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Oct 2, 2023
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Abstract
Pendahuluan: Penyakit coronavirus 2019 (COVID-19) masih berlangsung. Beberapa data menunjukkan bahwa penyakit ini menyerang berbagai organ, terutama pada kasus yang parah dan kritis. Kerusakan hati dan ARDS merupakan komplikasi yang sering terjadi pada pasien COVID-19. Tujuan penulisan makalah ini adalah untuk melaporkan dan mendiskusikan terapi pada kasus-kasus yang ditemukan oleh penulis sehingga diharapkan dapat bermanfaat secara klinis.
Ilustrasi kasus: Laki-laki 35 tahun dengan hasil swab nasofaring positif COVID-19 dengan kerusakan hati dan ARDS. Pasien mendapatkan protokol terapi standar pada saat perawatan di rumah sakit, plasma konvalesen 3 kolf dan terapi setelah perawatan di rumah sakit. Pasien telah membaik.
Diskusi: Menekan hiperaktivasi sitokin merupakan target utama dalam terapi COVID-19 agar tidak berkembang menjadi stadium yang lebih parah. Pemilihan favipiravir, colchicine, dexamethasone, UDCA, dan vitamin D adalah terapi yang menargetkan mekanisme ini.
Kesimpulan: Pasien dengan gejala berat hingga kritis berisiko mengalami kondisi yang lebih buruk bahkan kematian. Mengatasi hiperaktivasi sitokin merupakan target utama terapi kasus COVID-19, sehingga pemilihan obat yang digunakan didasarkan pada mekanisme patogenesis tersebut. Selain itu, pemberian terapi suportif lainnya juga perlu diperhatikan untuk penatalaksanaan yang lebih optimal.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
How to Cite
Anjarwati, D., Putri, R., & Rizqi, D. (2023). COVID-19 Patient with Moderate Liver Injury and Acute Respiratory Distress Syndrome (ARDS). Jurnal Klinik Dan Riset Kesehatan, 3(1), 57-63. https://doi.org/10.11594/jk-risk.03.1.7
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2. Li, J and Fan JG. 2020. Characteristics and Mechanisms of Liver Injury in 2019 Coronavirus Disease. Journal of Clinical and Translational Hepatology : 8, pp 13-17
3. Cha, MH , Reguero M, and Sandhu DS. 2020. Gastrointestinal and Hepatic Manifestation of COVID-19 : A Comprehensive Review. World J Gastroenterol : 26 (19), pp : 2323 – 2332
4. Zahedi, M., et al. 2020. Liver Function in Novel Coronavirus Disease (COVID-19): A Systematic Review and Meta-Analysis. https://doi.org/10.1101/2020.05.20.20108357
5. Woreta, TA., and Alqahtani, SA. 2014. Elevation of Abnormal Liver Test. Med Clin N Am 98. pp 1-16
6. Cao, P et al. 2021. Elevated Serum Ferritin Level Effectively Discriminates Severity Illness and Liver Injury of Coronavirus Disease 2019 Pneumonia. Biomarkers: 26 (3), pp 207 – 212
7. Kumar, MP., et al. 2020. Coronavirus Disease (COVID-19) and The Liver : A Comprehensive Systematic Review and Meta-analysis. Hepatology International : 14(5), 711-722
8. Zhang, Y., Zheng, L., Liu, L., Zhao, M., Xiao, J., and Zhao, Q. 2020. Liver Impairment in COVID-19 Patients : A Retrospective Analysis of 115 Cases From a Single Center in Wuhan City, China. Liver International :40 (9), pp 2095-2103.
