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COVID-19 患者的肝损伤:来自中国武汉市单个中心的 115 例回顾性分析。

Liver impairment in COVID-19 patients: A retrospective analysis of 115 cases from a single centre in Wuhan city, China.

机构信息

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.

出版信息

Liver Int. 2020 Sep;40(9):2095-2103. doi: 10.1111/liv.14455. Epub 2020 Apr 28.

Abstract

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.

摘要

背景

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。

方法

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。

结果

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。

结论

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。

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