SARS-CoV-2 Infection Induces a Dual Response in Liver Function Tests: Association with Mortality during Hospitalization.
SARS-CoV-2 Infection Induces a Dual Response in Liver Function Tests: Association with Mortality during Hospitalization.
复制标题
DOI：
10.3390/biomedicines8090328
复制
发表时间：
2020-09-04
期刊：
影响因子：
4.7
通讯作者：
M Arbones-Mainar J
中科院分区：
文献类型：
--
作者：
Bernal-Monterde V;Casas-Deza D;Letona-Giménez L;de la Llama-Celis N;Calmarza P;Sierra-Gabarda O;Betoré-Glaria E;Martínez-de Lagos M;Martínez-Barredo L;Espinosa-Pérez M;M Arbones-Mainar J
严重急性呼吸综合征冠状病毒2(SARS-CoV-2)与肝功能异常有关。我们推测，入院时早期肝脏生化改变可能与住院期间随后的改变具有不同的临床相关性。对连续540名经聚合酶链式反应(PCR)诊断为SARS-CoV-2的住院患者进行了单中心回顾性研究。肝功能异常定义为谷氨酰转氨酶(GGT)、丙氨酸氨基转移酶(ALT)或天冬氨酸氨基转移酶(AST)升高，高于本实验室设定的正常上限。线性混合模型(LMM)评估了纵向相关性，纳入了所有可用的后续实验室化学指标。随访期结束时，502例(94.5%)患者出院(109例(20.5%)死亡)。共有319人(64.3%)在入院时至少有一项肝脏检查结果异常。更常见的是AST升高(40.9%)和GGT升高(47.3%)。异常与存活率无关，但与入院时的呼吸道并发症有关。相反，调整了年龄和性别的LMM模型显示，住院期间铁蛋白、GGT和碱性磷酸酶(ALP)水平的纵向增加，以及白蛋白水平的下降，与生存率下降有关。这种肝损伤的双重模式可能会与之前相互矛盾的报告相一致。GGT和ALP轨迹可能有助于确定谁可能需要更多的监测和重症监护。
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with abnormal liver function tests. We hypothesized that early altered liver biochemistries at admission might have different clinical relevance than subsequent changes during hospitalization. A single-center retrospective study was conducted on 540 consecutive hospitalized patients, PCR-diagnosed with SARS-CoV-2. Liver test abnormalities were defined as the elevation of either gamma-glutamyltransferase (GGT), alanine aminotransferase (ALT), or aspartate aminotransferase (AST), above the upper limit of normality set by our laboratory. Linear mixed models (LMM) evaluated longitudinal associations, incorporating all available follow-up laboratory chemistries. By the end of the follow-up period, 502 patients (94.5%) were discharged (109 (20.5%) died). A total of 319 (64.3%) had at least one abnormal liver test result at admission. More prevalent were elevated AST (40.9%) and GGT (47.3%). Abnormalities were not associated with survival but with respiratory complications at admission. Conversely, LMM models adjusted for age and sex showed that longitudinal increases during hospitalization in ferritin, GGT, and alkaline phosphatase (ALP), as well as a decreased albumin levels, were associated with reduced survival. This dual pattern of liver damage might reconcile previous conflicting reports. GGT and ALP trajectories could be useful to determine who might need more surveillance and intensive care.
登录
查看更多内容
影响因子：
13.5
作者：
Chau, TN;Lee, KC;Lai, CL
通讯作者：
Lai, CL
影响因子：
7.3
作者：
Hamming, I;Timens, W;van Goor, H
通讯作者：
van Goor, H
影响因子：
15.9
作者：
Chen, Guang;Wu, Di;Ning, Qin
通讯作者：
Ning, Qin
影响因子：
--
作者：
Kasarala, George;Tillmann, Hans L
通讯作者：
Tillmann, Hans L
影响因子：
13.5
作者：
Bloom, Patricia P.;Meyerowitz, Eric A.;Chung, Raymond T.
通讯作者：
Chung, Raymond T.