Concluded Case

Hepatic dysfunction in COVID- 19

Liver injury or hepatic dysfunction is more prevalent in severe COVID- 19 patients . Management of Patients with Chronic liver disease with COVID- 19 patients. This study is from 1.Lancet Gastroenteral Hepatol 2020 https;// doi.org/10.1016/S2468- 1253(20) 30057- 1 2.EASL - ESCMID - Correspondence Address Thomas. Berg@medizin.uni-leipzig.de (T- Berg) Data indicate that 2- 11% of patients with COVID- 19 had liver co- morbidities but 14- 53 % cases reported abnormal ALT and AST levels during disease progression. Patients with severe COVID- 19 seem to have a higher risk of liver dysfunction..Liver damage in COVID- 19 patients might be directly caused by the viral infection of the hepatocytes .Pathological studies confirmed the presence of virus in liver tissue, although virus titre were relatively low . ACE 2 receptor expression is enriched in cholangiocytes indicating that SARS- COV- 2 might directly bind to ACE - 2 positive cholangiocytes to deregulate liver function. Associated COVID- 19 medications also add to hepatotoxicity .liver damage in mild COVID-19 cases can return to normal but when severe liver damage occurs requires liver protective medications. Certain specific considerations are needed in patients with pre- existing CLD and COVID-19 disease. 1.In patients with decompensated cirrhosis, treatment for cirrhosis associated complications such as portal hypertension, Ascitis, hepatic encephalopathy should be continued. 2.In patients with HCC - locoregional therapies should be postponed, whenever possible and immune check point inhibitor therapy temporarily withdrawn 3. In patients with liver transplantation, dose adjustment of calceurin and / or m- TOR inhibitors might be required depending upon the antiviral therapy indicated

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Severe COVID 19 patients can involve multi organs including Liver , kidneys and heart
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Very nice updates in present scenario regarding panendemics.useful for professional all branches.
Thank you doctor
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Wonderful update dear Parveen. Very useful for all Doctors on the earth, not only Curofians.
Thank you doctor
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Severe COVID 19 patients can involve multi organs including Liver , kidneys and heart
Useful
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