Review
Care of patients with liver disease during the COVID-19 pandemic: EASL-ESCMID position paper

https://doi.org/10.1016/j.jhepr.2020.100113Get rights and content
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Summary

The coronavirus disease 2019 (COVID-19) pandemic poses an enormous challenge to healthcare systems in affected communities. Older patients and those with pre-existing medical conditions have been identified as populations at risk of a severe disease course. It remains unclear at this point to what extent chronic liver diseases should be considered as risk factors, due to a shortage of appropriate studies. However, patients with advanced liver disease and those after liver transplantation represent vulnerable patient cohorts with an increased risk of infection and/or a severe course of COVID-19. In addition, the current pandemic requires unusual allocation of healthcare resources which may negatively impact the care of patients with chronic liver disease that continue to require medical attention. Thus, the challenge hepatologists are facing is to promote telemedicine in the outpatient setting, prioritise outpatient contacts, avoid nosocomial dissemination of the virus to patients and healthcare providers, and at the same time maintain standard care for patients who require immediate medical attention.

Abbreviations

ACE2
angiotensin-converting enzyme 2
ACE-I
angiotensin-converting enzyme inhibitor
ACLF
acute-on-chronic liver failure
ALT
alanine aminotransferase
AST
aspartate aminotransferase
COVID-19
coronavirus disease 2019
EGD
esophagogastroduodenoscopy
ERC
endoscopic retrograde cholangiography
HCC
hepatocellular carcinoma
MELD
model for end-stage liver disease
NAFLD
non-alcoholic fatty liver disease
NASH
non-alcoholic steatohepatitis
NUC
nucleoside analogue
PIs
protease inhibitors
RdRp
RNA-dependent RNA polymerase
SARS-CoV-2
severe acute respiratory syndrome coronavirus 2
ULN
upper limit of normal

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