How do liver enzyme levels correlate with COVID-19 severity. What are the implications of abnormal liver enzymes in hospitalized COVID-19 patients. How does liver injury impact patient outcomes and mortality risk in COVID-19 cases.

Prevalence and Classification of Liver Enzyme Abnormalities in COVID-19 Patients

The study examined 17,531 hospitalized COVID-19 patients from the ISARIC database. Liver enzyme levels were classified into three stages:

• Stage 0 (normal liver enzymes): 45.6% of patients
• Stage I liver injury: 46.2% of patients
• Stage II (severe) liver injury: 8.2% of patients

These findings highlight the significant prevalence of liver enzyme abnormalities in COVID-19 patients, with over half experiencing some degree of liver injury. The high proportion of patients with elevated liver enzymes underscores the importance of monitoring hepatic function in COVID-19 cases.

Impact of Liver Enzyme Alterations on COVID-19 Severity and Clinical Outcomes

The study revealed a clear association between liver enzyme abnormalities and increased COVID-19 severity:

• ICU admission rates: 19% for Stage 0, 35% for Stage I, and 40.1% for Stage II
• Oxygen supplementation requirements: 48% for Stage 0, 70.3% for Stage I, and 75.9% for Stage II
• Invasive ventilation needs: 9.8% for Stage 0, 21.3% for Stage I, and 27% for Stage II

These statistics demonstrate that patients with liver enzyme abnormalities were more likely to require intensive care and respiratory support. Do liver enzyme alterations directly contribute to COVID-19 severity, or are they a marker of more severe disease. While the exact causal relationship remains unclear, the strong correlation suggests that liver enzyme levels could be a valuable prognostic indicator in COVID-19 patients.

Liver Injury and Mortality Risk in COVID-19 Patients

The study found a significant link between liver injury and mortality risk in COVID-19 patients:

• Crude mortality risk for patients with normal liver enzymes: 14.3%
• Crude mortality risk for patients with Stage II liver injury: 32.7%

This stark difference in mortality rates emphasizes the potential severity of liver complications in COVID-19. Why does liver injury correlate with higher mortality rates in COVID-19 patients. The liver plays a crucial role in numerous physiological processes, including immune function and metabolism. Liver dysfunction may exacerbate the overall inflammatory response and metabolic disturbances associated with severe COVID-19, potentially contributing to poorer outcomes.

Length of Stay and Resource Utilization in COVID-19 Patients with Liver Enzyme Abnormalities

The study examined how liver enzyme alterations affected hospital and ICU length of stay:

• Median hospital stay: 9 days for Stage 0 and II, 8 days for Stage I
• Median ICU stay: 7 days for Stage 0, 8 days for Stage I, 9 days for Stage II

While the differences in hospital stay were minimal, there was a trend towards longer ICU stays for patients with more severe liver injury. How does this impact healthcare resource allocation. The extended ICU stays for patients with liver injury suggest that these cases may require more intensive and prolonged care, potentially straining healthcare resources during pandemic surges.

Multivariable Analysis: Liver Injury as an Independent Risk Factor

The study’s multivariable analysis revealed that liver injury (both Stage I and II) was independently associated with:

• Increased risk of ICU admission
• Higher likelihood of requiring invasive ventilation
• Elevated mortality risk

These findings suggest that liver injury is not merely a consequence of severe COVID-19 but may be an independent risk factor for poor outcomes. Can early detection and management of liver dysfunction improve patient outcomes in COVID-19? While further research is needed, these results indicate that close monitoring of liver function and targeted interventions for patients with liver injury could potentially improve overall outcomes in COVID-19 cases.

Comorbidities and Demographic Factors in COVID-19 Patients with Liver Enzyme Abnormalities

The study provided insights into the demographic and clinical characteristics of the patient cohort:

• Average age: 56.5 years
• Gender distribution: 60% male
• Common comorbidities: Diabetes and hypertension
• Prevalence of chronic liver disease: 3% of patients

These findings raise important questions about the relationship between pre-existing conditions and liver injury in COVID-19. Are certain comorbidities more strongly associated with liver enzyme abnormalities in COVID-19 patients? The relatively low prevalence of pre-existing chronic liver disease (3%) suggests that COVID-19-related liver injury often occurs in patients without prior hepatic issues. This highlights the need for liver function monitoring even in patients without a history of liver disease.

