脂肪性肝病和纤维化与 SARS-CoV-2 感染（COVID-19）患者临床结局的相关性。
Association of liver steatosis and fibrosis with clinical outcomes in patients with SARS-CoV-2 infection (COVID-19).
机构信息
Transplants and Hepatology Unit, Medica Sur Clinic and Foundation, Puente de Piedra 150, Toriello Guerra, Tlalpan, Mexico City, ZC 14050 Mexico.
Obesity and Digestive Diseases Unit, Medica Sur Clinic and Foundation, Puente de Piedra 150, Toriello Guerra, Tlalpan, Mexico City, ZC 14050 Mexico.
出版信息
Ann Hepatol. 2021 Jan-Feb;20:100271. doi: 10.1016/j.aohep.2020.09.015. Epub 2020 Oct 21.
INTRODUCTION AND OBJECTIVES
Liver function tests (LFT) abnormalities are reported in up to 50% of COVID-19 patients, and metabolic comorbidities are associated with poorer outcomes. The aim of the study was to determine the prevalence of liver steatosis and fibrosis in patients with COVID-19 and their association with clinical outcomes.
MATERIAL AND METHODS
Retrospective study in hospitalized COVID-19 patients was conducted. The risk for liver steatosis was estimated by HSI > 36, and risk for advanced liver fibrosis with APRI > 1.0, NAFLD FS > 0.675 and/or FIB-4 > 3.25. Clinical outcomes were admission to Intensive Care Unit (ICU) and mortality.
RESULTS
Of 155 patients, 71.6% were male (n = 111), and 28.4% (n = 44) were obese. Abnormal LFT were present in 96.8% (n = 150), prevalence of steatosis was 42.6% (n = 66) and of significative liver fibrosis was 44.5% (n = 69). Liver fibrosis by FIB-4 was associated with risk of ICU admission (OR 1.74 [95%CI 1.74-2.68; p = 0.023]) and mortality (OR 6.45 [95%CI 2.01-20.83, p = 0.002]); no independent associations were found.
CONCLUSIONS
The prevalence of steatosis and significant liver fibrosis was high in COVID-19 patients but was not associated with clinical outcomes.
介绍和目的
肝功能检查（LFT）异常在多达 50%的 COVID-19 患者中报告，代谢合并症与较差的结局相关。本研究的目的是确定 COVID-19 患者中肝脂肪变性和纤维化的患病率及其与临床结局的关系。
材料和方法
对住院 COVID-19 患者进行回顾性研究。通过 HSI > 36 估计肝脂肪变性的风险，通过 APRI > 1.0、NAFLD FS > 0.675 和/或 FIB-4 > 3.25 估计晚期纤维化的风险。临床结局为入住重症监护病房（ICU）和死亡率。
结果
在 155 名患者中，71.6%为男性（n = 111），28.4%为肥胖（n = 44）。96.8%（n = 150）存在异常 LFT，脂肪变性的患病率为 42.6%（n = 66），显著纤维化的患病率为 44.5%（n = 69）。FIB-4 纤维化与 ICU 入住风险（OR 1.74 [95%CI 1.74-2.68;p = 0.023]）和死亡率（OR 6.45 [95%CI 2.01-20.83;p = 0.002]）相关，但无独立相关性。
结论
COVID-19 患者的脂肪变性和显著纤维化患病率较高，但与临床结局无关。
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