{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T08:38:59Z","timestamp":1771663139792,"version":"3.50.1"},"reference-count":61,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T00:00:00Z","timestamp":1671062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>In the last few years, the world has had to face the SARS-CoV-2 infection and its multiple effects. Even though COVID-19 was first considered to be a respiratory disease, it has an extended clinical spectrum with symptoms occurring in many tissues, and it is now identified as a systematic disease. Therefore, various drugs are used during the therapy of hospitalized COVID-19 patients. Studies have shown that many of these drugs could have adverse side-effects, including drug-induced liver injury\u2014also known as DILI\u2014which is the focus of our review. Despite the consistent findings, the pathophysiological mechanism behind DILI in COVID-19 disease is still complex, and there are a few risk factors related to it. However, when it comes to the diagnosis, there are specific algorithms (including the RUCAM algorithm) and biomarkers that can assist in identifying DILI and which we will analyze in our review. As indicated by the title, a variety of drugs are associated with this COVID-19-related complication, including systemic corticosteroids, drugs used for the therapy of uncontrolled cytokine storm, as well as antiviral, anti-inflammatory, and anticoagulant drugs. Bearing in mind that hepatotoxicity is very likely to occur during COVID-19, especially in patients treated with multiple medications, we will also refer to the use of other drugs used for DILI therapy in an effort to control and prevent a severe and long-term outcome.<\/jats:p>","DOI":"10.3390\/medicina58121848","type":"journal-article","created":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T01:46:51Z","timestamp":1671155211000},"page":"1848","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Drug-Induced Liver Injury in Hospitalized Patients during SARS-CoV-2 Infection"],"prefix":"10.3390","volume":"58","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7094-0338","authenticated-orcid":false,"given":"Eleni","family":"Karlafti","sequence":"first","affiliation":[{"name":"Emergency Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"},{"name":"First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Paramythiotis","sequence":"additional","affiliation":[{"name":"First Propaedeutic Department of Surgery, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3672-994X","authenticated-orcid":false,"given":"Konstantina","family":"Pantazi","sequence":"additional","affiliation":[{"name":"First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0772-811X","authenticated-orcid":false,"given":"Vasiliki Epameinondas","family":"Georgakopoulou","sequence":"additional","affiliation":[{"name":"Pulmonology Department, Laiko General Hospital, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Georgia","family":"Kaiafa","sequence":"additional","affiliation":[{"name":"First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3565-4066","authenticated-orcid":false,"given":"Petros","family":"Papalexis","sequence":"additional","affiliation":[{"name":"Unit of Endocrinology, First Department of Internal Medicine, Laiko General Hospital, National and Kapodistrian University of Athens, 11527 Athens, Greece"},{"name":"Department of Biomedical Sciences, University of West Attica, 12243 Athens, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7117-0547","authenticated-orcid":false,"given":"Adonis A.","family":"Protopapas","sequence":"additional","affiliation":[{"name":"First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eleftheria","family":"Ztriva","sequence":"additional","affiliation":[{"name":"First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Varvara","family":"Fyntanidou","sequence":"additional","affiliation":[{"name":"Emergency Department, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christos","family":"Savopoulos","sequence":"additional","affiliation":[{"name":"First Propaedeutic Department of Internal Medicine, AHEPA University General Hospital, Aristotle University of Thessaloniki, 54636 Thessaloniki, Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1143","DOI":"10.4254\/wjh.v13.i9.1143","article-title":"Drug-induced liver injury and COVID-19: A review for clinical practice","volume":"13","author":"Ortiz","year":"2021","journal-title":"World J. Hepatol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Thakur, V., Ratho, R., Kumar, P., Bhatia, S., Bora, I., Mohi, G., Saxena, S., Devi, M., Yadav, D., and Mehariya, S. (2021). Multi-Organ Involvement in COVID-19: Beyond Pulmonary Manifestations. J. Clin. Med., 10.","DOI":"10.3390\/jcm10030446"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1231","DOI":"10.1016\/j.jhep.2020.06.006","article-title":"COVID-19 and the liver","volume":"73","author":"Jothimani","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s43066-021-00082-y","article-title":"The risks of liver injury in COVID-19 patients and pharmacological management to reduce or prevent the damage induced","volume":"11","author":"Vitiello","year":"2021","journal-title":"Egypt. Liver J."