Covid-19 and Hepatitis

Article by Dr. Rajiv Lochan, Lead Consultant – HPB and Transplant Surgery and Dr. Arvind K S, Consultant – Integrated Liver Care, Aster RV Hospital

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) - caused coronavirus disease (COVID-19) has arisen as a major global burden, posing serious public health challenges. HBV infection is another extensively disseminated virus that affects roughly 257 million people on a long-term basis. Coronavirus disease 2019 (COVID-19) is highly contagious and has a wide range of clinical presentations; it can damage a variety of organs other than the lungs, and liver harm is possible. Through systemic inflammatory response syndrome, cytokine storms, ischemia-reperfusion injury, and therapeutic drug side effects, severe acute respiratory syndrome coronavirus 2 can induce liver harm. COVID-19 patients' liver injury is primarily manifested by aberrant liver biochemical indicators, but there have been no instances of liver failure due to this condition. People with underlying liver cirrhosis, including viral hepatitis, may be at a higher risk of developing severe COVID-19 illness and/or more problems from their existing liver disease if infected with COVID-19, with prolonged hospitalisation and increased mortality. In order to counter this, it is very important for people with liver injury or suffering from Hepatitis to receive their Covid vaccination shots and consider taking booster jabs. People with autoimmune hepatitis must speak with their doctors if they are worried about any side-effects from taking the vaccine. 

Covid-19 Recommendations for people with Hepatitis

• If you suspect you or someone in your family has COVID-19, contact your doctor or seek medical assistance right away. Inform your doctor that you have chronic viral hepatitis, as this may affect your treatment options.
• Seek medical help right away if you're having trouble breathing, chest pain or pressure, confusion, inability to wake up or stay awake, pale lips, face, or toes, or any other severe or alarming symptoms.
• Unless your health care professional recommends it, do not discontinue or change your prescribed drugs.
• Stopping or modifying your medications could worsen your liver condition or cause other health issues.
• Make sure your prescriptions are up to date and that you have enough medication to last several months.
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• Alcohol should be avoided at all costs because it can worsen any underlying liver disease, regardless of the cause.

Stay safe and help reduce COVID-19 transmission in your neighbourhood by following these steps:

•  Maintain a physical distance of at least 6 feet from others and avoid crowds, particularly indoors.
• When you're not at home, cover your nose, mouth, and chin with a Mask.
• Handwashing is essential, as is wearing a face mask and exercising good hygiene.
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While we are fighting a raging pandemic, we must also not forget that India contributes to a significant portion of the worldwide burden of Hepatitis B and C. Known as a silent killer, many patients do not even realise that they are infected until the disease progresses severely to liver cirrhosis or liver cancer which then requires a transplant. As the pandemic has introduced several restrictions, the spread of Hepatitis is likely to have reduced, however we are still lagging behind in terms of completely eradicating the disease from our country. Reports suggest that about 1 lakh people succumb to liver failure caused by Hepatitis without realizing that they have the virus. While not everyone with the virus will develop serious liver disease, carriers of it can transmit it to others and with appropriate treatment Hepatitis can be controlled or cured. Severe liver disease consequently also increases the risk of suffering from severe Covid illness and vice versa. Symptoms such as jaundice, abdominal pain, nausea, vomiting often begin to appear when the liver is already severely damaged and liver-related complications begin to develop. In order to detect Hepatitis early, it is important to go for regular check-ups. A blood check-up where the liver profile is tested, will give you a better understanding of your liver health.