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

Philips, Cyriac Abby; Rela, Mohamed; Soin, Arvinder S.; Gupta, Subhash; Sudhindran, S.; Augustine, Philip

doi:10.14218/jcth.2021.00228

Cited by 4 publications

(5 citation statements)

References 124 publications

(245 reference statements)

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“…A similar observation in a larger group of patients showed an increased number of hospitalizations among patients with AH and ALD during the COVID-19 pandemic. Furthermore, the mortality in the course of ALD compared to pre-pandemic years was greater, too [225,226].…”

Section: Coronavirus In Ald Patientsmentioning

confidence: 97%

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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Section: Coronavirus In Ald Patientsmentioning

confidence: 97%

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

Michalak,

Lach,

Szczygieł

et al. 2024

IJMS

View full text Add to dashboard Cite

show abstract

“…The standard treatment for COVID-19 infection of different severity can be administered to LT recipients, albeit cautiously[ 53 , 54 ]. In most cases, it is advised to maintain immunosuppression, preferably the minimum effective regimen, to prevent rejection and aid recovery from COVID-19[ 55 ]. Systematic reviews and meta-analyses showed that the most commonly used immunosuppressant in LT recipients with COVID-19 were calcineurin inhibitors (CNI), followed by antimetabolites like mycophenolate mofetil (MMF), and finally corticosteroids.…”

Section: Covid-19 Treatment In Lt Recipientsmentioning

confidence: 99%

“…It is recommended to decrease but not stop CNI in LT recipients with COVID-19-related lymphopenia, fever, or deteriorating pulmonary status[ 58 ]. In patients with renal impairment, it is recommended to use a higher corticosteroid dose while reducing or stopping CNI until kidney functions are normalized[ 55 ].…”

Section: Covid-19 Treatment In Lt Recipientsmentioning

confidence: 99%

Diagnosis, treatment protocols, and outcomes of liver transplant recipients infected with COVID-19

Hashem¹,

El-Kassas²

2023

World J Clin Cases

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Several cases of fatal pneumonia during November 2019 were linked initially to severe acute respiratory syndrome coronavirus 2, which the World Health Organization later designated as coronavirus disease 2019 (COVID-19). The World Health Organization declared COVID-19 as a pandemic on March 11, 2020. In the general population, COVID-19 severity can range from asymptomatic/mild symptoms to seriously ill. Its mortality rate could be as high as 49%. The Centers for Disease Control and Prevention have acknowledged that people with specific underlying medical conditions, among those who need immunosuppression after solid organ transplantation (SOT), are at an increased risk of developing severe illness from COVID-19. Liver transplantation is the second most prevalent SOT globally. Due to their immunosuppressed state, liver transplant (LT) recipients are more susceptible to serious infections. Therefore, comorbidities and prolonged immunosuppression among SOT recipients enhance the likelihood of severe COVID-19. It is crucial to comprehend the clinical picture, immunosuppressive management, prognosis, and prophylaxis of COVID-19 infection because it may pose a danger to transplant recipients. This review described the clinical and laboratory findings of COVID-19 in LT recipients and the risk factors for severe disease in this population group. In the following sections, we discussed current COVID-19 therapy choices, reviewed standard practice in modifying immunosuppressant regimens, and outlined the safety and efficacy of currently licensed drugs for inpatient and outpatient management. Additionally, we explored the clinical outcomes of COVID-19 in LT recipients and mentioned the efficacy and safety of vaccination use.

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“…The disease was first discovered on December 19, 2019, in Wuhan, China [1], which was later declared as a public health emergency by the World Health Organization (WHO) on January 30, 2020. This viral pandemic spreads through respiratory droplets via sneezing and coughing and has an incubation period of approximately 3-5 days [2]. The most common clinical manifestations of COVID-19 are fever, cough, dyspnea, fatigue, myalgia, and gastrointestinal symptoms [3].…”

Section: Introductionmentioning

confidence: 99%

Rapid Turn From Cirrhosis to Encephalopathy Following COVID-19 Infection: A Cautionary Tale

Chowdhury¹,

Sultana²,

Dutta³

et al. 2022

Cureus

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The coronavirus disease 2019 infection has most commonly led to patients presenting with pulmonary disease, including severe acute respiratory syndrome. However, in about 14-53% of patients with a newly diagnosed COVID-19 infection, the liver is the organ most drastically affected, as opposed to the lungs. In patients with preexisting liver damage, the first symptom of a COVID-19 infection may come from worsening liver failure such as hepatic encephalopathy or worsening ascites. This case report highlights this unusual presentation of a COVID-19 infection in a patient with preexisting alcoholic liver cirrhosis. We report this case to heed warning that acutely worsening liver failure may be the first presenting symptom of a superimposed COVID-19 infection on preexisting liver disease.

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

Cited by 4 publications

References 124 publications

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

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

Diagnosis, treatment protocols, and outcomes of liver transplant recipients infected with COVID-19

Rapid Turn From Cirrhosis to Encephalopathy Following COVID-19 Infection: A Cautionary Tale

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