Mechanisms of Liver Injury in COVID-19: Potential Pathways and Implications

While the study focused on clinical outcomes rather than underlying mechanisms, the high prevalence of liver enzyme abnormalities raises questions about how SARS-CoV-2 affects the liver. Several potential mechanisms have been proposed in other research:

• Direct viral infection of liver cells
• Immune-mediated damage due to cytokine storm
• Drug-induced liver injury from COVID-19 treatments
• Hypoxic injury due to respiratory failure

Understanding these mechanisms is crucial for developing targeted therapies and preventive strategies. Can specific interventions targeting liver protection improve overall outcomes in COVID-19 patients? While this study doesn’t directly address treatment approaches, the strong association between liver injury and poor outcomes suggests that hepatoprotective strategies could be a valuable area for future research and clinical trials.

The complexity of liver involvement in COVID-19 underscores the need for a multidisciplinary approach to patient care, involving hepatologists, infectious disease specialists, and critical care experts. Future research should focus on elucidating the precise mechanisms of liver injury in COVID-19 and developing liver-specific treatment strategies to improve patient outcomes.

Limitations and Future Directions in COVID-19 Liver Research

While this study provides valuable insights into the prevalence and impact of liver enzyme abnormalities in COVID-19, several limitations and areas for future research should be noted:

• The study relied on liver enzyme measurements at or within 24 hours of hospitalization, potentially missing dynamic changes over the course of the disease.
• The classification of liver injury was based solely on enzyme levels, without consideration of other markers of liver function or imaging studies.
• The study did not account for potential confounding factors such as pre-existing liver conditions or medications that could affect liver enzymes.

Future studies should address these limitations and explore additional aspects of liver involvement in COVID-19. What is the long-term impact of COVID-19-related liver injury on patient health? Longitudinal studies tracking liver function in COVID-19 survivors could provide valuable insights into potential chronic liver issues and guide long-term follow-up care.

Additionally, research into the effectiveness of liver-protective therapies in COVID-19 patients could lead to improved treatment protocols. Can early intervention with hepatoprotective agents reduce the incidence of severe liver injury and improve overall outcomes in COVID-19 patients? Randomized controlled trials evaluating such interventions could provide crucial evidence to guide clinical practice.

Furthermore, investigating the potential role of liver dysfunction in “long COVID” symptoms could shed light on the prolonged health effects experienced by some COVID-19 survivors. Is there a connection between acute liver injury during COVID-19 and persistent symptoms or organ dysfunction in the months following recovery? Understanding this relationship could help in developing comprehensive care strategies for COVID-19 survivors.

Implications for Clinical Practice and Public Health

The findings of this study have several important implications for clinical practice and public health strategies:

1. Routine liver function monitoring: The high prevalence of liver enzyme abnormalities suggests that regular monitoring of liver function should be standard practice in hospitalized COVID-19 patients.
2. Risk stratification: Liver enzyme levels could be incorporated into risk assessment tools to identify patients at higher risk of severe outcomes, allowing for more targeted interventions and resource allocation.
3. Treatment considerations: The potential for liver injury should be considered when selecting medications for COVID-19 treatment, particularly in patients with pre-existing liver conditions.
4. Public health messaging: Raising awareness about the potential for liver involvement in COVID-19 could encourage earlier seeking of medical care and improve overall outcomes.

How can healthcare systems best implement these findings to improve patient care? Developing standardized protocols for liver function monitoring and management in COVID-19 patients could help ensure consistent, high-quality care across different healthcare settings. Additionally, incorporating liver-specific considerations into COVID-19 treatment guidelines could help clinicians make more informed decisions about patient management.

Global Perspectives on Liver Involvement in COVID-19

While this study provides valuable insights, it’s important to consider how liver involvement in COVID-19 may vary across different populations and healthcare systems globally. Factors such as genetic predisposition, prevalence of pre-existing liver conditions, and access to healthcare resources could influence the patterns of liver injury and associated outcomes in different regions.

