Impact of Liver Functions by Repurposed Drugs for COVID-19 Treatment  

作　　者：Rongzhi Zhang Qiang Wang Jianshe Yang 

机构地区：[1]The Second Clinical Medical College of Lanzhou University,Lanzhou,Gansu,China [2]Gansu Medical College,Pingliang,Gansu,China [3]Shanghai Tenth People’s Hospital,Tongji University School of Medicine,Shanghai,China

出　　处：《Journal of Clinical and Translational Hepatology》2022年第4期748-756,共9页临床与转化肝病杂志（英文版）

基　　金：This work was supported by the Cuiying Scientific and Technological Innovation Program of Lanzhou University Second Hospital(Grant No.CY2019-BJ07);the Gansu Natural Science Foundation(Grant No.20JR10RA745).

摘　　要：Liver injury is an important complication that may arise in patients suffering from coronavirus disease 2019(COV-ID-19)and is accompanied by a transient increase of transaminases and/or other liver enzymes.Liver function test(LFT)abnormalities generally disappear when the COV-ID-19 resolves or hepatotoxic drugs are discontinued.The LFT abnormalities are associated with drug-induced liver in-jury(DILI),due to the overuse of antimalarials,antivirals,and antimicrobials.Studies have reported varying levels of these liver injuries in COVID-19 patients;however,most in-volve elevated serum aminotransferases.Hepatic dysfunc-tion is significantly high in patients with severe illness and has poor outcome.Normally,the liver is involved in the me-tabolism of many drugs,including nucleoside analogs and protease inhibitors,which are currently repurposed to treat COVID-19.In addition to the manifestation of COVID-19,drugs implemented in its treatment may aggravate liver in-juries.Thus,DILI should be considered especially in those COVID-19 patients with underlying liver disease.It was unclear whether the elevated liver enzymes have originat-ed from the underlying disease or DILI in this population.Furthermore,it is difficult to establish a direct relationship between a specific drug and liver injury.Another possible effect of liver damage may due to inflammatory cytokine storm in severe COVID-19.Liver injury can change metabo-lism,excretion,dosing,and expected concentrations of the drugs,which may make it difficult to achieve a therapeutic dose of the drug or increase the risk of adverse effects.These repurposed drugs have shown limited efficacy against the virus and the disease itself;however,they still pose risk of adverse effects.Careful and close monitoring of LFTs in COVID-19 patients can provide early diagnosis of liver in-jury,and the risk of DILI could be reduced.Also,drug inter-actions in liver-transplanted patients should always be kept in mind for certain immunosuppressive therapies and their known signs of DILI.Altog

关 键 词：Liver injury HEPATOTOXICITY COVID-19 ANTIVIRALS AMINOTRANSFERASES DILI 

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