Sodeifian Fatemeh, Seyedalhosseini Zahra Sadat, Kian Naghmeh, Eftekhari Mahya, Najari Shaghayegh, Mirsaeidi Mehdi, Farsi Yeganeh, Nasiri Mohammad Javad
Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Front Med (Lausanne). 2021 Sep 20;8:731436. doi: 10.3389/fmed.2021.731436. eCollection 2021.
The severity of COVID-19 may be correlated with the risk of liver injury development. An increasing number of studies indicate that degrees of hepatotoxicity has been associated with using some medications in the management of COVID-19 patients. However, limited studies had systematically investigated the evidence of drug-induced liver injury (DILI) in COVID-19 patients. Thus, this study aimed to examine DILI in COVID-19 patients. A systematic search was carried out in PubMed/Medline, EMBASE, and Web of Science up to December 30, 2020. Search items included "SARS-CoV-2", "Coronavirus," COVID-19, and liver injury. We included 22 related articles. Among included studies, there was five case report, five case series, four randomizes control trial (RCT), seven cohort studies, and one cross-sectional study. The drugs included in this systematic review were remdesivir, favipiravir, tocilizumab, hydroxychloroquine, and lopinavir/ritonavir. Among included studies, some studies revealed a direct role of drugs, while others couldn't certainly confirm that the liver injury was due to SARS-CoV-2 itself or administration of medications. However, a significant number of studies reported that liver injury could be attributable to drug administration. Liver injury in COVID-19 patients could be caused by the virus itself or the administration of some types of drug. Intensive liver function monitoring should be considered for patients, especially patients who are treated with drugs such as remdesivir, lopinavir/ritonavir, and tocilizumab.
新冠病毒疾病（COVID-19）的严重程度可能与肝损伤发生风险相关。越来越多的研究表明，在COVID-19患者的治疗中，使用某些药物与肝毒性程度有关。然而，仅有有限的研究系统地调查了COVID-19患者药物性肝损伤（DILI）的证据。因此，本研究旨在检测COVID-19患者中的DILI。截至2020年12月30日，我们在PubMed/Medline、EMBASE和科学网进行了系统检索。检索词包括“SARS-CoV-2”“冠状病毒”“COVID-19”和“肝损伤”。我们纳入了22篇相关文章。在纳入的研究中，有5篇病例报告、5篇病例系列、4篇随机对照试验（RCT）、7篇队列研究和1篇横断面研究。本系统评价纳入的药物有瑞德西韦、法匹拉韦、托珠单抗、羟氯喹和洛匹那韦/利托那韦。在纳入的研究中，一些研究揭示了药物的直接作用，而其他研究不能肯定地证实肝损伤是由于SARS-CoV-2本身还是药物给药所致。然而，大量研究报告肝损伤可能归因于药物给药。COVID-19患者的肝损伤可能由病毒本身或某些类型药物的给药引起。对于患者，尤其是接受瑞德西韦、洛匹那韦/利托那韦和托珠单抗等药物治疗的患者，应考虑加强肝功能监测。
