Copyright
©The Author(s) 2021.
World J Gastroenterol. Jul 14, 2021; 27(26): 3951-3970
Published online Jul 14, 2021. doi: 10.3748/wjg.v27.i26.3951
Published online Jul 14, 2021. doi: 10.3748/wjg.v27.i26.3951
Medication | Hepatotoxicity | Action mechanism | Currently recommended use for COVID-19 |
Hydroxychloroquine | Likelihood score: D (possible). Rare cause of clinically-apparent liver injury | Altered metabolism of other medications | Not recommended |
Azithromycin | Likelihood score: A (well-known). Transient and asymptomatic elevation in serum aminotransferases; Typical cholestatic hepatitis | Unknown | Not recommended |
Ivermectin | Likelihood score: D (possible). Mild elevation of serum aminotransferases; Reports of acute liver failure | Unknown | Not recommended |
Dexamethasone | Likelihood score: A (well-known). Long-term use effects; Symptoms usually represent the worsening or triggering of an underlying liver disease | Drug-associated fatty liver disease | Recommended as emergency use |
Remdesivir | Likelihood score: D (possible). Mild to moderate transient elevation of serum aminotransferases | Inhibition of mitochondrial RNA polymerase or idiosyncratic injury | Recommended as emergency use |
Lopinavir/ritonavir | Likelihood score: D (possible). Moderate to severe elevation of serum aminotransferases (pattern hepatocellular to cholestatic or mixed); Duration 1-2 mo; Reports of acute liver failure; Caution in patients with co-infection by hepatitis B virus-hepatitis C virus-human immunodeficiency virus | Inhibits both of the isoforms of CYP3A del P450, which may result in production of a toxic intermediate | Not recommended |
Baricitinib | Likelihood score: E (unlikely). Moderate transient elevation of serum aminotransferases (17% of patients); Hepatitis B reactivation | Unknown | Recommended as emergency use |
Tocilizumab | Likelihood score: C (probably). Mild to moderate transient elevation of serum aminotransferases; Duration 8 wk | Unknown | Recommended as emergency use |
- Citation: Gracia-Ramos AE, Jaquez-Quintana JO, Contreras-Omaña R, Auron M. Liver dysfunction and SARS-CoV-2 infection. World J Gastroenterol 2021; 27(26): 3951-3970
- URL: https://www.wjgnet.com/1007-9327/full/v27/i26/3951.htm
- DOI: https://dx.doi.org/10.3748/wjg.v27.i26.3951