Running out of bullets: The challenging management of acute hepatitis and SARS-COV-2 from the SMatteo COvid19 Registry (SMACORE)

Liver Int. 2020 Nov;40(11):2655-2659. doi: 10.1111/liv.14609. Epub 2020 Aug 6.

Abstract

Liver impairment is frequent in patients with novel coronavirus disease (COVID-19) and direct viral tropism for the liver has been proven. Since several of the currently administered drugs against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are possibly hepatotoxic, the management of patients with COVID-19 and liver failure is still an almost unexplored field. Taking this challenging case of acute HBV with persistent hyperbilirubinemia and SARS-COV-2 infection with respiratory distress as a starting point, we here loop through this condition. Where the available therapeutic options are scarce, we here propose hemoperfusion (HP) as an attractive alternative to both delay any late-stage progression of hyper inflammation process in COVID-19 and remove the toxins involved in acute liver failure.

Keywords: COVID-19; HBV; hemoperfusion.

Publication types

  • Case Reports

MeSH terms

  • COVID-19 / blood
  • COVID-19 / complications*
  • COVID-19 / therapy
  • Hepatitis B / blood
  • Hepatitis B / complications*
  • Hepatitis B / therapy
  • Humans
  • Male
  • Middle Aged
  • Registries*
  • SARS-CoV-2 / isolation & purification