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"428","DOI":"10.1016\/S2468-1253(20)30057-1","article-title":"Liver injury in COVID-19: Management and challenges","volume":"5","author":"Zhang","year":"2020","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Gabrielli, M., Franza, L., Esperide, A., Gasparrini, I., Gasbarrini, A., and Franceschi, F. (2022). Liver Injury in Patients Hospitalized for COVID-19: Possible Role of Therapy. Vaccines, 10.","DOI":"10.3390\/vaccines10020192"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"731436","DOI":"10.3389\/fmed.2021.731436","article-title":"Drug-Induced Liver Injury in COVID-19 Patients: A Systematic Review","volume":"8","author":"Sodeifian","year":"2021","journal-title":"Front. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.3748\/wjg.v28.i11.1102","article-title":"Impaired coagulation, liver dysfunction and COVID-19: Discovering an intriguing relationship","volume":"28","author":"Boccatonda","year":"2022","journal-title":"World J. Gastroenterol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2021\/5556354","article-title":"NAFLD and Infection, a Nuanced Relationship","volume":"2021","author":"Adenote","year":"2021","journal-title":"Can. J. Gastroenterol. Hepatol."},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Vrani\u0107, L., Radovan, A., Poropat, G., Mikola\u0161evi\u0107, I., and Mili\u0107, S. (2021). Non-Alcoholic Fatty Liver Disease and COVID-19\u2013Two Pandemics Hitting at the Same Time. Medicina, 57.","DOI":"10.3390\/medicina57101057"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1016\/j.jhep.2019.02.014","article-title":"EASL Clinical Practice Guidelines: Drug-induced liver injury","volume":"70","author":"Andrade","year":"2019","journal-title":"J. Hepatol."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Sipos, M., Farcas, A., Leucuta, D., Bucsa, C., Huruba, M., and Mogosan, C. (2021). Second-Generation Cephalosporins-Associated Drug-Induced Liver Disease: A Study in VigiBase with a Focus on the Elderly. Pharmaceuticals, 14.","DOI":"10.3390\/ph14050441"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.12659\/AJCR.911393","article-title":"Idiosyncratic Drug-Induced Liver Injury Due to Ciprofloxacin: A Report of Two Cases and Review of the Literature","volume":"19","author":"Radovanovic","year":"2018","journal-title":"Am. J. Case Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"730","DOI":"10.3389\/fphar.2019.00730","article-title":"Idiosyncratic DILI: Analysis of 46,266 Cases Assessed for Causality by RUCAM and Published From 2014 to Early 2019","volume":"10","author":"Teschke","year":"2019","journal-title":"Front. Pharmacol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1367","DOI":"10.1007\/s00204-020-02734-1","article-title":"COVID-19 and drug-induced liver injury: A problem of plenty or a petty point?","volume":"94","author":"Boeckmans","year":"2020","journal-title":"Arch. Toxicol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1016\/S2213-2600(20)30076-X","article-title":"Pathological findings of COVID-19 associated with acute respiratory distress syndrome","volume":"8","author":"Xu","year":"2020","journal-title":"Lancet Respir. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"110033","DOI":"10.1016\/j.mehy.2020.110033","article-title":"Cytochrome P450-mediated drug interactions in COVID-19 patients: Current findings and possible mechanisms","volume":"144","author":"Shoieb","year":"2020","journal-title":"Med. Hypotheses"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Delgado, A., Stewart, S., Urroz, M., Rodr\u00edguez, A., Borobia, A.M., Akatbach-Bousaid, I., Gonz\u00e1lez-Mu\u00f1oz, M., and Ram\u00edrez, E. (2021). Characterisation of Drug-Induced Liver Injury in Patients with COVID-19 Detected by a Proactive Pharmacovigilance Program from Laboratory Signals. J. Clin. Med., 10.","DOI":"10.3390\/jcm10194432"},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Danan, G., and Teschke, R. (2015). RUCAM in Drug and Herb Induced Liver Injury: The Update. Int. J. Mol. Sci., 17.","DOI":"10.3390\/ijms17010014"},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Teschke, R., M\u00e9ndez-S\u00e1nchez, N., and Eickhoff, A. (2022). Liver Injury in COVID-19 Patients with Drugs as Causatives: A Systematic Review of 996 DILI Cases Published 2020\/2021 Based on RUCAM as Causality Assessment Method. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23094828"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"747","DOI":"10.4254\/wjh.v13.i7.747","article-title":"Liver injury associated with drug intake during pregnancy","volume":"13","author":"Kamath","year":"2021","journal-title":"World J. Hepatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1002\/ygh2.455","article-title":"Liver injury, SARS-COV-2 infection and COVID-19: What physicians should really know?","volume":"3","author":"Licata","year":"2021","journal-title":"GastroHep"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.biochi.2020.08.018","article-title":"Treatments in Covid-19 patients with pre-existing metabolic dysfunction-associated fatty liver disease: A potential threat for drug-induced liver injury?","volume":"179","author":"Ferron","year":"2020","journal-title":"Biochimie"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"332","DOI":"10.1136\/flgastro-2021-101886","article-title":"Guideline review: EASL clinical practice guidelines: Drug-induced liver injury (DILI)","volume":"13","author":"Brennan","year":"2022","journal-title":"Front. Gastroenterol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"791","DOI":"10.1002\/cpt.1866","article-title":"Incidence of Adverse Drug Reactions in COVID-19 Patients in China: An Active Monitoring Study by Hospital Pharmacovigilance System","volume":"108","author":"Sun","year":"2020","journal-title":"Clin. Pharmacol. Ther."