As the COVID-19 pandemic continues to cause devastating health crises and economic strains across the globe, people with underlying diseases — including liver impairment — have urgent concerns about their added vulnerability to this virus, which has been reported to severely impact those who are older and/or with co-diagnosed conditions. If you or your loved one has liver disease, it’s important to understand your COVID-19 risk to properly protect yourself and get the appropriate medical help when necessary.

UNDERSTANDING YOUR RISK

Some people living with existing chronic conditions could be at greater risk of serious health complications if they become infected with COVID-19. In the wake of SARS (a viral respiratory illness caused by an earlier strain of coronavirus) in 2004, a study found that up to 6 percent of patients with SARS had liver diseases, with liver biopsy specimens that showed viral nucleic acids and injury. The study authors noted that these may have been the result of drug-induced liver injury, considering that most of these patients were treated with high doses of potentially hepatotoxic antivirals, antibiotics, and steroids. With the rapid spread of COVID-19, it doesn’t come as a surprise that having simultaneous liver impairment, such as hepatitis or fatty liver disease, has emerged as an important concern.

People with other chronic conditions also pose a significant risk of contacting COVID-19. Older adults and those with co-diagnosed conditions such as diabetes, cardiovascular disease, and hypertension. Hydroxychloroquine and chloroquine, which have been in the spotlight in the fight against COVID-19, are reportedly fatal if mixed with anti-diabetic drug metformin. A recent study on mice found a potential serious clinical toxicity with unsupervised drug combinations. “We hope that our report will be helpful to stimulate pharmacovigilance and monitoring of adverse drug reactions with the use of CQ or HCQ, particularly in combination with metformin,” stressed the study authors.

It’s also worth noting that people with hepatitis have also been found to have high rates of comorbid conditions like heart diseases. People with non-alcoholic fatty liver disease (NAFLD) or its more severe form, nonalcoholic steatohepatitis (NASH), often have cardiovascular risk factors, including metabolic syndrome, obesity, and diabetes, which all increase the risk for severe COVID-19 complications.

People with undiagnosed liver disease, especially nonalcoholic fatty liver disease, may also be at higher risk of having severe COVID-19 outcomes. Having an unrecognized liver condition could make them more susceptible to liver injury from the virus, medications used in supportive management or hypoxia.

REMINDERS FOR PEOPLE WITH HEPATITIS

People with hepatitis should use the same protective measures recommended for the general population, including staying at home and physical distancing when in public, wearing a mask as recommended, and washing their hands frequently. Monitor your health and your medications, particularly for those with hepatitis B or C who are taking medical treatment. While hepatitis medication supplies are not anticipated to be impacted by COVID-19-related treatment, be sure to have your physician’s contact information and have a plan on getting your prescriptions refilled. Know how to contact your health care provider through telehealth options, should you need to have a consultation during the pandemic. ADRLF encourages you to stay healthy, safe and vigilant about your health in these unprecedented times — with knowledge, confidence and togetherness, we can stay strong!

For additional tips for people with liver impairment, click here

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