Berat EBİK, Nazım EKİN, Ferhat BACAKSIZ, Jihat KILIÇ

COVID-19’lu Hastalarda Tedaviye Bağlı Karaciğer Hasarı Gelişme Sıklığı, Favipravir bu Tabloda ne Kadar Etkili?

Amaç: Çalışma amacımız; COVID-19 tedavisinde kullanılan ilaçların karaciğer fonksiyon testleri üzerindeki etkisini incelemek ve hastalarda tedavi sırasında ilaca bağlı karaciğer hasarı (İBKH) gelişim sıklığını araştırmaktır. Ayrıca literatürde karaciğer üzerindeki etkisiyle ilgili çok fazla veri olmayan favipravirin; COVID-19 tedavisinde yaygın bir şekilde kullanılmaya başlanmasıyla gelişen karaciğer fonksiyon bozukluklarının favipravir ile ilişkisini araştırmaktır. Yöntemler: Çalışmamıza 2020 Nisan-Eylül döneminde PZR (polimeraz zincir reaksiyonu) testi ile COVID 19 tanısı konulan ve hastanede yatarak tedavi gören 1301 hasta aldık. Önceden bilinen kronik karaciğer hastalığı olanları, COVID-19 sırasında sitokin fırtınası, sepsis ve iskemik hepatit gelişen hastaları çalışmaya almadık. Hastaları kullandıkları ilaç tedavisine göre gruplara ayırdık. Gruplar arasında, karaciğer fonksiyon bozukluğu ve İBKH gelişen vaka sayısında fark olup olmadığını inceledik. Bulgular: Çalışmaya aldığımız 1301 hastanın %50.2 sinde tedavi sırasında ALT-AST yüksekliği gelişmesine rağmen bu yüksekliklerin %45.3’ünün hafif ve orta düzeyde enzim artışı olduğu görüldü. Hastaların %4,9’unda İBKH gelişti. Sadece favipravir alan hastaların %1,1’inde İBKH gelişmesine karşın; favipravir+antibiyotik alan hastalarda bu oran %8,7 idi.(p

The Frequency Of Development Of Liver Damage Related To Treatment ın Patients With COVID-19, How Favipravir ıs Effect On This Situation?

Objective: Our working purpose; was to examine the effect of drugs used in the treatment of COVID-19 on liver function tests and to investigate the frequency of development of DILI (drug-induced liver damage) during treatment in patients. In addition, there is not much data in the literature regarding the effect of favipravir on the liver; liver function disorders caused by the widespread use in the treatment of COVID-19; to investigate its relationship with favipravir. Methods: We included 1301 patients who were diagnosed with COVID-19 by PCR test and were hospitalized in our study between April-September -2020. We did not include patients with previously known chronic liver disease, those who developed cytokine release syndrome during COVID-19, and patients who developed sepsis and ischemic hepatitis. We divided the patients into groups according to the medication they used. We examined whether there was a difference in the number of cases with liver dysfunction and DILI between the groups. Results: ALT-AST elevation developed in 50.2% of the 1301 patients we included in the study during the treatment. 45.3% of this increase was mild and moderate enzyme elevation. DILI developed in 4.9% of the patients. DILI developed in 1.1% of the patients who received only favipravir, while the rate of DILI development was found to be 8.7% in patients who received favipravir + antibiotics. (p

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