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1561","DOI":"10.1016\/j.cgh.2020.04.002","article-title":"Clinical Features of COVID-19-Related Liver Functional Abnormality","volume":"18","author":"Fan","year":"2020","journal-title":"Clin. Gastroenterol. Hepatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"18","DOI":"10.1002\/hep.32327","article-title":"A revised electronic version of RUCAM for the diagnosis of DILI","volume":"76","author":"Hayashi","year":"2022","journal-title":"Hepatology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"809","DOI":"10.1111\/j.1398-9995.2004.00547.x","article-title":"The lymphocyte transformation test in the diagnosis of drug hypersensitivity","volume":"59","author":"Pichler","year":"2004","journal-title":"Allergy"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"566","DOI":"10.1016\/j.jhep.2020.04.006","article-title":"COVID-19: Abnormal liver function tests","volume":"73","author":"Cai","year":"2020","journal-title":"J. Hepatol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1007\/s40140-021-00440-x","article-title":"Challenges in Sedation Management in Critically Ill Patients with COVID-19: A Brief Review","volume":"11","author":"Karamchandani","year":"2021","journal-title":"Curr. Anesthesiol. Rep."},{"key":"ref_31","first-page":"1","article-title":"Long-term ketamine infusion-induced cholestatic liver injury in COVID-19-associated acute respiratory distress syndrome","volume":"26","author":"Erlebach","year":"2022","journal-title":"Crit. Care"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"3381","DOI":"10.1007\/s00204-020-02885-1","article-title":"Drug induced liver injury: An update","volume":"94","author":"Cortes","year":"2020","journal-title":"Arch. Toxicol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1111\/1751-2980.12697","article-title":"Corticosteroid therapy in drug-induced liver injury: Pros and cons","volume":"20","author":"Hu","year":"2019","journal-title":"J. Dig. Dis."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"826","DOI":"10.1007\/s12098-022-04237-6","article-title":"Remdesivir-Induced Liver Injury in a COVID-Positive Newborn","volume":"89","author":"Kaur","year":"2022","journal-title":"Indian J. Pediatr."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1813","DOI":"10.1056\/NEJMoa2007764","article-title":"Remdesivir for the Treatment of COVID-19\u2014Preliminary report","volume":"383","author":"Beigel","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"2327","DOI":"10.1056\/NEJMoa2007016","article-title":"Compassionate Use of Remdesivir for Patients with Severe Covid-19","volume":"382","author":"Grein","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1111\/apt.15916","article-title":"Systematic review with meta-analysis: Liver manifestations and outcomes in COVID-19","volume":"52","author":"Kulkarni","year":"2020","journal-title":"Aliment. Pharmacol. Ther."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"659","DOI":"10.1002\/phar.2429","article-title":"Remdesivir: Review of Pharmacology, Pre-clinical Data, and Emerging Clinical Experience for COVID-19","volume":"40","author":"Jorgensen","year":"2020","journal-title":"Pharmacother. J. Hum. Pharmacol. Drug Ther."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"998","DOI":"10.1111\/liv.14435","article-title":"Liver injury during highly pathogenic human coronavirus infections","volume":"40","author":"Xu","year":"2020","journal-title":"Liver Int."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41525-020-00143-y","article-title":"Pharmacogenomics of COVID-19 therapies","volume":"5","author":"Takahashi","year":"2020","journal-title":"NPJ Genom. Med."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"1166","DOI":"10.1002\/phar.2464","article-title":"Acetylcysteine for the Treatment of Suspected Remdesivir-Associated Acute Liver Failure in COVID-19: A Case Series","volume":"40","author":"Carothers","year":"2020","journal-title":"Pharmacother. J. Hum. Pharmacol. Drug Ther."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1547","DOI":"10.1111\/bcp.14489","article-title":"Abnormal laboratory findings and plasma concentration monitoring of lopinavir and ritonavir in COVID-19","volume":"87","author":"Batteux","year":"2021","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"377","DOI":"10.3748\/wjg.v27.i5.377","article-title":"Liver injury in the era of COVID-19","volume":"27","author":"Michalak","year":"2021","journal-title":"World J. Gastroenterol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/j.jiac.2020.12.021","article-title":"Suspected cholestatic liver injury induced by favipiravir in a patient with COVID-19","volume":"27","author":"Yamazaki","year":"2021","journal-title":"J. Infect. Chemother."