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COVID-19 住院非 ICU 患者的临床特征与肝损伤:一项回顾性研究。

Clinical characteristics of non-ICU hospitalized patients with coronavirus disease 2019 and liver injury: A retrospective study.

机构信息

Department of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.

Liver research center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, China.

出版信息

Liver Int. 2020 Jun;40(6):1321-1326. doi: 10.1111/liv.14449. Epub 2020 Apr 12.

Abstract

BACKGROUND & AIMS: Coronavirus disease 2019 (COVID-19) has raised world concern for global epidemic since December, 2019. Limited data are available for liver function in COVID-19 patients. We aimed to investigate the risk factors related to liver injury in the COVID-19 patients.

METHODS

A retrospective study was performed in non-ICU Ward at Jinyintan Hospital from February 2, 2020 to February 23, 2020. Consecutively confirmed COVID-19 discharged cases were enrolled. The clinical characteristics of patients with liver injury and without liver injury were compared.

RESULTS

A total of 79 COVID-19 patients were included. 31.6%, 35.4% and 5.1% COVID-19 patients had elevated levels of alanine transaminase (ALT), aspartate aminotransferase (AST) and bilirubin respectively. Median value of ALT, AST and bilirubin for entire cohort was 36.5 (17.5 ~ 71.5) U/L, 34.5 (25.3 ~ 55.3) U/L and 12.7 (8.1 ~ 15.4) mmol/L respectively. There were no significant differences in age, previous medical history and symptoms between the two groups. Males were more likely to have liver injury when infected with COVID-19 (P < .05); compared with patients without liver injury, patients with liver injury had increased levels of white blood cell counts, neutrophils, CRP and CT score (P < .05) and had a longer length of stay (P < .05). Logistic regression analyses suggested that the extent of pulmonary lesions on CT was a predictor of liver function damage (P < .05).

CONCLUSIONS

Liver injury is common in non-ICU hospitalized COVID-19 patients. It may be related to systemic inflammation. Intense monitoring and evaluation of liver function in patients with severe pulmonary imaging lesions should be considered.

摘要

背景与目的

自 2019 年 12 月以来,新型冠状病毒病 2019(COVID-19)引起了全球对全球大流行的关注。关于 COVID-19 患者的肝功能数据有限。本研究旨在探讨 COVID-19 患者肝损伤的相关危险因素。

方法

2020 年 2 月 2 日至 2020 年 2 月 23 日,我们对金银潭医院非 ICU 病房进行了回顾性研究。连续纳入确诊为 COVID-19 出院的病例。比较了有肝损伤和无肝损伤患者的临床特征。

结果

共纳入 79 例 COVID-19 患者,分别有 31.6%、35.4%和 5.1%的患者 ALT、AST 和胆红素升高。全队列 ALT、AST 和胆红素的中位数分别为 36.5(17.571.5)U/L、34.5(25.355.3)U/L 和 12.7(8.1~15.4)mmol/L。两组在年龄、既往病史和症状方面无显著差异。男性感染 COVID-19 时更易发生肝损伤(P<.05);与无肝损伤患者相比,肝损伤患者的白细胞计数、中性粒细胞计数、CRP 和 CT 评分更高(P<.05),住院时间更长(P<.05)。Logistic 回归分析提示 CT 上肺部病变范围是肝功能损伤的预测因素(P<.05)。

结论

非 ICU 住院 COVID-19 患者中肝损伤常见,可能与全身炎症有关。对于肺部影像学严重的患者,应密切监测和评估肝功能。

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