The effectiveness of Zafacol 3D on the dynamics of calprotectin and a1-antitrypsin levels and calcium metabolism in patients with non-alcoholic fatty liver disease and intestinal lesions who have had COVID-19
DOI:
https://doi.org/10.32782/2415-8127.2023.68.45Keywords:
non-alcoholic fatty liver disease, COVID-19, intestinal lesions, fecal calprotectin, α1-antitrypsin, treatmentAbstract
Introduction. COVID-19 can induce changes in the digestive system, especially in patients with comorbidities. The aim of the study was to determine the effectiveness of complex therapy using Zafacol 3D on the dynamics of clinical manifestations and laboratory markers of intestinal damage in patients with non-alcoholic fatty liver disease (NAFLD) who have had COVID-19. Object and research methods. We examined 44 patients with NAFLD and intestinal lesions after COVID-19. Patients were divided into two groups: group I included patients who, against the background of correction of the functional state of the liver, if necessary, carbohydrate metabolism, additionally took the mebeverine and lactulose, 5.0 ml 3 times a day for 1 month (n=20); group II consisted of 24 patients who, in addition to mebeverine, received the complex probiotic Zafacol 3D, 1 tablet 2 times a day after meals for 1 month. Research results and their discussion. In patients of group II, constipation decreased by 58.3%, while in patients of group I – only by 45.0% (p<0.05) after the course of treatment. The complex therapy performed mainly in patients of group II contributed to a significant decrease in the level of fecal calprotectin (FCP) (to 54.8±1.4 μg/l – p<0.01), while in patients of group I only minor changes in FCP levels were diagnosed. The same trend was observed when analyzing the level of α1-antitrypsin (α1-AT) in the blood serum and feces, as well as its clearance – especially among the subjects of group II. Normalization of vitamin D3 and calcium ions in the blood serum was found mainly in patients of group II (patients taking Zafacol 3D). Conclusions. 1. In patients with NAFLD after COVID-19, intestinal damage is often manifested by impaired bowel movements in the form of constipation, followed by diarrhea, as well as flatulence and pain along the colon. 2. Determination of the level of FCP and the level of α1-AT (in the blood serum, in the feces and calculation of its clearance) is an effective method for diagnosing intestinal damage in patients with NAFLD who have had COVID-19. 3. The use of Zafacol 3D as part of complex therapy in patients with NAFLD and intestinal damage resulting from COVID-19 is an effective, safe and pathogenetically sound treatment. At the same time, not only a decrease in the severity of clinical symptoms, but also a positive dynamics of such inflammatory biomarkers as the level of FFA and α1-AT was found. 4. A course of Zafacol 3D as part of complex therapy in patients with NAFLD and intestinal damage after COVID-19 helps to normalize the level of vitamin D3 and calcium ions in the blood serum.
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