Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Nanjing, China.
Department of Infectious Diseases, The Affiliated Infectious Diseases Hospital of Soochow University, Suzhou, China.
J Med Virol. 2021 Jun;93(6):3305-3311. doi: 10.1002/jmv.26663. Epub 2020 Nov 22.
We aimed to describe liver injury and identify the risk factors of liver injury in coronavirus disease (COVID-19) patients without chronic liver diseases (CLD). The clinical data of 228 confirmed COVID-19 patients without CLD were retrospectively collected from ten hospitals in Jiangsu, China. Sixty-seven (29.4%) of 228 patients without CLD showed abnormal liver function on admission, including increased alanine aminotransferase (ALT) (25 [11.0%]) U/L, aspartate aminotransferase (AST) 30 [13.2%]) U/L, gamma-glutamyl transferase (GGT) 28 [12.4%]) U/L, total bilirubin (Tbil) 16 [7.0%] μmol/L, and alkaline phosphatase (ALP) 10 [4.5%]) U/L. During hospitalization, 129 (56.3%) of 228 patients showed abnormal liver function, including elevated ALT (84 [36.8%]), AST (58 [25.4%]), GGT (67 [29.5%]), and Tbil (59 [25.9%]). Age over 50 years (odds ratio [OR], 2.086; 95% confidence interval [CI], 1.030-4.225; p = .041), male sex (OR, 2.737; 95% CI, 1.418-5.284; p = .003), and lopinavir-ritonavir (OR, 2.504; 95% CI, 1.187-5.283; p = .016) were associated with higher risk of liver function abnormality, while the atomized inhalation of interferon α-2b (OR, 0.256; 95% CI 0.126-0.520; p < .001) was associated with reduced risk of liver function abnormality during hospitalization. Mild to moderate liver injury was common in COVID-19 patients in Jiangsu, China. Age over 50 years, male sex, and lopinavir-ritonavir were the independent risk factors of liver impairment in COVID-19 patients during hospitalization.
我们旨在描述无慢性肝病(CLD)的冠状病毒病(COVID-19)患者的肝损伤,并确定其肝损伤的危险因素。我们回顾性收集了来自中国江苏省 10 家医院的 228 例确诊 COVID-19 患者的临床资料。228 例无 CLD 的患者中,67 例(29.4%)入院时肝功能异常,包括丙氨酸氨基转移酶(ALT)升高(25 例[11.0%])U/L、天门冬氨酸氨基转移酶(AST)升高 30 例[13.2%])U/L、γ-谷氨酰转移酶(GGT)升高 28 例[12.4%])U/L、总胆红素(Tbil)升高 16 例[7.0%]μmol/L 和碱性磷酸酶(ALP)升高 10 例[4.5%])U/L。住院期间,228 例患者中有 129 例(56.3%)肝功能异常,包括 ALT 升高(84 例[36.8%])、AST 升高(58 例[25.4%])、GGT 升高(67 例[29.5%])和 Tbil 升高(59 例[25.9%])。年龄大于 50 岁(比值比[OR],2.086;95%置信区间[CI],1.030-4.225;p=0.041)、男性(OR,2.737;95%CI,1.418-5.284;p=0.003)和洛匹那韦-利托那韦(OR,2.504;95%CI,1.187-5.283;p=0.016)与肝功能异常风险增加相关,而雾化吸入干扰素-α-2b(OR,0.256;95%CI 0.126-0.520;p<0.001)与住院期间肝功能异常风险降低相关。在中国江苏的 COVID-19 患者中,常出现轻度至中度肝损伤。年龄大于 50 岁、男性和洛匹那韦-利托那韦是 COVID-19 患者住院期间肝损伤的独立危险因素。