Gastroenterologìa (Apr 2021)
Efficacy of ursodeoxycholic acid in the treatment of COVID-19 infection and drug-induced liver damage
Abstract
Background. According to the global studies of viral infection COVID-19, 14–76 % of patients have biochemical signs of liver damage. They are the result of both the direct action of the virus and a general inflammatory reaction and damage induced by the drugs used to treat the infection. The purpose was to study the effect of coronavirus infection on the functional state of the liver and the effectiveness of correction of detected disorders. Materials and methods. We examined 16 patients (6 women and 10 men) aged (48.5 ± 10.2) years who had a history of coronavirus infection and received azithromycin. All patients underwent serum biochemical examination with determination of alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, total bilirubin, and international normalized ratio, ultrasound examination of abdominal organs followed by statistical data processing. The type of liver damage (hepatocellular, cholestatic, and mixed) and its degree (minimal, moderate, and severe) were determined. Results. Hepatic impairment induced by azithromycin in the treatment of COVID-19 was characterized by complaints of pain and heaviness in the right hypochondrium in all patients and dyspeptic manifestations in the form of nausea, bloating — in most patients. Liver damage was characterized mainly by cholestatic and mixed types of damage. Patients have been prescribed the drug of ursodeoxycholic acid in a daily dose of 10–15 mg/kg for 4–6 weeks. The dynamics of treatment revealed a decrease in the frequency and intensity of pain, the severity of dyspeptic and asthenic manifestations, improved cytolysis and cholestasis. Conclusions. The use of ursodeoxycholic acid in the treatment of COVID-19 infection and drug-induced liver damage is an effective and safe tool that can improve both the subjective condition of patients and normalize blood biochemical parameters.
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