CLINICAL AND LABORATORY CHARACTERISTICS OF PATIENTS WITH LIVER DAMAGE IN THE COVID-19 EARLY REHABILITATION PERIOD

ABSTRACT

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 discussion. 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. © 2018 the Author (s). Published by Kurdistan University of Medical Sciences.