COVID-19 in decompensated cirrhosis

Elderly patients with diabetes, hypertension and obesity are at risk of severe course the novel coronavirus infection COVID-19. Patients chronic liver disease also high death due to SARS-CoV-2. Case report . Patient D., 65 years old, since 2010, was observed for Child-Pugh class B-C cirrhosis mixed etiology (alimentary metabolic), type 2 diabetes. He hospitalized on May 17, 2020 shortness breath, increased encephalopathy CT signs bilateral polysegmental pneumonia, involving about 75% lung tissue (CT-scan indicates possible COVID-19-associated pneumonia). Despite repeated negative results PCR test targeting SARS-CoV-2 viral RNA, clinical picture scans pointed COVID-19 (virus not identified). Because decompensated cirrhosis, patient decided refrain from antiviral anticytokine therapy. Oxygen therapy, positional antithrombotic therapy (fondaparinux sodium), antibacterial (ceftriaxone, then levofloxacin), infusion 20% albumin solution fresh frozen plasma were carried out. Due increasing hypoxemia, transferred ICU placed under mechanical ventilation. all measures, he developed symptoms multiple organ failure died asystole. Discussion. Mortality in diseases, including caused by SARS-CoV-2, reaches 40% [4]. Factors aggravating such include immune-mediated cell damage, direct cytotoxicity resulting replication hepatocytes, hypoxia, drug-induced injury, reactivation previously latent diseases (including hepatitis B C virus). onclusion In above case, end-stage (CT stage 3–4), complicated disseminated intravascular coagulation (DIC) syndrome, progressive respiratory failure, led suffering