Are there significant variations in the prevalence and severity of liver enzyme abnormalities in COVID-19 patients across different countries or ethnic groups? International collaborative research efforts could help answer this question and provide a more comprehensive understanding of liver involvement in COVID-19 on a global scale.

Furthermore, studying the impact of different COVID-19 variants on liver function could provide insights into the evolving nature of the disease. Do emerging SARS-CoV-2 variants show different patterns of liver involvement compared to earlier strains? Ongoing surveillance and research in this area could help healthcare systems adapt their approaches as the virus continues to evolve.

Interdisciplinary Approaches to COVID-19 Liver Research

The complex nature of liver involvement in COVID-19 necessitates an interdisciplinary approach to research and clinical management. Collaboration between hepatologists, virologists, immunologists, and critical care specialists could lead to more comprehensive understanding and effective treatment strategies.

How can artificial intelligence and machine learning contribute to our understanding of liver injury in COVID-19? Advanced data analysis techniques could potentially identify subtle patterns and risk factors that may not be apparent through traditional statistical methods. Integrating clinical, laboratory, and imaging data through AI-driven analyses could lead to more accurate predictive models and personalized treatment approaches.

Additionally, exploring the intersection of COVID-19-related liver injury with other areas of hepatology research could yield valuable insights. For example, investigating how COVID-19 affects patients with pre-existing liver conditions such as nonalcoholic fatty liver disease or viral hepatitis could provide important clinical guidance for managing these high-risk populations.

Ethical Considerations in COVID-19 Liver Research

As research into liver involvement in COVID-19 progresses, it’s crucial to consider the ethical implications of study designs and potential interventions. How can researchers balance the urgent need for information with the protection of vulnerable patient populations? Ensuring informed consent, maintaining patient privacy, and considering the equitable distribution of any potential liver-protective therapies are essential ethical considerations.

Furthermore, the global nature of the COVID-19 pandemic raises questions about equitable access to liver function testing and potential treatments. How can the international medical community ensure that advances in understanding and managing liver involvement in COVID-19 benefit patients worldwide, regardless of geographic or economic factors?

Addressing these ethical considerations will be crucial in conducting responsible and impactful research that ultimately improves patient outcomes and public health responses to COVID-19 and potential future pandemics.

The Role of Liver Health in Overall Pandemic Preparedness

The significant liver involvement observed in COVID-19 patients highlights the importance of liver health in overall pandemic preparedness. How can public health strategies incorporate liver health considerations to better prepare for future infectious disease outbreaks?

Potential approaches could include:

• Promoting liver health through public health initiatives focused on reducing risk factors for chronic liver disease
• Improving surveillance systems for liver function in the general population
• Developing rapid liver function testing capabilities for emergency situations
• Incorporating liver-specific considerations into pandemic response plans and treatment protocols

By recognizing the liver as a potential target organ in infectious diseases, healthcare systems can develop more comprehensive and effective strategies for managing future pandemics. This approach could not only improve outcomes in liver-specific complications but also contribute to better overall patient care and resource allocation during health crises.

In conclusion, this study provides crucial insights into the prevalence and impact of liver enzyme abnormalities in COVID-19 patients. The findings underscore the importance of liver function monitoring and highlight potential areas for intervention to improve patient outcomes. As research in this field continues to evolve, a multidisciplinary, ethically conscious, and globally minded approach will be essential in advancing our understanding and management of liver involvement in COVID-19 and preparing for future pandemic challenges.

Prevalence and severity of liver enzyme alterations in COVID-19 and association with patient-centered outcomes

• Download PDF Copy

By Tarun Sai LomteNov 15 2022Reviewed by Danielle Ellis, B.Sc.

In a recent study posted to medRxiv*, researchers examined the prevalence of changes in liver enzymes in coronavirus disease 2019 (COVID-19).

