Concerning Connection between COVID-19 and Liver Injuries
(From left) Professor Vincent Wong, Professor Grace Wong, and Dr Terry Yip from the Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics of CU Medicine.
In a recent study published in the world-renowned medical journal, Gut, researchers from the Faculty of Medicine at The Chinese University of Hong Kong (CU Medicine) showed that about 20% of more than 1,000 COVID-19 patients in Hong Kong had some form of liver injury.
This is concerning, because COVID-19 patients with liver injuries are eight times more likely to be admitted to an intensive care unit (ICU), require invasive mechanical ventilation or, in the worst cases, lose their lives.
Lead author of the study, Dr Terry Cheuk Fung Yip, a post-doctoral fellow of the Department of Medicine and Therapeutics at CU Medicine, explained, ‘Our findings proved that the chance of patients with liver injury having adverse clinical outcomes is higher than that of others.’ From the data obtained in the study, 53 patients (5.1%) were admitted to an ICU, 22 (2.1%) received invasive mechanical ventilation, and 4 (0.4%) passed away.
Professor Grace Lai Hung Wong, Professor in the Division of Gastroenterology and Hepatology, Department of Medicine and Therapeutics at CU Medicine, believes that liver injuries could possibly be caused by systemic inflammation and adverse drug reactions. ‘As the degree of liver injury could be impacted by coexisting chronic hepatitis in patients, a thorough review of medical histories and detailed investigations for concomitant liver diseases are crucial for improving patient outcomes.’
As clinical outcomes in COVID-19 patients are closely related to liver health, there is an urgent need for better treatment practices. This is particularly important for patients in Asia Pacific, where liver diseases are most prevalent. According to the World Health Organization, liver diseases caused 4.6% of deaths in the Asia-Pacific region in 2015, compared with 2.7% in the USA and 2.1% in Europe.
Call for a New Treatment Approach
Earlier this year, CU Medicine researchers led a group of experts from mainland China, Japan, Singapore and Australia in issuing a position statement in The Lancet Gastroenterology & Hepatology on the management of COVID-19 patients with liver derangement in the Asia-Pacific region.
CU Medicine leads a group of international experts in issuing a position statement on the management of COVID-19 patients with liver derangement in the Asia-Pacific region.
Among its recommendations, the group proposed that precautions should be taken in the use of pharmacological treatments for COVID-19 patients with liver derangement. In particular, it emphasised the need for assessments and careful management of patients who had hepatitis B or hepatitis C, non-alcoholic fatty liver disease, liver cirrhosis, or liver transplants.