WGO Guidance for the Care of Patients With COVID-19 and Liver Disease

作者：Saeed Hamid, Mário Reis Álvares‐da‐Silva, Kelly W. Burak, Tao Chen, Joost P.H. Drenth, Gamal Esmat, Rui Gaspar, Douglas R. LaBrecque, Alice Lee, Guilherme Macedo, Brian J. McMahon, Qin Ning, Nancy Reau, Mark Sonderup, Dirk J. van Leeuwen, David Armstrong, Cihan Yurdaydın · 发表于：Journal of Clinical Gastroenterology · 年份：2020 · DOI：10.1097/mcg.0000000000001459 · 被引用次数：49 · 研究领域：Liver Disease Diagnosis and Treatment、COVID-19 Clinical Research Studies、Pancreatitis Pathology and Treatment

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the least deadly but most infectious coronavirus strain transmitted from wild animals. It may affect many organ systems. Aim of the current guideline is to delineate the effects of SARS-CoV-2 on the liver. Asymptomatic aminotransferase elevations are common in coronavirus disease 2019 (COVID-19) disease. Its pathogenesis may be multifactorial. It may involve primary liver injury and indirect effects such as "bystander hepatitis," myositis, toxic liver injury, hypoxia, and preexisting liver disease. Higher aminotransferase elevations, lower albumin, and platelets have been reported in severe compared with mild COVID-19. Despite the dominance of respiratory disease, acute on chronic liver disease/acute hepatic decompensation have been reported in patients with COVID-19 and preexisting liver disease, in particular cirrhosis. Metabolic dysfunction-associated fatty liver disease (MAFLD) has a higher risk of respiratory disease progression than those without MAFLD. Alcohol-associated liver disease may be severely affected by COVID-19-such patients frequently have comorbidities including metabolic syndrome and smoking-induced chronic lung disease. World Gastroenterology Organization (WGO) recommends that interventional procedures such as endoscopy and endoscopic retrograde cholangiopancreatography should be performed in emergency cases or when they are considered strictly necessary such as high risk varices or cholangit...