Yeoman Andrew, Maggs Daniel Raun, Gardezi Syed A A, Haboubi Hasan Nadim, Yahya Muhammad Imran, Yousuf Fidan, Czajkowski Marek Alexander
Gwent Liver Unit, Aneurin Bevan University Health Board, Newport, UK.
Frontline Gastroenterol. 2020 Aug 21;12(2):89-94. doi: 10.1136/flgastro-2020-101532. eCollection 2021.
SARS-CoV-2 (COVID-19) is a novel coronavirus that emerged in Wuhan, China in late 2019 and since become a global pandemic. As such, its clinical behaviour is a subject of much interest. Initial reports suggested a significant proportion of patients have abnormal liver blood tests. Gwent has experienced one of the highest incidences of COVID-19 infection in the UK, which itself has among the highest COVID-19 impacts worldwide.
We set out to report the incidence, clinical pattern and severity of liver blood test abnormalities in hospitalised patients with confirmed COVID-19 in our institution over a 3-week period. Data on clinical outcomes such as admission to intensive therapy unit (ITU), hospital discharge and mortality were recorded.
318 hospitalised COVID-19 positive had liver blood tests available for analysis. Ninety-seven patients (31%) had one or more abnormal liver blood tests and were abnormal admission in 64%. Liver tests were predominantly cholestatic (72%) in contrast to other studies to date. Male gender and abnormal liver blood tests were associated with ITU admission.
Almost one-third of admissions with COVID-19 have abnormal LBTs which are typically mild and are associated with male gender. Importantly, we have identified that cholestatic patterns dominate but were not clearly associated with ITU admission or death.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2，即新冠病毒）是一种新型冠状病毒，于2019年末在中国武汉出现，随后成为全球大流行疾病。因此，其临床行为备受关注。初步报告显示，相当一部分患者的肝脏血液检查结果异常。在英国，格温特郡的新冠病毒感染率是最高的地区之一，而英国本身在全球范围内受新冠病毒的影响也位居前列。
我们着手报告本院确诊为新冠病毒感染的住院患者在3周内肝脏血液检查异常的发生率、临床模式及严重程度。记录了诸如入住重症监护病房（ITU）、出院及死亡率等临床结局数据。
318名住院的新冠病毒检测呈阳性患者有可供分析的肝脏血液检查结果。97名患者（31%）的一项或多项肝脏血液检查结果异常，其中64%在入院时即出现异常。与迄今为止的其他研究不同，肝脏检查主要表现为胆汁淤积（72%）。男性及肝脏血液检查异常与入住重症监护病房相关。
近三分之一的新冠病毒感染住院患者存在肝脏血液检查异常，这些异常通常较轻，且与男性相关。重要的是，我们发现胆汁淤积模式占主导，但与入住重症监护病房或死亡并无明显关联。
