluation, and clinical implications

Nasir

2024

Hepatology Forum

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“…Nonetheless, the situation becomes more complicated among individuals with pre-existing hepatic disorders-mainly non-alcoholic fatty liver disease (NAFLD), MAFLD and cirrhosis [179][180][181]. On the other hand, previously diagnosed viral hepatitis was not found as a triggering factor for liver damage after being infected with the coronavirus [182]. According to global data, the overall risk of a severe course and death because of COVID-19 in patients with CLD becomes 2.44 times greater in comparison to the population with no hepatic problems [183][184][185].…”

Section: Covid-19 In Patients With Pre-existing Liver Failure-general...mentioning

confidence: 99%

“…Another source of data revealed that in 2020 ALD constituted 40.1% of all LT listings and this result was greater than cases related to hepatitis C virus (HCV) and NASH taken together. Another retrospective study performed in the United States between March 2020 and September 2022 showed a more pronounced mortality due to ALD, cirrhosis and hepatic failure in all; the excess risks were 1.4-2.8 times higher [182,203]. One could ask: why?…”

Section: Ethanol Liver and Covid-19-a Global Perspectivementioning

confidence: 99%

COVID-19, Possible Hepatic Pathways and Alcohol Abuse—What Do We Know up to 2023?

Michalak,

Lach,

Szczygieł

et al. 2024

IJMS

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The pandemic period due to coronavirus disease 2019 (COVID-19) revolutionized all possible areas of global health. Significant consequences were also related to diverse extrapulmonary manifestations of this pathology. The liver was found to be a relatively common organ, beyond the respiratory tract, affected by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Multiple studies revealed the essential role of chronic liver disease (CLD) in the general outcome of coronavirus infection. Present concerns in this field are related to the direct hepatic consequences caused by COVID-19 and pre-existing liver disorders as risk factors for the severe course of the infection. Which mechanism has a key role in this phenomenon—previously existing hepatic disorder or acute liver failure due to SARS-CoV-2—is still not fully clarified. Alcoholic liver disease (ALD) constitutes another not fully elucidated context of coronavirus infection. Should the toxic effects of ethanol or already developed liver cirrhosis and its consequences be perceived as a causative or triggering factor of hepatic impairment in COVID-19 patients? In the face of these discrepancies, we decided to summarize the role of the liver in the whole picture of coronavirus infection, paying special attention to ALD and focusing on the pathological pathways related to COVID-19, ethanol toxicity and liver cirrhosis.

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Impact of COVID-19 on liver transplant recipients: A nationwide cohort study evaluating hospitalization, transplant rejection, and inpatient mortality

Inayat,

Patel,

Ali

et al. 2024

World J Transplant

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BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has posed a major public health concern worldwide. Patients with comorbid conditions are at risk of adverse outcomes following COVID-19. Solid organ transplant recipients with concurrent immunosuppression and comorbidities are more susceptible to a severe COVID-19 infection. It could lead to higher rates of inpatient complications and mortality in this patient population. However, studies on COVID-19 outcomes in liver transplant (LT) recipients have yielded inconsistent findings. AIM To evaluate the impact of the COVID-19 pandemic on hospital-related outcomes among LT recipients in the United States. METHODS We conducted a retrospective cohort study using the 2019–2020 National Inpatient Sample database. Patients with primary LT hospitalizations and a secondary COVID-19 diagnosis were identified using the International Classification of Diseases, Tenth Revision coding system. The primary outcomes included trends in LT hospitalizations before and during the COVID-19 pandemic. Secondary outcomes included comparative trends in inpatient mortality and transplant rejection in LT recipients. RESULTS A total of 15720 hospitalized LT recipients were included. Approximately 0.8% of patients had a secondary diagnosis of COVID-19 infection. In both cohorts, the median admission age was 57 years. The linear trends for LT hospitalizations did not differ significantly before and during the pandemic (P = 0.84). The frequency of in-hospital mortality for LT recipients increased from 1.7% to 4.4% between January 2019 and December 2020. Compared to the pre-pandemic period, a higher association was noted between LT recipients and in-hospital mortality during the pandemic, with an odds ratio (OR) of 1.69 [95% confidence interval (CI): 1.55-1.84), P < 0.001]. The frequency of transplant rejections among hospitalized LT recipients increased from 0.2% to 3.6% between January 2019 and December 2020. LT hospitalizations during the COVID-19 pandemic had a higher association with transplant rejection than before the pandemic [OR: 1.53 (95%CI: 1.26-1.85), P < 0.001]. CONCLUSION The hospitalization rates for LT recipients were comparable before and during the pandemic. Inpatient mortality and transplant rejection rates for hospitalized LT recipients were increased during the COVID-19 pandemic.

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COVID-19 in patients with liver disease and liver transplant: clinical implications, prevention, and management

Cited by 3 publications

References 109 publications

Insight into COVID-19 associated liver injury: Mechanisms, evaluation, and clinical implications

Insight into COVID-19 associated liver injury: Mechanisms, evaluation, and clinical implications

COVID-19, Possible Hepatic Pathways and Alcohol Abuse—What Do We Know up to 2023?

Impact of COVID-19 on liver transplant recipients: A nationwide cohort study evaluating hospitalization, transplant rejection, and inpatient mortality

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