nogrЭкспериментальная и клиническая гастроэнтерологияExperimental and Clinical Gastroenterology1682-8658«Global Media Technologies»10.31146/1682-8658-ecg-187-3-178-185nogr-1615Research ArticleОБЗОРREVIEWПоражения печени при Covid-19: патогенез и лечениеLiver damage while Covid-19: problems of pathogenesis and treatmenthttps://orcid.org/0000-0003-4878-0838ЛялюковаЕ. А.LyalyukovaE. A.lyalykova@rambler.ruhttps://orcid.org/0000-0003-2658-0181ДолгалёвИ. В.DolgalevI. V.noemail@neicon.ruЧернышеваЕ. Н.ChernyshevaE. N.noemail@neicon.ruДрукИ. В.DrukI. V.noemail@neicon.ruКоноваловаГ. М.KonovalovaG. M.noemail@neicon.ruЛялюковА. В.LyalyukovA. V.noemail@neicon.ruФГБОУ ВО «Омский государственный медицинский университет» Минздрава РоссииРоссияFSBEI VO “Omsk State Medical University” of the Ministry of HealthRussian FederationФГБОУ ВО Сибирский государственный медицинский университет Минздрава РоссииРоссияFSBEI VO “Siberian State Medical University” of the Ministry of Health of RussiaRussian FederationФГБОУ ВО «Астраханский государственный медицинский университет» Минздрава РоссииРоссияFSBEI VO “Astrakhan State Medical University” of the Ministry of Health of RussiaRussian FederationФГБОУ ВПО «Майкопский государственный технологический университет Медицинский институт»РоссияFSBEI VPO “Maykop State Technological University Medical Institute”Russian FederationФГБОУ ВО «Сочинский государственный университет»РоссияFSBEI VO “Sochi State Medical University”Russian Federation20212205202103178185Copyright © Лялюкова Е.А., Долгалёв И.В., Чернышева Е.Н., Друк И.В., Коновалова Г.М., Лялюков А.В., 20212021Лялюкова Е.А., Долгалёв И.В., Чернышева Е.Н., Друк И.В., Коновалова Г.М., Лялюков А.В.Lyalyukova E.A., Dolgalev I.V., Chernysheva E.N., Druk I.V., Konovalova G.M., Lyalyukov A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.nogr.org/jour/article/view/1615

Цель обзора - представить анализ современных литературных данных о патогенезе и терапии поражений печени при Covid-19. Повреждения печени у больных COVID-19 могут быть вызваны прямым циклопатическим эффектом SARS-CoV-2, неконтролируемой иммунной реакцией, сепсисом, тяжёлой гипоксией или лекарственным поражением. Кроме того, COVID-19 может вызвать обострение и декомпенсацию ранее сформировавшихся хронических заболеваний печени с развитием острой печеночной недостаточности. Врачам следует тщательно оценивать исходное состояние печени, а после назначения терапии усилить мониторинг её функционального состояния, особенно, у пациентов с тяжелым течением COVID-19. В каждом клиническом случае врачу необходимо установить возможные механизмы повреждения органа с целью выбора наиболее оптимальной тактики ведения пациента, в которой учитывались бы все аспекты особенностей течения COVID-19 и поражения печени. В настоящее время требуются дополнительные научные сведения, раскрывающие особенности поражений печени во время инфекции SARS-CoV-2 и постковидный период. С целью оценки отдалённых последствий COVID-19 все пациенты, перенесшие это заболевание, нуждаются в дальнейшем наблюдении.

The purpose of the review is to present an analysis of the current literature data on the pathogenesis and therapy of liver damage in Covid-19. Liver damage in COVID-19 patients can be caused by the direct cytopathogenic effect of SARS-CoV-2, an uncontrolled immune response, sepsis, severe hypoxia, or drug damage. In addition, COVID-19 can exacerbate and decompensate previously formed chronic liver diseases with the development of acute liver failure. Physicians should carefully assess the initial state of the liver, and after prescribing therapy, intensify monitoring of its functional state, especially in patients with severe COVID-19. In each clinical case, the doctor needs to establish the possible mechanisms of organ damage in order to select the most optimal patient management tactics, which would take into account all aspects of the COVID-19 course and liver damage. Currently, additional scientific information is required to uncover the features of liver damage during SARS-CoV-2 infection and in the postcovid period. Patients who have undergone COVID-19 need further monitoring to assess the long-term effects of the disease.

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The authors declare that there are no conflicts of interest present.