Guo Hongying, Zhang Zhengguo, Zhang Yuyi, Liu Yu, Wang Jiefei, Qian Zhiping, Zou Ying, Lu Hongzhou
Department of Severe Hepatopathy, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Department of Infectious Disease and Immunology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China.
Aging (Albany NY). 2020 Oct 1;12(19):18844-18852. doi: 10.18632/aging.103860.
We analyzed clinical parameters and risk factors for coronavirus disease 2019 (COVID-19)-related liver damage.
Of the 332 COVID-19 patients, 306 and 26 were included in the non-critical and critical groups, respectively. The median time from onset to admission was 4.0 (2.0-8.0) days. Of the 332 COVID-19 patients, 98 (29.5%) were admitted with liver injury. The rates of aspartate transaminase, γ-glutamyl transpeptidase, and total bilirubin abnormalities were higher in the critical group than in the non-critical group. The patient's sex, COVID-19 severity, and a low liver CT density strongly correlated with liver injury (ORs: 2.936, 6.543, and 3.387, respectively). Statistical analysis on drug administration after admission showed that the usage rates of lopinavir/ritonavir, glucocorticoids, and thymopeptides were significantly higher in the abnormal group than the normal groups (<0.05).
Though not severe, the liver injury among COVID-19 patients was pervasive. Being male, COVID-19 severity, low CT density, and medications may be risk factors for liver damage. Following recovery, liver function gradually returns to normal.
This retrospective study screened 332 confirmed COVID-19 patients from January 20 to March 13, 2020. Liver indicators were evaluated on admission. The risk factors, medications, and the dynamic change of liver functions were analyzed.
我们分析了2019冠状病毒病（COVID-19）相关肝损伤的临床参数和危险因素。
在332例COVID-19患者中，非重症组和重症组分别有306例和26例。从发病到入院的中位时间为4.0（2.0 - 8.0）天。在332例COVID-19患者中，98例（29.5%）因肝损伤入院。重症组天冬氨酸转氨酶、γ-谷氨酰转肽酶和总胆红素异常率高于非重症组。患者的性别、COVID-19严重程度以及肝脏CT低密度与肝损伤密切相关（比值比分别为2.936、6.543和3.387）。对入院后用药情况的统计分析表明，异常组洛匹那韦/利托那韦、糖皮质激素和胸腺肽的使用率显著高于正常组（<0.05）。
COVID-19患者的肝损伤虽不严重，但普遍存在。男性、COVID-19严重程度、CT低密度以及药物可能是肝损伤的危险因素。康复后，肝功能逐渐恢复正常。
本回顾性研究筛查了2020年1月20日至3月13日确诊的332例COVID-19患者。入院时评估肝脏指标。分析危险因素、用药情况以及肝功能的动态变化。
