Liver impairment in COVID-19 patients: A retrospective analysis of 115 cases from a single centre in Wuhan city, China
Liver impairment in COVID-19 patients: A retrospective analysis of 115 cases from a single centre in Wuhan city, China
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DOI：
10.1111/liv.14455
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发表时间：
2020-04-28
影响因子：
6.7
通讯作者：
Zhao, Qiu
中科院分区：
文献类型：
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作者：
Zhang, Yafei;Zheng, Liang;Zhao, Qiu
背景SARS-CoV-2大流行是一个持续的全球卫生紧急情况。本研究的目的是探讨新冠肺炎患者肝功能的变化及其临床意义。方法本回顾性单中心研究对2020年1月18日至2020年2月22日在武汉大学中南医院确诊的115例新冠肺炎患者进行了回顾性研究。结果部分COVID-19患者出现不同程度的肝功能指标异常。然而，与住院的社区获得性肺炎患者相比，COVID-19患者的ALT、AST、TBIL、GGT和LDH水平没有显著差异，白蛋白水平甚至显著更高。与轻型病例相比，重型病例的ALT、AST、TBIL、LDH和INR水平显示出统计学显著性升高。然而，升高的临床意义并不显著。大多数重症COVID-19患者的白蛋白水平显著下降，并在疾病进展中持续下降。COVID-19患者的大多数肝功能指标与炎症标志物CRP和NLR相关。Logistic回归分析进一步确定NLR是COVID-19严重的独立危险因素，以及年龄。结论虽然COVID-19患者肝功能指标异常很常见，但肝功能损害不是COVID-19的突出特征，也可能不会产生严重的临床后果。
Background The SARS-CoV-2 pandemic is an ongoing global health emergency. The aim of our study was to investigate the changes of liver function and its clinical significance in COVID-19 patients.Method This retrospective, single-centre study was conducted on 115 confirmed cases of COVID-19 in Zhongnan hospital of Wuhan University from 18 January 2020 to 22 February 2020. Liver function and related indexes were analysed to evaluate its relationship with disease progression in COVID-19 patients.Results Part of the COVID-19 patients presented with varying degrees of abnormality in liver function indexes. However, the levels of ALT, AST, TBIL, GGT and LDH in COVID-19 patients were not significantly different when compared with hospitalised community-acquired pneumonia patients, and the levels of albumin is even significantly higher. The levels of ALT, AST, TBIL, LDH and INR showed statistically significant elevation in severe COVID-19 cases compared with that in mild cases. However, the clinical significance of the elevation is unremarkable. Majority of severe COVID-19 patients showed significantly decreasing in albumin level and continuously decreasing in the progress of illness. Most of the liver function indexes in COVID-19 patients were correlated with CRP and NLR, the markers of inflammation. Logistic regression analysis further identified NLR as the independent risk factor for severe COVID-19, as well as age.Conclusions Although abnormalities of liver function indexes are common in COVID-19 patients, the impairment of liver function is not a prominent feature of COVID-19, and also may not have serious clinical consequences.