Drug-Induced Liver Injury in COVID-19 Patients: A Systematic Review

Introduction: The severity of COVID-19 may be correlated with the risk of liver injury development. An increasing number of studies indicate that degrees of hepatotoxicity has been associated with using some medications in the management of COVID-19 patients. However, limited studies had systematica...

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Published in:Frontiers in medicine Vol. 8; p. 731436
Main Authors: Sodeifian, Fatemeh, Seyedalhosseini, Zahra Sadat, Kian, Naghmeh, Eftekhari, Mahya, Najari, Shaghayegh, Mirsaeidi, Mehdi, Farsi, Yeganeh, Nasiri, Mohammad Javad
Format: Journal Article
Language:English
Published: Switzerland Frontiers Media SA 20.09.2021
Frontiers Media S.A
Subjects:
adverse drug reaction
Antibiotics
Case reports
Cohort analysis
COVID-19
Cross-sectional studies
Disease
drug induced liver injury (DILI)
Fever
Liver
liver injury
Medicine
Pathogenesis
Patients
Pneumonia
SARS-CoV-2
Severe acute respiratory syndrome coronavirus 2
Side effects
Systematic review
Viral infections
Italy
Netherlands
United States > US
China
Japan
COVID-19
SARS-CoV-2
liver injury
drug induced liver injury (DILI)
adverse drug reaction
ISSN:2296-858X, 2296-858X
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Summary:Introduction: The severity of COVID-19 may be correlated with the risk of liver injury development. An increasing number of studies indicate that degrees of hepatotoxicity has been associated with using some medications in the management of COVID-19 patients. However, limited studies had systematically investigated the evidence of drug-induced liver injury (DILI) in COVID-19 patients. Thus, this study aimed to examine DILI in COVID-19 patients. Methods: A systematic search was carried out in PubMed/Medline, EMBASE, and Web of Science up to December 30, 2020. Search items included “SARS-CoV-2”, “Coronavirus,” COVID-19, and liver injury. Results: We included 22 related articles. Among included studies, there was five case report, five case series, four randomizes control trial (RCT), seven cohort studies, and one cross-sectional study. The drugs included in this systematic review were remdesivir, favipiravir, tocilizumab, hydroxychloroquine, and lopinavir/ritonavir. Among included studies, some studies revealed a direct role of drugs, while others couldn't certainly confirm that the liver injury was due to SARS-CoV-2 itself or administration of medications. However, a significant number of studies reported that liver injury could be attributable to drug administration. Discussion: Liver injury in COVID-19 patients could be caused by the virus itself or the administration of some types of drug. Intensive liver function monitoring should be considered for patients, especially patients who are treated with drugs such as remdesivir, lopinavir/ritonavir, and tocilizumab.
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This article was submitted to Infectious Diseases - Surveillance, Prevention and Treatment, a section of the journal Frontiers in Medicine
Edited by: Marc Jean Struelens, Université libre de Bruxelles, Belgium
Reviewed by: Timotius Ivan Hariyanto, University of Pelita Harapan, Indonesia; Liberata Sportiello, Università della Campania Luigi Vanvitelli, Italy
ISSN:2296-858X
2296-858X
DOI:10.3389/fmed.2021.731436