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Covid-19 Hastalarında Karaciğer Laboratuvar Anormalliklerinin Değerlendirilmesi

Year 2023, Volume: 20 Issue: 2, 242 - 247, 31.08.2023
https://doi.org/10.35440/hutfd.1126578

Abstract

ÖZET
Giriş:Covid-19 hastalığı, ribonükleikasid(RNA) genomu taşıyan koronavirüs (CoV) ailesinin neden olduğu bir hastalıktır. CoV’da en sık tutulan organ akciğer(AC) olmasına rağmen, gastrointestinel sistem(GİS) ve karaciğer(KC) de etkilenebilmektedir. Bu çalışmamızda Covid-19 hastalarında karaciğer fonksiyonlarının değerlendirilmesi amaçlanmıştır.

Materyal-metod: Çalışmada 01.10.2020-01.12.2021 tarihleri arasında300 Covid-19 hastasının hastanaye ilk başvurudaki transaminaz(AST, ALT) ve kolestaz(ALP, GGT) enzimleri ile albümin düzeylerine bakıldı. Laboratuvar sonuçları, hastanemiz normal laboratuvar değerlerine göre gruplandırılarak incelendi. Araştırma için kurumsal izin alındı. Harran Üniversitesi Tıp Fakültesi Etik Kurulu'nun 21.03.2022 tarih ve 06 sayılı oturum kararı ile onay alındı.

Bulgular:Hastaların 173’ü (%57,7) erkek ve 127’si (%42,3) kadın, yaş ortalaması 53±17,6(min 18 – max 95) yıl olarak saptandı. Hastaların 266 (%88,7) tanesi serviste, 31 (%10,3) tanesi servis ve yoğun bakım ünitesinde (YBÜ) ve 3 (%1) tanesi sadece YBÜ’de takip edildi. Toplam takip süresi ortalaması 7,22±17,68 gün olup, servis takip süresi 6,69±2,63 gün idi. Cinsiyete göre laboratuvar değerlerinin ortalama ve standart sapmaları tablo 1’de verilmiştir.
Hastaların %69’unda AST, %29’unda ALT, %16,3 ALP ve %28,3 GGT yüksekliği saptanırken, %19,3 oranında albümin düşüklüğü saptandı. AST, ALT ve GGT yükseklikleri daha çok erkeklerde görülürken, albümin düşüklüğü de daha çok kadınlarda görüldü.

Sonuç:CoV bağlı KC disfonksiyonu geliştiğinde sırasıyla daha çok AST, ALT, GGT ve albümin anormallikleri görülmektedir. CoV’a bağlı özellikle AST olmak üzere transaminazların, kolestaz enzimlerine göre daha sık arttığı saptanmıştır.

Supporting Institution

YOK

Project Number

YOK

Thanks

“Covid-19 hastalarında, karaciğer laboratuvar anormalliklerinin değerlendirilmesi” başlıklı özgün yazımızı yayımlanmak üzere değerlendirmenize sunuyoruz. Literatürde Covid-19 hastalarındaki karaciğer laboratuvar anormallikleri ile ilgili az sayıda çalışmalar olup, yazımızın literatüre katkı sağlayacağını ve çalışmamıza atıf yapılacağını düşünüyoruz. Yazımızın orijinal olduğunu, başka bir dergi tarafından tümünün yayınlanmadığını veya şu anda yayınlanmak üzere değerlendirilmediğini onaylıyoruz. Makalemiz, Şanlıurfa’da 17-19 Mart 2022 tarihindeki Anadolu Güncel Gastroenteroloji kongre günlerinde sözlü sunum olarak sunulmuştur. Yazımızın makalesi tarafınızca kabul edilirse, makale telif hakkı sahibinin yazılı izni olmadan aynı biçimde, İngilizce veya başka bir dilde ve başka bir yerde yayımlanmayacaktır. Çalışmamıza doğrudan katkıda bulunan tüm yazarlarımız, makalemizin son halini okudular ve derginize gönderilmesini onayladılar. Gönderdiğimiz yazıyla ilgili veya ilgisiz olarak bir çıkar çatışması oluşturabilecek hiçbir ticari ilişkimiz, sözleşme ilişkimiz veya mülkiyet kaygımız yoktur. Makalemizi dikkate aldığınız için teşekkür ederiz. Saygılarımla, Sorumlu yazar: Dr.Mehmet Selim MAMİŞ Harran Üniversitesi Tıp Fakültesi Hastanesi İç Hastalıkları Anabilim Dalı, Osman Bey Kampüsü, 63290, Haliliye/Şanlıurfa/Türkiye E-posta: dr.mehmetselim@outlook.com Tel: 0544 689 63 42 Cep telefonu numarası: 0544 689 63 42

