Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, People's Republic of China.
Cardiovascular Research Institute, Wuhan University, Wuhan, People's Republic of China.
Int J Clin Pract. 2021 Mar;75(3):e13632. doi: 10.1111/ijcp.13632. Epub 2020 Dec 28.
The profiles of liver function abnormalities in COVID-19 patients need to be clarified.
In this retrospective study, consecutive COVID-19 patients over 60 years old in Renmin Hospital of Wuhan University from January 1 to February 6 were included. Data of demographics, clinical characteristics, comorbidities, laboratory tests, medications and outcomes were collected and analysed. Sequential alterations of serum alanine aminotransferase (ALT) were monitored.
A total of 330 patients were included and classified into two groups with normal (n = 234) or elevated ALT (n = 96). There were fewer females (40.6% vs 54.7%, P = .020) and more critical cases (30.2% vs 19.2%, P = .026) in patients with elevated ALT compared with the normal group. Higher levels of bacterial infection indices (eg, white blood cell count, neutrophil count, C-reactive protein and procalcitonin) were observed in the elevated group. Spearman correlation showed that both ALT and AST levels were positively correlated with those indices of bacterial infection. No obvious effects of medications on ALT abnormalities were found. In patients with elevated ALT, most ALT elevations were mild and transient. 59.4% of the patients had ALT concentrations of 41-100 U/L, while only a few patients (5.2%) had high serum ALT concentrations above 300 U/L. ALT elevations occurred at 13 (10-17) days and recovered at 28 (18-35) days from disease onset. For most patients, the elevation of serum ALT levels occurred at 6-20 days after disease onset and reached their peak values within a similar time frame. The recovery of serum ALT levels to normal frequently occurred at 16-20 days or 31-35 days after disease onset.
Liver function abnormalities were observed in 29.1% of elderly people COVID-19 patients, which were slightly and transient in most cases. Liver function abnormalities in COVID-19 may be correlated with bacterial infection.
需要明确 COVID-19 患者肝功能异常的特征。
本回顾性研究纳入 2020 年 1 月 1 日至 2 月 6 日期间于武汉大学人民医院就诊的年龄大于 60 岁的连续 COVID-19 患者。收集并分析患者的人口统计学、临床特征、合并症、实验室检查、药物使用和结局等数据。监测血清丙氨酸氨基转移酶（ALT）的连续变化。
共纳入 330 例患者，分为 ALT 正常组（n=234）和 ALT 升高组（n=96）。与 ALT 正常组相比，ALT 升高组女性患者（40.6% vs 54.7%，P=0.020）和危重症患者（30.2% vs 19.2%，P=0.026）比例较低，细菌感染指标（如白细胞计数、中性粒细胞计数、C 反应蛋白和降钙素原）水平较高。Spearman 相关性分析显示，ALT 和 AST 水平与细菌感染指标呈正相关。未发现药物对 ALT 异常有明显影响。在 ALT 升高的患者中，大多数 ALT 升高为轻度和一过性。59.4%的患者 ALT 浓度为 41-100 U/L，而只有少数患者（5.2%）的血清 ALT 浓度超过 300 U/L。ALT 升高发生在发病后 13（10-17）天，在发病后 28（18-35）天恢复。对于大多数患者，血清 ALT 水平升高发生在发病后 6-20 天，在相似时间范围内达到峰值。血清 ALT 水平恢复正常常发生在发病后 16-20 天或 31-35 天。
在老年 COVID-19 患者中，肝功能异常的发生率为 29.1%，大多数情况下为轻度和一过性。COVID-19 患者的肝功能异常可能与细菌感染有关。
