The Liver and COVID-19

The virus that causes COVID-19 is very contagious. People with liver disease are just as likely to get infected as anyone else.


How does COVID-19 affect the liver?

COVID-19 can affect the liver along with many other organs.

If you catch COVID-19, it can raise levels of the enzymes alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) in the liver. It can also raise bilirubin levels.

These problems normally go away as you recover from COVID-19. But some people experience liver injury, thought to be due to side-effects of medicines or being very unwell from the infection.


Are people with liver disease at greater risk of severe COVID-19?

Your liver disease does not put you increased risk of catching COVID-19.

But some people are more likely to develop severe infection if they catch the virus. This includes people older than 65 and people with underlying medical conditions including high blood pressure, diabetes, obesity and heart disease.

People with these medical conditions often also have fatty liver disease.

Other people who may be at greater risk of complications from COVID-19 are:

  • People with cirrhosis
  • People with liver cancer
  • Transplant recipients and other people taking long-term medications to suppress the immune system

Are there special considerations for people with liver disease during the COVID-19 pandemic?

Avoid infection: Wear a face mask when in indoor public spaces and when you can’t physically distance from others. Avoid crowded situations where possible.

Get vaccinated and have boosters: COVID-19 vaccination is safe for people with liver disease. Make sure you are up to date with recommended vaccination boosters.

Get antiviral treatment if you test positive: Oral antiviral treatments for COVID-19 can prevent severe infection. They are recommended for people aged 70 or older, people aged 50 or older with 2 additional risk factors (these are common in people with liver disease) and Aboriginal and Torres Strait Islander people aged 30 or older with 1 additional risk factor. Antivirals are also recommended for all adults who are moderately or severely immunocompromised (people who have immune system problems).

Talk to your doctor about other vaccinations: Have the vaccination for influenza. People with cirrhosis, cancer or receiving immunosuppressive medications are also recommended to have pneumococcal vaccination.  Discuss vaccination with your doctor.

Manage your liver condition: If you have chronic liver diseases such as cirrhosis, hepatitis B, hepatitis C, autoimmune hepatitis or liver cancer, it’s very important to keep seeing your doctor and taking your medicines. Make sure you keep having your surveillance tests for liver cancer every 6 months if you are at risk.

Watch out for new symptoms: If you notice any change in your usual condition, such as fluid build-up, significant weight gain or loss, bleeding or new pain, it’s important to seek medical attention from your doctor, specialist or hospital.

Manage other conditions: Have regular check-ups with your doctor and make sure you take any medicines they give you. Take care of conditions such as high blood pressure and diabetes.

Watch the alcohol: Some people have started drinking more alcohol during the pandemic. This may be harmful in people with liver disease. Talk to your doctor about how to minimise alcohol.

Keep taking immunosuppressive medicines: There have been concerns that being treated with immunosuppressive medicines may increase the risk of severe COVID-19. But if you reduce or stop your medicines, your health is potentially at even greater risk from a flare of liver disease, or an episode of rejection if you’ve had a liver transplant. Always discuss with your doctor before changing any of your medicines.

Avoid immune boosters: Avoid taking over-the-counter medicines or medicines bought on the internet that someone has suggested might boost the immune system or prevent COVID-19 infection.


Where to find more information

Recommendations and guidelines for preventing and managing COVID-19 infection are constantly changing.

For the latest information on Covid-19, please visit the Australian Department of Health and Aged Care website.

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