Agustos 2021
COVID 19 hastalarinda karaciger fonksiyon bozuklugu ve prognoz ile iliskisi
The relationship between liver function and prognosis in COVID-19 patients
- Ana Sayfa
- Sayılar
- Agustos 2021
- COVID 19 hastalarinda karaciger fonksiyon bozuklugu ve prognoz ile iliskisi...
Saglik Bilimleri Üniversitesi, Gülhane Tip Fakültesi, 3Enfeksiyon Hastaliklari ve Klinik Mikrobiyoloji Anabilim Dali, 4Iç Hastaliklari Anabilim Dali, 5Gögüs Hastaliklari Anabilim Dali, 8Yogun Bakim Bilim Dali, 9Anesteziyoloji ve Reanimasyon Anabilim Dali,10Gastroenteroloji Bilim Dali, Ankara
Özet
Giris ve Amaç: COVID-19’da karaciger hasarinin ana mekanizmasinin, siddetli akut solunum sendromu koronavirüs-2’nin safra kanali hücrelerinde yüksek oranda eksprese edilen anjiyotensin dönüstürücü enzim 2 reseptörüne baglanmasi oldugu düsünülmektedir. Bu çalismada COVID-19 tanisi ile yatirilarak takip ve tedavi edilen hastalarin, komorbid karaciger hastaliklarinin arastirilmasi, yatis gününde anormal karaciger biyokimyasal test sonuçlari sikliginin degerlendirilerek hastaligin seyri ve prognozu ile iliskisinin arastirilmasi amaçlandi. Gereç ve Yöntem: COVID-19 tanisi ile yatirilarak tedavi edilen 18 yasindan büyük hastalara ait veriler retrospektif olarak degerlendirildi. Hastalarin aspartat aminotransferaz, alanin aminotransferaz, alkalen fosfataz, gama glutamil transferaz, total bilirübin degerleri ile hastanede kalis süreleri, yogun bakim ünitesi ihtiyaci, mortalite arasindaki iliski arastirildi. Bulgular: COVID-19 tanisi revers transkripsiyon polimeraz zincir reaksiyonu ile dogrulanmis 795 hastadan 113’ünde (%14.2) yüksek karaciger enzim (alanin aminotransferaz ve/veya aspartat aminotransferaz) prevalansi saptandi. COVID-19’lu olgularda yüksek alanin aminotransferaz prevalansi %11.1 iken aspartat aminotransferaz prevalansi ise %9.6 idi. Alanin aminotransferaz yüksekligi en fazla 71 yas ve üstünde (%17.4), aspartat aminotransferaz yüksekligi ise en fazla 51-70 yas grubunda (%14.8) bulundu. Alanin aminotransferaz ve/veya aspartat aminotransferaz yüksekligi saptanan ve saptanmayan hastalar arasinda, hastaligin seyri, hastanede ve yogun bakimda yatis süresi ve mortalite açisindan anlamli bir fark tespit edilmedi. Ayrica, aspartat aminotransferaz ve alanin aminotransferaz yüksekliginin sag kalim zamaninda anlamli bir fark olusturmadigi saptandi. Sonuç: COVID-19 hastalarinda anormal karaciger fonksiyon testleri tespit edilebilir. Ancak bunun sebepleri ve prognoza etkileri konusunda yeterli bilgiye sahip olmak için daha genis popülasyonu içeren prospektif çalismalara ihtiyaç vardir
Abstract
Background and Aims: The primary mechanism of liver damage incoronavirus disease-2019 is the binding of severe acute respiratory syndrome coronavirus-2 to the angiotensin-converting enzyme 2 receptors,which is highly expressed in the bile duct cells. This study aimed to investigate comorbid liver diseases in patients hospitalized with coronavirusdisease-2019 and assess the relationship between the rates of abnormal liver function biochemical test results on the day of hospitalizationand the clinical course and prognosis of the disease. Materials andMethods: Data of patients over the age of 18 years who were hospitalized due to coronavirus disease-2019 were retrospectively assessed.This included data analysis of the relationship between aspartate aminotransferase, alanine transaminase, alkaline phosphatase, gamma-glutamyl transferase, total bilirubin levels of patients and length of hospitalstay, admission to the intensive care unit, and mortality. Results: Outof 795 patients who were confirmed as infected with coronavirus disease-2019 by the reverse transcription-polymerase chain reaction test,113 (14.2%) had a high prevalence of liver enzyme (alanine transaminase and/or aspartate aminotransferase), whereas the high prevalenceof alanine transaminase was 11.1% and aspartate aminotransferasewas 9.6%. The rate of high alanine transaminase levels was greatest inthe 71-and-above age group (17.4%), and high aspartate aminotransferase levels were more common in the 51–57 age group (14.8%). Nosignificant difference was found between patients with and withouthigh alanine transaminase and/or aspartate aminotransferase in termsof the clinical course of coronavirus disease-2019, length of hospitalstay, intensive care admission, and mortality. In addition, aspartateaminotransferase and alanine transaminase elevations were found tonot make a significant difference in the survival time. Conclusions:Abnormal liver function can be detected in patients with coronavirusdisease-2019. However, to develop sufficient knowledge of its causesand effects on patient prognosis, further prospective studies based onlarger populations are needed
