Law MF, Ho R, Law KWT, Cheung CKM. Gastrointestinal and hepatic side effects of potential treatment for COVID-19 and vaccination in patients with chronic liver diseases. World J Hepatol 2021; 13(12): 1850-1874 [PMID: 35069994 DOI: 10.4254/wjh.v13.i12.1850]
Corresponding Author of This Article
Man Fai Law, MRCP, Staff Physician, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, Hong Kong, China. mflaw99@yahoo.com.hk
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Review
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Dec 27, 2021; 13(12): 1850-1874 Published online Dec 27, 2021. doi: 10.4254/wjh.v13.i12.1850
Gastrointestinal and hepatic side effects of potential treatment for COVID-19 and vaccination in patients with chronic liver diseases
Man Fai Law, Rita Ho, Kimmy Wan Tung Law, Carmen Ka Man Cheung
Man Fai Law, Carmen Ka Man Cheung, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong, China
Rita Ho, Department of Medicine, North District Hospital, Hong Kong, China
Kimmy Wan Tung Law, West Island School, Hong Kong, China
Author contributions: Law MF, Ho R, Law KWT and Cheung CKM contributed acquisition, analysis, and interpretation of data/references; Law MF and Cheung CKM contributed drafting and approving the manuscript; Ho R and Law KWT contributed approving the manuscript.
Conflict-of-interest statement: The authors have no relevant conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Man Fai Law, MRCP, Staff Physician, Department of Medicine and Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, 30-32 Ngan Shing Street, Shatin, Hong Kong, China. mflaw99@yahoo.com.hk
Received: May 6, 2021 Peer-review started: May 6, 2021 First decision: June 15, 2021 Revised: July 20, 2021 Accepted: November 15, 2021 Article in press: November 15, 2021 Published online: December 27, 2021
Abstract
The outbreak of coronavirus disease 2019 (COVID-19) is a global pandemic. Many clinical trials have been performed to investigate potential treatments or vaccines for this disease to reduce the high morbidity and mortality. The drugs of higher interest include umifenovir, bromhexine, remdesivir, lopinavir/ritonavir, steroid, tocilizumab, interferon alpha or beta, ribavirin, fivapiravir, nitazoxanide, ivermectin, molnupiravir, hydroxychloroquine/chloroquine alone or in combination with azithromycin, and baricitinib. Gastrointestinal (GI) symptoms and liver dysfunction are frequently seen in patients with COVID-19, which can make it difficult to differentiate disease manifestations from treatment adverse effects. GI symptoms of COVID-19 include anorexia, dyspepsia, nausea, vomiting, diarrhea and abdominal pain. Liver injury can be a result of systemic inflammation or cytokine storm, or due to the adverse drug effects in patients who have been receiving different treatments. Regular monitoring of liver function should be performed. COVID-19 vaccines have been rapidly developed with different technologies including mRNA, viral vectors, inactivated viruses, recombinant DNA, protein subunits and live attenuated viruses. Patients with chronic liver disease or inflammatory bowel disease and liver transplant recipients are encouraged to receive vaccination as the benefits outweigh the risks. Vaccination against COVID-19 is also recommended to family members and healthcare professionals caring for these patients to reduce exposure to the severe acute respiratory syndrome coronavirus 2 virus.
Core Tip: Gastrointestinal symptoms such as anorexia, dyspepsia, nausea, vomiting, diarrhea and abdominal pain are common among patients with coronavirus disease 2019 (COVID-19). Liver injury can be a result of systemic inflammation or cytokine storm, or due to the adverse drug reactions of different treatments. Regular monitoring of liver function is recommended. Patients with inflammatory bowel disease, chronic liver diseases or liver transplant recipients are encouraged to receive the COVID-19 vaccine, and the benefits will outweigh the risks in the vast majority of patients.
