Karaali Rezan, Bora Ejder Saylav, Topal Firdevs
Department of Emergency Medicine, Faculty of Medicine, Izmir Democracy University, Izmir, Turkey.
Department of Emergency Medicine, Izmir Ataturk Research and Training Hospital, Izmir, Turkey.
Prz Gastroenterol. 2023;18(3):320-326. doi: 10.5114/pg.2023.131393. Epub 2023 Sep 22.
Cirrhosis is a common liver disease, which is characterized by life-limiting complications. In cirrhosis, liver ACE2 mRNA levels were 34-times upregulated, ACE2 protein 97-times upregulated, and ACE2 receptors increased in 80% of hepatocytes. Increased ACE2 receptor sensitizes hepatocytes to COVID-19.
To evaluate the applications of cirrhosis patients to the Emergency Department before and after the pandemic.
The study was conducted retrospectively in a single centre on cirrhotic patients who applied to the Emergency Department in a 2-year period. The obtained data were compared with the laboratory values of the patients: the severity of cirrhosis, the reasons for applying to the Emergency Department, hospitalization/discharge status, and pre-pandemic and pandemic period values. The mortality of the patients was recorded.
The biochemical values, CTP score, and complications of cirrhosis patients deteriorated during the pandemic period, which contributed to the increase in mortality and that the CTP score and its complications worsened, which contributed to the increase in mortality. COVID-19 positivity contributes to the progression of the CTP score, but it is not directly associated with mortality.
We think that new treatment protocols should be included in the guidelines to minimize the effects of this type of viral infection on the liver.
肝硬化是一种常见的肝脏疾病,其特征为会出现危及生命的并发症。在肝硬化患者中,肝脏血管紧张素转换酶2(ACE2)的信使核糖核酸(mRNA)水平上调了34倍,ACE2蛋白上调了97倍,且80%的肝细胞中ACE2受体增加。ACE2受体增加使肝细胞对2019冠状病毒病(COVID-19)更敏感。
评估大流行前后肝硬化患者前往急诊科的情况。
本研究在一个单一中心对2年内前往急诊科就诊的肝硬化患者进行回顾性研究。将获得的数据与患者的实验室值进行比较:肝硬化的严重程度、前往急诊科的原因、住院/出院状态以及大流行前和大流行期间的值。记录患者的死亡率。
在大流行期间,肝硬化患者的生化值、Child-Turcotte-Pugh(CTP)评分和并发症恶化,这导致了死亡率的增加,且CTP评分及其并发症恶化,这也导致了死亡率的增加。COVID-19阳性会促使CTP评分进展,但与死亡率无直接关联。
我们认为指南中应纳入新的治疗方案,以尽量减少此类病毒感染对肝脏的影响。