Study: Liver injury in hospitalized patients with COVID-19: An International observational cohort study. Image Credit: Magic mine/Shutterstock

*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Background

The COVID-19 pandemic remains a substantial contributor to global morbidity and mortality. Although respiratory manifestations are predominant in COVID-19, increasing evidence indicates the involvement of multiple organs. Liver injury has been observed in 15% to 65% of COVID-19 patients. Abnormalities in liver enzyme levels have been associated with COVID-19 severity and higher mortality risk. 

The International Severe Acute Respiratory and Emerging Infection Consortium (ISARIC), in collaboration with the World Health Organization, initiated the clinical characterization protocol and case report forms in January 2020 to collect information on demographics, disease severity, therapeutic strategies, and outcomes for patients hospitalized with COVID-19.

About the study

The present study evaluated the prevalence and severity of liver enzyme changes in patients hospitalized with COVID-19 using the ISARIC dataset. All hospitalized patients from January 30, 2021, to September 21, 2021, with suspected/confirmed infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) were included in the primary analysis. Patients lacking data on clinical outcomes or liver enzyme tests were excluded.

Serum bilirubin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) measured at the time of or within 24 hours of hospitalization were considered for analysis. The normal upper limits were 1 mg/dL for serum bilirubin and 40 U/L for ALT and AST. A liver injury classification (LIC) score was assigned to patients at baseline – stages 0, I, and II for the normal (liver enzyme) state, liver injury, and severe liver injury, respectively.

The study’s primary exposure and outcome were baseline liver enzyme levels and in-hospital death, respectively. Secondary outcomes were admission to the intensive care unit (ICU), the requirement of oxygen therapy, ventilation, renal replacement therapy, and inotropes/vasopressors, and the hospital/ICU length of stay (LoS).

In addition, the researchers evaluated the associations between baseline liver enzymes and complications developed in the hospital. Logistic regression was used to determine the relationship between exposure and outcome variables. Sensitivity analysis was performed by including patients with laboratory-confirmed SARS-CoV-2 infection. 

Results

The study included 17,531 patients from the ISARIC database based on eligibility. Most patients (60%) were male, and the average age was 56.5 years. Diabetes and hypertension were the common comorbidities. Chronic liver disease was observed in 3% of patients. Cough and fever were the common COVID-19 symptoms.

Related Stories

• Study identifies the predictors of post-coronavirus disease 2019 (COVID-19) syndrome symptoms
• Viral clearance: A potential predictor of COVID-19 treatment efficacy
• Pangolin study uncovers novel strains of coronaviruses and raises concerns about origin

Normal liver enzyme levels (LIC – stage 0) were recorded in 45.6% of patients, stage I liver injury was noted in 46.2% of patients, and stage II liver injury was identified in 8.2% of the cohort. Around 19% of stage 0 patients were admitted to the ICU, compared to 35% of stage I and 40. 1% of stage II patients.

Oxygen supplementation was required for 48%, 70.3%, and 75.9% of stage 0, I, and II patients, respectively. Invasive ventilation was required by 9.8% of stage 0 patients, 21.3% of stage I patients, and 27% of stage II patients. The median LoS in the hospital was nine days for stage 0 and II patients and eight days for stage I patients.

The median LoS in the ICU was seven, eight, and nine days for stage 0, I, and II patients, respectively. The crude mortality risk was 14.3% for patients with normal liver enzymes compared to 32.7% for those with stage II liver injury. Multivariable analyses revealed that liver injury stages I and II were associated with an increased risk of ICU admission, invasive ventilation, and death.

Furthermore, liver injury (stage I or II) was associated with increased odds of developing acute kidney injury (AKI), sepsis, and acute respiratory distress syndrome (ARDS). Moreover, stage II liver injury was associated with increased odds of developing neurologic and hemodynamic complications.

Conclusions

The study noted that liver enzyme abnormalities were common in COVID-19 patients at hospital admission. Increased severity of liver injury was associated with an elevated risk of ICU admission, invasive ventilation, and mortality. Adding evidence from an extensive dataset, these findings are largely concordant with previous studies. Taken together, the results suggest that COVID-19 patients commonly exhibit abnormal liver enzyme levels that are associated with poor clinical outcomes.

