MARKERS OF INFLAMMATORY AND HYPERCOAGULATION SYNDROMES IN PATIENTS WITH LIVER DAMAGE IN THE REHABILITATION PERIOD OF COVID-19

Purpose of the study: to study some biochemical parameters of mesenchymal-inflammatory and hypercoagulable syndromes in patients with liver damage who underwent SARS-COV2 infection. Materials and research methods. 243 patients who had COVID-19 at the age of 18-60 were under observation. Inclusion criteria in the study were: transferred no earlier than 10 days prior to entry into the COVID-19 study; at the time of inclusion in the study PCR-negative COVID-19, negative PCR and markers of replication of hepatitis viruses. As a control group (CG), 20 healthy volunteers were examined. Enzymes were determined in the blood serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl aminotransferase (GGT), lactate dehydrogenase (LDH), alkaline phosphatase (AP), total and direct bilirubin, albumin, ferritin, C reactive protein and complete blood count. Research results The activity of blood liver enzymes in patients who underwent COVID-19 was significantly increased compared to CG: ALT exceeded the average values in CG by almost 10 times, AST = almost 3 times, LDH - 3 times, GGT and ALP - almost 1 .5 times. The level of bilirubin in the CG was significantly higher (p<0.001). The concentration of albumin in the peripheral blood of patients was reduced (p<0.001 significance of the difference from CG). The level of hemoglobin and erythrocytes in peripheral blood was significantly lower than in the CG (p<0.001 and p<0.05). The platelet count was reduced (p<0.001 significant difference from CG). The ESR and CRP concentrations were significantly increased compared with the CG (p<0.001 significance for both indicators). Conclusion In patients who have undergone COVID-19, functional changes in the liver are noted, characterized by cytolytic, cholestatic syndrome, and a decrease in protein-synthesizing function. Also, these patients have signs of redistributive anemia and sideropenia, thrombocytopenia, and persistent activity of mesenchymal-inflammatory and coagulopathic syndromes. ALT activity significantly positively correlates with the activity of systemic inflammation and hypercoagulability indices.