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COVID-19 Sırasında Gelişen Karaciğer Hasarı Ne Kadar Önemli?

Year 2021, Volume: 23 Issue: 3, 239 - 243, 30.12.2021
https://doi.org/10.18678/dtfd.947189

Abstract

Amaç: Bu çalışma, koronavirüs hastalığı 2019 (coronavirus disease 2019, COVID-19) nedeniyle hastaneye yatırılan hastalarda karaciğer fonksiyon bozukluğu prevalansını incelemeyi ve yoğun bakım ünitesine yatış ve mortaliteyi öngörmede karaciğer fonksiyon bozukluğunun rolünü araştırmayı amaçlamaktadır.
Gereç ve Yöntemler: Önceden bilinen bir kronik karaciğer hastalığı olmayan ve polimeraz zincir reaksiyonu testi ile doğrulanmış COVID-19 pozitif olan toplam 2168 hasta, hafif ve şiddetli COVID-19 olarak gruplara ayrıldı. Karaciğer hasarı gelişiminin COVID-19’un seyrine ve prognozuna etkisi araştırıldı.
Bulgular: Hafif COVID-19’lu hastaların %26,3’ünde (n=461) ve şiddetli COVID-19’lu hastaların %45,3’ünde (n=189) karaciğer enzimlerinde yükselme meydana geldi. En yüksek ALT ve AST artışları, antibiyotikler ile birlikte birden fazla ilaç kullanan hastalarda tespit edildi (p<0,001). Hafif COVID-19’lu hastaların %1,4’ünde (n=25) ve şiddetli COVID-19’lu hastaların %6,5’inde (n=27) şiddetli hepatit gelişti (p<0,001). Şiddetli COVID-19’lu hastalarda, ALT ile albumin arasında zayıf düzeyde negatif bir korelasyon (p=0,017; r=-0,497) saptanırken, bilirubin ile zayıf düzeyde pozitif bir korelasyon (p=0,024; r=0,352), ferritin ile orta düzeyde pozitif bir korelasyon (p=0,016; r=0,504) ve INR ile zayıf düzeyde pozitif bir korelasyon (p=0,022; r=0,383) olduğu saptandı.
Sonuç: Sonuçlar, COVID-19 hastalarının %30’unda farklı şiddette karaciğer fonksiyon testlerinde bozulma meydana geldiğini ve şiddetli COVID-19 hastalarında karaciğer hasarının daha yaygın olduğunu göstermektedir. Ayrıca COVID-19 sırasında meydana gelen karaciğer hasarının yoğun bakım gereksinimi ve ölüm riskini artıran bir etken olduğu da belirlenmiştir.

References

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  • Niu P, Shen J, Zhu N, Lu R, Tan W. Two-tube multiplex real-time reverse transcription PCR to detect six human coronaviruses. Virol Sin. 2016;31(1):85-8.
  • Brüssow H. COVID-19 by numbers - infections, cases and deaths. Environ Microbiol. 2021;23(3):1322-33.
  • Liu J, Li S, Liu J, Liang B, Wang X, Wang H, et al. Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients. EBioMedicine. 2020;55:102763.
  • Chai X, Hu L, Zhang Y, Han W, Lu Z, Ke A, et al. Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection. bioRxiv. 2020. doi: 10.1101/2020.02.03.931766.
  • Mantovani A, Beatrice G, Dalbeni A. Coronavirus disease 2019 and prevalence of chronic liver disease: a meta-analysis. Liver Int. 2020;40(6):1316-20.
  • Cai Q, Huang D, Yu H, Zhu Z, Xia Z, Su Y, et al. COVID-19: Abnormal liver function tests. J Hepatol. 2020;73(3):566-74.
  • Tan YJ, Fielding BC, Goh PY, Shen S, Tan TH, Lim SG, et al. Overexpression of 7a, a protein specifically encoded by the severe acute respiratory syndrome coronavirus, induces apoptosis via a caspase-dependent pathway. J Virol. 2004;78(24):14043-7.
  • Casas-Rojo JM, Antón-Santos JM, Millán-Núñez-Cortés J, Lumbreras-Bermejo C, Ramos-Rincón JM, Roy-Vallejo E, et al. Clinical characteristics of patients hospitalized with COVID-19 in Spain: results from the SEMI-COVID-19 Registry. Rev Clin Esp (Barc). 2020;220(8):480-94.
  • EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis. European Association for the Study of the Liver. J Hepatol. 2015;63(1):237-64.
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  • Zhao D, Yao F, Wang L, Zheng L, Gao Y, Ye J, et al. A comparative study on the clinical features of coronavirus 2019 (COVID-19) pneumonia with other pneumonias. Clin Infect Dis. 2020;71(15):756-61.
  • Del Zompo F, De Siena M, Ianiro G, Gasbarrini A, Pompili M, Ponziani FR. Prevalence of liver injury and correlation with clinical outcomes in patients with COVID-19: systematic review with meta-analysis. Eur Rev Med Pharmacol Sci. 2020;24(24):13072-88.
  • Sharma A, Jaiswal P, Kerakhan Y, Saravanan L, Murtaza Z, Zergham A, et al. Liver disease and outcomes among COVID-19 hospitalized patients – A systematic review and meta-analysis. Ann Hepatol. 2021;21:100273.
  • Xu L, Liu J, Lu M, Yang D, Zheng X. Liver injury during highly pathogenic human coronavirus infections. Liver Int. 2020;40(5):998‐1004.
  • Alqahtani SA, Schattenberg JM. Liver injury in COVID-19: The current evidence. United European Gastroenterol J. 2020;8(5):509-19.