*Important notice: medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:

• Preliminary scientific report.
  Tirupakuzhi Vijayaraghavan, B. et al. (2022) “Liver injury in hospitalized patients with COVID-19: An International observational cohort study”. medRxiv. doi: 10.1101/2022.11.06.22282006. https://www.medrxiv.org/content/10.1101/2022.11.06.22282006v1

Posted in: Medical Science News | Medical Research News | Disease/Infection News

Tags: Acute Kidney Injury, Acute Respiratory Distress Syndrome, Alanine, Chronic, Coronavirus, Coronavirus Disease COVID-19, Cough, covid-19, Diabetes, Enzyme, Fever, Hospital, Intensive Care, Kidney, Laboratory, Liver, Liver Disease, Mortality, Oxygen, Oxygen Therapy, Pandemic, Renal Replacement Therapy, Respiratory, SARS, SARS-CoV-2, Sepsis, Severe Acute Respiratory, Severe Acute Respiratory Syndrome, Syndrome

Comments (0)

• Download PDF Copy

Please use one of the following formats to cite this article in your essay, paper or report:

• APA

  Sai Lomte, Tarun. (2022, November 15). Prevalence and severity of liver enzyme alterations in COVID-19 and association with patient-centered outcomes. News-Medical. Retrieved on July 04, 2023 from https://www.news-medical.net/news/20221115/Prevalence-and-severity-of-liver-enzyme-alterations-in-COVID-19-and-association-with-patient-centered-outcomes.aspx.

• MLA

  Sai Lomte, Tarun. “Prevalence and severity of liver enzyme alterations in COVID-19 and association with patient-centered outcomes”. News-Medical. 04 July 2023. <https://www.news-medical.net/news/20221115/Prevalence-and-severity-of-liver-enzyme-alterations-in-COVID-19-and-association-with-patient-centered-outcomes.aspx>.

• Chicago

  Sai Lomte, Tarun. “Prevalence and severity of liver enzyme alterations in COVID-19 and association with patient-centered outcomes”. News-Medical. https://www.news-medical.net/news/20221115/Prevalence-and-severity-of-liver-enzyme-alterations-in-COVID-19-and-association-with-patient-centered-outcomes. aspx. (accessed July 04, 2023).

• Harvard

  Sai Lomte, Tarun. 2022. Prevalence and severity of liver enzyme alterations in COVID-19 and association with patient-centered outcomes. News-Medical, viewed 04 July 2023, https://www.news-medical.net/news/20221115/Prevalence-and-severity-of-liver-enzyme-alterations-in-COVID-19-and-association-with-patient-centered-outcomes.aspx.

Suggested Reading

Liver Enzyme Tests Often Fail to Identify Cirrhosis

Istock

Science News

A majority of people with alcohol-related liver cirrhosis may have normal ALT levels.

January 19, 2022
•

By

Sukanya Charuchandra

Twitter

Facebook

Pinterest

Tumblr

• Share

• Print

Advertisement

Standard liver enzyme tests that measure alanine aminotransferase (ALT) and aspartate transaminase (AST) can fail to detect alcohol-related liver cirrhosis, according to study results published in the American Journal of the Medical Sciences.

“The core message here is that if you just look at the test, you’ll miss the diagnosis,” Don Rockey, MD, of the Medical University of South Carolina, said in a press release. 

Heavy alcohol consumption can lead to serious liver disease, including advanced fibrosis, cirrhosis, liver cancer and the need for a liver transplant. Although cirrhosis is generally not reversible, early diagnosis offers an opportunity to reduce drinking and receive treatment that can reduce symptoms and increase life expectancy. 

Liver disease is often diagnosed with the help of liver enzyme tests. Elevated ALT and AST levels can indicate liver inflammation or injury. People with liver disease may also have elevated bilirubin levels, which can lead to jaundice.

Rockey and colleagues conducted a retrospective analysis to assess whether liver enzyme levels were normal or abnormal in people with alcohol-related cirrhosis. The study population included 78 people with the condition who were admitted to a medical center between January 2016 and December 2018. More than half were men, and the average age was 55 years.

