The aim of the study. To analyze the course of COVID-19 infection in patients with primary biliary cholangitis (PBC).Materials and methods. In a single-center retrospective study, survey and analysis of medical records of 144 patients with PBC was carried out.Results. All patients (n = 144) received basic therapy with ursodeoxycholic acid (UDCA), 5 of them received fibrates as well. Response to therapy (EASL criteria) was obtained in 30 people. Between March 2020 and March 2021, 50 patients (34.7 %) suffered COVID-19, with mean age of 58.8 ± 10.7 years, 16 of which were diagnosed with liver cirrhosis. Mild COVID-19 was observed in 34 (68 %) people, moderate course — in 14 (28 %), severe — in 2 (4 %), cases of extremely severe course were not recorded. 12 patients were hospitalized, 8 of which received oxygen therapy due to a decrease in SpO2 < 94 %, there was no need for the use of other methods of oxygen therapy in any case. The duration of hospitalization was 11.4 ± 5.7 days. There was a higher initial activity of serum alkaline phosphatase (1.8 ± 1.0 versus 1.7 ± 1.4 times of the upper limit of normal, M ± SD, p = 0.04) in patients with COVID-19 infection and lack of UDCA therapy effectiveness was more prominent (40 % vs. 19.1 % of cases, p = 0.04) compared with patients who did not have COVID-19. There were no significant differences in characteristics of the course of PBC (stage, response to therapy) and age in correlation with severity of the course of COVID-19. Among hospitalized patients and those in need of oxygen support, large proportion were older patients (58.3 % and 62.5 %, respectively) and patients with concomitant diseases (62.5 % and 75 %, respectively). Patients who hadn`t previously responded to UDCA therapy were more likely to require oxygen support compared to patients responding to basic therapy (p < 0.01).Conclusion. PBC is not a risk factor for severe COVID-19. A protective effect of UDCA in SARS-CoV-2 infection is possible, which requires further investigation.
Introduction. The increase in serum transaminases (ALT and AST) and the persistence of their high values is associated with morbidity and mortality from liver diseases. Bicyclol has anti-inflammatory and antioxidant effects, which formed the basis for this study.Materials and methods. The study enrolled 51 patients (MELD < 19); hepatitis stage – 84.4%, cirrhosis – 15.6%. Treatment: Bicyclol 75 mg/day for 12 weeks. Criteria of efficacy: dynamics of ALT, AST, CRP; general well-being (D-FIS scale).Results. After 4 weeks of treatment the share of patients with ALT normalization was 50,9% (p < 0,001); with AST normalization – 62.7% (p < 0.001); after 12 weeks - 79,5% and 89,7% respectively (p < 0,001). CRP decreased statistically significantly after 2 and 4 weeks from the beginning of treatment. The D-FIS questionnaire was filled in by 36 patients at the beginning of the study, in 4 weeks - by 35 patients, in 12 weeks – by 32 patients. Median D-FIS decreased from 12 (8.2; 32.2) to 8 (5; 29) points (p < 0,001) after 4 weeks of treatment, after 12 weeks – to 6.5 (3; 28.5) points (p < 0.001). The CRP was positively correlated with the D-FIS value. Fibrosis (“Fibromax”, “Fibroscan”) was studied in 10 additional patients, the dose of Bicyclol was 150/75 mg/day during 6 months, the result was statistically significant (p < 0.001).Conclusion. Application of Bicyclol leads to reduction of fatigue, local and systemic inflammation, fibrosis in chronic diffuse liver diseases regardless of etiology.
Aim. Estimation of the liver steatosis and fibrosis incidence with transient elastography and the controlled attenuation parameter in residents of St. Petersburg.Materials and methods. A prospective open single-centre population study included history, anthropometric and laboratory data on 318 outpatients aged 24—89 years (mean age 52.6 ± 14.6 years). The degrees of steatosis (assessed with the controlled attenuation parameter as ultrasound amplitude dropdown quantification in liver) and fibrosis were determined with a Fibroscan 502 Touch unit (Echosens, France).Results. Hepatic steatosis of predominantly high degree was revealed in 44.7%, combined fibrosis and steatosis — in 28%; isolated fibrosis of various stage — in 2.5%, no structural changes — in 24.8% individuals. The growth of body mass index and waist circumference significantly correlated in women with pronounced liver changes. Serum transaminase activity increased with more severe liver changes, being statistically significant for aspartic transaminase only.Conclusion. A high incidence of primary liver steatosis and fibrosis in residents of St. Petersburg warrants improved diagnostic algorithms and routine preventive measures. Transient elastography with the controlled attenuation parameter estimation provides a convenient non-invasive screening for hepatic fibrosis and steatosis.
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