COVID-19 and the Liver: Lessons Learnt from the EAST and the WEST, A Year Later.

Abstract

Globally, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus) has been a major cause for significant morbidity and mortality. Since the start of the pandemic, several hepato-biliary manifestations in coronavirus disease 2019 (COVID-19) have been described and unique considerations raised. The review aims to summarize the pathogenesis and hepato-biliary manifestations in COVID-19 and discuss the similarities, contrasting features and disease-specific management across a range of hepato-biliary diseases from the EAST and the WEST. Published studies and regional society guidelines from the EAST and the WEST were comprehensively reviewed and summarized. A wide range of hepato-biliary manifestations, including the infrequent and chronic manifestation of cholangiopathy, has been observed in COVID-19. The pathogenesis of liver injury is multifactorial and with scant evidence for a direct SARS-CoV-2 infection of the liver. Patients with non-alcoholic fatty liver disease, cirrhosis, and liver cancer are potentially at increased risk for severe COVID-19, and there are unique considerations in chronic hepatitis B or C, hepatocellular carcinoma, and in those immunosuppressed such as autoimmune hepatitis or liver transplant recipients. With the surges in SARS-CoV-2 infection, liver transplant activity has variably been impacted. Preliminarily, SARS-CoV-2 vaccines appear to be safe in those with chronic liver disease and in transplant recipients, while emerging data suggest the need for a third dose in immunosuppressed patients. In conclusion, patients with chronic liver disease, particularly cirrhosis, and liver transplant recipients, are vulnerable to severe COVID-19. Over the past year, several unique considerations have been highlighted across a spectrum of hepato-biliary diseases. Vaccination is strongly recommended for those with chronic liver disease and liver transplant recipients.

• Authors: Sirina Ekpanyapong, Chalermrat Bunchorntavakul, K Rajender Reddy
• Journal: Journal of viral hepatitis (J Viral Hepat) Vol. 29 Issue 1 Pg. 4-20 (01 2022) ISSN: 1365-2893 [Electronic] England
• PMID: 34352133 (Publication Type: Journal Article, Review)
• Copyright: © 2021 John Wiley & Sons Ltd.

Chemical References

• COVID-19 Vaccines

Topics

• COVID-19
• COVID-19 Vaccines
• Humans
• Liver Diseases (epidemiology)
• SARS-CoV-2