References

  • 1. Ankara Üniversitesi, Tıp Fakültesi COVİD-19, ISBN:978-605-136-477-3, Copyright 2020, s:21
  • 2. Yang L, Tu L. Implications of gastrointestinal manifestations of COVID-19. Lancet Gastroenterol Hepatol 2020;5:629-30.
  • 3. Guan WJ, Ni ZY, Hu Y, et al; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1708-1720.
  • 4. Girardi E, Petrosillo N, Aloisi MS, Ravà L, Ippolito G. Peer-reviewed articles and public health: the mad cow affair in Italian news papers. JAMA. 1998: 15;280(3):292-294
  • 5. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirusin Wuhan, China. Lancet 2020:395;497-506.
  • 6. Fan Z, Chen L, Li J, Cheng X, Yang J, Tian C, Zhang Y, Huang S, Liu Z, Cheng J. Clinical Features of COVID-19-Related Liver Functional Abnormality. Clin Gastroenterol Hepatol.2020;18(7):1561-1566.
  • 7. Zhang C, Shi L, Wang FS. Liver injury in COVID-19: management and challenges. Lancet Gastroenterol Hepatol 2020; 5:428.
  • 8. 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.
  • 9. Xie H, Zhao J, Lian N, Lin S, Xie Q, Zhuo H. Clinical characteristics of Non-ICU hospitalized patents with coronavirus disease 2019 and liver injury. A Retrospective study. Liver Int. 2020. 10.1111/liv.14449.
  • 10. Ridruejo E, Soza A.& eliver in times of COVID-19: What hepatologists should know. Annals of Hepatology. 2020:19; 353–358.
  • 11. Xu XW, Wu XX, Jiang XG, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARSCov-2) outside of Wuhan, China: retrospective case series. BMJ 2020;368:606.
  • 12. Shi H, Han X, Jiang N, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study.Lancet Infect Dis 2020;20:425-434.
  • 13. Chai X, Hu L, Zhang Y, Han W. ACE2 expression in cholangiocytes may cause liver damage a% er 2019-nCoV infection. bioRxiv 2020.
  • 14. XiaoqiangChai LH, Yan Zhang. Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection. bioRxiv 2020. (Preprint) Available at:10.1101/2020.02.03.931766. Accessed February 20, 2020.
  • 15. Redd WD, Zhou JC, Hathorn KE, McCarty TR, Bazarbashi AN, & ompson CC, et al. Prevalence and Characteristics of Gastrointestinal Symptoms in PatientsWith Severe Acute Resp!ratory Syndrome Coronavirus 2 Infection in the United States: A Multicenter Cohort Study. Gastroenterology 2020; 159:765-767.
  • 16. Arentz M, Y!m E, Klaff L, Lokhandwala S, Riedo FX, Chong M, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. JAMA 2020;323:1612- 1614.
  • 17. Ye Z, Song B. Liver injury in COVID-19: Diagnosis and associated factors. Liver Int 2020;40:2040-2041.
  • 18. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507-553.
  • 19. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW; the Northwell COVID-19 Research Consortium, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area [publ ished correction appears in JAMA. 2020 May 26;323(20):2098]. JAMA. 2020;323(20):2052-2059
  • 20. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, Fan Y, Zheng C. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020;20(4):425-434.
  • 21. Phipps MM, Barraza LH, LaSota ED, et al. Acuteliver injury in COVID‐19: Prevalence and associationwith clinical outcomes in a large US cohort.Hepatology. 2020 May 3010.1002/hep.31404.
  • 22. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020;323:1061-1069.
  • 23. Pratt DS, Kaplan MM. Evaluat!on of abnormal liver-enzyme results in asymptomatic patients. N Engl J Med 2000;342:1266-1271.
  • 24. Weisberg IS, Jacobson IM. Cardiovascular diseases and the liver. Clin Liver Dis 2011;15:1-20.
  • 25. vanDeursen VM, Damman K, Hillege HL,Beek V, Van Veldhuisen DJ, Voors AA, et al. Abnormal liver function in relation to hemodynamic profile in heart failure patients. J Card Fail 2010;16:84-90.
  • 26. Bertolini A, van de Peppel IP, Bodewes FAJA, et al. Abnormal liver function tests in COVID-19 patients: relevance and potential pathogenesis. Hepatology 2020. Version of Record. doi:10.1002/hep.31480
  • 27. Fan Z, Chen L, Li J, Cheng X, Yang J, Tian C, Zhang Y, Huang S, Liu Z, Cheng J. Clinical Features of COVID-19-Related Liver Functional Abnormality. Clin Gastroenterol Hepatol. 2020;18(7):1561-1566.
  • 28. Xu Z, Shi L, Wang Y. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8:420–422.
  • 29. Arentz M, Yim E, Klaff L, Lokhandwala S, Riedo FX, Chong M, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. JAMA 2020;323:1612-1614.

