Department of Medicine and Therapeutics, and Medical Data Analytic Centre, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, China.
Department of Gastroenterology, St Vincent's Hospital Melbourne, University of Melbourne, Melbourne, VIC, Australia.
Lancet Gastroenterol Hepatol. 2020 Aug;5(8):776-787. doi: 10.1016/S2468-1253(20)30190-4. Epub 2020 Jun 23.
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.
COVID-19 大流行在全球迅速蔓延。无论是肝炎、胆汁淤积还是两者兼有,临床上都常见到 COVID-19 患者肝功能异常。肝功能异常在不同临床情况下的临床意义可能不同。鉴于其临床意义的证据不断增加,在 COVID-19 大流行期间,为各种常见的肝功能异常临床情况提供临床建议将具有临床帮助。亚太地区 COVID-19 期间肝脏功能障碍工作组成立,旨在对文献进行系统审查,特别关注在大流行期间已经或有发生肝功能异常风险的患者的临床管理。本文讨论了涵盖肝功能异常时 COVID-19 的药物治疗使用、慢性乙型肝炎或丙型肝炎、非酒精性脂肪性肝病、肝硬化和肝移植患者的评估和管理等临床情况。