Table 2.
Test
|
Comments
|
Prolonged INR or thrombocytopenia | In one-third of sick patients |
Spontaneous coagulopathy/DIC may be present | |
Thromboembolic incidents are probably frequent | |
There may be a chance of ACLF | |
Imaging | Where chest-CT is frequently performed: Assessing liver/biliary tract disease might be helpful |
Do US, if necessary, but refrain from using US for superfluous imaging (not formally investigated) | |
Hypoalbuminemia | Common in people with systemic inflammatory response |
May also be a sign of acute hepatic decompensation or acute liver failure in people with pre-existing liver cirrhosis | |
High transaminases or bilirubin (> 3 × ULN) | Although not typical for COVID-19, ACLF may be present in patients with cirrhosis who already have liver disease |
Dyselectrolytemia | Diarrhea and other GI problems might result in numerous electrolyte abnormalities |
Anemia | Consider bleeding due to variceal hemorrhage in the context of MAFLD cirrhosis, portal hypertensive gastropathy or stress mucosal GI ulcer |
ACLF: Acute on chronic liver failure; CT: Computed tomography; DIC: Disseminated intravascular coagulation; GI: Gastrointestinal; ULN: Upper limit of normal; US: Ultrasonography; COVID-19: Coronavirus disease 2019; MAFLD: Metabolic-associated fatty liver disease.