Drug-Induced Liver Disturbance During the Treatment of COVID-19

Zhai, Guangju; Li, Meifen; Wang, Ying; Wu, Jian

doi:10.3389/fphar.2021.719308

Cited by 17 publications

(17 citation statements)

References 63 publications

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“… 9 , 18 Although cases of AKI and increased aminotransferase level have been reported for treating COVID‐19, even among healthy volunteers, many randomised controlled studies have demonstrated limited adverse events with an acceptable safety profile. 9 , 11 , 12 , 13 , 14 , 15 , 19 , 20 , 21 …”

Section: Introductionmentioning

confidence: 99%

“…9,18 Although cases of AKI and increased aminotransferase level have been reported for treating COVID-19, even among healthy volunteers, many randomised controlled studies have demonstrated limited adverse events with an acceptable safety profile. 9,[11][12][13][14][15][19][20][21] In brief, kidney and liver injury are reported shortly after remdesivir initiation in case studies, 9,[22][23][24] but the exact injury mechanisms remain to be defined and investigated. Controlled trials may find remdesivir to be generally tolerable, [25][26][27] yet its safety data on AKI and acute liver injury (ALI) in the post-marketing real-world setting have not been published so far.…”

Section: Introductionmentioning

confidence: 99%

“…Despite these possible injurious mechanisms, the previous usage of remdesivir treating MER and EVD demonstrates a safe profile without significant renal adverse events 9,18 . Although cases of AKI and increased aminotransferase level have been reported for treating COVID‐19, even among healthy volunteers, many randomised controlled studies have demonstrated limited adverse events with an acceptable safety profile 9,11–15,19–21 …”

Section: Introductionmentioning

confidence: 99%

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Remdesivir use and risks of acute kidney injury and acute liver injury among patients hospitalised with COVID‐19: a self‐controlled case series study

Wong

Cheng

et al. 2022

Aliment Pharmacol Ther

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Aim To investigate and quantify the risks of AKI and ALI associated with remdesivir use, given the underlying diseases of SARS‐CoV‐2 infection. Methods This self‐controlled case series (SCCS) study was conducted using electronic hospital records between 23 January 2020 and 31 January 2021 as retrieved from the Hong Kong Hospital Authority which manages all laboratory‐confirmed COVID‐19 cases in Hong Kong. Outcomes of AKI and ALI were defined using the KDIGO Guideline and Asia Pacific Association of Study of Liver consensus guidelines. Incidence rate ratios (IRR) for AKI and ALI following the administration of remdesivir (exposure) in comparison to a non‐exposure period were estimated using the conditional Poisson regression models. Results Of 860 COVID‐19 patients administered remdesivir during hospitalisation, 334 (38.8%) and 137 (15.9%) had incident ALI and AKI, respectively. Compared with the baseline period, both ALI and AKI risks were increased significantly during the pre‐exposure period (ALI: IRR = 6.169, 95% CI = 4.549–8.365; AKI: IRR = 7.074, 95% CI = 3.763–13.298) and remained elevated during remdesivir treatment. Compared to the pre‐exposure period, risks of ALI and AKI were not significantly higher in the first 2 days of remdesivir initiation (ALI: IRR = 1.261, 95% CI = 0.915–1.737; AKI: IRR = 1.261, 95% CI = 0.889–1.789) and between days 2 and 5 of remdesivir treatment (ALI: IRR = 1.087, 95% CI = 0.793–1.489; AKI: IRR = 1.152, 95% CI = 0.821–1.616). Conclusion The increased risks of AKI and ALI associated with intravenous remdesivir treatment for COVID‐19 may be due to the underlying SARS‐CoV‐2 infection. The risks of AKI and ALI were elevated in the pre‐exposure period, yet no such increased risks were observed following remdesivir initiation when compared to the pre‐exposure period.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Remdesivir use and risks of acute kidney injury and acute liver injury among patients hospitalised with COVID‐19: a self‐controlled case series study

Wong

Cheng

et al. 2022

Aliment Pharmacol Ther

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“…The manifestations of SARS-CoV-2 infection mainly include fever, fatigue, and dry cough [5]. Some patients present symptoms, including runny nose, sore throat, nasal congestion, and diarrhea [6]. Those with severe symptoms usually present dyspnea and hypoxemia one week after the disease appear.…”

