DHAKA, July 27, 2020 (BSS) – Patients, who are suffering from advanced liver disease and already have gone through liver transplantation, are more vulnerable to COVID-19, said liver experts.
Patients with advanced chronic liver disease are at increased risk of COVID -19 due to cirrhosis-associated immune dysfunction,” Secretary General of National Liver Foundation of Bangladesh Professor Mohammad Ali told BSS today.
“Patients who have gone through liver transplantation recently and received immune- suppressive therapies may face the same hazards,” he said.
“Elevated liver enzymes in people with Covid-19 should do prompt testing for hepatitis B and C,” Prof Mamun Al Mahtab (Shwapnil), Chairman, Liver Department, Bangabandhu Sheikh Mujib Medical University (BSMMU) 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 told BSS.
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, they 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 autoimmune 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 Mahtab.
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, they said.
Most people infected with the Covid-19 virus may 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.