Treatment of toxic hepatitis in COVID-19 patients
- Authors: Maev I.V.1, Shaburov R.I.1,2, Pavlov A.I.3, Molodova A.I.1, Karakozov A.G.1, Kazakov S.P.4,5, Lebedeva E.G.1, Ivolgin A.F.3, Eremin M.N.1, Levchenko O.B.1
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Affiliations:
- Yevdokimov Moscow State University of Medicine and Dentistry
- Central Clinical Hospital “RZhD-Medicine”
- Vishnevsky 3-rd Central Military Clinical Hospital
- Russian Medical Academy of Continuous Professional Education
- Burdenko Main Military Clinical Hospital
- Issue: Vol 94, No 12 (2022)
- Pages: 1413-1420
- Section: Original articles
- URL: https://journals.rcsi.science/0040-3660/article/view/144205
- DOI: https://doi.org/10.26442/00403660.2022.12.202021
- ID: 144205
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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.
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##article.viewOnOriginalSite##About the authors
Igor V. Maev
Yevdokimov Moscow State University of Medicine and Dentistry
Email: aram_k@mail.ru
ORCID iD: 0000-0001-6114-564X
акад. РАН, д-р мед. наук, проф., зав. каф. пропедевтики внутренних болезней и гастроэнтерологии ФГБОУ ВО «МГМСУ им. А.И. Евдокимова»
Russian Federation, MoscowRafik I. Shaburov
Yevdokimov Moscow State University of Medicine and Dentistry; Central Clinical Hospital “RZhD-Medicine”
Email: aram_k@mail.ru
ORCID iD: 0000-0001-9741-0150
канд. мед. наук, доц. каф. пропедевтики внутренних болезней и гастроэнтерологии ФГБОУ ВО «МГМСУ им. А.И. Евдокимова», глав. врач ЧУЗ «ЦКБ “РЖД-Медицина”»
Russian Federation, Moscow; MoscowAlexandr I. Pavlov
Vishnevsky 3-rd Central Military Clinical Hospital
Email: aram_k@mail.ru
ORCID iD: 0000-0003-1836-7946
д-р мед. наук, доц., зам. нач. госпиталя по медицинской части ФГБУ «3 ЦВКГ им. А.А. Вишневского»
Russian Federation, KrasnogorskAlevtina I. Molodova
Yevdokimov Moscow State University of Medicine and Dentistry
Email: aram_k@mail.ru
ORCID iD: 0000-0003-3302-6541
aссистент каф. пропедевтики внутренних болезней и гастроэнтерологии ФГБОУ ВО «МГМСУ им. А.И. Евдокимова»
Russian Federation, MoscowAram G. Karakozov
Yevdokimov Moscow State University of Medicine and Dentistry
Author for correspondence.
Email: aram_k@mail.ru
ORCID iD: 0000-0002-3196-4457
д-р мед. наук, проф. каф. пропедевтики внутренних болезней и гастроэнтерологии ФГБОУ ВО «МГМСУ им. А.И. Евдокимова»
Russian Federation, MoscowSergey P. Kazakov
Russian Medical Academy of Continuous Professional Education; Burdenko Main Military Clinical Hospital
Email: aram_k@mail.ru
ORCID iD: 0000-0001-6528-1059
д-р мед. наук, доц., зав. каф. медицинской биохимии и иммунопатологии ФГБОУ ДПО РМАНПО, нач. центра клинической лабораторной диагностики – главный лаборант ФГБУ «ГВКГ им. Н.Н. Бурденко»
Russian Federation, Moscow; MoscowEkaterina G. Lebedeva
Yevdokimov Moscow State University of Medicine and Dentistry
Email: aram_k@mail.ru
ORCID iD: 0000-0001-9572-1932
канд. мед. наук, доц. каф. пропедевтики внутренних болезней и гастроэнтерологии ФГБОУ ВО «МГМСУ им. А.И. Евдокимова»
Russian Federation, MoscowAleksandr F. Ivolgin
Vishnevsky 3-rd Central Military Clinical Hospital
Email: aram_k@mail.ru
ORCID iD: 0000-0002-8849-680X
нач. неврологического центра – главный невролог ФГБУ «3 ЦВКГ им. А.А. Вишневского»
Russian Federation, KrasnogorskMikhail N. Eremin
Yevdokimov Moscow State University of Medicine and Dentistry
Email: aram_k@mail.ru
ORCID iD: 0000-0002-8798-5011
канд. мед. наук, ассистент каф. пропедевтики внутренних болезней и гастроэнтерологии ФГБОУ ВО «МГМСУ им. А.И. Евдокимова»
Russian Federation, MoscowOlga B. Levchenko
Yevdokimov Moscow State University of Medicine and Dentistry
Email: aram_k@mail.ru
ORCID iD: 0000-0002-6594-7006
aссистент каф. пропедевтики внутренних болезней и гастроэнтерологии ФГБОУ ВО «МГМСУ им. А.И. Евдокимова»
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