Bzeizi Khalid, Abdulla Maheeba, Mohammed Nafeesa, Alqamish Jehad, Jamshidi Negar, Broering Dieter
Department of Liver & Small Bowel Transplantation & Hepatobiliary-Pancreatic Surgery, King Faisal Specialist Hospital & Research Center, P.O. Box 3354, Riyadh, 11211, Saudi Arabia.
Internal Medicine Department, Salmaniya Medical Complex, Manama, Bahrain.
Sci Rep. 2021 May 19;11(1):10599. doi: 10.1038/s41598-021-89513-9.
Emerging evidence suggest association of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with the development of many liver abnormalities. The overarching aim of this study was therefore to assess the available evidence on the clinical effects of SARS-CoV-2 on the profiles of liver chemistries and coagulation in COVID-19 diagnosed patients. We considered all study designs including epidemiological and observational that reported liver function test abnormalities in patients confirmed with SARS-CoV-2 infection. Medline, Embase databases and Google Scholar as well as relevant reviews were searched to identify appropriate studies from inception to 31st of August 2020. We calculated the pooled mean with 95% confidence intervals (95% CI) through a random-effect model meta-analysis. A total of 35 studies with 10,692 participants were considered for the review from which 23 studies with sufficient quantitative data were included in the meta-analysis. The pooled mean for liver enzymes and coagulation parameters did not significantly change in patients diagnosed with COVID-19 and remained within normal range. Notwithstanding potential bias from confounding factors in interpretation of data in this review, findings from the observational studies and case reports suggest that COVID-19 does not appear to have a significant impact on the transaminases or total bilirubin levels of patients with confirmed SARS-CoV-2 infection. Further controlled studies and larger sample size observational studies are needed with adequate reporting of other liver function parameters are warranted.
新出现的证据表明，严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染与许多肝脏异常的发生有关。因此，本研究的总体目标是评估关于SARS-CoV-2对新冠肺炎确诊患者肝脏生化指标和凝血情况的临床影响的现有证据。我们纳入了所有报告了SARS-CoV-2感染确诊患者肝功能检查异常的研究设计，包括流行病学研究和观察性研究。检索了Medline、Embase数据库、谷歌学术以及相关综述，以识别从研究起始至2020年8月31日的合适研究。我们通过随机效应模型荟萃分析计算了合并均值及95%置信区间（95%CI）。本综述共纳入了35项研究、10692名参与者，其中23项具有充分定量数据的研究被纳入荟萃分析。新冠肺炎确诊患者的肝脏酶和凝血参数合并均值无显著变化，仍在正常范围内。尽管本综述在数据解读中存在混杂因素导致的潜在偏倚，但观察性研究和病例报告的结果表明，新冠肺炎似乎对SARS-CoV-2感染确诊患者的转氨酶或总胆红素水平没有显著影响。需要进一步开展对照研究和更大样本量的观察性研究，并充分报告其他肝功能参数。
