Shen Jia-Xin, Zhuang Ze-Hao, Zhang Qiao-Xian, Huang Jiao-Feng, Chen Gong-Ping, Fang Ying-Ying, Cheng Ai-Guo
Endoscopy Center, First Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China.
Nursing Department, First Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China.
J Multidiscip Healthc. 2021 Mar 10;14:629-637. doi: 10.2147/JMDH.S293378. eCollection 2021.
COVID-19 is a new infectious disease with global spread. The aim of the present study was to explore possible risk factors and evaluate prognosis in COVID-19 with liver injury.
A retrospective study was conducted on 356 COVID-19 patients in the Third People's Hospital of Yichang, Hubei, China. Clinical characteristics and laboratory tests between patients with and without liver injury were compared, while risk factors of COVID-19-related liver injury were analyzed. Univariate and multivariate Cox regression analyses were conducted to identify risk factors of in-hospital death.
Of the patients with liver injury, severe and critical types of COVID-19 comprised 12.43% and 14.69%, respectively, higher than in patients without liver injury (both <0.05). CRP and male sex were independent risk factors for for patients with liver injury, while decreased lymphocyte count (HR 0.024, 95% CI 0.001-0.821) and elevated monocytes (HR 1.951, 95% CI 1.040-3.662) and CRP (HR 1.028, 95% CI 1.010-1.045) were independent risk factors of prognosis of death in COVID-19 patients with liver injury.
Liver injury is a common complication in severe COVID-19 patients. Male sex and elevated CRP were independent risk factors in COVID-19 complicated by liver damage. Liver damage with increased CRP and monocyte count and decreased lymphocyte count may imply a poor prognosis.
新型冠状病毒肺炎（COVID-19）是一种全球传播的新型传染病。本研究旨在探讨COVID-19合并肝损伤的可能危险因素并评估其预后。
对中国湖北省宜昌市第三人民医院的356例COVID-19患者进行回顾性研究。比较有肝损伤和无肝损伤患者的临床特征及实验室检查结果，分析COVID-19相关肝损伤的危险因素。采用单因素和多因素Cox回归分析确定院内死亡的危险因素。
肝损伤患者中，COVID-19重型和危重型分别占12.43%和14.69%，高于无肝损伤患者（均<0.05）。CRP和男性是肝损伤患者的独立危险因素，而淋巴细胞计数降低（HR 0.024，95%CI 0.001 - 0.821）、单核细胞升高（HR 1.951，95%CI 1.040 - 3.662）和CRP升高（HR 1.028，95%CI 1.010 - 1.045）是COVID-19合并肝损伤患者死亡预后的独立危险因素。
肝损伤是重症COVID-19患者的常见并发症。男性和CRP升高是COVID-19合并肝损伤的独立危险因素。CRP和单核细胞计数升高以及淋巴细胞计数降低的肝损伤可能预示预后不良。
