Manajemen Pasien Sirosis Hepatis saat Pandemi COVID-19

Authors

  • Guruh Dirga Saputra Universitas Wijaya Kusuma, Surabaya, Indonesia

DOI:

https://doi.org/10.55175/cdk.v49i9.293

Keywords:

COVID-19, SARS-CoV-2, sirosis hepatis

Abstract

Penyakit coronavirus (COVID-19) mengakibatkan keadaan darurat kesehatan manusia secara global, tak terkecuali pasien penyakit hati, seperti sirosis hepatis yang dianggap lebih rentan terinfeksi virus karena respons imun yang terganggu. Kerusakan hati terkait COVID-19 berhubungan dengan sitotoksisitas virus langsung, aktivasi sistem kekebalan sistemik, kerusakan hati terkait penggunaan obat, reaktivasi penyakit hati yang sudah ada, dan hepatitis, sehingga tingkat morbiditas dan mortalitas terkait COVID-19 pada pasien sirosis relatif lebih tinggi. Hingga saat ini, masih belum ada pengobatan farmakologis yang terbukti efektif dan aman untuk pasien sirosis dengan COVID-19. Fokus utama tata laksana adalah mencegah perburukan dan menangani komplikasi.

 

Coronavirus disease (COVID-19) is a global human health emergency, and patients with liver diseases such as liver cirrhosis are considered more susceptible to viral infections due to an activation of the systemic immune system. COVID-19-associated liver damage is associated with direct viral cytotoxicity, activation of the systemic immune system, drug-associated liver damage, reactivation of pre-existing liver disease, and hepatitis. Most evidences suggest a relatively higher rate of COVID-19-related morbidity and mortality in cirrhotic patients. An effective and safe pharmacological treatment for cirrhotic patients with COVID-19 has not been determined. The main focus is to prevent worsening course and manage complications.

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References

Bajaj JS, Garcia-Tsao G, Biggins SW, Kamath PS, Wong F, McGeorge S, et al. Comparison of mortality risk in patients with cirrhosis and COVID-19 compared with patients with cirrhosis alone and COVID-19 alone: Multicentre matched cohort. Gut 2021;70:531-6. DOI: 10.1136/gutjnl-2020-322118

Baud D, Qi X, Nielsen-Saines K, Musso D, Pomar L, Favre G. Real estimates of mortality following COVID-19 infection. Lancet Infect Dis. 2020;20:773. DOI:10.1016/S1473-3099(20)30195-X

Fung M, Babik JM. COVID-19 in immunocompromised hosts: What we know so far. Clin Infect Dis. 2021;72:340-50. DOI: 10.1093/cid/ciaa863

Guan WJ, Ni ZY, Hu Y, Liang WH, Ou CQ, He JX, et al. China medical treatment expert group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med. 2020;382:1708-20. DOI: 10.1056/NEJMoa2002032.

Bhatraju PK, Ghassemieh BJ, Nichols M, Kim R, Jerome KR, Nalla AK, et al. Covid-19 in critically ill patients in the Seattle Region - case series. N Engl J Med. 2020;382: 2012-22. DOI: 10.1056/NEJMoa2004500.

Boettler T, Marjot T, Newsome PN, Mondelli MU, Maticic M, Cordero E, et al. Impact of COVID-19 on the care of patients with liver disease: EASL-ESCMID position paper after 6 months of the pandemic. JHEP Rep. 2020;2:100169. DOI: 10.1016/j.jhepr.2020.100169.

Poston JT, Patel BK, Davis AM. Management of critically ill adults with COVID-19. JAMA. 2020;323:1839-41. DOI: 10.1001/jama.2020.4914.

Sun J, Aghemo A, Forner A, Valenti L. COVID-19 and liver disease. Liver Int. 2020;40:1278-81. DOI: 10.1111/liv.14470.

World Health Organization. Weekly epidemiological update [Internet]. 2020 [cited 30 December 2020]. Available from: https://www.who.int/publications/m/item/weekly-epidemiological-update-29-december-2020.

Wu Z, McGoogan JM. Characteristics of and important lessons from the coronavirus disease 2019 (COVID-19) outbreak in China: Summary of a report of 72 314 cases from the Chinese Center for Disease Control and Prevention. JAMA. 2020;323:1239-42. DOI: 10.1001/jama.2020.2648.

Xiao Y, Pan H, She Q, Wang F, Chen M. Prevention of SARS-CoV-2 infection in patients with decompensated cirrhosis. Lancet Gastroenterol Hepatol. 2020;5:528-9. DOI:10.1016/S2468-1253(20)30080-7.

Musa S. Hepatic and gastrointestinal involvement in coronavirus disease 2019 (COVID-19): What do we know till now? Arab J Gastroenterol. 2020;21(1):3-8

Wong GL, Wong VW, Thompson A, Jia J, Hou J, Lesmana CRA, et al. Asia-Pacific Working Group for Liver Derangement during the COVID-19 Pandemic. Management of patients with liver derangement during the COVID-19 pandemic: An Asia-Pacific position statement. Lancet Gastroenterol Hepatol. 2020;5:776-87. DOI: 10.1016/S2468-1253(20)30190-4.

Zhang C, Shi L, Wang FS. Liver injury in COVID-19: Management and challenges. Lancet Gastroenterol Hepatol. 2020;5:428-30. DOI: 10.1016/S2468-1253(20)300571.

Williamson EJ, Walker AJ, Bhaskaran K, Bacon S, Bates C, Morton CE, et al. Factors associated with COVID-19- related death using OpenSAFELY. Nature 2020;584:430-6. DOI:10.1038/s41586-020-2521-4.

Lee YR, Kang MK, Song JE, Kim HJ, Kweon YO, Tak WY, et al. Clinical outcomes of coronavirus disease 2019 in patients with pre-existing liver diseases: A multicenter study in South Korea. Clin Mol Hepatol. 2020;26:562-76. DOI:10.3350/cmh.2020.0126.

Phipps MM, Barraza LH, LaSota ED, Sobieszczyk ME, Pereira MR, Zheng EX, et al. Acute liver injury in COVID-19: Prevalence and association with clinical outcomes in a large U.S. Cohort. Hepatology 2020;72:807-17. DOI: 10.1002/hep.31404.

Zhou F, Yu T, Du R, Fan G, Liu Y, Liu Z, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: A retrospective cohort study. Lancet 2020;395:1054-62. DOI: 10.1016/S0140-6736(20)30566-3.

Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. China Novel Coronavirus Investigating and Research Team. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020;382:727-33. DOI: 10.1056/NEJMoa2001017.

Tapper EB, Asrani SK. The COVID-19 pandemic will have a long-lasting impact on the quality of cirrhosis care. J Hepatol. 2020;73:441-5. DOI: 10.1016/j.jhep.2020.04.005.

United States Food and Drug Administration. FDA approves first treatment for COVID-19 [Internet]. 2020 [cited 2020 December 25]. Available from: https://www.fda.gov/news-events/pressannouncements/ fda-approves-first-treatment-covid-19

National Institutes of Health. Therapeutic management of patients with COVID-19 [Internet]. 2020 [cited 2020 December 26]. Available from: https://files.covid19treatmentguidelines.nih.gov/guidelines/section/section_100.pdf

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Published

01-09-2022

How to Cite

Saputra, G. D. (2022). Manajemen Pasien Sirosis Hepatis saat Pandemi COVID-19. Cermin Dunia Kedokteran, 49(9), 489–492. https://doi.org/10.55175/cdk.v49i9.293

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Articles