КЛИНИКО-ЛАБОРАТОРНАЯ ХАРАКТЕРИСТИКА БОЛЬНЫХ С ПОРАЖЕНИЕМ ПЕЧЕНИ В РАННЕМ РЕАБИЛИТАЦИОННОМ ПЕРИОДЕ COVID-19

Abstract

Abstract. Introduction. The emergence of COVID-19 has set health professionals tasks related to the rapid diagnosis and provision of medical care to patients. Patients with COVID-19 also have extrapulmonary symptoms; including clinical signs of damage to the gastrointestinal tract (GI tract) and the hepatobiliary system which are diagnosed in 26–53% of patients. Aim. The aim of the study was to evaluate clinical and laboratory indicators of liver damage in patients in the early rehabilitation period of COVID-19. Material and methods. There were 243 patients with COVID-19 aged 18–60 years under observation. The criteria for inclusion in the study were: transferred no earlier than 10 days before inclusion in the study COVID-19; at the time of inclusion in the study PCR-negative COVID-19. The indicators of the general blood test, in the blood serum – C-reactive protein, alanine aminotransferase, aspartate aminotransferase, gamma glutamyl aminotransferase, lactate dehydrogenase, alkaline phosphatase, total and direct bilirubin, albumin. Results and dis- cussion. The assessment of the clinical condition of patients showed that the prevalence of respiratory syndrome was 81,48%, dyspeptic – 67,90%, hemorheological – 54,73%, asthenic – 42,39%, encephalopathy – 36,21%. In the general blood test, the hemoglobin level, the number of erythrocytes and platelets were significantly lower than in the control group (p<0,001, p<0,05 and p<0,001). The activity of blood enzymes in post COVID-19 patients included in the study was significantly increased compared to the control group: alanine aminotransferase exceeded the average values in the control group by almost 10 times, aspartate aminotransferase – almost 3 times, lactate dehydrogenase – 3 times, gamma glutamyl aminotransferase and alkaline phosphatase – almost one and a half times. The level of bilirubin b significantly exceeded the indicator recorded in the control group (p<0,001). The concentration of albumin in the peripheral blood of patients was reduced (p<0,001 the significance of the difference with the control group). Conclusion. In patients with liver damage in post COVID-19 patients the early rehabilitation period, the most frequent clinical syndromes were respiratory (81,48%) and dyspeptic (67,90%). Laboratory changes characteristic of hypochromic anemia, consumption thrombocytopenia, mesenchymal-inflammatory activity, liver functional disorders (the presence of cytolytic cholestatic syndromes and a decrease in protein synthesizing liver function) were also revealed.