Among this population, 70 people (90%) had normal ALT levels, 12 people (15%) had normal AST values and 20 people (26%) had normal bilirubin levels. All participants experienced decompensating events indicating liver failure, and one third died. The researchers found no association between liver complications or death and aminotransferase levels.

“Aminotransferase levels are often unremarkable in patients with alcohol-related cirrhosis and bear no relationship to clinical events or outcomes,” the researchers concluded. “Clinicians should be cautious when interpreting aminotransferases in patients with alcoholic cirrhosis.”

“We would see these patients with advanced disease and complications, yet their liver tests seemed to be normal,” Rockey said. “So if you just looked at their liver tests, you’d say, ‘Oh no problem,’ but in fact, that wasn’t the case.” 

These findings suggest that noninvasive methods, such as CT scans, MRI scans and elastography (FibroScan), may be more effective for early detection of liver cirrhosis.

Click here to read the study abstract.

Click here to learn more about alcohol-related liver disease.

Read More About:

• #alcohol-related liver disease
• #cirrhosis
• #liver cancer
• #liver enzymes

Advertisement

Join The Discussion

Tests for pancreatic necrosis

Pancreatic necrosis is a severe complication of acute pancreatitis in which cells die
pancreas. The pancreas (PZH) is a parenchymal organ, a gland of mixed secretion and
secretes enzymes into the lumen of the duodenum and hormones (insulin and glucagon) into the blood. When abused
alcoholic beverages, serious overeating and poisoning with certain chemicals, early
activation of enzymes produced by the pancreas, and a violation of their outflow, accompanied by an increase
pressure in the ducts, which leads to the destruction and digestion of the organ’s own cells.

This pathology requires stabilization of the patient’s condition with subsequent removal of necrotic tissues
glands surgically. Pancreatic necrosis is accompanied by a high probability of death.

What is pancreatic necrosis?

There are several main classifications of pancreatic necrosis. Depending on the extent of the process
pancreas isolated focal and diffuse forms.

Depending on the pathogenesis, hemorrhagic, fatty and mixed pancreatic necrosis is distinguished. With hemorrhagic
variant, the elastase enzyme destroys the walls of blood vessels, edema occurs and the nutrition of the organ is disrupted,
resulting in foci of necrosis. Fatty pancreatic necrosis occurs against the background of increased lipase activation,
destroying adipose tissue both inside the gland and around. Mixed necrosis is considered to be the most severe and
common.

In addition, the most important is the division of pancreatic necrosis into aseptic (sterile), without the presence of any
infectious agents, and infected, which is a more severe form in which
purulent-septic complications with higher mortality.

How is the pathological process in the pancreas clinically manifested?

The clinic develops rapidly, almost always associated with provoking factors – a lot of fatty foods, alcohol.
The most striking symptom is girdle pain, which radiates to the left hypochondrium and shoulder blade. pain almost
always accompanied by vomiting that does not bring relief. In addition, there are bloating, symptoms
dehydration – dry mouth, anuria (lack of urine), thirst, electrolyte imbalance. Maybe
discoloration of the skin to yellow with a bluish tint, fever.

With the progression of the process and the death of nerve endings, a decrease in the intensity of pain is possible
syndrome, which is a poor prognostic sign.

How is a pathology diagnosed? What tests are given for suspected pancreatic necrosis?

Since pancreatic necrosis is an acute surgical pathology, if the development of the process is suspected, the patient
urgently sent to the hospital. Diagnosis is primarily based on a thorough examination of the patient,
history taking and physical examination. In addition, a number of laboratory and instrumental
research.

1. Complete blood count

As with any other pathology, complete blood count is an important study in pancreatic necrosis. Appreciate
the number of basic formed elements that make up the blood, as well as hemoglobin and sedimentation rate
erythrocytes (ESR). With an inflammatory process in the pancreas or any other organ in the general analysis
ESR increases and leukocytosis is observed with a shift in the formula towards young forms (to the left). A sharp decline
red blood cells and hemoglobin can be observed with bleeding, which is accompanied by anemia. In some
cases, other pathological processes can be identified.

