Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China.
Clinical Center and Key Lab of Intestinal and Colorectal Diseases of Hubei Province, Wuhan, China.
Liver Int. 2020 Sep;40(9):2095-2103. doi: 10.1111/liv.14455. Epub 2020 Apr 28.
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.
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.
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.
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.
SARS-CoV-2 大流行是一场持续的全球卫生紧急事件。我们的研究目的是探讨 COVID-19 患者肝功能变化及其临床意义。
这是一项回顾性、单中心研究,纳入了 2020 年 1 月 18 日至 2 月 22 日期间武汉大学中南医院的 115 例确诊 COVID-19 患者。分析肝功能及相关指标,评估其与 COVID-19 患者疾病进展的关系。
部分 COVID-19 患者肝功能指标出现不同程度异常。然而,COVID-19 患者的 ALT、AST、TBIL、GGT 和 LDH 水平与住院社区获得性肺炎患者相比无显著差异,白蛋白水平甚至更高。重症 COVID-19 患者的 ALT、AST、TBIL、LDH 和 INR 水平明显高于轻症患者。然而,这种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,且在疾病进展过程中持续下降。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 是重症 COVID-19 的独立危险因素,年龄也是一个危险因素。
尽管 COVID-19 患者肝功能指标异常常见,但肝功能损害不是 COVID-19 的突出特征,也可能没有严重的临床后果。