How Important Is Liver Damage During COVID-19?

Year 2021, Volume: 23 Issue: 3, 239 - 243, 30.12.2021
https://doi.org/10.18678/dtfd.947189

Abstract

Aim: The present study aimed to examine the prevalence of liver dysfunction in patients hospitalized due to coronavirus disease 2019 (COVID-19) and to investigate the role of liver dysfunction in predicting intensive care unit admission and mortality.
Material and Methods: A total of 2168 patients who had no previously known chronic liver disease and were found to be COVID-19 positive on polymerase chain reaction test were divided into mild and severe COVID-19 groups. The effect of the development of liver damage on the course and prognosis of COVID-19 was investigated.
Results: Elevated liver enzymes developed in 26.3% (n=461) of the patients with mild COVID-19 and in 45.3% (n=189) of the patients with severe COVID-19. The highest ALT and AST elevation was detected in patients using more than one drug with antibiotics (p<0.001). Severe hepatitis developed in 1.4% (n=25) of the patients with mild COVID-19 and 6.5% (n=27) of the patients with severe COVID-19 (p<0.001). There was a weak negative correlation between ALT and albumin (p=0.017, r=-0.497), while a weak positive correlation with bilirubin (p=0.024, r=0.352), a moderate positive correlation with ferritin (p=0.016, r=0.504), and a weak positive correlation with INR (p=0.022, r=0.383) were found in patients with severe COVID-19.
Conclusion: The results showed that 30% of COVID-19 patients had impaired liver function of varying severity and that liver damage was more common in patients with severe COVID-19. It was also determined that liver damage occurring during COVID-19 was an indicator of intensive care requirement and the mortality risk.

