Association Between Drug Treatments and the Incidence of Liver Injury in Hospitalized Patients With COVID-19

Abstract

The outbreak of coronavirus disease 2019 (COVID-19) has led to the emergence of global health care. In this study, we aimed to explore the association between drug treatments and the incidence of drug-induced liver injury (DILI) in hospitalized patients with COVID-19. A retrospective study was conducted on 5113 COVID-19 patients in Hubei province, among which 395 incurred liver injury. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazards models. The results showed that COVID-19 patients who received antibiotics (HR 1.97, 95% CI: 1.55–2.51, p < 0.001), antifungal agents (HR 3.10, 95% CI: 1.93–4.99, p < 0.001) and corticosteroids (HR 2.31, 95% CI: 1.80–2.96, p < 0.001) had a higher risk of DILI compared to non-users. Special attention was given to the use of parenteral nutrition (HR 1.82, 95% CI: 1.31–2.52, p < 0.001) and enteral nutrition (HR 2.71, 95% CI: 1.98–3.71, p < 0.001), which were the risk factors for liver injury. In conclusion, this study suggests that the development of DILI in hospitalized patients with COVID-19 needs to be closely monitored, and the above-mentioned drug treatments may contribute to the risk of DILI.

Effectiveness of COVID-19 Vaccination with mRNA Vaccines for Patients with Cirrhosis in Hungary: Multicentre Matched Cohort Study

“…Previous studies showed that remdesivir was associated with liver injury in COVID-19 patients [ 26 , 27 , 28 ]. Moreover, Gao and colleagues reported that COVID-19 patients receiving corticosteroids had an increased risk of drug-induced liver injury (DILI) in contrast to non-user COVID-19 patients [ 29 ]. Therefore, in our dataset, patients receiving remdesivir or steroids were mostly patients in GROUP A ( Figure 3 ).…”

Impact of COVID-19 in individuals with and without pre-existent digestive disorders with a particular focus on elderly patients

“…In addition, impaired liver function in the elderly increases the drug concentrations in their livers. The decline in liver function also explains the higher incidence of DILI in the elderly[ 105 ]. Therefore, intensive liver function monitoring should be considered for patients treated with drugs such as remdesivir, LPV/v, and tocilizumab.…”

Factors affecting the development of liver fibrosis in patients who experienced COVID-19

“…Поражение печени, возникающее у части пациентов при коронавирусной инфекции, зависит от возраста, географического региона, тяжести протекания COVID-19 в целом и ряда других обстоятельств. Печень является основным органом метаболизма и детоксикации; таким образом, поддержание здоровой функции печени имеет решающее значение для эффективности и переносимости разных схем лечения COVID-19 [25].…”

“…Между пациентами, которые использовали, и теми, кто не использовал эти препараты, наблюдалась достоверная разница в частоте развития лекарственной гепатопатии (p < 0,05). Пациенты, которые получали гидроксихлорохин/хлорохин 362 (95,26%) и ТКМ 3234 (92,77%), реже имели острое повреждение печени [25].…”