Gastrointestinal and hepatic side effects of potential treatment for COVID-19 and vaccination in patients with chronic liver diseases
Abstract
The COVID-19 pandemic has had a profound global impact, prompting extensive clinical trials to explore potential treatments and vaccines aimed at reducing its high rates of morbidity and mortality. Key drugs of interest in these trials include umifenovir, bromhexine, remdesivir, lopinavir/ritonavir, steroids, tocilizumab, interferon alpha or beta, ribavirin, favipiravir, nitazoxanide, ivermectin, molnupiravir, hydroxychloroquine/chloroquine (alone or with azithromycin), and baricitinib. Gastrointestinal (GI) symptoms and liver dysfunction are common among COVID-19 patients, complicating the process of distinguishing between disease-related manifestations and treatment side effects. GI symptoms such as anorexia, dyspepsia, nausea, vomiting, diarrhea, and abdominal pain can occur, while liver injury may result from systemic inflammation, cytokine storms, or the adverse effects of medications. Routine monitoring of liver function is therefore essential. Rapid development of COVID-19 vaccines has employed various technologies, including mRNA, viral vectors, inactivated viruses, recombinant DNA, protein subunits, and live attenuated viruses. Vaccination is strongly recommended for patients with chronic liver disease, inflammatory bowel disease, and those who have received liver transplants, as the benefits of vaccination outweigh potential risks. It is also advised that family members EIDD-2801 and healthcare professionals who care for these patients be vaccinated to reduce the risk of exposure to SARS-CoV-2.