Department of Blood Transfusion, the Third Xiangya Hospital of Central South University, Changsha, China.
Department of Clinical Laboratory, the First People's Hospital of Yueyang, Yueyang, China.
Ups J Med Sci. 2020 Nov;125(4):293-296. doi: 10.1080/03009734.2020.1822960. Epub 2020 Sep 29.
The novel coronavirus disease 2019 (COVID-19) is currently breaking out worldwide. COVID-19 patients may have different degrees of coagulopathy, but the mechanism is not yet clear. We aimed to analyse the relationship between coagulation dysfunction and liver damage in patients with COVID-19.
A retrospective analysis of 74 patients with COVID-19 admitted to the First People's Hospital of Yueyang from 1 January to 30 March 2020 was carried out. According to the coagulation function, 27 cases entered the coagulopathy group and 47 cases entered the control group. A case control study was conducted to analyse the correlation between the occurrence of coagulation dysfunction and liver damage in COVID-19 patients.
Alanine aminotransferase (ALT) and aspartate aminotransferase (AST), markers of liver damage, were positively correlated with coagulopathy ( = 0.039, OR 2.960, 95% CI 1.055-8.304; and = 0.028, OR 3.352, 95% CI 1.137-9.187). Alkaline phosphatase (ALP), γ-glutamyl transpeptidase (γ-GT), and total bilirubin (TBIL) were not statistically correlated with coagulopathy. According to the diagnosis and treatment plan, the included cases were classified into mild, moderate, severe, and critical. The results showed that the occurrence of coagulation dysfunction had no statistical correlation with the severity of COVID-19.
Coagulation dysfunction in patients with COVID-19 is closely related to liver damage. A longer course of the disease may cause a vicious circle of coagulopathy and liver damage. Clinicians need to closely monitor coagulation and liver function tests and to give prophylactic or supportive therapy when needed.
新型冠状病毒病 2019（COVID-19）目前在全球范围内爆发。COVID-19 患者可能有不同程度的凝血功能障碍，但机制尚不清楚。我们旨在分析 COVID-19 患者凝血功能障碍与肝损伤之间的关系。
对 2020 年 1 月 1 日至 3 月 30 日期间入住岳阳市第一人民医院的 74 例 COVID-19 患者进行回顾性分析。根据凝血功能，27 例进入凝血障碍组，47 例进入对照组。采用病例对照研究分析 COVID-19 患者凝血功能障碍与肝损伤的相关性。
丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST），肝损伤的标志物，与凝血障碍呈正相关（ = 0.039，OR 2.960，95% CI 1.055-8.304； = 0.028，OR 3.352，95% CI 1.137-9.187）。碱性磷酸酶（ALP）、γ-谷氨酰转肽酶（γ-GT）和总胆红素（TBIL）与凝血障碍无统计学相关性。根据诊断和治疗方案，将纳入病例分为轻症、中度、重症和危重症。结果显示，凝血功能障碍的发生与 COVID-19 的严重程度无统计学相关性。
COVID-19 患者的凝血功能障碍与肝损伤密切相关。疾病持续时间较长可能导致凝血障碍和肝损伤的恶性循环。临床医生需要密切监测凝血和肝功能检查，并在需要时给予预防性或支持性治疗。
