Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, 100,015, China.
Beijing Key Laboratory of Emerging Infectious Diseases, Beijing, 100,015, China.
Mil Med Res. 2020 Jun 7;7(1):28. doi: 10.1186/s40779-020-00256-6.
Recent studies reported that patients with coronavirus disease-2019 (COVID-19) might have liver injury. However, few data on the combined analysis and change patterns of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil) have been shown.
This is a single-center retrospective study. A total of 105 adult patients hospitalized for confirmed COVID-19 in Beijing Ditan Hospital between January 12, and March 17, 2020 were included, and divided into mild group (n = 79) and severe group(n = 26). We compared liver functional test results between the two groups. Category of ALT change during the disease course was also examined.
56.2% (59/105) of the patients had unnormal ALT, AST, or total TBil throughout the course of the disease, but in 91.4% (96/105) cases the level of ALT, AST or TBil ≤3 fold of the upper limit of normal reference range (ULN). The overall distribution of ALT, AST, and TBil were all significantly difference between mild and severe group (P < 0.05). The percentage of the patients with elevated both ALT and AST was 12.7% (10/79) in mild cases vs. 46.2% (12/26) in severe cases (P = 0.001). 34.6% (9/26) severe group patients started to have abnormal ALT after admission, and 73.3% (77/105) of all patients had normal ALT before discharge.
Elevated liver function index is very common in patients with COVID-19 infection, and the level were less than 3 × ULN, but most are reversible. The abnormality of 2 or more indexes is low in the patients with COVID-19, but it is more likely to occur in the severe group.
最近的研究报告称，2019 年冠状病毒病（COVID-19）患者可能存在肝损伤。然而，关于丙氨酸氨基转移酶（ALT）、天门冬氨酸氨基转移酶（AST）和总胆红素（TBil）联合分析和变化模式的数据很少。
这是一项单中心回顾性研究。共纳入 2020 年 1 月 12 日至 3 月 17 日期间在北京地坛医院住院确诊 COVID-19 的 105 例成年患者，分为轻症组（n=79）和重症组（n=26）。比较两组患者肝功能检查结果，观察疾病过程中 ALT 变化的分类。
56.2%（59/105）的患者在疾病过程中 ALT、AST 或总 TBil 均异常，但在 91.4%（96/105）的病例中，ALT、AST 或 TBil 水平均未超过正常参考范围上限（ULN）的 3 倍。轻症组和重症组 ALT、AST 和 TBil 的总体分布均有显著差异（P<0.05）。轻症组患者中同时升高 ALT 和 AST 的患者比例为 12.7%（10/79），重症组为 46.2%（12/26）（P=0.001）。重症组有 34.6%（9/26）的患者在入院后开始出现 ALT 异常，所有患者中有 73.3%（77/105）在出院前 ALT 正常。
COVID-19 感染患者肝功能指标升高非常常见，且水平均<3×ULN，但多为可逆性。COVID-19 患者中 2 项或以上指标异常的比例较低，但在重症组中更易发生。
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