Turkiye Klinikleri Journal of Anesthesiology Reanimation

.: REVIEW
COVID-19, Anesthesia and Liver: Traditional Review
COVID-19, Anestezi ve Karaciğer: Geleneksel Derleme
Ayşe Hande ARPACIa , Berrin IŞIKb
aDepartment of Oral and Maxillofacial Surgery, Ankara University Faculty of Dentistry, Ankara, Türkiye
bDepartment of Anesthesiology and Reanimation, Gazi University Faculty of Medicine, Ankara, Türkiye
Turkiye Klinikleri J Anest Reanim. 2023;21(2):68-73
doi: 10.5336/anesthe.2022-94630
Article Language: EN
Full Text
ABSTRACT
 In the coronavirus disease-2019 (COVID-19) pandemic, which started in 2019 and was caused by the severe acute respiratory syndrome-coronavirus-2 virus, the clinical course of the infection was observed in a wide range from very mild symptoms to death. Although the respiratory system and lungs are mostly affected in COVID-19 infection, other organs and systems are also affected. The most common symptoms in COVID-19 are fever, cough, fatigue, difficulty breathing, anosmia, and loss of taste. In cases where clinical symptoms are more severe, acute respiratory distress syndrome, cytokine storms, multiple organ failure, sepsis and thrombosis are seen. Liver involvement has an important place in the course of COVID-19 apart from lung involvement, some patients with COVID-19 infection and cooperation difficulties require general anesthesia during computed tomography imaging procedures or intensive care treatments. Again, the need for urgent surgical intervention during infection causes them to be exposed to general anesthetics. The negative effects of general anesthesia agents on organ systems, especially on the liver, is an important issue that is frequently emphasized in the literature. Liver enzymes should be monitored in the clinical follow-up and estimation of mortality in patients with a diagnosis of COVID-19. Non-emergency surgeries of patients with a diagnosis of COVID-19 should be postponed or if anesthesia applications are necessary, non-hepatotoxic or minimally hepatotoxic methods should be performed. In this review, it is aimed to share information on anesthesia applications in terms of COVID-19 and liver functions by examining the relationship of COVID-19 with the liver.

Keywords: COVID-19; anesthesia; liver
ÖZET
 2019 yılında başlayan, şiddetli akut solunum sendromu-koronavirüs-2 virüsünün etken olduğu koronavirüs hastalığı-2019 [coronavirus disease-2019 (COVID-19)] pandemisinde, enfeksiyonun klinik seyri çok hafif belirtilerden ölüme varan geniş bir yelpazede izlenmiştir. COVID-19 enfeksiyonunda daha çok solunum sistemi ve akciğerler etkilenmekle birlikte, diğer organ ve sistemler de etkilenmektedir. COVID-19'da en sık görülen semptomlar ateş, öksürük, yorgunluk, nefes almakta zorluk, anosmi ve tat alma duyusunda kayıptır. Klinik belirtilerin daha ağır seyrettiği olgularda ise akut solunum sıkıntısı sendromu, sitokin fırtınaları, çoklu organ yetersizliği, sepsis ve trombozlar görülmektedir. COVID-19 seyrinde solunum sistemi ve akciğer dışı organ hasarlarında karaciğer tutulumu önemli bir yer tutmaktadır. COVID-19 enfeksiyonu geçiren ve uyum sorunu olan bazı hastalara bilgisayarlı tomografi görüntüleme işlemleri ya da yoğun bakım tedavileri sırasında genel anestezi uygulamaları gerekmektedir. Yine enfeksiyon sırasında acil cerrahi müdahale gerekmesi genel anesteziklere maruz kalmalarına neden olmaktadır. Genel anestezi ajanlarının organ sistemleri üzerine, özellikle de karaciğer üzerine olumsuz etkileri literatürde sıklıkla vurgulanan önemli bir konudur. COVID-19 tanılı hastaların klinik takibinde ve mortalite tahmininde karaciğer enzimleri izlenmelidir. COVID-19 tanılı hastaların acil olmayan cerrahileri ertelenmeli, anestezi uygulamaları hepatotoksik olmayan ya da en az hepatotoksik olan yöntemlerle yapılmalıdır. Bu derlemede, COVID-19'un karaciğer ile ilişkisi irdelenerek, COVID-19 ve karaciğer fonksiyonları açısından anestezi uygulamaları konusunda bilgi paylaşılması amaçlanmıştır.

Anahtar Kelimeler: COVID-19; anestezi; karaciğer
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"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com