• Published on: Jul 14, 2021
  • 1 minute read
  • By: Raj Dwivedi

Telemedicine, COVID-19 And Liver Diseases

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  • For liver diseases, there have been successful experiences with the use of different modalities of telemedicine [i.e. asynchronous telemedicine (analysis of patient's data by a single physician or multidisciplinary team), synchronous real-time patient management and tele-education]
  • Our Telemedicine program showed successful results as the sustained virologic responses achieved by those patients treated in primary care settings under the expert guidance.
  • Currently, this type of care is considered a vital tool for the goal of global elimination of HCV infection.In addition to HCV management, telemedicine offers opportunities for a better management of patients with chronic liver diseases by increasing their access to tertiary care, thus improving efficiency of healthcare delivery at reasonable cost .
  •  We forsee expansion of telemedicine into other areas of hepatology is desirable and hold potential for improving management of pre- and post-liver transplant patients, patients with hepatocellular carcinoma (HCC) and patients with both compensated and decompensated cirrhosis.
  • It is important to note that in liver transplant setting existing data suggest that use of telemedicine may expedite evaluation and listing of patients referred to liver transplant centers and could improve outcomes (hospital readmissions, and quality of life) after liver transplantation.
  • In the case of HCC, telemedicine aslo offers the possibility of multidisciplinary evaluation in virtual tumor boards leading to tailored and more effective treatments . Finally, in cirrhosis, telemedicine may enhance self-care and facilitate HCC surveillance eventually preventing readmissions in recently hospitalized patients.
  • With the onset of COVID-19 pandemic everyone has forced the implementation of telemedicine actions for many liver patients.
  • Major international societies have released recommendations encouraging the use of remote care to manage patients with all liver diseases, particularly liver transplant patients.
  • However, the crisis will seriously impact cirrhosis care with social distancing and isolation causing major delays in elective procedures and routine care with potential overwhelm of medical centers managing postponed and potentially decompensated patients in the upcoming months.
  • Developing robust telemedicine programs and revamping remote care initiatives in hepatology will be critical during COVID times. The next challenge will be how to integrate telemedicine into routine clinical care beyond the COVID-19 pandemic.
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Yellowing

Yellow Eyes and Skin Symptoms: Causes, Warning Signs and When to Seek Care

Yellowing of the eyes and skin is one of the most noticeable physical changes a person can experience. Often referred to as jaundice, this symptom is not a disease by itself but a sign of underlying health conditions. Understanding yellow eyes and skin symptoms is essential because they frequently indicate problems involving the liver, blood or bile ducts and may require urgent medical attention.

In India, jaundice is a common presentation across age groups due to infections, liver disease and metabolic disorders.

 

What Does Yellowing of Eyes and Skin Mean?

The yellow colour appears due to excess bilirubin in the blood.

Bilirubin is:

  • a yellow pigment

  • produced from the breakdown of red blood cells

  • processed and removed by the liver

When bilirubin builds up, it deposits in tissues, causing yellow discoloration.

 

Why the Eyes Turn Yellow First

The sclera, or white part of the eyes, contains elastic tissue that binds bilirubin easily.

This makes yellowing:

  • more visible in eyes

  • detectable before skin changes

Yellow eyes are often the earliest sign of jaundice.

 

Common Causes of Yellow Eyes and Skin

Liver-Related Causes

The liver plays a central role in bilirubin metabolism.

Common liver causes include:

  • viral hepatitis (A, B, C, E)

  • fatty liver disease

  • alcoholic liver disease

  • liver cirrhosis

  • drug-induced liver injury

ICMR reports viral hepatitis as a major cause of jaundice in India.

 

Bile Duct Obstruction

Blocked bile flow prevents bilirubin excretion.

Causes include:

  • gallstones

  • bile duct strictures

  • pancreatic or bile duct tumours

This type of jaundice is often associated with itching and pale stools.

 

Blood Disorders

Excess breakdown of red blood cells increases bilirubin production.

Conditions include:

  • hemolytic anemia

  • malaria

  • inherited blood disorders

The liver may be overwhelmed despite being healthy.

 

Infections

Certain infections directly affect liver function.

Examples include:

  • hepatitis viruses

  • leptospirosis

  • severe sepsis

WHO data highlights hepatitis as a leading infectious cause of jaundice globally.

 

Newborn and Pregnancy-Related Causes

While common in newborns, jaundice in adults always needs evaluation.

Pregnancy-related liver disorders can also cause yellowing.

 

Associated Symptoms That Provide Clues

Yellow eyes and skin are often accompanied by:

  • dark yellow or tea-coloured urine

  • pale or clay-coloured stools

  • itching

  • fatigue

  • abdominal pain

  • loss of appetite

These symptoms help identify the underlying cause.

 

When Yellowing Becomes Dangerous

Seek urgent medical care if yellowing is accompanied by:

  • high fever

  • severe abdominal pain

  • confusion or drowsiness

  • vomiting

  • rapid worsening of colour

These signs suggest severe liver or systemic disease.

 

Jaundice and Liver Function

The liver normally:

  • conjugates bilirubin

  • excretes it into bile

When liver cells are damaged, bilirubin accumulates.

Lancet studies confirm jaundice as a key marker of liver dysfunction.

 

Diagnostic Evaluation

Doctors evaluate jaundice using:

  • blood tests for bilirubin levels

  • liver function tests

  • viral markers

  • ultrasound or CT scans

  • additional tests based on findings

Early testing identifies reversible causes.

 

Impact on Daily Life

Persistent jaundice can affect:

  • energy levels

  • digestion

  • mental clarity

  • work performance

Untreated liver disease can progress silently.

 

Treatment Depends on the Cause

There is no single treatment for jaundice.

Management focuses on:

  • treating infection

  • relieving bile obstruction

  • stopping harmful medications

  • managing chronic liver disease

Self-medication can worsen liver injury.

 

Role of Preventive Healthcare

Preventive measures include:

  • hepatitis vaccination

  • safe drinking water

  • limiting alcohol intake

  • regular health checkups

NITI Aayog emphasises liver health in preventive care strategies.

 

Lifestyle Factors That Affect Liver Health

Risk factors include:

  • excessive alcohol

  • obesity

  • high-fat diets

  • unsafe injections

Addressing these reduces jaundice risk.

 

Importance of Early Detection

Early diagnosis:

  • prevents complications

  • improves recovery

  • reduces hospitalisation

Delays increase the risk of liver failure.

 

Jaundice Is a Symptom, Not a Diagnosis

Understanding this distinction is crucial.

Treating the symptom alone:

  • does not resolve the disease

  • may mask serious conditions

Medical evaluation is essential.

 

Conclusion

Yellow eyes and skin symptoms are visible warning signs that should never be ignored. Most often linked to jaundice, they reflect underlying problems involving the liver, bile ducts or blood. Early medical evaluation, accurate diagnosis and timely treatment are critical to prevent serious complications. Recognising these symptoms and seeking care promptly can protect liver health and save lives.

 

References

  • Indian Council of Medical Research (ICMR) – Hepatitis and Liver Disease Reports

  • World Health Organization (WHO) – Jaundice and Hepatitis Guidelines

  • National Family Health Survey (NFHS-5) – Liver and Metabolic Health Indicators

  • Lancet – Liver Function and Bilirubin Research

  • NITI Aayog – Non-Communicable Diseases and Liver Health

  • Statista – Liver Disease and Hepatitis Trends

See all

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