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

https://doi.org/10.18705/2311-4495-2020-7-6-65-72

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.

About the Authors

A. M. Smok
Academician I. P. Pavlov First Saint Petersburg State Medical University; Alexandrovskaya hospital
Russian Federation

Smok Aleksandr M., Anesthesiologist-Resuscitator, Resuscitation and Intensive Care Unit of the 2nd Clinic of the Scientific and Clinical Center of Anesthesiology and Resuscitation of the Academician I. P. Pavlov First Saint Petersburg State Medical University; Intensive Care Unit, Alexandrovskaya Hospital

Saint Petersburg



A. M. Malkova
Saint Petersburg State University
Russian Federation

Malkova Anna M., Junior Researcher, Laboratory of Autoimmune Mosaics

Saint Petersburg



D. A. Kudlay
National Research Center — Institute of Immunology Federal MedicalBiological Agency of Russia; Sechenov First Moscow State Medical University
Russian Federation

Kudlay Dmitry A., Dr. Sci., Professor of the Department of Pharmacology, Institute of Pharmacy, Sechenov First Moscow State Medical University (Sechenov University); Leading Researcher, Laboratory of Personalized Medicine and Molecular Immunology No. 71, National Research Center — Institute of Immunology Federal MedicalBiological Agency of Russia

Moscow



A. A. Starshinova
Almazov National Medical Research Centre
Russian Federation

Starshinova Anna A., Dr. Sci., Head of Research Department

Akkuratova str. 2, Saint Petersburg, 197341



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Review

For citations:


Smok A.M., Malkova A.M., Kudlay D.A., Starshinova A.A. Possibilities for correcting hepatotoxic reactions during therapy in patients with COVID-19 (case report). Translational Medicine. 2020;7(6):65-72. (In Russ.) https://doi.org/10.18705/2311-4495-2020-7-6-65-72

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ISSN 2311-4495 (Print)
ISSN 2410-5155 (Online)