2. Blood chemistry (pancreatic enzymes)

The most important test for suspected acute pancreatitis and pancreatic necrosis is the blood chemistry.
First of all, pay attention to the amount of pancreatic enzymes in the blood. With pancreatic necrosis
there is a sharp increase in the level of lipase and amylase, which is associated with excessive destruction of cells and the release of
large amounts of enzymes in the blood. In addition, in the biochemical analysis in panreonecrosis, an increased
glucose levels, which may be associated with both initial functional pancreatic insufficiency and
impaired glucose tolerance, and with necrotic processes in the pancreas, due to which the production of
insulin.

Many other indicators are examined to assess the general condition of the patient and the impact of the process on other systems
biochemical reactions. For example, liver enzymes, creatinine and urea, cholesterol, lipoproteins of various
densities, protein fractions, etc. Be sure to evaluate electrolytes in the blood, as pancreatic necrosis
accompanied by dehydration and leads to various disorders.

3. Urinalysis for amylase

If possible, a urinalysis should be done if necrotizing pancreatitis is suspected. It is most important to assess the level
alpha-amylase (diastase) in biological fluid. When cells in the pancreas are destroyed,
an increase in the concentration of hydrolytic enzyme not only in the blood, but also in the urine. Normal amylase levels
in the urine should be in the range from 1 to 17 U / h (or about 9-430 U/l).

A urinalysis is also done to assess the function of the kidneys and other systems. Urine is examined macroscopically
(evaluate color, turbidity, odor), evaluate acidity (pH) and density, microscopically study the presence
proteins, blood cells, glucose, epithelial cells, etc.

Pancreatic necrosis cannot be diagnosed based on laboratory tests alone. Be sure to evaluate
clinical manifestations and apply methods of instrumental diagnostics – ultrasound examination of the abdominal organs
cavity, if necessary, CT, retrograde cholangiopancreatography (examination of the pancreatic ducts and bile ducts
by introducing contrast).

If you experience symptoms characteristic of a pathology of the pancreas, immediately consult a doctor for
diagnosis and treatment. Do not try to interpret the results of laboratory tests yourself. None
change is not a diagnosis.

Biochemical blood test in Moscow – hand over, price

A biochemical blood test provides invaluable information for various diseases, evaluating various parameters of metabolic processes (protein, fat, carbohydrate). The laboratory assistant determines a number of indicators that reflect the state of internal organs and systems, as well as the activity of certain enzymes contained in the blood serum. Biochemical indicators depend on the functioning of the cardiovascular, digestive, excretory, respiratory and endocrine systems, muscle and bone tissue, as well as the gastrointestinal tract.

Prices for biochemical blood tests

Test panels and examination algorithms

Indications for examination order

It is recommended to take a biochemical blood test:

It is recommended to donate blood biochemistry when the general condition worsens as a primary diagnosis.

Preparation for the procedure

To get the most reliable results, it is necessary to study a number of rules before taking blood for biochemical analysis (preparatory stage):

1. Avoid intense physical activity the day before the clinic visit associated with an increase in metabolites.

2. Avoid drinking alcoholic beverages.

3. Avoid stressful situations accompanied by an increase in adrenaline levels.

What can affect the result

Distortion of indicators is observed when taking certain medications. The results may be incorrect if fried, fatty foods and alcohol are consumed 1-2 before the study. Smoking should be avoided one hour before blood sampling.

Analysis

Indicators of a biochemical blood test that can be examined in the laboratory:

• proteins and their fractions;

• indicators of nitrogen metabolism;

• glucose and its metabolites;

• lipids;

• pigments;

• enzymes;

• markers of myocardial injury.

An increase or decrease in certain indicators indicates the development of a particular pathology. Laboratory studies are an important, but not definitive method for diagnosing diseases. It is possible to determine exactly what the patient is suffering from only on the basis of a comparison of objective data, the history of the development of the disease, laboratory and instrumental studies.

