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本文引用的文献

1
Clinical Characteristics and Outcomes of Coronavirus Disease 2019 Among Patients With Preexisting Liver Disease in the United States: A Multicenter Research Network Study.美国已有肝病患者中2019冠状病毒病的临床特征与转归:一项多中心研究网络研究
Gastroenterology. 2020 Aug;159(2):768-771.e3. doi: 10.1053/j.gastro.2020.04.064. Epub 2020 May 4.
2
Association of Obesity with Disease Severity Among Patients with Coronavirus Disease 2019.肥胖与 2019 冠状病毒病患者疾病严重程度的相关性。
Obesity (Silver Spring). 2020 Jul;28(7):1200-1204. doi: 10.1002/oby.22859. Epub 2020 Jun 12.
3
Coronavirus disease 2019 and prevalence of chronic liver disease: A meta-analysis.2019 年冠状病毒病与慢性肝病的流行情况:一项荟萃分析。
Liver Int. 2020 Jun;40(6):1316-1320. doi: 10.1111/liv.14465. Epub 2020 Apr 24.
4
Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area.在纽约市地区,5700 名因 COVID-19 住院的患者的特征、合并症和结局。
JAMA. 2020 May 26;323(20):2052-2059. doi: 10.1001/jama.2020.6775.
5
COVID-19: Abnormal liver function tests.COVID-19:肝功能异常。
J Hepatol. 2020 Sep;73(3):566-574. doi: 10.1016/j.jhep.2020.04.006. Epub 2020 Apr 13.
6
Clinical Features of COVID-19-Related Liver Functional Abnormality.新型冠状病毒病相关肝功能异常的临床特征。
Clin Gastroenterol Hepatol. 2020 Jun;18(7):1561-1566. doi: 10.1016/j.cgh.2020.04.002. Epub 2020 Apr 10.
7
Epidemiological, clinical and virological characteristics of 74 cases of coronavirus-infected disease 2019 (COVID-19) with gastrointestinal symptoms.74 例伴有胃肠道症状的 2019 年冠状病毒病(COVID-19)患者的流行病学、临床和病毒学特征。
Gut. 2020 Jun;69(6):1002-1009. doi: 10.1136/gutjnl-2020-320926. Epub 2020 Mar 24.
8
Effect of Gastrointestinal Symptoms in Patients With COVID-19.新型冠状病毒肺炎患者胃肠道症状的影响
Gastroenterology. 2020 Jun;158(8):2294-2297. doi: 10.1053/j.gastro.2020.03.020. Epub 2020 Mar 19.
9
Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study.中国武汉成人 COVID-19 住院患者的临床病程和死亡危险因素:一项回顾性队列研究。
Lancet. 2020 Mar 28;395(10229):1054-1062. doi: 10.1016/S0140-6736(20)30566-3. Epub 2020 Mar 11.
10
Liver injury in COVID-19: management and challenges.新型冠状病毒肺炎中的肝损伤:管理与挑战
Lancet Gastroenterol Hepatol. 2020 May;5(5):428-430. doi: 10.1016/S2468-1253(20)30057-1. Epub 2020 Mar 4.

慢性肝脏疾病对 COVID-19 住院患者结局的影响:美国多中心经验。

Impact of chronic liver disease on outcomes of hospitalized patients with COVID-19: A multicentre United States experience.

机构信息

Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women's Hospital, Boston, MA, USA.

Harvard Medical School, Boston, MA, USA.

出版信息

Liver Int. 2020 Oct;40(10):2515-2521. doi: 10.1111/liv.14583. Epub 2020 Jul 5.

DOI:10.1111/liv.14583
PMID:32585065
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7361757/
Abstract

Liver injury has been described with COVID-19, and early reports suggested 2%-11% of patients had chronic liver disease (CLD). In this multicentre retrospective study, we evaluated hospitalized adults with laboratory-confirmed COVID-19 and the impact of CLD on relevant clinical outcomes. Of 363 patients included, 19% had CLD, including 15.2% with NAFLD. Patients with CLD had longer length of stay. After controlling for age, gender, obesity, cardiac diseases, hypertension, hyperlipidaemia, diabetes and pulmonary disorders, CLD and NAFLD were independently associated with ICU admission ([aOR 1.77, 95% CI 1.03-3.04] and [aOR 2.30, 95% CI 1.27-4.17]) and mechanical ventilation ([aOR 2.08, 95% CI 1.20-3.60] and [aOR 2.15, 95% CI 1.18-3.91]). Presence of cirrhosis was an independent predictor of mortality (aOR 12.5, 95% CI 2.16-72.5). Overall, nearly one-fifth of hospitalized COVID-19 patients had CLD, which was associated with more critical illness. Future studies are needed to identify interventions to improve clinical outcomes.

摘要

已有研究报道 COVID-19 可导致肝损伤,早期报告显示 2%-11%的患者合并慢性肝病(CLD)。在这项多中心回顾性研究中,我们评估了住院的 COVID-19 患者,并分析了 CLD 对相关临床结局的影响。363 例患者中,19%合并 CLD,其中 15.2%患有非酒精性脂肪性肝病(NAFLD)。合并 CLD 的患者住院时间更长。在校正年龄、性别、肥胖、心脏疾病、高血压、高脂血症、糖尿病和肺部疾病后,CLD 和 NAFLD 与入住 ICU([aOR 1.77,95%CI 1.03-3.04] 和 [aOR 2.30,95%CI 1.27-4.17])和机械通气([aOR 2.08,95%CI 1.20-3.60] 和 [aOR 2.15,95%CI 1.18-3.91])独立相关。肝硬化的存在是死亡的独立预测因素(aOR 12.5,95%CI 2.16-72.5)。总体而言,近五分之一的住院 COVID-19 患者合并 CLD,且 CLD 与更严重的疾病相关。需要进一步研究以确定改善临床结局的干预措施。