Gan Qinyi, Gong Beilei, Sun Manli, Cao Zhujun, Zheng Yuyan, Zhang Yajie, Wen Pengfei, Shen Yuanbing, Hong Lei, Hou Tingting, Jia Yuqin, Li Wei, Li Hecheng, Xie Qing
Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
The First Affiliated Hospital of Bengbu Medical College, Bengbu, China.
Front Physiol. 2021 Mar 17;12:642922. doi: 10.3389/fphys.2021.642922. eCollection 2021.
Coronavirus disease 2019 (COVID-19) pandemic has become the most severe global health issue. Abnormal liver functions are frequently reported in these patients. However, liver function abnormality was often overlooked during COVID-19 treatment, and data regarding liver functions after cure of COVID-19 is limited. This study aimed to reveal the changes of liver function tests (LFTs) during hospitalization, and its clinical significance in patients with COVID-19.
In this retrospective, bi-center study, a total of 158 hospitalized patients diagnosed with COVID-19 in China were included from January 22nd, 2020 to February 20th, 2020. Clinical features, laboratory parameters including LFTs, and treatment data were collected and analyzed. LFTs included alanine transaminase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transferase, and total bilirubin. Patients were considered with abnormal LFTs when any value of these tests was higher than upper limit of normal.
Of 158 patients with COVID-19, 67 (42.41%) patients had abnormal LFTs on admission and another 50 (31.65%) patients developed abnormal LFTs during hospitalization. The incidence of LFTs abnormality in severe COVID-19 cases was significantly higher than non-severe cases. All LFTs in COVID-19 patients were correlated with oxygenation index. There was no statistical difference in treatment between the patients with or without liver test abnormalities. By the time of discharge, there were still 64 (40.50%) patients with abnormal LFTs. Logistic regression analysis identified younger age, hypertension and low lymphocyte counts as independent risk factors for persistent abnormal LFTs during hospitalization.
Liver function tests abnormality was common in COVID-19 patients and was more prevalent in severe cases than in non-severe cases. A substantial percentage of patients still had abnormal LFTs by the time of discharge.
2019年冠状病毒病（COVID-19）大流行已成为最严重的全球健康问题。这些患者中经常报告肝功能异常。然而，在COVID-19治疗期间肝功能异常常常被忽视，且关于COVID-19治愈后肝功能的数据有限。本研究旨在揭示住院期间肝功能检查（LFTs）的变化及其在COVID-19患者中的临床意义。
在这项回顾性、双中心研究中，纳入了2020年1月22日至2020年2月20日期间在中国确诊为COVID-19的158例住院患者。收集并分析临床特征、包括LFTs在内的实验室参数以及治疗数据。LFTs包括丙氨酸转氨酶、天冬氨酸转氨酶、碱性磷酸酶、γ-谷氨酰转移酶和总胆红素。当这些检查中的任何一项值高于正常上限时，患者被认为肝功能检查异常。
158例COVID-19患者中，67例（42.41%）入院时肝功能检查异常，另有50例（31.65%）患者在住院期间出现肝功能检查异常。重症COVID-19病例中肝功能检查异常的发生率显著高于非重症病例。COVID-19患者的所有肝功能检查指标均与氧合指数相关。肝功能检查异常和未异常的患者在治疗方面无统计学差异。出院时，仍有64例（40.50%）患者肝功能检查异常。逻辑回归分析确定年龄较小、高血压和淋巴细胞计数低是住院期间持续性肝功能检查异常的独立危险因素。
肝功能检查异常在COVID-19患者中很常见，且在重症病例中比非重症病例更普遍。相当一部分患者出院时肝功能检查仍异常。
