Cytolytic syndrome in patients with COVID-19

Abstract

. Identify cytolysis syndrome among patients with COVID-19 and explore the potential relationship between the course of COVID-19 and liver damage. Materials and methods. 450 people with a diagnosis of "U07.1 - Coronavirus infection COVID-19, virus identified" were examined, undergoing and inpatient and outpatient treatment at Tuymazinskaya Central District Hospital. CT scan of the chest organs, biochemical blood test with calculation of ALT, AST, total protein, glucose, total bilirubin, APTT, PTI, INR, fibrinogen were evaluated. Results. The presence of cytolytic syndrome was detected in 217 (48.2%) patients. The ALT level was 60 [23;72] U/L, and the AST level was 45 [22;57] U/L. Between the severity of the course and the ALT level, a direct, strong significant correlation was revealed (ρ=0.724, t=22.26, p>95%). A direct, significant correlation of moderate strength was found between the severity and percentage of lung parenchymal lesions (ρ=0.68, t=19.62, p>95%), AST level (ρ=0.68, t=19.53, p>95%), age of patients (ρ=0.51, t=12.55, p>95%), BMI (ρ=0.4, t=9.44, p>95%). Comparing the degree of damage to the lung parenchyma with the level of AST, a direct, significant correlation of moderate strength (ρ=0.5, t=12.38, p>95%) was revealed, as well as with the level of ALT (ρ=0,5, t=11.98, p>95%), total protein level (ρ=0.38, t=8.8, p>95%), age (ρ=0.35, t=7.85, p>95%. Conclusion. Clinical manifestations of COVID-19 are characterized by polysyndromicity, including a cytolytic syndrome. Changes in liver function parameters found in COVID-19 are associated with the severity of the infection, age and BMI. An important point in the post-COVID rehabilitation of patients is inclusion of hepatoprotectors.

Short- and long-term outcomes of patients with COVID-19 and acute kidney injury

“…По данным нескольких крупных многоцентровых исследований, повышение печеночных трансаминаз ассоциировано с более тяжелым течением COVID-19 [21,22]. В отечественной работе было отмечено более частое повышение АЛТ, нежели АСТ [23]. Однако в нашей работе и метаанализе нескольких исследований [24] было показано, что повышение АСТ чаще встречается у пациентов с COVID-19, нежели АЛТ, и ассоциировано с неблагоприятными исходами.…”