Possibilities for correcting hepatotoxic reactions during therapy in patients with COVID-19 (case report)

Abstract

In 2020, a pandemic of the new coronavirus infection (COVID-19) began. Treatment of this infection is limited by the lack of effective etiological treatment, which requires the selection of empirical and symptomatic therapy. The obtained some effectiveness of the use of antimalarial drugs, antiretroviral drugs in combination with antibacterial therapy made it possible to recommend it for use in the treatment regimen for patients with COVID-19. However, these drugs provoke the development of undesirable side reactions that require correction to continue treatment. Considering the need to use complex therapy in the treatment of patients with COVID-19 and the direct effect of the virus on liver cells, the likelihood of developing hepatotoxicity is quite high. The described cases of liver damage are characterized by impaired functional activity, an increase in the level of liver function tests, the development of small-drop fatty infiltration and a mild inflammatory reaction in the liver lobules. The development of these complications requires the hepatoprotective drugs, which increase the liver’s resistance to the damaging effects of various pathogens and help restore the functional activity of hepatocytes. According to the conducted studies, hepatotropic drug inosine+ + meglumine + methionine + nicotinamide + succinic acid and reamberin contribute to the normalization of lipid metabolism, a decrease in the level of enzyme markers of liver damage. The article presents the complex treatment with lopinavir + ritonavir. Thanks to hepatoprotective therapy, a week later, a decrease in ALT, alpha-amylase, blood counts to normal values was achieved.

Management of patients with digestive diseases during the COVID-19 pandemic. Clinical Practice Guidelines by the Russian scientific medical society of internal medicine (RSMSIM) and the Gastroenterological Scientific Society of Russia (2nd edition)

“…По результатам экспериментальных исследований на крысиной модели установлено, что УДХК значительно уменьшалал и пополисахаридиндуцированный отек легких, и воспалительные изменения в легких за счет стимуляции выведения жидкости из альвеол [146]. Успешный [154,155].…”