ABSTRACT
BACKGROUND: The article reflects the clinical significance of the early diagnosis of toxic hepatitis in patients who have undergone a new coronavirus infection with the determination of clinical and laboratory predictors of the response to therapy. A dynamic analysis of the effectiveness of toxic hepatitis therapy in patients of three experimental groups and a control group is presented. AIM: The aim of the present study is to increase the effectiveness of the treatment of toxic hepatitis in patients who have undergone COVID-19. MATERIALS AND METHODS: On the basis of the newly created infection centers of the Central Clinical Hospital "RZhD-Medicine" and Vishnevsky 3-rd Central Military Clinical Hospital 996 patients with COVID-19, who had clinical and laboratory signs of toxic liver damage (cytolytic and/or cholestatic syndromes) against the background of COVID-19 therapy. RESULTS: On the 14th day from the start of therapy in group 3, there was a significant decrease in the clinical manifestations of jaundice in 163 (72.8%) patients, on the 21st day of treatment, this symptom was stopped in all patients. In groups 1 and 2, the decrease in clinical manifestations of jaundice was significantly lower - 122 (55.2%) and 134 (58.8%); p<0.05. At the end of therapy, no manifestations of jaundice were observed in all experimental groups, while in the control group, symptom reduction was achieved only in 47 (14.5%) patients. CONCLUSION: The use of drugs with hepatoprotective effect in the form of monotherapy in groups 1 (UDCA) and 2 (ademethionine) showed a low therapeutic effect with positive dynamics of clinical and laboratory indicators of toxic hepatitis activity. The use of combined treatment in group 3 (UDCA and ademethionine) demonstrated the maximum therapeutic effect, pronounced positive dynamics in the form of normalization of clinical and laboratory indicators of toxic hepatitis activity.
Subject(s)
COVID-19 , Chemical and Drug Induced Liver Injury , Jaundice , Humans , Drug Therapy, Combination , Chemical and Drug Induced Liver Injury/diagnosis , Chemical and Drug Induced Liver Injury/epidemiology , Chemical and Drug Induced Liver Injury/etiology , Treatment OutcomeABSTRACT
INTRODUCTION. To expand the range of the pantohematogen based drugs usage, to develop indications for their use in various forms and methods, scientific research is necessary and appropriate on evaluation of the effectiveness of the antler drugs use for the rehabilitation of patients with post-coronavirus syndrome, which is detected in most patients after the coronavirus infection COVID-19 and is characterized by various changes in metabolism and hemostasis, autonomic nervous system, external respiration, indicators of central and peripheral hemodynamics, reduced exercise tolerance, quality of life and working capacity of patients. AIM. To scientifically establish and develop of a comprehensive program of COVID-rehabilitation of patients with the use of pantohematogen at the sanatorium-resort stage. MATERIAL AND METHODS. We conducted randomized study in parallel groups. The study included women aged 39 to 65 years (mean age 53.9±1.18 years) - 30 patients. The rehabilitation program of the patients who had pneumonia associated with COVID-19 novel coronary virus infection was evaluated 3-4 months after the disease. The study group was additionally prescribed 1 capsule of pantohematogen, three times a day with meals, for 10-12 days (dietary supplements with increased iron content). The comparison group received the same rehabilitation program, but without the use of pantohematogen. RESULTS AND DISCUSSION. According to the severity of post-COVID pneumonia, 66.6% were diagnosed with pneumonia of moderate severity and 33.4% with mild severity. Mild degree of dyspnea was revealed in 63.3% of patients, physical asthenia was diagnosed in 70% of patients. The use of pantohematogen showed an advantage in terms of a more significant decrease in the level of physical asthenia, a decrease in dyspnea during physical exertion, a decrease in the frequency of autonomic disorders, an improvement in the psycho-emotional status, and a more significant decrease in reactive anxiety in these patients. In order to prolong the effectiveness of the post-COVID rehabilitation program for patients, it is advisable to continue taking pantohematogen in outpatient or home conditions for 2 weeks, 1 capsule three times a day. CONCLUSION. For the first time the possibility and expediency of using pantogematogen with additional iron content to increase the efficiency of the health center rehabilitation program has been studied and proved;it can be used in patients with post-COVID conditions for normalization of functional disorders, vegetative-status and normalization of psycho-emotional status in all organizational forms of sanatorium-resort organizations, as well as at home. © 2022, Alexander V. Shakula, Irina A Nesina, Alexander I. Pavlov, Elena A. Kurniavkina, Vareria S. Chursina, Irina V. Telepanova This is an open article under the CC BY license.
ABSTRACT
BACKGROUND: The novel coronavirus infection COVID-19 can be manifested by damage to the organs of the gastrointestinal tract (GIT). Damage to the gastrointestinal tract by the SARS-CoV-2 virus leads to a violation of the microbial-tissue complex of the mucous membrane of the digestive tract. A common gastroenterological manifestation of COVID-19 is diarrhea. AIM: Study of the clinical features of gastroenterological disorders and the possibility of optimizing the treatment of diarrheal syndrome in patients with COVID-19 with a mild form of viral infection. MATERIALS AND METHODS: The observation group consisted of 230 patients with mild COVID-19: K-group (n=115) with respiratory symptoms, I group (n=115) with gastrointestinal manifestations in combination and without signs of respiratory damage. In order to compare the effectiveness of treatment of diarrheal syndrome, patients of group I are randomized into 2 subgroups: Ia (n=58) prebiotic treatment (Zacofalk) and Ib (n=57) enterosorbents. RESULTS: The development of gastrointestinal symptoms with SARS-CoV-2 infection is significantly more often noted in comorbid patients (67%). Gastrointestinal symptoms were dominated by diarrhea (93.9%) and flatulence (76.5%), in 1/3 of patients they were the first manifestos of infection. It was established that in 98.4% of patients of group I (against 42.6% of the K-group) signs of infectious intoxication were detected. In patients with gastrointestinal lesions, an elongation of the febrile period by 91.5 days was noted, a later (6 days) verification of the viral etiology of the disease. It was found that in patients of group I, the regression of clinical symptoms, the duration of viral disease, the dynamics of antibody formation, the prognosis for the development of IBS-like disorders in the post-infectious period depended on the treatment. In patients taking (Zacofalk), these indicators were significantly better. CONCLUSION: In mild cases, to reduce the severity of viral intestinal damage, for effective relief of intestinal symptoms, to reduce the risk of IBS-like symptoms, it is advisable to prescribe (Zacofalk) in an initial dose of 3 tablets per day.