Coronavirus (COVID-19) – Advice for patients with liver diseases
Now don’t overlook the liver:

• Though respiratory symptoms are the most common presenta+on, but they’re not the only early signs of COVID-19.
• Diarrhea, nausea, vomi+ng, and abdominal pain are early signs of COVID 19.
• 30% of COVID-19 infected have diges+ve symptoms. Those having diges+ve symptoms have worse outcome of infec+on.
• Liver impairment is another emerging concern with COVID-19,
• Individuals at high risk for severe COVID-19 are typically of older age and/or present with comorbid condi+ons such as diabetes, cardiovascular disease, and hypertension. This is also the same profile for those at increased risk for unrecognised underlying liver disease, especially nonalcoholic fa y liver disease. This could make them more suscep+ble to liver injury from the virus, medica+ons used in suppor+ve management, or hypoxia.
• People who have had a liver transplant and are on immunosuppressant medica+on are considered to be at an even higher risk of severe illness from COVID-19.
• Isola+on might need to be prolonged beyond when respiratory tract specimens are nega+ve, especially in those with gastrointes+nal manifesta+ons.
• For those who are immune-suppressed, over 70years of age, have an underlying health condi+on or are pregnant, I strongly advise you to follow the above measures as much as you can, and to significantly limit your face-to-face interac+on with friends and family if possible.

Precau onary measures

• Don’t touch your eyes, nose or mouth if your hands are not clean.
• Avoid crowds and limit close contact as much as possible.
• Wash your hands with soap and water very often – use hand sani+ser gel if soap and water are not available
• Kindly put used +ssues in the bin immediately
• Clean and disinfect regularly touched objects and surfaces using your regular cleaning products to reduce the risk of passing the infec+on on to other people.
• Burn the mask after use

Dr Vishal khurana MBBS, MD, DM-Gastroenterology,
MNAMS Senior consultant-Gastroenterology Metro Hospital Faridabad 7289840710