The Liver’s Fate Amid COVID-19 Pandemic

Corona-virus disease (COVID-19) affected medical services worldwide because of its pandemic nature; including patients with chronic liver disease (CLD). Generally, there are three situations in which CLD patients can be affected by the coronavirus. Patients who have pre-existing liver conditions, especially those that need constant follow-up, will be exposed during follow-up visits to the hospital and are more vulnerable to infection. Second, patients with COVID-19 who have liver function derangements and incidental findings of ongoing CLD, especially those with cirrhosis will have more severe courses of the disease and possible acute-on-chronic liver failure. Finally, patients who undergo treatment for CLD who are infected with COVID-19, where drug-drug interactions are possible (e.g. lopinavir-ritonavir) that may increase the concentration of the protease inhibitor DAA for Hepatitis C treatment. This review is aims to provide guidelines for managing patients with CLD amid the pandemic, and how we move forward after the lockdown.