Liver Enzyme Elevation in Coronavirus Disease 2019: A Multicenter, Retrospective, Cross-Sectional Study
Liver Enzyme Elevation in Coronavirus Disease 2019: A Multicenter, Retrospective, Cross-Sectional Study
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2019 年冠状病毒病中的肝酶升高：一项多中心、回顾性、横断面研究
DOI：
10.14309/ajg.0000000000000717
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发表时间：
2020-07-01
影响因子：
9.8
通讯作者：
Yang, Yi-Da
中科院分区：
文献类型：
--
作者：
Hao, Shao-Rui;Zhang, Shan-Yan;Yang, Yi-Da
引言：在2019冠状病毒病（COVID - 19）患者中观察到肝酶水平升高；然而，这些特征尚未明确。
方法：纳入2020年1月17日至2月12日中国浙江省的COVID - 19住院患者。肝酶水平升高定义为入院时男性谷丙转氨酶水平>35 U/L，女性>25 U/L。谷丙转氨酶水平正常的患者纳入对照组。采用逆转录聚合酶链反应确认严重急性呼吸综合征冠状病毒2（SARS - CoV - 2）感染，有SARS - CoV - 2感染症状的患者定义为COVID - 19患者。收集并比较流行病学、人口统计学、临床、实验室、治疗和结局数据。
结果：在788例COVID - 19患者中，222例（28.2%）患者肝酶水平升高（中位[四分位间距{IQR}]年龄为47.0[35.0 - 55.0]岁；女性占40.5%）。男性、超重和吸烟会增加肝酶水平升高的风险。肝酶水平升高组咽痛较对照组少，腹泻较对照组多。肝酶水平升高组从发病到入院的中位时间为3天（IQR，2 - 6），而86例（38.7%）出院患者的中位住院时间为13天（IQR，11 - 16）。两组之间在疾病严重程度和临床结局方面未发现差异。
讨论：我们发现28.2%的COVID - 19患者入院时肝酶水平升高，这可能部分与SARS - CoV - 2感染有关。男性患者肝酶水平升高的风险更高。通过早期医疗干预，肝酶水平升高并未使COVID - 19患者的预后恶化。
INTRODUCTION: Elevated liver enzyme levels are observed in patients with coronavirus disease 2019 (COVID-19); however, these features have not been characterized. METHODS: Hospitalized patients with COVID-19 in Zhejiang Province, China, from January 17 to February 12, 2020, were enrolled. Liver enzyme level elevation was defined as alanine aminotransferase level >35 U/L for men and 25 U/L for women at admission. Patients with normal alanine aminotransferase levels were included in the control group. Reverse transcription polymerase chain reaction was used to confirm severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and patients symptomatic with SARS-CoV-2 infection were defined as patients with COVID-19. Epidemiological, demographic, clinical, laboratory, treatment, and outcome data were collected and compared. RESULTS: Of 788 patients with COVID-19, 222 (28.2%) patients had elevated liver enzyme levels (median [interquartile range {IQR}] age, 47.0 [35.0–55.0] years; 40.5% women). Being male, overweight, and smoking increased the risk of liver enzyme level elevation. The liver enzyme level elevation group had lesser pharyngalgia and more diarrhea than the control group. The median time from illness onset to admission was 3 days for liver enzyme level elevation groups (IQR, 2–6), whereas the median hospitalization time for 86 (38.7%) discharged patients was 13 days (IQR, 11–16). No differences in disease severity and clinical outcomes were noted between the groups. DISCUSSION: We found that 28.2% of patients with COVID-19 presented with elevated liver enzyme levels on admission, which could partially be related to SARS-CoV-2 infection. Male patients had a higher risk of liver enzyme level elevation. With early medical intervention, liver enzyme level elevation did not worsen the outcomes of patients with COVID-19.