CLINICAL AND LABORATORY CHARACTERISTICS OF THE COURSE OF COVID-19 IN HOSPITALIZED PATIENTS WITH NON-ALCOHOLIC FATTY LIVER DISEASE
Abstract
Introduction. The course of COVID-19, in particular changes in clinical and laboratory parameters in hospitalized patients with non-alcoholic fatty liver disease (NAFLD), were previously presented in a number of scientific publications, however, the contradictory results of some of them require a more comprehensive approach in identifying the features of the clinical course of COVID-19 infection in patients with NAFLD. According to previously published studies, the presence of metabolic syndrome, insulin resistance, and dyslipidemia in patients with NAFLD increased the risk of hospitalization, required longer treatment and the need for emergency treatment and admission to the intensive care unit. Purpose of the study — to evaluate clinical and laboratory parameters in patients with NAFLD hospitalized with COVID-19. Materials and methods. A retrospective and prospective analysis of 185 case histories of patients hospitalized in infectious diseases hospitals in Moscow from June to August 2021 was carried out. Inclusion criteria were patients with and without NAFLD, over the age of 18, hospitalized with COVID-19 infection. Exclusion criteria included patients under 18 years of age; viral and alcoholic liver damage. Processing of statistical data was carried out using the SPSS programs and MS Excel. Research results. Evaluation of laboratory parameters of alanine aminotransferase (ALT), aspartate aminotransferase (AST), C-reactive protein (CRP), gamma-glutamyl transpeptidase (GGTP) upon admission and over time revealed a significant excess of these parameters in hospitalized patients with NAFLD compared to the control group; in addition, a statistically significant relationship was identified between the parameters of cytolysis and inflammation with the need for emergency respiratory support (artificial ventilation of the lungs). Patients with NAFLD hospitalized with COVID-19 compared to the comparison group were older, had a high body mass index and longer hospitalization. Conclusion. The course of COVID-19 in hospitalized patients with NAFLD was characterized by increased levels of ALT, AST, GGTP, CRP on the first day of hospitalization and a significant excess of these parameters on the 7th day of hospital stay, which indicates a more severe course and risk of adverse outcomes in this category of patients who required longer hospitalization, additional emergency treatment measures and the need for artificial pulmonary ventilation.
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