References

  • Rahimi B, Vesal A, Edalatifard M. Coronavirus and its effect on the respiratory system: Is there any association between pneumonia and immune cells. J Family Med Prim Care. 2020;9(9):4729-35.
  • Niu P, Shen J, Zhu N, Lu R, Tan W. Two-tube multiplex real-time reverse transcription PCR to detect six human coronaviruses. Virol Sin. 2016;31(1):85-8.
  • Brüssow H. COVID-19 by numbers - infections, cases and deaths. Environ Microbiol. 2021;23(3):1322-33.
  • Liu J, Li S, Liu J, Liang B, Wang X, Wang H, et al. Longitudinal characteristics of lymphocyte responses and cytokine profiles in the peripheral blood of SARS-CoV-2 infected patients. EBioMedicine. 2020;55:102763.
  • Chai X, Hu L, Zhang Y, Han W, Lu Z, Ke A, et al. Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection. bioRxiv. 2020. doi: 10.1101/2020.02.03.931766.
  • Mantovani A, Beatrice G, Dalbeni A. Coronavirus disease 2019 and prevalence of chronic liver disease: a meta-analysis. Liver Int. 2020;40(6):1316-20.
  • Cai Q, Huang D, Yu H, Zhu Z, Xia Z, Su Y, et al. COVID-19: Abnormal liver function tests. J Hepatol. 2020;73(3):566-74.
  • Tan YJ, Fielding BC, Goh PY, Shen S, Tan TH, Lim SG, et al. Overexpression of 7a, a protein specifically encoded by the severe acute respiratory syndrome coronavirus, induces apoptosis via a caspase-dependent pathway. J Virol. 2004;78(24):14043-7.
  • Casas-Rojo JM, Antón-Santos JM, Millán-Núñez-Cortés J, Lumbreras-Bermejo C, Ramos-Rincón JM, Roy-Vallejo E, et al. Clinical characteristics of patients hospitalized with COVID-19 in Spain: results from the SEMI-COVID-19 Registry. Rev Clin Esp (Barc). 2020;220(8):480-94.
  • EASL-ALEH Clinical Practice Guidelines: Non-invasive tests for evaluation of liver disease severity and prognosis. European Association for the Study of the Liver. J Hepatol. 2015;63(1):237-64.
  • Kulkarni AV, Kumar P, Tevethia HV, Premkumar M, Arab JP, Candia R, et al. Systematic review with meta-analysis: liver manifestations and outcomes in COVID-19. Aliment Pharmacol Ther. 2020;52(4):584-99.
  • Zhao D, Yao F, Wang L, Zheng L, Gao Y, Ye J, et al. A comparative study on the clinical features of coronavirus 2019 (COVID-19) pneumonia with other pneumonias. Clin Infect Dis. 2020;71(15):756-61.
  • Del Zompo F, De Siena M, Ianiro G, Gasbarrini A, Pompili M, Ponziani FR. Prevalence of liver injury and correlation with clinical outcomes in patients with COVID-19: systematic review with meta-analysis. Eur Rev Med Pharmacol Sci. 2020;24(24):13072-88.
  • Sharma A, Jaiswal P, Kerakhan Y, Saravanan L, Murtaza Z, Zergham A, et al. Liver disease and outcomes among COVID-19 hospitalized patients – A systematic review and meta-analysis. Ann Hepatol. 2021;21:100273.
  • Xu L, Liu J, Lu M, Yang D, Zheng X. Liver injury during highly pathogenic human coronavirus infections. Liver Int. 2020;40(5):998‐1004.
  • Alqahtani SA, Schattenberg JM. Liver injury in COVID-19: The current evidence. United European Gastroenterol J. 2020;8(5):509-19.
There are 16 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Article
Authors

Berat Ebik 0000-0002-0012-2505

Nazım Ekin This is me 0000-0001-5302-8953

Ferhat Bacaksız 0000-0002-9670-3290

Jihat Kılıç This is me 0000-0003-3722-350X

Publication Date December 30, 2021
Submission Date June 3, 2021
Published in Issue Year 2021 Volume: 23 Issue: 3

Cite

APA Ebik, B., Ekin, N., Bacaksız, F., Kılıç, J. (2021). How Important Is Liver Damage During COVID-19?. Duzce Medical Journal, 23(3), 239-243. https://doi.org/10.18678/dtfd.947189
AMA Ebik B, Ekin N, Bacaksız F, Kılıç J. How Important Is Liver Damage During COVID-19?. Duzce Med J. December 2021;23(3):239-243. doi:10.18678/dtfd.947189
Chicago Ebik, Berat, Nazım Ekin, Ferhat Bacaksız, and Jihat Kılıç. “How Important Is Liver Damage During COVID-19?”. Duzce Medical Journal 23, no. 3 (December 2021): 239-43. https://doi.org/10.18678/dtfd.947189.
EndNote Ebik B, Ekin N, Bacaksız F, Kılıç J (December 1, 2021) How Important Is Liver Damage During COVID-19?. Duzce Medical Journal 23 3 239–243.
IEEE B. Ebik, N. Ekin, F. Bacaksız, and J. Kılıç, “How Important Is Liver Damage During COVID-19?”, Duzce Med J, vol. 23, no. 3, pp. 239–243, 2021, doi: 10.18678/dtfd.947189.
ISNAD Ebik, Berat et al. “How Important Is Liver Damage During COVID-19?”. Duzce Medical Journal 23/3 (December 2021), 239-243. https://doi.org/10.18678/dtfd.947189.
JAMA Ebik B, Ekin N, Bacaksız F, Kılıç J. How Important Is Liver Damage During COVID-19?. Duzce Med J. 2021;23:239–243.
MLA Ebik, Berat et al. “How Important Is Liver Damage During COVID-19?”. Duzce Medical Journal, vol. 23, no. 3, 2021, pp. 239-43, doi:10.18678/dtfd.947189.
Vancouver Ebik B, Ekin N, Bacaksız F, Kılıç J. How Important Is Liver Damage During COVID-19?. Duzce Med J. 2021;23(3):239-43.