POST COVID PATIENT WITH DERANGED LEFT

30yr/M post covid recovering phase day25. Having dearranged LFT. Rising trend as compared to before. He is asymptomatic of covid illness since last 4 days. Presently post covid .on low dose asprin 75mg od and low dose steroids. Not on any antibiotic since last 5 days . Still lft are on rising trend. Crp has come down to 1 . Which is normal But lft are dearranged. T. Bilirubin rising. Usg abdomen is normal Hepatobiliary system normal on usg. Please give suggestion . How to corect liver

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Post covid hyperbilirubinaemia Mainly due to drugs like Fabipiravir & the disease causing liver injury Rest Low salt diet High protein Vitamin E Immune moduler Ursedeoxycholic acid Lecithin

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Indirect bilirubin is >direct Bilirubininia Post covid status This is a manifestation of multi system inflammatory syndrome Since no hepatobiliary damage is seen Likely hemolytic jaundice Hemogram does not reflect low hb as it is likely concentrated hb So far management is to plan is symptomatic Steroids Liver supportive treatment Antacids Multivitamins Sos antivirals to be added like sobsovir or heptavir or lemovudine

Thanx dr Pushkar ji Bhomia
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Seems like Hepatocellular jaundice Please rule out viral hepatitis by doing all viral markers Studies from China showed an increase of transaminases and other liver enzymes in 14–53% of infected patients. These abnormalities were generally mild with moderate increase in transaminase levels in symptomatic and/or severe forms of COVID-19 infection. The mechanisms are still mostly unknown. It may involve the role of the virus itself, the role of virus-induced inflammation, liver hypoxia (thrombotic context, severe acute respiratory syndrome) and/or drug-induced liver injury (including paracetamol misuse, anti-infectious agents, etc.).. Moreover use of Favipravir is a/w cholestatic derangement in few case reports so it's unlikely for this case

YES DR.... UPTO... 50%. OF. RECOVERED. PATIENTS. SHOW.... ..DERANGED. AND. ELEVATED... LIVER. ENZYMES / LIVER. FUNCTIONS... ... IN. POST. COVID. PHASE..... POSSIBLY. DUE. TO... ..... LIVER. INJURY.... EITHER. AS HEPATOCELLULAR OR CHOLESTATIC. INJURIES NEEDS SUPPORTIVE. AND SYMPTOMATIC. MANAGEMENT ........MAY. TAKE UPTO ....... THREE. MONTHS. FOR. COMPLETE. NORMALCY....

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* HEPATITIS .. ALCOHOLIC LIVER PATHOLOGY.. * DRUG INDUCED.. NEED'S.. LIVER TONICS .. T/T OF CAUSE..

Tnx Dr Shivraj Agarwal sir
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Post Covid syndrome I have used low dose Glargine insulin 4 units once a day for non diabetic patients with good outcome, in variety of delayed complications of Covid 19 such as Bipap ventilation requirement at home, oxygen requirement at home etc Role of insulin in treatment of Covid 19, please read my article https://jmscr.igmpublication.org/home/index.php/archive/178-volume-08-issue-07-july-2020/9517-use-of-insulin-in-treatment-of-covid-19-a-proposal-to-explore-feasibility

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LIVER CIRRHOSIS ? DEGENERATION OF CELLS? TYPICALLY RESULT OF ALCOHOLISM? TAB - AZITHROMYCIN 250 BD PC 6 DAYS TAB - PANTOPRAZOLE AND DOMPERIDONE BD AC 10 DAYS . MULTIVITAMIN ? ANTIOXIDANS SHOULD GIVE?.

Consider glutathione IV

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Rest to liver 25% glucose 100 ml bd Syp Liv 52 2 tsf tds Syp Sorbiline 2 tsf bd Vit C Vit B

Drug induce Viral hepatitis Rest Udiliv 300 bd

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