Covid-19 patients require extra attention on liver

People with pre-existing liver diseases are more vulnerable to liver damage if infected with Coronavirus ( Covid-19), said a liver expert.

"People with liver-related problem need to be more cautious against the deadly virus… Persons with advanced liver diseases and those after liver transplantation are vulnerable patients with an increased risk of infection," Secretary General, National Liver Foundation of Bangladesh, Professor Mohammad Ali told BSS.

"Liver injuries occur more often in severe Covid-19 cases and that liver enzyme elevations in mild Covid-19 cases have usually been transient. Elevated liver enzymes in people with Covid-19 should prompt testing for hepatitis B and C," he suggested.

"Experimental agents that are being tested as treatments for Covid-19 may have liver toxicities such as 'statins, remdesivir, tocilizumab, lopinavir and ritonavir'" he said.

"Although raised liver enzymes should not be a bar to experimental use of these drugs, regular monitoring of liver enzymes should form part of any experimental protocol for Covid-19 treatment", he said.

"Post liver transplantation patients with age over 60 and immunosuppressed, are more susceptible to get Covid-19 infection, said Prof Ali, also the pioneer liver transplant surgeon of Bangladesh.

"People who have developed advanced liver diseases (including cirrhosis) and deteriorating health as a result of hepatitis B or C should be vigilant in protecting themselves from contracting Covid-19 as they are at risk of more serious illness," he said.

"Patients with auto immune hepatitis, taking prednisolone or Azathioprine should be cautious for Covid-19 as they are more susceptible to infection," he said.

Patients with liver damage are advised to be treated with drugs that could both protect liver function and inhibit inflammatory responses, said Prof Ali.

Attention should also be paid to monitor the occurrence of liver injury and to the application of drugs which may induce liver damage," he said adding, "Patients with liver damage are advised to be treated with drugs that could both protect liver function and inhibit inflammatory responses."

"Drug-induced liver injury during the treatment of coronavirus infection should not be ignored and needs to be carefully investigated," he further added.

Most people infected with the Covid-19 virus will experience mild to moderate respiratory illness and recover without requiring special treatment. Older people and those with underlying medical problems like chronic respiratory disease, cardiovascular disease, diabetes and cancer are more likely to develop serious illness.