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COVID-19 患者肝功能及临床特征分析:91 例患者的横断面研究。

Pattern of liver function and clinical profile in COVID-19: A cross-sectional study of 91 patients.

机构信息

Department of Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, 834009, India.

Department of Medicine, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, 834009, India.

出版信息

Diabetes Metab Syndr. 2020 Nov-Dec;14(6):1951-1954. doi: 10.1016/j.dsx.2020.10.001. Epub 2020 Oct 6.

Abstract

BACKGROUND

  • COVID-19 caused by SARS-CoV-2 leads to myriad range of organ involvement including liver dysfunction.

AIM

To analyse the liver function in patients with COVID-19 and their association with respect to age, sex, severity of disease and clinical features.

MATERIALS AND METHODS

This study was a cross-sectional study done at Rajendra Institute of Medical Sciences, Ranchi. 91 patients admitted with confirmed SARS-CoV-2 infection were included in this study and divided into asymptomatic, mild, moderate and severe groups. Liver function tests were compared among different severity groups.

RESULTS

Of 91 patients with COVID-19, 70 (76.9%) had abnormal liver function. Aspartate transaminase (AST), alanine transaminase (ALT), alkaline phosphatase (ALP), total bilirubin levels was 1-2 × ULN in 33(36.3%), 34(37.3%), 12(13.2%), 6(6.6%) cases and >2 × ULN in 20(22%), 18(19.8%), 7(7.7%) and 2 (2.2%) cases respectively. Mean AST and ALP levels among different severity groups of COVID-19 was statistically significant (p < 0.05) whereas mean ALT and total bilirubin levels was statistically non-significant (p > 0.05). There was no statistical difference between males and females with regard to abnormal liver function. Liver injury was seen in 64.3% cases of hypertension and 73.3% cases of diabetes. Fever, myalgia, headache and breathlessness were found to be correlated significantly with severity of disease.

CONCLUSION

Liver injury is common in SARS-CoV-2 infection and is more prevalent in the severe disease group. Aspartate transaminase and alkaline phosphatase are better indicators of covid-19 induced liver injury than alanine transaminase and total bilirubin.

摘要

背景

由 SARS-CoV-2 引起的 COVID-19 导致多种器官受累,包括肝功能障碍。

目的

分析 COVID-19 患者的肝功能及其与年龄、性别、疾病严重程度和临床特征的关系。

材料和方法

本研究为横断面研究,在印度拉杰恩德雷医学科学研究所进行。纳入 91 例确诊为 SARS-CoV-2 感染的住院患者,分为无症状、轻症、中症和重症组。比较不同严重程度组的肝功能检查结果。

结果

91 例 COVID-19 患者中,70 例(76.9%)存在肝功能异常。天门冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、碱性磷酸酶(ALP)、总胆红素水平在 33 例(36.3%)、34 例(37.3%)、12 例(13.2%)、6 例(6.6%)患者中为 1-2×正常值上限(ULN),在 20 例(22%)、18 例(19.8%)、7 例(7.7%)和 2 例(2.2%)患者中>2×ULN。不同严重程度 COVID-19 组之间的 AST 和 ALP 平均水平具有统计学意义(p<0.05),而 ALT 和总胆红素水平无统计学差异(p>0.05)。男性和女性之间肝功能异常的发生率无统计学差异。高血压患者中有 64.3%出现肝损伤,糖尿病患者中有 73.3%出现肝损伤。发热、肌痛、头痛和呼吸困难与疾病严重程度显著相关。

结论

SARS-CoV-2 感染中肝损伤常见,且在重症组中更为普遍。AST 和 ALP 是 COVID-19 诱导肝损伤的更好指标,优于 ALT 和总胆红素。

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