Evaluation of Liver Laboratory Abnormalities in Covid-19 Patients

Year 2023, Volume: 20 Issue: 2, 242 - 247, 31.08.2023
https://doi.org/10.35440/hutfd.1126578

Abstract

SUMMARY

Introduction: Covid-19 disease is a disease caused by the coronavirus (CoV) family, which carries the ribonucleic acid (RNA) genome. Although the lung is the most frequently involved organ in CoV disease, the gastrointestinal tract (GIS) and liver can also be affected. This study is aimed to evaluate liver functions in Covid-19 patients.

Material-method: In the study, transaminase (AST, ALT) and cholestasis (ALP, GGT) enzymes and albumin levels of 300 Covid-19 patients at their first admission to the hospital were examined between 01.10.2020 and 01.12.2021. Laboratory results were analyzed by grouping them according to the normal laboratory values of our hospital. Institutional permission was obtained for the study. Approval was obtained by the Ethics Committee of Harran University Faculty of Medicine with the session decision dated 21.03.2022 and numbered 06.

Results: 173 (57.7%) of the patients were male and 127 (42.3%) were female, their mean age was 53±17.68 years. Of the patients, 266 (88.7%) were followed up in the ward, 31 (10.3%) in the ward and intensive care unit (ICU), and 3 (1%) only in the ICU. The mean total monitorization period was 7.22±17.68 days, and the service monitorization period was 6.69±2.63 days. The mean and standard deviations of laboratory values by gender are given in table 1.
While 69% of the patients had AST elevation, 29% had ALT elevation, 16.3% had ALP elevation and 28.3% had GGT elevation the albumin rate was found to be low in 19.3% of the patients. While AST, ALT and GGT elevations were more common in men, low albumin levels were more common in women.

Conclusion: When CoV-induced liver dysfunction develops, AST, ALT, GGT and albumin abnormalities are seen, In chronological order. It was thus determined that transaminases, especially AST, increased more frequently than cholestasis enzymes due to CoV.

