COVID-19 drug-induced liver injury: A recent update of the literature

Abstract

The severity of coronavirus disease 2019 (COVID-19) may be correlated with the risk of liver injury development. An increasing number of studies indicate that degrees of hepatotoxicity have been associated with using some medications in the management of COVID-19 patients. However, limited studies have systematically investigated the evidence of drug-induced liver injury (DILI) in COVID-19 patients. An increasing number of studies indicate that degrees of hepatotoxicity have been associated with using some of these medications in the management of COVID-19 patients. Significantly, it was relieved after the cessation of these agents. However, to our knowledge, no studies have systematically investigated the evidence of DILI in COVID-19 patients. In this review, we discussed the association between hepatotoxicity in COVID-19 patients and the drugs used in these patients and possible mechanisms of hepatotoxicity. The currently available evidence on the association of different therapeutic agents with hepatotoxicity in COVID-19 patient was systematically reviewed.

Age-dependent immune responses in COVID-19-mediated liver injury: focus on cytokines

“…Several hepatotoxic medications, particularly those used to treat COVID-19, have been related to drug-induced liver damage ( 15 ). However, liver injury is defined as any damage to the liver that occurs during disease or treatment ( 16 ). As a result, the proportion of hospitalized COVID-19 patients with altered liver biomarkers ranges from 14% to 53%.…”

Asymptomatic COVID-19 presenting with features of mixed pattern acute liver injury in a young healthy female, a case report

“…There are no standard guidelines, and various management approaches have been discussed in the literature based on expert opinion and individual case-based clinical judgment [12] . We created an algorithm to summarize those proposals mentioned in the literature [13] , [14] , as in Fig. 2 .…”

“…**Other cause of raised liver enzymes other than liver injury: myositis (especially glutamic oxalacetic transaminase > ALT), cardiac injury, ischemia, and cytokine release syndrome [12] . ***Likely causes of drug induced liver damage in COVID 19 patient: anti-viral drugs like Remdesevir, Lopinavir/Ritonavir, corticosteroids, Oseltamivir, Tocilizumab, tofacitinib, Acetaminophen, SARS-Cov-2 Vaccination, antibiotics like azithromycin, anti-malarial like hydroxychloroquine [14] . …”

Coronavirus Disease 2019 Associated Liver Injury and Disease Severity: A Cross-Sectional Study

“…This is exacerbated by the viral cytopathic effect and inflammation, namely cytokine storm, common in critical Covid-19 cases. [14][15][16] Thus, vigilance and stricter surveillance, as well as an individualized therapeutic approach, are needed in patients with severe Covid-19 infection, especially those subjects with characteristics supporting liver injury. 4,17,18 The strength of this study is that it has attempted to rule out baseline liver disease in the subjects; thus, it can provide an overview of changes in liver function due to Covid-19 infection.…”