Covid-19 & Liver Disease

What do patients with liver disease need to know about their risk of contracting the virus that causes COVID-19, and about the continuity of care at Weill Cornell Medicine? Here Emily Schonfeld, MD, assistant professor of medicine in the Division of Gastroenterology and Hepatology at Weill Cornell Medical Center, and transplant hepatologist Arun Jesudian, MD, explain what patients with liver disease need to know.

What impact does COVID-19 have on patients with liver disease? Does it present differently for these patients?

Overall, more investigation into the effects of COVID-19 on the liver is necessary. But we do know that COVID-19 may cause blood tests that are a marker of liver function to rise. Patients with advanced liver disease may experience more complications from the virus.

Do any of the medications or treatments for liver disease increase the risk of contracting COVID-19?

The treatments for liver disease should not increase or decrease the risk of getting COVID-19. As far as we know right now, anti-viral medications for liver specific viruses do not protect against COVID-19. Patients with liver disease should not adjust medications without speaking with a physician first.

Is there anything specific that liver disease patients need to do to protect themselves during the pandemic?

The primary way to lower someone’s risk of contracting the virus that causes COVID-19 is by using the same precautions recommended for patients without liver disease: making sure to socially distance, wear masks in public settings or when in close proximity to people outside the home, and washing hands thoroughly or using hand sanitizer if touching something outside the home.

Has the pandemic had an effect on the listing and/or transplant process? Will a confirmed case of COVID-19 have an impact on eligibility?

We’ve created new policies for COVID-19 testing in both donors and recipients for liver transplant. But we are still evaluating patients for transplant, treating patients on the transplant wait list, and performing transplants.

Once a patient is clear of the virus, COVID-19 itself should not be a contraindication to transplant.

What other changes has Weill Cornell Medicine had to make in light of the pandemic?

A lot of these changes are operational. We’re seeing patients in person on the ninth floor of the David H. Koch Center and also are conducting some appointments online.

The decision to schedule an appointment online or in person depends on both patient preference and medical urgency. Our providers’ offices are happy to guide patients with this.

We were able to continue all urgent and emergency procedures, even during the height of the pandemic in the New York metropolitan area. Labs and diagnostic tests are back to normal, and we’ve resumed elective procedures, including liver biopsy and endoscopies. We do require patients to undergo COVID-19 tests before scheduled invasive procedures.