9. Cepelak, I., Dodig, S., and Vucenik, I. 2020. Hyperferritinemia and COVID-19?. RAD CASA Medical Sciences. pp. 18-25
10. Hoiyo, S., et al. 2020. How COVID-19 Induced Cytokine Storm With High Mortality. Inflammation and Regeneration, 40 : 37
11. Abdullah, HM., et al. 2020. Severe Refractory COVID-19 Patients Responding to Convalescent Plasma: A Case Series. Annals of Medicine and Surgery : 56, 125-127
12. Fatoni, AZ., Rakhmatullah, R. 2021. Acute Respiratory Distress Syndrome (ARDS) in Pneumonia COVID-19. Journal of Anesthesia and Pain : 2(1), pp 11-24
13. Ni, Y., et al. 2021. Immunological Perspective on the Pathogenesis, Diagnosis, Prevention, and Treatment of COVID-19. Molecular Biomedicine : 2(1)
14. Ye, Q., Wang, B., and Mao, J. 2020. The Pathogenesis and Treatment of The 'Cytokine Storm' in COVID-19. Journal of Infection, pp : 607-613
15. Tang C., Wang ., Lv H., Guan Z., and Gu J. 2020. Caution Against Corticosteroid-based COVID-19 Treatment. Lancet : 395(10239):1759 –60
16. Patel, SK., et al. 2020. Dexamethasone : A Boon for Critically Ill COVID-19 Patients?. Travel Medicine and Infectious Diseases : 37
17. Horby, P., et al. 2020. Dexamethasone in Hospitalized Patients with Covid-19 - Preliminary Report. N. Engl. J. Med : 384 (8), pp 693-704
18. Sharum, K., et al. 2020. Dexamethasin to Combat Cytokine Storm in COVID-19 : Clinical Trials and Preliminary Evidance. International Journal of Surgery : 82 , 179 – 181
19. Gomez, GM, et al. 2020. Colchicine: A Potential Therapeutic Tool Against COVID-19. Experience of 5 Patients. Rheumatol Clinic.https://doi.org/10.1016/j.reuma.2020.05.001
20. Reyes, AZ., et al. 2021. Anti-inflammatory Therapy for COVID-19 Infection : The Case for Colchicine. Ann Rheum Dis : 80 , pp 550 – 557
21. Joshi, S., et al. 2021. Role of Favipiravir in The Treatment of COVID-19. International Journal of Infectious Diseases : 102 , 501 – 508
22. Agrawal, U., Raju, R., and Udwadia, ZF. 2020. Favipiravir : A New and Emerging Antiviral Option in COVID-19. ScienceDirect : 75, pp 370-376
23. Olry, A., Meunier, L., Delire, B., Larrey, D., Horsmans, Y., and Louet, HL. 2020. Drug-Induced Liver Injury and COVID-19 Infection : The Rules Remain The Same. Drug Saf : 43 (7), pp 615-617
24. Bethesda. 2017. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury. United States : National Institute of Diabetes and Digestive and Kidney Diseases
25. Burhan, E., et al. 2020.Guidelines for the Management of COVID-19 Edition 3. Jakarta :Indonesian Association of Pulmonary Doctors (PDPI) Indonesian Association of Cardiovascular Specialists (PERKI) Indonesian Association of Internal Medicine Specialists (PAPDI) Indonesian Association of Anesthesiologists and Intensive Therapy (PERDATIN) Indonesian Association of Pediatricians (IDAI)
26. Carubbi, F., et al. 2021. Ferritin is Associated with The Severity of Lung Involvement but Not With Worse Prognosis in Patients With COVID-19 : Data from Two Italian COVID-19 Units.Sci Rep : 11 (4863)
27. Bertolini, A., et al. 2020. Abnormal Liver Function Tests in Patients With COVID-19: Relevance and Potential Pathogenesis. Hepatology : 72 (5), 1864-1872
28. Mucha, SR., et al. 2020. Coagulopathy in COVID-19 : Manifestation and Management. Cleveland Clinic of Medicine : 87(8) 461–8
29. Ali, N. 2020. Role of Vitamin D in Preventing of COVID-19 Infection, Progression, and Severity. Journal of Infection and Public Health : 13, 1373 – 1380
30. Raharusuna, P., Priambada, S., Budiarti, C., Agung, E., Budi, C. 2020. Patterns of COVID-19 Mortality and Vitamin D: An Indonesian Study. SSRN J : http://dx.doi.org/10.2139/ssrn.3585561
31. Mexitalia, M., Susilawati, M., Pratiwi, R., and Susanto, JC. 2020. Vitamin D and Sun Exposure to Prevent COVID-19: Facts or Myths?. Med Hosp : 7 (1A) , pp 320 – 328
32. Orantes, LDC., et al. 2021. Oral anticoagulation with rivaroxaban as thromboprophylaxis in patients recovered from COVID-19 pneumonia in Veracruz, Mexico. Journal of Anesthesia and Critical Care : 13 (1), pp 12-15
33. The European Society for Cardiology. ESC Guidance for the Diagnosis and Management of CV Disease during the COVID-19 Pandemic. https://www.escardio.org/Education/COVID-19-and-Cardiology/ESCCOVID-19-Guidance . (Last updated: 10 June 2020)
34. National Institute in Health. Coronavirus Disease 2019 (COVID-19) Treatment Guideline. https://www.covid19treatmentguidelines.nih.gov/antithrombotic-therapy/. (Last update : 11 February 2021)
35. Abdulrab, S., Al-Maweri, S., and Halboub, E. 2020.Ursodeoxycholic acid as a therapeutic candidate to alleviate and/or prevent COVID-19-associated cytokine storm. Medical Hypotheses. https://doi.org/10.1016/j.mehy.2020.109897
36. Subramanian, S., Iles, T., Ikramuddin, S., and Steer, CJ. 2020. Merit of an Ursodeoxycholic Acid Clinical Trial in COVID-19 Patients. Vaccines (Basel) : 8 (2), 320
37. Chen, L., Xiong, J., Boo, L., and Shi, Y. 2020. Convalescent Plasma as A Potential Therapy for COVID-19.Lancet: 20, https://doi.org/10.1016/S1473-3099(20)30132-8