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. 2023 Jan 14;29(2):241–256. doi: 10.3748/wjg.v29.i2.241

Table 2.

Treatments of liver injury in coronavirus disease 2019

Mechanisms of liver damage
Treatments
Caution
Ref.
Hepatocellular injury Hepatoprotective, anti-inflammatory, and jaundice-reducing agents Preventive administration is not recommended [109,111,112]
Cytokine storm syndrome Continuous renal replacement therapy. IL-1 inhibitor, IL-6 inhibitor, TNF inhibitor IL-1 or IL-6 inhibitors could reduce inflammation; however, they have a potential to cause DILI and worsen clinical conditions [109,139,140]
DILI Prompt discontinuation or reduction of doses of suspected triggers. Medication reconciliation is important. Discontinue all non-vital therapy, redundant types/doses, modify course duration Requires a trade-off between therapeutic effects and side effects [109]
Reactivation of pre-existing liver disease Continue treatment for hepatitis B and hepatitis C if already on treatment Difficulty distinguishing between new-onset liver injury and reactivation of pre-existing liver disease [16,109]
Hypoxic hepatitis Circulation and respiratory support Higher PEEP, which may be needed to improve oxygenation, may affect cardiac output, decreasing hepatic arterial flow, thus enhancing arterial dysfunction [139,140]

DILI: Drug-induced liver injury; IL: Interleukin; PEEP: Positive end-expiratory pressure; TNF: Tumor necrosis factor alpha.