Drug-induced liver injury and COVID-19: Use of artificial intelligence and the updated Roussel Uclaf Causality Assessment Method in clinical practice

Table 1 Characteristics of the coronavirus disease 2019 inpatients with drug-induced liver injury detected by artificial intelligence in March, 2021

Patient ID	Age/sex	ALT peak (U/L)	Hospital sector	Type of liver injury	Suspected drug	Posology/time treatment	RUCAM score	Causality	DILI diagnosis in EMR	Outcomes (timeframe)	Hospital length of stay (d)
1	83/M	388	ICU	Unclassified	Ivermectin	48 mg daily/6 d	3	Possible	No	Recovered (10 d)	18
					Bicalutamide	150 mg daily/8 d	2	Unlikely
					Linezolid	600 mg 12/12 h/5 d	4	Possible
					Azithromycin	500 mg daily/5 d	4	Possible
					Ceftriaxone	2 g 12/12 h/3 d	4	Possible
2	61/M	269	ICU	Mix	Amoxicillin + Clavulanate	625 mg 8/8 h/3 d	7	Probable	No	Recovered (7 d)	40
					Azithromycin	500 mg daily/7 d	7	Probable
					Ceftriaxone	1 g 12/12 h/5 d	7	Probable
3	62/M	307	ICU	Mix	Tocilizumab	800 mg/1 d	1	Unlikely	No	Recovered (12 d)	31
4	67/M	222	Non-ICU	Cholestatic	Azithromycin	500 mg daily/3 d	3	Possible	No	Recovered (25 d)	28
					Ceftriaxone	1 g 12/12 h/4 d	3	Possible
5	69/F	588	ICU	Cholestatic	Azithromycin	500 mg daily/5 d	4	Possible	No	Death	25
					Ceftriaxone	2 g daily/7 d	4	Possible
6	78/M	163	Non-ICU	Unclassified	Ceftriaxone	2 g daily/7 d	3	Possible	No	Recovered (23 d)	70
7	55/M	682	Non-ICU	Hepatocellular	Azithromycin	500 mg daily/5 d	3	Possible	No	Recovered (6 d)	8
					Ivermectin	18 mg daily/4 d	4	Possible
8	50/F	157	Non-ICU	Unclassified	Ivermectin	18 mg daily/5 d	3	Possible	No	Recovered	7
9	49/F	127	ICU	Cholestatic	Azithromycin	500 mg daily/6 d	3	Possible	No	Recovered (2 d)	17
					Ceftriaxone	2 g daily/9 d	3	Possible
10	57/M	274	Non-ICU	Mix	Azithromycin	500 mg daily/5 d	6	Probable	No	Recovered (4 d)	10
11	22/M	312	Non-ICU	Hepatocellular	Azithromycin	500 mg daily/4 d	4	Possible	No	Recovered	5
					Ceftriaxone	1 g 12/12 h/3 d	4	Possible
12	33/M	551	Non-ICU	Hepatocellular	Ceftriaxone	1 g 12/12 h/53 d	3	Possible	No	Recovered	8
13	61/F	168	Non-ICU	Mix	Piperacillin + tazobactam	4.5 g 8/8 h/9 d	6	Probable	No	Recovered	21
14	32/M	489	Non-ICU	Cholestatic	Ceftriaxone	2 g daily/5 d	5	Possible	No	Recovered (10 d)	10
15	73/M	160	Non-ICU	Mix	Ceftriaxone	1 g daily/8 d	6	Possible	No	Recovered	15
16	29/F	369	Non-ICU	Mix	Amoxicillin + clavulanate	625 mg 8/8 h/3 d	4	Possible	Yes	Recovered	15
17	33/M	213	ICU	Mix	Azithromycin	500 mg daily/5 d	5	Possible	No	Recovered (10 d)	22
					Piperacillin + tazobactam	4.5 g 8/8 h/10 d	4	Possible
					Ivermectin	18 mg daily/1 d	5	Possible
					Albendazole	400 mg daily/2 d	5	Possible

Outcomes (timeframe): Timeframe between drug suspension and recovery of liver injury. Patients 8, 11, 12, 13, and 15 were discharged for ambulatory care without alanine aminotransferase follow-up. Patient 16: Drug-induced liver injury diagnosis was presented in electronic medical record by physicians; however, the suspected drug was ivermectin used by self-medication prior to hospital stay. DILI: Drug-induced liver injury; EMR: Electronic medical records; RUCAM: Roussel Uclaf causality assessment method; ICU: Intensive care unit.