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"318","DOI":"10.1016\/j.intimp.2016.09.012","article-title":"Azithromycin modulates immune response of human monocyte-derived dendritic cells and CD4 + T cells","volume":"40","author":"Lin","year":"2016","journal-title":"Int. Immunopharmacol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"106053","DOI":"10.1016\/j.ijantimicag.2020.106053","article-title":"Macrolides and viral infections: Focus on azithromycin in COVID-19 pathology","volume":"56","author":"Pani","year":"2020","journal-title":"Int. J. Antimicrob. Agents"},{"key":"ref_47","first-page":"e17","article-title":"Liver and Kidney Injuries in COVID-19 and Their Effects on Drug Therapy; a Letter to Editor","volume":"8","author":"Rismanbaf","year":"2020","journal-title":"Arch. Acad. Emerg. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1150","DOI":"10.1111\/bcp.14482","article-title":"Clinical outcomes and adverse events in patients hospitalised with COVID-19, treated with off-label hydroxychloroquine and azithromycin","volume":"87","author":"Kelly","year":"2021","journal-title":"Br. J. Clin. Pharmacol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1111\/liv.14516","article-title":"First case of drug-induced liver injury associated with the use of tocilizumab in a patient with COVID-19","volume":"40","year":"2020","journal-title":"Liver Int."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"1027","DOI":"10.1111\/resp.14152","article-title":"Tocilizumab administration for the treatment of hospitalized patients with COVID -19: A systematic review and meta-analysis","volume":"26","author":"Kyriakopoulos","year":"2021","journal-title":"Respirology"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1055\/s-2007-1024398","article-title":"Letales Leberversagen nach Corticosteroidtherapie bei Hepatitis-B-Carrier-Status","volume":"124","author":"Hammond","year":"2008","journal-title":"DMW Dtsch. Med. Wochenschr."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"e474","DOI":"10.1016\/S2665-9913(20)30173-9","article-title":"Tocilizumab in patients with severe COVID-19: A retrospective cohort study","volume":"2","author":"Guaraldi","year":"2020","journal-title":"Lancet Rheumatol."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1002\/hep.31487","article-title":"Abnormal Liver Tests in COVID-19: A Retrospective Observational Cohort Study of 1,827 Patients in a Major U.S. Hospital Network","volume":"72","author":"Hundt","year":"2020","journal-title":"Hepatology"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1007\/s40121-021-00545-0","article-title":"Efficacy and Safety of Immunomodulators in Patients with COVID-19: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials","volume":"11","author":"Ngamprasertchai","year":"2022","journal-title":"Infect. Dis. Ther."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1080\/14787210.2021.1982695","article-title":"Janus kinase (JAK)-inhibitors and coronavirus disease 2019 (Covid-19) outcomes: A systematic review and meta-analysis","volume":"20","author":"Limen","year":"2022","journal-title":"Expert Rev. Anti-infective Ther."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"263","DOI":"10.1016\/bs.apha.2018.12.004","article-title":"Evaluation and treatment of acetaminophen toxicity","volume":"85","author":"Fisher","year":"2019","journal-title":"Adv. Pharmacol."},{"key":"ref_57","first-page":"112","article-title":"A focus on epidemiology of drug-induced liver injury: Analysis of a prospective cohort","volume":"21","author":"Licata","year":"2017","journal-title":"Eur. Rev. Med. Pharmacol. Sci."},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1007\/s11845-020-02440-y","article-title":"Remdesivir versus ritonavir\/lopinavir in COVID-19 patients","volume":"190","author":"Vitiello","year":"2021","journal-title":"Ir. J. Med. Sci."},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Fischer, W., Eron, J.J., Holman, W., Cohen, M.S., Fang, L., Szewczyk, L.J., Sheahan, T.P., Baric, R., Mollan, K.R., and Wolfe, C.R. (2021). Molnupiravir, an Oral Antiviral Treatment for COVID-19. medRxiv.","DOI":"10.1101\/2021.06.17.21258639"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"1850","DOI":"10.4254\/wjh.v13.i12.1850","article-title":"Gastrointestinal and hepatic side effects of potential treatment for COVID-19 and vaccination in patients with chronic liver diseases","volume":"13","author":"Law","year":"2021","journal-title":"World J. Hepatol."},{"key":"ref_61","doi-asserted-by":"crossref","unstructured":"Pazgan-Simon, M., Serafi\u0144ska, S., Kukla, M., Kucharska, M., Zuwa\u0142a-Jagie\u0142\u0142o, J., Buczy\u0144ska, I., Zieli\u0144ska, K., and Simon, K. (2022). Liver Injury in Patients with COVID-19 without Underlying Liver Disease. J. Clin. Med., 11.","DOI":"10.3390\/jcm11020308"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/12\/1848\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:42:04Z","timestamp":1760146924000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/12\/1848"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,15]]},"references-count":61,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["medicina58121848"],"URL":"https:\/\/doi.org\/10.3390\/medicina58121848","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,12,15]]}}}