Project Number

YOK

References

  • 1. Ankara Üniversitesi, Tıp Fakültesi COVİD-19, ISBN:978-605-136-477-3, Copyright 2020, s:21
  • 2. Yang L, Tu L. Implications of gastrointestinal manifestations of COVID-19. Lancet Gastroenterol Hepatol 2020;5:629-30.
  • 3. Guan WJ, Ni ZY, Hu Y, et al; China Medical Treatment Expert Group for Covid-19. Clinical characteristics of coronavirus disease 2019 in China. N Engl J Med 2020;382:1708-1720.
  • 4. Girardi E, Petrosillo N, Aloisi MS, Ravà L, Ippolito G. Peer-reviewed articles and public health: the mad cow affair in Italian news papers. JAMA. 1998: 15;280(3):292-294
  • 5. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirusin Wuhan, China. Lancet 2020:395;497-506.
  • 6. Fan Z, Chen L, Li J, Cheng X, Yang J, Tian C, Zhang Y, Huang S, Liu Z, Cheng J. Clinical Features of COVID-19-Related Liver Functional Abnormality. Clin Gastroenterol Hepatol.2020;18(7):1561-1566.
  • 7. Zhang C, Shi L, Wang FS. Liver injury in COVID-19: management and challenges. Lancet Gastroenterol Hepatol 2020; 5:428.
  • 8. 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.
  • 9. Xie H, Zhao J, Lian N, Lin S, Xie Q, Zhuo H. Clinical characteristics of Non-ICU hospitalized patents with coronavirus disease 2019 and liver injury. A Retrospective study. Liver Int. 2020. 10.1111/liv.14449.
  • 10. Ridruejo E, Soza A.& eliver in times of COVID-19: What hepatologists should know. Annals of Hepatology. 2020:19; 353–358.
  • 11. Xu XW, Wu XX, Jiang XG, et al. Clinical findings in a group of patients infected with the 2019 novel coronavirus (SARSCov-2) outside of Wuhan, China: retrospective case series. BMJ 2020;368:606.
  • 12. Shi H, Han X, Jiang N, et al. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study.Lancet Infect Dis 2020;20:425-434.
  • 13. Chai X, Hu L, Zhang Y, Han W. ACE2 expression in cholangiocytes may cause liver damage a% er 2019-nCoV infection. bioRxiv 2020.
  • 14. XiaoqiangChai LH, Yan Zhang. Specific ACE2 expression in cholangiocytes may cause liver damage after 2019-nCoV infection. bioRxiv 2020. (Preprint) Available at:10.1101/2020.02.03.931766. Accessed February 20, 2020.
  • 15. Redd WD, Zhou JC, Hathorn KE, McCarty TR, Bazarbashi AN, & ompson CC, et al. Prevalence and Characteristics of Gastrointestinal Symptoms in PatientsWith Severe Acute Resp!ratory Syndrome Coronavirus 2 Infection in the United States: A Multicenter Cohort Study. Gastroenterology 2020; 159:765-767.
  • 16. Arentz M, Y!m E, Klaff L, Lokhandwala S, Riedo FX, Chong M, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. JAMA 2020;323:1612- 1614.
  • 17. Ye Z, Song B. Liver injury in COVID-19: Diagnosis and associated factors. Liver Int 2020;40:2040-2041.
  • 18. Chen N, Zhou M, Dong X, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395:507-553.
  • 19. Richardson S, Hirsch JS, Narasimhan M, Crawford JM, McGinn T, Davidson KW; the Northwell COVID-19 Research Consortium, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area [publ ished correction appears in JAMA. 2020 May 26;323(20):2098]. JAMA. 2020;323(20):2052-2059
  • 20. Shi H, Han X, Jiang N, Cao Y, Alwalid O, Gu J, Fan Y, Zheng C. Radiological findings from 81 patients with COVID-19 pneumonia in Wuhan, China: a descriptive study. Lancet Infect Dis. 2020;20(4):425-434.
  • 21. Phipps MM, Barraza LH, LaSota ED, et al. Acuteliver injury in COVID‐19: Prevalence and associationwith clinical outcomes in a large US cohort.Hepatology. 2020 May 3010.1002/hep.31404.
  • 22. Wang D, Hu B, Hu C, et al. Clinical characteristics of 138 hospitalized patients with 2019 novel coronavirus-infected pneumonia in Wuhan, China. JAMA 2020;323:1061-1069.
  • 23. Pratt DS, Kaplan MM. Evaluat!on of abnormal liver-enzyme results in asymptomatic patients. N Engl J Med 2000;342:1266-1271.
  • 24. Weisberg IS, Jacobson IM. Cardiovascular diseases and the liver. Clin Liver Dis 2011;15:1-20.
  • 25. vanDeursen VM, Damman K, Hillege HL,Beek V, Van Veldhuisen DJ, Voors AA, et al. Abnormal liver function in relation to hemodynamic profile in heart failure patients. J Card Fail 2010;16:84-90.
  • 26. Bertolini A, van de Peppel IP, Bodewes FAJA, et al. Abnormal liver function tests in COVID-19 patients: relevance and potential pathogenesis. Hepatology 2020. Version of Record. doi:10.1002/hep.31480
  • 27. Fan Z, Chen L, Li J, Cheng X, Yang J, Tian C, Zhang Y, Huang S, Liu Z, Cheng J. Clinical Features of COVID-19-Related Liver Functional Abnormality. Clin Gastroenterol Hepatol. 2020;18(7):1561-1566.
  • 28. Xu Z, Shi L, Wang Y. Pathological findings of COVID-19 associated with acute respiratory distress syndrome. Lancet Respir Med. 2020;8:420–422.
  • 29. Arentz M, Yim E, Klaff L, Lokhandwala S, Riedo FX, Chong M, et al. Characteristics and outcomes of 21 critically ill patients with COVID-19 in Washington State. JAMA 2020;323:1612-1614.
There are 29 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Article
Authors

Ahmet Uyanıkoğlu 0000-0003-4881-5244

Mehmet Selim Mamiş 0000-0003-0245-3321

Esat Cihan Karahancı 0000-0003-0245-3321

Tuba Dumak 0000-0003-1597-3748

Project Number YOK
Early Pub Date August 15, 2023
Publication Date August 31, 2023
Submission Date June 6, 2022
Acceptance Date May 15, 2023
Published in Issue Year 2023 Volume: 20 Issue: 2

Cite

Vancouver Uyanıkoğlu A, Mamiş MS, Karahancı EC, Dumak T. Covid-19 Hastalarında Karaciğer Laboratuvar Anormalliklerinin Değerlendirilmesi. Harran Üniversitesi Tıp Fakültesi Dergisi. 2023;20(2):242-7.

Harran Üniversitesi Tıp Fakültesi Dergisi  / Journal of Harran University Medical Faculty