Management of Patients with Liver Transplant and Chronic Liver Diseases During COVID-19 Pandemic: A Brief Review

Taher, Mohammad; Miroliaee, Arash; Daryani, Nasser Ebrahimi; Avanaki, Foroogh Alborzi; Aletaha, Najmeh; Nasiri-Toosi, Mohsen; Dashti, Habibollah; Basirat, Vahid; Jafarian, Ali

doi:10.34172/aim.2020.92

Cited by 3 publications

(3 citation statements)

References 29 publications

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“…Multiple guidelines and reviews have been published with the aim of outlining the management of patients with COVID-19 who are either liver transplant candidates or have post-liver transplant status[ 92 - 98 ]. Most have very similar recommendations to the ones by the American Association for the Study of Liver Diseases (AASLD)[ 99 ] and Asian-Pacific Association for the Study of the Liver (APASL)[ 100 ] summarized below.…”

Section: Sars-cov-2 Infection In Liver Transplant Patientsmentioning

confidence: 99%

Liver dysfunction and SARS-CoV-2 infection

Gracia‐Ramos¹,

Jáquez-Quintana²,

Contreras-Omaña³

et al. 2021

WJG

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Severe acute respiratory syndrome coronavirus 2 infection is the cause of coronavirus disease 2019 (COVID-19), which predominantly affects the respiratory system; it also causes systemic and multi-organic disease. Liver damage is among the main extrapulmonary manifestations. COVID-19-associated liver injury is defined as any liver damage occurring during the disease course and treatment of COVID-19 in patients with or without pre-existing liver disease, and occurs in approximately one in five patients. Abnormal liver test results have been associated with a more severe course of COVID-19 and other complications, including death. Mechanisms linking COVID-19 to liver injury are diverse. Particular consideration should be made for patients with pre-existing liver disease, such as metabolic dysfunction-associated fatty liver disease, chronic liver disease due to viral or autoimmune disease, liver transplant carriers, or cirrhosis, given the risk for more severe outcomes. This manuscript summarizes the current lines of evidence on COVID-19-associated liver injury regarding pathophysiology, clinical significance, and management in both patients with or without pre-existing liver disease, to facilitate clinicians’ access to updated information and patient care. Finally, we mention the ideas and recommendations to be considered for future research.

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Section: Sars-cov-2 Infection In Liver Transplant Patientsmentioning

confidence: 99%

Liver dysfunction and SARS-CoV-2 infection

Gracia‐Ramos¹,

Jáquez-Quintana²,

Contreras-Omaña³

et al. 2021

WJG

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“…A positive correlation between death and the length of time on immunosuppressants was reported from an Italian LT center. All deaths associated with COVID-19 were related to patients receiving minimal long-term immunosuppression after LT but not to recently transplanted, fully immunosuppressed patients [58] . Therefore, LT patients seem to be more vulnerable to SARS-CoV-2 due to the use of immunosuppressants, but there is no significant difference in case mortality between LT patients and the general population.…”

Section: Effect Of Covid-19 On Liver Transplantation Patientsmentioning

confidence: 99%

Management of COVID-19 patients with chronic liver diseases and liver transplants

Sun

Guo

et al. 2022

Annals of Hepatology

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The epidemic of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has increasingly attracted worldwide concern. Liver damage or dysfunction occurred in patients with COVID-19 (mainly characterized by moderately elevated serum aspartate aminotransferase levels). However, it is not yet clear whether the COVID-19-related liver injury is mainly caused by the virus infection, potentially hepatotoxic drugs, or other coexisting conditions. Progression of pre-existing chronic liver disease (CLD) may be the underlying mechanism of liver injury. Although COVID-19 patients with CLD, such as nonalcoholic fatty liver disease, liver cirrhosis, and liver cancer, have been deemed at increased risk for serious illness in many studies, little is known about the impact of CLD on the natural history and outcome of COVID-19 patients. Thereby, based on the latest evidence from case reports and case series, this paper discusses the clinical manifestations, treatment, prognosis, and management of the COVID-19 patients with different CLD. This article also reviews the effect of COVID-19 on liver transplantation patients (LT), hoping to work for future prevention, management, and control measures of COVID-19. However, due to the lack of relevant research, most of them are still limited to the theoretical stage, further study of COVID-19 and CLD needs to be improved in the future.

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“…1 COVID-19 has extrapulmonary involvement, including smelling sensation, and neurological, cardiovascular, digestive, hepatobiliary, renal, endocrinologic, and dermatologic systems, among the others. [2][3][4] Digestive symptoms, including anorexia, nausea, vomiting, and diarrhea, are not uncommon in patients with COVID-19, and in some cases, digestive symptoms may occur in the absence of any respiratory symptoms. Furthermore, SARS-CoV-2 could be detected in the stool of infected patients, implicating the possibility of fecal-oral transmission.…”

Section: Introductionmentioning

confidence: 99%

Small Intestine Perforation in a 69-Year-Old Man with COVID-19

Miroliaee

Aletaha

Daryani

et al. 2022

Middle East J Dig Dis

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Coronavirus disease 2019 (COVID-19) had caused pandemia with a high rate of mortality and morbidity. Lung involvement is the main cause of mortality, but central nervous system and cardiac disease, and thromboemboli may participate in increasing mortality. A wide spectrum of organs involvement and complication has been reported as data gathering during the pandemia has progressed. We report a 69-year-old man who was admitted to Imam Khomeini hospital in Tehran and complained of severe abdominal pain and fever. He had been admitted 10 days earlier because of dyspnea and fever. At the first admission, based on the findings in the lung computed tomography (CT) and a positive nasopharyngeal polymerase chain reaction (PCR) test for COVID-19, he was treated with intravenous remdesivir for 5 days and prophylactic anti-coagulant heparin during hospital admission. Two days before the new admission, he was discharged with relative recovery. During the new admission, because of the absence of hypoxemia and leukocytosis diagnostic approach to abdominal pain was planned. In abdominal imaging, evidence of bowel perforation appeared. In laparotomy, suppurative peritonitis and proximal jejunal perforation without definite etiology were seen, and bowel resection and primary anastomosis were done. After 5 days, the patient was discharged in good condition. This case is reported to inform that bowel perforation due to ischemia or vasculitis may complicate the course of COVID-19 and, in cases of gastrointestinal symptoms, should be considered.

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Management of Patients with Liver Transplant and Chronic Liver Diseases During COVID-19 Pandemic: A Brief Review

Cited by 3 publications

References 29 publications

Liver dysfunction and SARS-CoV-2 infection

Liver dysfunction and SARS-CoV-2 infection

Management of COVID-19 patients with chronic liver diseases and liver transplants

Small Intestine Perforation in a 69-Year-Old Man with COVID-19

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