Effenberger Maria, Grander Christoph, Fritsche Gernot, Bellmann-Weiler Rosa, Hartig Frank, Wildner Sophie, Seiwald Stefanie, Adolph Timon Erik, Zoller Heinz, Weiss Gunter, Tilg Herbert
Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology and Metabolism, Medical University of Innsbruck, Innsbruck, Austria.
Department of Internal Medicine II, Infectious Disease, Pulmonology & Rheumatology, Medical University of Innsbruck, Innsbruck, Austria.
BMJ Open Gastroenterol. 2020 Jul;7(1). doi: 10.1136/bmjgast-2020-000445.
Severe liver damage is associated with worse outcome in COVID-19. Our aim was to explore the degree of liver damage, liver stiffness (LS) and severity of illness in patients with COVID-19.
We investigated 32 patients with COVID-19 admitted to the University Hospital of Innsbruck in a prospective cross-sectional study. We performed laboratory testing, liver and spleen sonography and elastography to measure organ stiffness.
12 patients (38%) showed elevated aminotransferases and gamma-glutamyltransferase levels. LS was positively correlated with elevated aminotransferase levels in patients with COVID-19 compared with those without elevated enzymes. Even mild liver damage raised LS significantly in COVID-19 as it was in patients with gastrointestinal symptoms. Furthermore, higher LS measurements were significantly associated with illness severity like pneumonia, need for mechanical ventilation, and even death.
Transient elastography is a useful and non-invasive tool to assess onset and severity of acute liver injury in patients with COVID-19 patients. Increased LS seems to be predictive for a more severe and complicated course of disease.
在新型冠状病毒肺炎（COVID-19）中，严重肝损伤与更差的预后相关。我们的目的是探讨COVID-19患者的肝损伤程度、肝脏硬度（LS）和疾病严重程度。
我们在一项前瞻性横断面研究中调查了因COVID-19入住因斯布鲁克大学医院的32例患者。我们进行了实验室检测、肝脏和脾脏超声检查以及弹性成像以测量器官硬度。
12例患者（38%）转氨酶和γ-谷氨酰转移酶水平升高。与转氨酶未升高的COVID-19患者相比，COVID-19患者的LS与转氨酶水平升高呈正相关。即使是轻度肝损伤也会使COVID-19患者的LS显著升高，就像有胃肠道症状的患者一样。此外，更高的LS测量值与肺炎、机械通气需求甚至死亡等疾病严重程度显著相关。
瞬时弹性成像对于评估COVID-19患者急性肝损伤的发生和严重程度是一种有用的非侵入性工具。LS升高似乎预示着疾病的病程更严重和复杂。
