Emphasizing that the liver and digestive system organs are most affected after the lungs in patients with Kovid-19, Turkish Liver Research Association Board Member and Gastroenterology Specialist Prof. Dr. Sabahattin Kaymakoğlu said, “28 percent of 554 Kovid patients we hospitalized in Istanbul Medical Faculty had high liver enzymes. Intensive care admissions were more common in these patients. Moreover, these people did not have a liver disease in the past,” he said.
Istanbul University, Istanbul Faculty of Medicine, Gastroenterology, Department of Gastroenterology and Turkish Liver Research Association Board Member Prof. Dr. Sabahattin Kaymakoğlu said that liver patients, who avoided going to hospitals for fear of becoming Kovid during the pandemic period, just like cancer and heart diseases, started to apply to emergencies with much more aggravated pictures. Prof. Dr. Kaymakoğlu said, “Kovid-19 disease mainly comes up with lung problems. But in 20 to 50 percent of patients, it also causes problems in different organ systems outside the lung. The most common organs with extrapulmonary involvement are the digestive canal and liver. In patients hospitalized with 19 diagnoses, problems with the liver, stomach and intestines also occur. This results in a more severe course of Kovid, “he said.
LIVER DAMAGE IN COVID INCREASES THE NEED FOR INTENSIVE CARE
Pointing out that patients whose liver and digestive system are affected by Kovid, the need for intensive care and respiratory equipment is higher. Dr. Kaymakoğlu said, “When we look especially in terms of liver, we found that 28 percent of 554 patients who were hospitalized in Istanbul Medical Faculty with the diagnosis of Kovid-19 had high liver enzymes. These were people who did not have liver disease in the past. If a person with a pre-existing liver disease catches Kovid, this means a much worse, more serious course. Especially if this liver disease is more advanced in stage, that is, in the stage of cirrhosis, it definitely means a negative risk factor for the patient. “The need for breathing apparatus is more in these patients. The length of stay in the hospital is prolonged and the risk of losing the patient increases,” he said. Kaymakoğlu emphasized that the risk of death due to Kovid alone is around 2-3 percent, but the risk of Kovid-19 in liver disease increases to 10 percent, “If the patient has evidence of liver failure, the risk can increase to 30-40 percent. “It is a table we are afraid of patients caught with Kovid-19 in the cirrhotic stage,” he said.
“PATIENTS WITH WATER COLLECTION BEGIN TO COME”
Stating that patients with chronic diseases and requiring a doctor’s follow-up for some reason were adversely affected during the Kovid-19 process, Prof. Dr. Kaymakoğlu pointed out that the control of the patients was disrupted due to the fear of getting Covid and the Kovid cases because other clinics did not serve for a period. Kaymakoğlu said, “These patients had physicians and centers that they were connected to in every hospital. But hospitals mobilized their resources for Kovid-19 in this process. In addition, patients were perceived ‘hospitals are dangerous for Kovid’. This leads to delays in both follow-up and diagnosis in chronic diseases. A patient with liver cirrhosis or a patient in the pre-cirrhosis stage has to be monitored at regular intervals due to both the medications he has taken and the complications caused by the disease. liver cancer developed or varicose bleeding began to come to emergency outpatient clinics. This is why we are experiencing a huge increase in the number of chronic liver patients coming to emergency outpatient clinics. This is a situation we do not want at all, “he said.
“THOSE WITH CHRONIC INTEGRAL DISEASE SHOULD BE VERY CAREFUL FOLLOWING”
Prof. Dr. Emphasizing that ulcerative colitis and Crohn’s patients, known as inflammatory bowel disease, are also in the high-risk group for Kovid, he warned: “These underlying diseases can cause a worse course in Kovid. Because some drugs used by these patients can negatively affect the course of Kovid. Therefore, the management of these patients is also characteristic during the Kovid pandemic process. These patients should never disrupt their follow-up and control. “
“1 MILLION 250 THOUSAND PEOPLE ARE UNABLE TO HAVE HEPATITIS B”
about 950 thousand in Turkey, saying that patients with liver cirrhosis Prof. Dr. Sabahattin Kaymakoğlu, saying that 70 thousand in liver cancer patients found “the most fundamental feature of liver disease for a long time that there is no reason for any complaints. In two-thirds of the patients until they develop complications of the disease, no complaints can not be seen. Estimated that 2 million people with the hepatitis B virus in Turkey 1 million 250 thousand of them do not know their diagnosis. Again, it is estimated that there are about 400 thousand Hepatitis C patients, but about 250 thousand of them are walking around without knowing their diagnosis. These people need to be diagnosed. “The illnesses are over? No. The numbers have dropped because the patients do not come to the hospital,” he said.
“ALL OUR PATIENTS, INCLUDING PATIENTS WITH LIVER TRANSPLANTATION, MAY BE VACCINATED”
Drawing attention to the fact that with the progress of vaccination, patients are more courageous to come to their control gradually, Prof. Dr. Referring to the importance of vaccination, Kaymakoğlu said: “With the vaccination, our patients’ hesitancy about coming to hospitals has disappeared. We have prioritized our patients as physicians in order to follow up chronic patients. By using electronic communication methods, we obtained the results of the patients’ examinations and managed their treatment with video communication. Thus, our handicaps decreased a little more. All our patients with chronic diseases should never stop their treatment without asking their physicians. Whether it is liver disease or digestive tract disease, liver disease with suppressed immune system, even liver transplant patients, m our patients can safely get their vaccinations. They can be vaccinated while continuing the treatments they receive. Some of our patients may only need to delay their medications for up to a week. They can manage this in consultation with their physician. Therefore, our most important wish is that our patients should never hesitate to get vaccinated and everyone who deserves to be vaccinated get vaccinated immediately. “