新型冠状病毒相关肝损伤的系统评价和荟萃分析。
A systematic review and meta-analysis of the COVID-19 associated liver injury.
机构信息
Department of Gastroenterology and Hepatology, Changi General Hospital; Yong Loo Lin School of Medicine, National University of Singapore.
Department of Gastroenterology and Hepatology, Changi General Hospital; Yong Loo Lin School of Medicine, National University of Singapore.
出版信息
Ann Hepatol. 2020 Nov-Dec;19(6):627-634. doi: 10.1016/j.aohep.2020.08.064. Epub 2020 Aug 31.
INTRODUCTION AND OBJECTIVES
The novel coronavirus disease 2019 (COVID-19) has affected more than 5 million people globally. Data on the prevalence and degree of COVID-19 associated liver injury among patients with COVID-19 remain limited. We conducted a systematic review and meta-analysis to assess the prevalence and degree of liver injury between patients with severe and non-severe COVID-19.
METHODS
We performed a systematic search of three electronic databases (PubMed/MEDLINE, EMBASE and Cochrane Library), from inception to 24 April 2020. We included all adult human studies (>20 subjects) regardless of language, region or publication date or status. We assessed the pooled odds ratio (OR), mean difference (MD) and 95% confidence interval (95%CI) using the random-effects model.
RESULTS
Among 1543 citations, there were 24 studies (5961 subjects) which fulfilled our inclusion criteria. The pooled odds ratio for elevated ALT (OR = 2.5, 95%CI: 1.6-3.7, I = 57%), AST (OR = 3.4, 95%CI: 2.3-5.0, I = 56%), hyperbilirubinemia (OR = 1.7, 95%CI: 1.2-2.5, I = 0%) and hypoalbuminemia (OR = 7.1, 95%CI: 2.1-24.1, I = 71%) were higher subjects in critical COVID-19.
CONCLUSION
COVID-19 associated liver injury is more common in severe COVID-19 than non-severe COVID-19. Physicians should be aware of possible progression to severe disease in subjects with COVID-19-associated liver injury.
介绍与目的
新型冠状病毒病 2019（COVID-19）已在全球范围内影响超过 500 万人。关于 COVID-19 患者中 COVID-19 相关肝损伤的患病率和严重程度的数据仍然有限。我们进行了系统回顾和荟萃分析，以评估重症和非重症 COVID-19 患者之间肝损伤的患病率和严重程度。
方法
我们对三个电子数据库（PubMed/MEDLINE、EMBASE 和 Cochrane Library）进行了系统检索，检索时间从建库到 2020 年 4 月 24 日。我们纳入了所有成人人类研究（>20 例），无论语言、地区、出版日期或状态如何。我们使用随机效应模型评估汇总优势比（OR）、均数差（MD）和 95%置信区间（95%CI）。
结果
在 1543 条引用中，有 24 项研究（5961 例）符合我们的纳入标准。ALT 升高（OR=2.5，95%CI：1.6-3.7，I²=57%）、AST 升高（OR=3.4，95%CI：2.3-5.0，I²=56%）、高胆红素血症（OR=1.7，95%CI：1.2-2.5，I²=0%）和低白蛋白血症（OR=7.1，95%CI：2.1-24.1，I²=71%）的汇总 OR 更高的患者发生危重症 COVID-19 的可能性更高。
结论
COVID-19 相关肝损伤在重症 COVID-19 中比非重症 COVID-19 更常见。医生应该意识到 COVID-19 相关肝损伤的患者可能会发展为严重疾病。
Zotero 插件