Document Type : Original Article
Authors
1
Assistant Professor, Department of Internal Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
2
2. Assistant Professor, Department of Pharmacy, Lorestan University of Medical Sciences, Khorramabad, Iran
3
3. Assistant Professor, Department of Internal Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
4
Assistant Professor, Department of Biology, Lorestan University of Medical Sciences, Khorramabad, Iran
5
5. Research Physician, Clinical Research and Development Center, Shohada Ashayer Hospital, Lorestan University of Medical Sciences, Khorramabad, Iran
Abstract
Objective: In addition to the respiratory system, COVID-19 can lead to liver disorders and inflammatory complications. The effect of remdesivir and tocilizumab, as common treatment options for this disease, on liver enzyme levels and inflammatory markers still requires more detailed investigation. The present study aimed to determine the levels of liver enzymes and inflammatory factors in patients with COVID-19 receiving remdesivir and tocilizumab at Shahid Rahimi Khorramabad Medical Center during 2021.
Method: This descriptive-analytical cross-sectional study reviewed the medical records of 475 patients diagnosed with COVID-19 and treated with remdesivir or tocilizumab during the second quarter of 2021 at Shahid Rahimi Hospital.
Results: The average hospital stay was 9.9 ± 4.3 days. The mean duration of ICU and general ward hospitalization was 5.5 ± 2.7 and 4.4 ± 2.2 days, respectively. Administration of remdesivir and tocilizumab significantly increased AST and ALT levels, although no significant change in bilirubin was observed. Remdesivir also led to a significant reduction in CRP and LDH, whereas tocilizumab only reduced CRP. Furthermore, remdesivir caused a transient and statistically non-significant rise in lymphocyte, neutrophil and total leukocyte counts. In contrast, tocilizumab significantly reduced lymphocyte and neutrophil counts.
Conclusions: In the treatment of COVID-19, understanding the interaction of antiviral drugs and immunomodulators is very important. Both remdesivir and tocilizumab were associated with increases in liver enzymes AST and ALT, but remdesivir was more effective in reducing inflammatory markers CRP and LDH than tocilizumab. These findings may help more accurately manage drug side effects, continuously monitor liver function, and select anti-inflammatory drugs based on the patient's inflammatory profile in this group of patients.
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