Challenges in COVID-19 drug treatment in patients with advanced liver diseases:A hepatology perspective  

作　　者：Amr Shaaban Hanafy Sherief Abd-Elsalam 

机构地区：[1]Internal Medicine Department,Zagazig University,Zagazig 44519,Egypt [2]Department of Tropical Medicine,Tanta University,Tanta 35127,Egypt

出　　处：《World Journal of Gastroenterology》2020年第46期7272-7286,共15页世界胃肠病学杂志（英文版）

摘　　要：The global incidence of coronavirus disease 2019(COVID-19)continues to increase despite health care efforts.The disease is caused by coronavirus 2 with high transmission and mortality rates.Little is known about the management of COVID-19 in advanced liver disease.The aim of work was to propose a plan for management of this drastic disease in case of this specific population with review of medications that could be suitable for advanced liver disease.All the guidelines and medications available for treatment of COVID-19 were reviewed with selection of the less toxic medications that could be used in advanced liver disease.Drugs suitable to manage COVID-19 in patients with liver disease might include remdesivir intravenously,nitazoxanide+sofosbuvir,ivermectin,tocilizumab,convalescent plasma,and low molecular weight heparin in certain situations.Advanced liver disease is associated with portal hypertension and splenomegaly with reduction of blood elements and immune dysfunction and impaired T cell function.Thus,when confronted by cytokine storm as an immune response to COVID-19,there may be an increase in the mortality rate of these patients.Through this review,a plan to treat COVID-19 in this special group of patients with advanced cirrhosis is proposed.

关 键 词：CIRRHOSIS COVID-19 DRUGS Advanced liver disease ANTICOAGULATION COAGULOPATHY 

分 类 号：R575[医药卫生—消化系统] R563.1[医药卫生—内科学]