Liver injury in non-severe COVID-19 with various pandemic phases: a real-world study
Jirayuth Winyupakorn, Chunlanee Sangketchon, Watcharaporn Devakul Na Ayutthaya, Supatsri Sethasine
doi:10.21203/rs.3.rs-3484296/v1
The using of a variety of anti-COVID-19 medicines connected to the degree of liver impairment in the short term was intriguing. To evaluate the dynamic course of liver injury in patients with mild to moderate COVID-19 within 10 days of admission. This was a prospective cohort study of 300 patients who were newly proven mild to moderate COVID-19 between September 2021 and October 2022. There were 188 patients in hospitel/ eld hospital (n = 188) and cohort wards (n = 112). One hundred and fteen patients (38.3%) suffered from liver injury (LI). The majority of Group LI participants (n = 104) received medication to treat the COVID-19 infection, including favipiravir (45%), remdesivir (17.4%), molnupiravir (11.3%), Andrographis paniculata (ADG) (8.7%), and favipiravir in combination with ivermectin (7.7%). When compared to no LI, molnupiravir medication was linked with the largest proportion of transaminase < 2 and 2-5 times the ULN [11.3% vs. 4.9%, p = 0.038; 15.2% vs. 4.9%, p = 0.013]. After 10 days, the majority of patients exhibited a transaminase decline. A less-than-critical level of liver damage was reported in mild to moderate COVID-19 that allows clinicians to administer a variety of standard medications during short periods of hospital stay.
We emphasized the real-world dynamics of LI in mild to moderate COVID-19, the less-than-critical state of liver impairment that enables physicians to give a variety of common drugs over the course of the entire hospitalization period.
Declarations Data availability The data used in this work are available upon reasonable request from the corresponding author.
References
Asselah, Durantel, Pasmant, Lau, Schinazi, COVID-19: Discovery, diagnostics and drug development, J Hepatol
Cai, Huang, Yu, Zhu, Xia et al., COVID-19: Abnormal liver function tests, J Hepatol
Chen, Zhou, Dong, Qu, Gong et al., Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study, Lancet
Fan, Chen, Li, Cheng, Yang et al., Clinical Features of COVID-19-Related Liver Functional Abnormality, Clin Gastroenterol Hepatol
Guan, Ni, Hu, Liang, Ou et al., Clinical Characteristics of Coronavirus Disease 2019 in China, N Engl J Med
Huang, Wang, Li, Ren, Zhao et al., Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China, Lancet
Hundt, Deng, Ciarleglio, Nathanson, Lim, Abnormal Liver Tests in COVID-19: A Retrospective Observational Cohort Study of 1,827 Patients in a Major U, S. Hospital Network. Hepatology
Ji, Qin, Xu, Zhang, Cheng et al., Non-alcoholic fatty liver diseases in patients with COVID-19: A retrospective study, J Hepatol
Kaewdech, Nawalerspanya, Assawasuwannakit, Chamroonkul, Jandee et al., The use of Andrographis paniculata and its effects on liver biochemistry of patients with gastrointestinal problems in Thailand during the COVID-19 pandemic: a cross sectional study, Sci Rep
Kaneko, Kurosaki, Nagata, Taki, Ueda et al., Liver injury with COVID-19 based on gastrointestinal symptoms and pneumonia severity, PLoS One
Kulkarni, Kumar, Tevethia, Premkumar, Arab et al., Systematic review with meta-analysis: liver manifestations and outcomes in COVID-19, Aliment Pharmacol Ther
Li, Moore, Vasilieva, Sui, Wong et al., Angiotensin-converting enzyme 2 is a functional receptor for the SARS coronavirus, Nature
Ortiz, Lenhart, Becker, Schwambach, Tovo et al., Drug-induced liver injury and COVID-19: A review for clinical practice, World J Hepatol
Phipps, Barraza, Lasota, Sobieszczyk, Pereira et al., Acute Liver Injury in COVID-19: Prevalence and Association with Clinical Outcomes in a Large U, Hepatology
Pontolillo, Ucciferri, Borrelli, Nicola, Vecchiet et al., Molnupiravir as an Early Treatment for COVID-19: A Real Life Study, Pathogens
Singh, Khan, Clinical Characteristics and Outcomes of Coronavirus Disease 2019 Among Patients With Preexisting Liver Disease in the United States: A Multicenter Research Network Study, Gastroenterology
Sodei An, Seyedalhosseini, Kian, Eftekhari, Najari et al., Drug-Induced Liver Injury in COVID-19 Patients: A Systematic Review, Front Med
Songvut, Suriyo, Panomvana, Rangkadilok, Satayavivad, A comprehensive review on disposition kinetics and dosage of oral administration of Andrographis paniculata, an alternative herbal medicine, in co-treatment of coronavirus disease, Front Pharmacol
Vespa, Pugliese, Piovani, Capogreco, Danese et al., Liver tests abnormalities in COVID-19: trick or treat?, J Hepatol
Wang, Hu, Hu, Zhu, Liu et al., Clinical Characteristics of 138 Hospitalized Patients With 2019 Novel Coronavirus-Infected Pneumonia in Wuhan, China, Jama
Wijarnpreecha, Ungprasert, Panjawatanan, Harnois, Zaver et al., COVID-19 and liver injury: a meta-analysis, Eur J Gastroenterol Hepatol
Williamson, Walker, Bhaskaran, Bacon, Bates et al., Factors associated with COVID-19-related death using OpenSAFELY, Nature
Yu, Du, Yan, Guo, He et al., Liver injury in COVID-19: clinical features and treatment management, Virol J
Zhang, Shi, Wang, Liver injury in COVID-19: management and challenges, Lancet Gastroenterol Hepatol
