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Management of patients with liver derangement during the COVID-19 pandemic: an Asia-Pacific position statement

Wong GL 1 , Wong VW 1 , Thompson A 2 , Jia J 3 , Hou J 4 , Lesmana CRA 5 Show all authors , Susilo A 6 , Tanaka Y 7 , Chan WK 8 , Gane E 9 , Ong-Go AK 10 , Lim SG 11 , Ahn SH 12 , Yu ML 13 , Piratvisuth T 14 , Chan HL 15 , Asia-Pacific Working Group for Liver Derangement during the COVID-19 Pandemic

Affiliations 

  • 1 Department of Medicine and Therapeutics, and Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China
  • 2 Department of Gastroenterology, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, VIC, Australia
  • 3 Liver Research Centre, Beijing Friendship Hospital, Capital Medical University, Beijing, China
  • 4 Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
  • 5 Department of Gastroenterology, Dr Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, Indonesia
  • 6 Division of Tropical Medicine and Infection, Department of Internal Medicine, Dr Cipto Mangunkusumo National General Hospital, Universitas Indonesia, Jakarta, Indonesia
  • 7 Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
  • 8 Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia
  • 9 New Zealand Liver Transplant Unit, Auckland City Hospital, University of Auckland, Auckland, New Zealand
  • 10 Department of Gastroenterology, Metropolitan Medical Center, Manila, Philippines
  • 11 Department of Medicine, National University of Singapore, Singapore
  • 12 Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
  • 13 Hepatobiliary Division, Department of Internal Medicine and Hepatitis Center, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Taiwan
  • 14 Department of Gastroenterology, NKC Institute of Gastroenterology and Hepatology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Thailand
  • 15 Department of Medicine and Therapeutics, and Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China. Electronic address: [email protected]
Lancet Gastroenterol Hepatol, 2020 08;5(8):776-787.
PMID: 32585136 DOI: 10.1016/S2468-1253(20)30190-4

Abstract

The COVID-19 pandemic has spread rapidly worldwide. It is common to encounter patients with COVID-19 with abnormal liver function, either in the form of hepatitis, cholestasis, or both. The clinical implications of liver derangement might be variable in different clinical scenarios. With growing evidence of its clinical significance, it would be clinically helpful to provide practice recommendations for various common clinical scenarios of liver derangement during the COVID-19 pandemic. The Asia-Pacific Working Group for Liver Derangement during the COVID-19 Pandemic was formed to systematically review the literature with special focus on the clinical management of patients who have been or who are at risk of developing liver derangement during this pandemic. Clinical scenarios covering the use of pharmacological treatment for COVID-19 in the case of liver derangement, and assessment and management of patients with chronic hepatitis B or hepatitis C, non-alcoholic fatty liver disease, liver cirrhosis, and liver transplantation during the pandemic are discussed.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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