A blood test for biochemistry allows us to draw the following conclusions:

• assess the functional reserve of the liver and kidneys;

• determine if there is damage to cells, especially the heart muscle, which is important for the early diagnosis of myocardial infarction;

• identify any electrolyte disturbances that may affect the normal functioning of important organs;

• determine the likelihood of developing atherosclerosis and related complications;

• diagnose diseases associated with metabolic disorders.

Normal

Table – Indicators of a biochemical blood test

Explanation of indicators

A detailed biochemical blood test allows you to determine the following conditions:

• total protein. An increase indicates dehydration. This condition occurs with extensive burns (usually thermal), severe injuries and infections. A decrease in protein content is observed with an insufficient amount of protein foods in the diet. Its increased loss is characteristic of kidney diseases, diabetes mellitus, ascites, and oncopathology. Violation of protein synthesis is determined with liver damage, long-term treatment with corticosteroid hormones, as well as with a decrease in its absorption (enteritis, pancreatitis).

• Indicators of nitrogen metabolism. Proteins are broken down in the body to form the end product, urea. It is excreted by the kidneys, and an increase in its concentration in the blood indicates various pathologies of this organ (renal failure, glomerulonephritis, pyelonephritis, arterial hypertension, prostate adenoma). The reduced concentration of urea has no diagnostic value.

• Glucose and its metabolites. Examining the concentration of glucose in the blood is the most important step in diagnosing diabetes.

  In patients with diabetes, levels can be very high (hyperglycemia) or low (hypoglycemia). A critical change in glucose concentration can lead to coma and therefore requires immediate intensive care.

• Lipids. Triglycerides, cholesterol and its fractions are converted into lipids. The content of these substances increases with dyslipoproteinemia, which leads to the development of atherosclerosis.

• Bilirubin. In this group of indicators, the content of bile dyes is studied. An increase in serum levels indicates the presence of jaundice. Depending on the number of increases in concentration and on what type of pigment was increased (direct / indirect bilirubin), we can conclude the causes of jaundice: stopping the outflow of bile, destruction of liver cells; breakdown of erythrocytes.

• Enzymes. There are two large groups that are studied in the laboratory: non-specific (general metabolic processes) and specific (metabolism of certain tissues). These include aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), alkaline phosphatase (ALP). Glutamate dehydrogenase increases with liver damage. Alpha-amylase and lipase increase in response to damage to the pancreas.

• Heart markers. They are delivered to the blood in large quantities when myocardial cells are damaged. An increase in concentration clearly indicates massive destruction of part of the heart muscle and allows you to accurately diagnose a heart attack.

Most often, a biochemical blood test after decoding does not allow an accurate diagnosis. However, knowledge of the causes of changes in the internal environment of the body directs the doctor to the right idea, which is the key to successful treatment.

Recommendations

For men, women and children, there are approximate limits of normal indicators of the studied parameters. Deviation from them indicates the development of dysfunction of internal organs or pathological processes in the body. A biochemical blood test allows not only to detect a health problem in a timely manner, but also to make a correct diagnosis, monitor the course of the disease and monitor the effectiveness of therapy.

Questions and answers

1. Do I need to cancel medications before a blood test for biochemistry?

   Significantly affect the results of biochemical tests drugs to lower blood pressure. Cancellation of drugs must be agreed with the doctor.

2. Where can I donate blood for biochemistry at an affordable price in Moscow?

   A general biochemical blood test at a low price can be taken at the RebenOK clinic. We employ experienced professionals and use modern equipment. How much does a biochemical blood test cost, check by phone or on the website of the medical center.

3. Are lab results reliable?

   The results of laboratory tests obtained at the RebenOK clinic meet international quality standards.

We promptly respond to additions and price changes in the price list. In order to avoid misunderstandings, it is recommended to clarify the full list of services and their cost at the clinic’s reception desk or by calling 8-495-104-35-35.
The price list posted on the site is not an offer. Medical services are provided on the basis of a concluded contract.

Patients’ latest reviews

A super doctor who saved a child from third otitis as a complication after an illness! Did all the research and analysis that was needed. She immediately prescribed treatment (and explained why it was not necessary to do what had been done before).