Even in May 2020, early enough in the pandemic, an international study helped understand among people with chronic liver disease and cirrhosis, death rates from COVID-19 were alarming. Compared to healthy individuals, patients with the underlying liver disease tend to perform poorly with Covid-19. Therefore, everything should be done to keep the liver as healthy as possible.

The researchers, led by teams from the Oxford University Hospitals NHS Foundation Trust and the University of North Carolina, have set up an international registry to collect clinical details of patients with chronic liver disease and cirrhosis who develop COVID-19.

Between March 25, 2020 and April 20, 2020, 152 cases were submitted to the registry, of which more than 95% were hospitalized.

Patients with cirrhosis had poor outcomes with an overall mortality rate of 40%.

People with an advanced disease called decompensated cirrhosis had the highest death rate (between 43 and 63%), compared to 12% for patients with liver disease but without cirrhosis.

The link between liver health and the ability to fight COVID-19:
According to the Centers for Disease Control and Prevention (CDC) – Seniors and people of all ages who have serious underlying medical conditions, including people with liver disease, could be at risk highest level of serious illness due to COVID-19. People with chronic liver disease, including hepatitis B and hepatitis C, must be extra vigilant to be protected against coronavirus disease 2019 (COVID-19) – an illness caused by the SARS-CoV virus -2.

Here’s what the CDC says about liver health and a person’s ability to fight COVID-19:

1. COVID-19 can damage your liver:
2. The virus enters human cells by locking onto the angiotensin converting enzyme receptor (ACE-2). Besides the lungs, these receptors are expressed in cells of the intestine, liver and bile ducts, making these organs prone to damage from the virus.
3. Some patients hospitalized with COVID-19 have experienced increased levels of liver enzymes – such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST). An increase in liver enzyme levels can mean that a person’s liver is at least temporarily damaged. People with cirrhosis [liver scarring] may be at increased risk of COVID-19. Some studies have shown that people with pre-existing liver disease (chronic liver disease, cirrhosis, or associated complications) who have been diagnosed with COVID-19 have a higher risk of death than people without pre-existing liver disease.

Types of liver disease:

• Common causes of chronic liver disease in India include alcohol abuse, non-alcoholic fatty liver disease, hepatitis B, hepatitis C, and autoimmunity.
• The immune system of these patients is weak and they must be extremely careful because there is an increased risk of serious illness from the virus.
• The more severe the Covid infection, the more severe the liver damage.
• Most of the drugs used for the treatment of Covid-19 also tend to injure the liver.
• Keep in contact with your doctor for close monitoring and dose adjustment from time to time.

How should people with liver disease protect themselves against COVID-19?

1. The best way to avoid COVID-19 is to avoid exposure to the virus that causes it.
2. Fatty liver disease creates an unhealthy environment in which the virus can thrive.
3. Avoiding fatty foods, sweets, and fast food should become the rule for you.
4. Exercise regularly for 30 minutes a day at least 5 days a week for liver health.
5. Excessive alcohol consumption should be avoided.
6. Patients with chronic hepatitis due to hepatitis B, hepatitis C and autoimmunity should take their medications regularly.
7. Like everyone else, liver patients should continue to wear a mask, stay six feet from people who do not live with them, avoid crowds and poorly ventilated spaces, and wash their hands often.
8. Follow all appropriate COVID SOPs, stay alert, and only go outside when necessary.
9. COVID-19 vaccination will help protect you against COVID-19.
10. After getting vaccinated against COVID-19, you must continue to take measures to protect yourself.
11. If soap and water are not available, use a hand sanitizer containing at least 60% alcohol.
12. The more action you take, the more protected you are against COVID-19.
13. Do not skip any appointments with your liver care team and consider telemedicine for appointments when possible.

Disclaimer: The tips and suggestions mentioned in the article are for general information only and should not be construed as professional medical advice. Always consult your doctor or dietitian before starting a fitness program or making any changes to your diet.