Department of Internal Medicine I, Gastroenterology, Hepatology, Endocrinology & Metabolism, Medical University of Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria.
Central Institute for Medical and Chemical Laboratory Diagnosis, Medical University of Innsbruck, Anichstrasse 35, Innsbruck 6020, Austria.
Dig Liver Dis. 2021 Feb;53(2):158-165. doi: 10.1016/j.dld.2020.08.004. Epub 2020 Aug 10.
A cytokine storm conceivably contributes to manifestations of corona virus disease (COVID-19). Inflammatory cytokines such as interleukin-6 (IL-6) cause acute liver injury while serum detectability indicates systemic inflammation.
We explored a link between systemic IL-6, related acute phase proteins and liver injury in hospitalized COVID-19 patients.
655 patients with suspected COVID-19 were screened in the emergency department at the University Hospital of Innsbruck, Austria, between February and April 2020. 96 patients (∼15%) were hospitalized with COVID-19. 15 patients required intensive-care treatment (ICT). Plasma aminotransferases, alkaline phosphatase, bilirubin, and gamma glutamyl transferase, as well as IL-6, C-reactive protein (CRP), ferritin and lactate dehydrogenase (LDH) were determined by standard clinical assays.
Of all hospitalized COVID-19 patients, 41 (42%) showed elevated aspartate aminotransferase (AST) concentration. COVID-19 patients with elevated AST exhibited significantly higher IL-6 (p < 0.001), ferritin (p < 0.001), LDH (p < 0.001) and CRP (p < 0.05) serum concentrations compared to patients with normal AST. Liver injury correlated with systemic IL-6 (p < 0.001), CRP (p < 0.001), ferritin (p < 0.001) and LDH (p < 0.001) concentration. In COVID-19 patients requiring ICT, correlations were more pronounced.
Systemic inflammation could be a fuel for hepatic injury in COVID-19.
细胞因子风暴可能导致冠状病毒病（COVID-19）的临床表现。白细胞介素-6（IL-6）等炎症细胞因子会导致急性肝损伤，而血清检测则表明存在全身炎症。
我们探讨了住院 COVID-19 患者全身 IL-6 与相关急性期蛋白和肝损伤之间的关系。
2020 年 2 月至 4 月期间，在奥地利因斯布鲁克大学医院急诊科对 655 例疑似 COVID-19 的患者进行了筛查。96 例（约 15%）患者因 COVID-19 住院。15 例患者需要重症监护治疗（ICT）。通过标准临床检测测定血浆氨基转移酶、碱性磷酸酶、胆红素和γ-谷氨酰转移酶以及 IL-6、C 反应蛋白（CRP）、铁蛋白和乳酸脱氢酶（LDH）。
所有住院 COVID-19 患者中，41 例（42%）天门冬氨酸氨基转移酶（AST）浓度升高。AST 升高的 COVID-19 患者的 IL-6（p<0.001）、铁蛋白（p<0.001）、LDH（p<0.001）和 CRP（p<0.05）血清浓度显著高于 AST 正常的患者。肝损伤与全身 IL-6（p<0.001）、CRP（p<0.001）、铁蛋白（p<0.001）和 LDH（p<0.001）浓度相关。在需要 ICT 的 COVID-19 患者中，相关性更为明显。
全身炎症可能是 COVID-19 肝损伤的一个诱因。
