Department of General Surgery, Peking University Third Hospital, Beijing, China.
Department of Nephrology, PLA Strategic Support Force Characteristic Medical Center, Beijing, China.
BMJ Open. 2020 Jul 7;10(7):e040517. doi: 10.1136/bmjopen-2020-040517.
COVID-19 has spread rapidly in China and around the world. Published studies have revealed that some patients with COVID-19 had abnormal liver function in laboratory tests. However, the results were inconsistent and the analysis of epidemiological data stratified by the severity of COVID-19 was not available in previous meta-analyses. Furthermore, these meta-analyses were suspected of overestimating the incidence of liver injury in patients with COVID-19 because some studies considered transaminase elevation as liver injury, which might partially result from cardiac and muscle injury. This systematic review aims to enrol published literatures related to COVID-19 without language restriction, analyse the data based on the severity of the COVID-19 and explore the impact of varied definitions of liver injury on the incidence of liver injury.
We have conducted a preliminary search on PubMed and Excerpta Medica Database on 13 April 2020, for the studies published after December 2019 on the prevalence of acute liver injury and hypertransaminemia in patients with COVID-19. Two reviewers will independently screen studies, extract data and assess the risk of bias. We will estimate the pooled incidence of hypertransaminemia and acute liver injury in patients with COVID-19 by using the random-effects model. The I test will be used to identify the extent of heterogeneity. Publication bias will be assessed by funnel plot and performing the Begg's and Egger's test if adequate studies are available. We will perform a risk of bias assessment using the Joanna Briggs Institute's critical appraisal checklist.
Since this study will be based on the published data, it does not require ethical approval. The final results of this study will be published in a peer-reviewed journal.
CRD42020179462.
COVID-19 在全球范围内迅速传播。已发表的研究表明，一些 COVID-19 患者的实验室检查肝功能异常。然而，结果并不一致，之前的荟萃分析中没有对 COVID-19 严重程度分层的流行病学数据进行分析。此外，这些荟萃分析可能高估了 COVID-19 患者肝损伤的发生率，因为一些研究将转氨酶升高视为肝损伤，这可能部分是由于心脏和肌肉损伤所致。本系统评价旨在纳入与 COVID-19 相关的已发表文献，无语言限制，根据 COVID-19 的严重程度进行数据分析，并探讨不同的肝损伤定义对肝损伤发生率的影响。
我们于 2020 年 4 月 13 日在 PubMed 和 Excerpta Medica 数据库进行了初步检索，检索了 2019 年 12 月以后发表的关于 COVID-19 患者急性肝损伤和高转氨酶血症患病率的研究。两名评审员将独立筛选研究、提取数据并评估偏倚风险。我们将使用随机效应模型估计 COVID-19 患者高转氨酶血症和急性肝损伤的总发生率。用 I 2 检验来确定异质性的程度。如果有足够的研究，将通过漏斗图和贝叶斯（Begg's）和伊格尔（Egger）检验评估发表偏倚。我们将使用 Joanna Briggs 研究所的批判性评价清单进行偏倚风险评估。
由于本研究将基于已发表的数据，因此不需要伦理批准。本研究的最终结果将发表在同行评议的期刊上。
PROSPERO 注册号：CRD42020179462。