Section: Introductionmentioning

confidence: 99%

Effects of Different Therapeutic Schedules on Patients with COVID-19: A Prospective Case–Control Study in China

Wang

Cai

et al. 2022

Advanced Gut & Microbiome Research

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Background and Aims. At present, a targeted drug has not been found for patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study assessed the effects of different therapeutic schedules on patients with COVID-19. Methods. The clinical characteristics, the prognosis of patients with western medicine (WM) treatment, and the combination of traditional Chinese medicine and western medicine (TCM-WM) treatment were retrospectively explored from January 20, 2020 to February 20, 2021. Results. 19 patients (15.20%) and 7 patients (5.60%) in the WM treatment group developed into severe type and critically ill, which were higher than 5 patients (9.43%) and 0 patients (0.00%) in the TCM-WM treatment group ( p = 0.306 and p = 0.08 ). The time from admission to severe in the WM treatment group was significantly shorter than that of the TCM-WM treatment group (7.5 vs. 11.2, p < 0.001 ). Compared with patients in the TCM-WM treatment group, the average stay time and the negative nucleic acid time of patients in the WM treatment group were both significantly longer (both p < 0.05 ). Besides, there existed no statistical difference for the safety of the two treatment options and nucleic acid test positive 14 days after discharge between the two groups. In line with the performance for severe patients, the average stay, the nucleic acid negative time, and the days of hormone therapy in the WM treatment group were all significantly longer than that of the TCM-WM treatment group (32.5 vs. 18.8, p < 0.001 ; 24.5 vs. 14.5, p < 0.001 ; 6.5 vs. 3.0, p < 0.001 ). Conclusions. TCM-WM has better performance in both the disease progression and treatment of severe patients. We recommended that timely TCM-WM should be treated with patients with COVID-19.

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“…In a recent article [ 32 ], it was stated that it is important to evaluate the potential liver damage caused by various drugs in order to help guide clinical practice. In this review, these treatments were associated with minimal liver function abnormalities, but it is very important to pay attention to multimedication.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Hepatic Biochemical Parameters during Antiviral Treatment in COVID-19 Patients

Marc

Moldovan

Hoza

et al. 2021

Biology

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(1) Background: The antiviral treatment for COVID-19 disease started to be largely used in 2020 and has been found to be efficient, although it is not specific for SARS-CoV-2 virus. There were some concerns that it may produce liver damage or other side effects. (2) Methods: The aim of this study was to observe if antiviral therapy is affecting liver parameters or producing other side-effects in patients hospitalized for COVID-19 disease. The study included a group of patients hospitalized in the internal medicine department of Oradea Municipal Clinical Hospital, Romania, between August 2020–June 2021, diagnosed with SARS-CoV-2 viral infection by RT-PCR method or rapid antigen test. During hospitalization, patients were treated with a Lopinavir/Ritonavir (Kaletra) combination, or with Favipiravir or Remdesivir. In addition to monitoring the evolution of the disease (clinical and biochemical), also hepatic parameters were analyzed at admission, during hospitalization, and at discharge. (3) Results: In the group of studied patients, the mean value of aspartat aminotrensferase did not increase above normal at discharge, alanin aminotransferase increased, but below twice the normal values, and cholestasis registered a statistically insignificant slight increase. (4) Conclusions: In our study, we found that all three antivirals were generally well tolerated and their use did not alter liver function in a significant manner.

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Drug-Induced Liver Disturbance During the Treatment of COVID-19

Cited by 17 publications

References 63 publications

Remdesivir use and risks of acute kidney injury and acute liver injury among patients hospitalised with COVID‐19: a self‐controlled case series study

Remdesivir use and risks of acute kidney injury and acute liver injury among patients hospitalised with COVID‐19: a self‐controlled case series study

Effects of Different Therapeutic Schedules on Patients with COVID-19: A Prospective Case–Control Study in China

Evaluation of Hepatic Biochemical Parameters during Antiviral Treatment in COVID-19 Patients

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