Care of patients with liver disease during the COVID-19 pandemic: EASL-ESCMID position paper
Tobias Boettler,
Philip N. Newsome,
Mario U. Mondelli,
Mojca Maticic,
Elisa Cordero,
Markus Cornberg,
Thomas Berg
Affiliations
Tobias Boettler
Department of Medicine II, Medical Center – University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
Philip N. Newsome
National Institute for Health Research, Birmingham Biomedical Research Centre at University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK; Centre for Liver & Gastrointestinal Research, Institute of Immunology and Immunotherapy, University of Birmingham, Birmingham, UK
Mario U. Mondelli
Division of Infectious Diseases and Immunology, Fondazione IRCCS Policlinico San Matteo, University of Pavia, Pavia, Italy
Mojca Maticic
Clinic for Infectious Diseases and Febrile Illnesses, University Medical Centre Ljubljana, Slovenia; Faculty of Medicine, University of Ljubljana, Slovenia
Elisa Cordero
Department of Medicine, University of Seville, Clinical Unit of Infectious Diseases University Hospital Virgen del Rocio, Institute of Biomedicine, Sevilla, CSIC, Spain
Markus Cornberg
Department of Gastroenterology, Hepatology and Endocrinology, Hannover Medical School, Hannover, Germany; Centre for Individualised Infection Medicine (CIIM), Hannover, Germany
Thomas Berg
Division of Hepatology, Clinic and Polyclinic for Gastroenterology, Hepatology, Infectious Diseases, and Pneumology, University Hospital Leipzig, Leipzig, Germany; Corresponding author. Address: University Hospital Leipzig, Department of Internal Medicine, Liebigstraße 18, D-04103 Leipzig, Germany; Tel.: +49 341/97-12200, fax: +49 341/97-12209.
Summary: The coronavirus disease 2019 (COVID-19) pandemic poses an enormous challenge to healthcare systems in affected communities. Older patients and those with pre-existing medical conditions have been identified as populations at risk of a severe disease course. It remains unclear at this point to what extent chronic liver diseases should be considered as risk factors, due to a shortage of appropriate studies. However, patients with advanced liver disease and those after liver transplantation represent vulnerable patient cohorts with an increased risk of infection and/or a severe course of COVID-19. In addition, the current pandemic requires unusual allocation of healthcare resources which may negatively impact the care of patients with chronic liver disease that continue to require medical attention. Thus, the challenge hepatologists are facing is to promote telemedicine in the outpatient setting, prioritise outpatient contacts, avoid nosocomial dissemination of the virus to patients and healthcare providers, and at the same time maintain standard care for patients who require immediate medical attention.
