[Treatment of toxic hepatitis in COVID-19 patients].

Autor:	Maev IV; Yevdokimov Moscow State University of Medicine and Dentistry., Shaburov RI; Yevdokimov Moscow State University of Medicine and Dentistry.; Central Clinical Hospital 'RZhD-Medicine'., Pavlov AI; Vishnevsky 3-rd Central Military Clinical Hospital., Molodova AI; Yevdokimov Moscow State University of Medicine and Dentistry., Karakozov AG; Yevdokimov Moscow State University of Medicine and Dentistry., Kazakov SP; Russian Medical Academy of Continuous Professional Education.; Burdenko Main Military Clinical Hospital., Lebedeva EG; Yevdokimov Moscow State University of Medicine and Dentistry., Ivolgin AF; Vishnevsky 3-rd Central Military Clinical Hospital., Eremin MN; Yevdokimov Moscow State University of Medicine and Dentistry., Levchenko OB; Yevdokimov Moscow State University of Medicine and Dentistry.
Jazyk:	ruština
Zdroj:	Terapevticheskii arkhiv [Ter Arkh] 2023 Jan 16; Vol. 94 (12), pp. 1413-1420. Date of Electronic Publication: 2023 Jan 16.
DOI:	10.26442/00403660.2022.12.202021
Abstrakt:	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.
Databáze:	MEDLINE
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