An Yang, Ma Zhuang, Guo Xiaozhong, Tang Yufu, Meng Hao, Yu Hao, Peng Chengfei, Chu Guiyang, Wang Xinwei, Teng Yue, Zhang Quanyu, Zhu Tianyi, Wang Bing, Tong Zhenhua, Zhao Haitao, Lu Hui, Qi Xingshun
COVID-19 Study Group, General Hospital of Northern Theater Command.
Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command.
Medicine (Baltimore). 2021 May 14;100(19):e25497. doi: 10.1097/MD.0000000000025497.
Coronavirus disease (COVID-19) patients frequently develop liver biochemical abnormality. However, liver biochemical abnormality in COVID-19 patients with liver cirrhosis is under-recognized.Patients hospitalized during COVID-19 pandemic in China (ie, from February to April 2020) were screened. All of 17 COVID-19 patients with liver cirrhosis consecutively admitted to the Wuhan Huoshenshan Hospital were identified. Meanwhile, 17 age-, sex-, and severity-matched COVID-19 patients without liver cirrhosis admitted to this hospital were selected as a control group; all of 14 cirrhotic patients without COVID-19 consecutively admitted to the Department of Gastroenterology of the General Hospital of Northern Theater Command were selected as another control group. Incidence of liver biochemical abnormality and decompensated events were primarily compared.Among the COVID-19 patients with liver cirrhosis, the incidence of liver biochemical abnormality at admission and during hospitalization were 76.50% and 84.60%, respectively; 7 (41.20%) had decompensated events at admission; 1 was transferred to intensive care unit due to gastrointestinal bleeding. Among the COVID-19 patients without liver cirrhosis, the incidence of liver biochemical abnormality at admission and during hospitalization were 58.80% (P = .271) and 60.00% (P = .150), respectively. Among the cirrhotic patients without COVID-19, the incidence of liver biochemical abnormality at admission and during hospitalization were 69.20% (P = .657) and 81.80% (P = .855), respectively; 11 (78.60%) had decompensated events at admission (P = .036). None died during hospitalization among the three groups.Liver biochemical abnormality is common in COVID-19 patients with liver cirrhosis. Management of decompensated events in cirrhotic patients without COVID-19 should not be neglected during COVID-19 pandemic.
冠状病毒病（COVID-19）患者常出现肝脏生化异常。然而，COVID-19合并肝硬化患者的肝脏生化异常未得到充分认识。对在中国COVID-19大流行期间（即2020年2月至4月）住院的患者进行筛查。确定了连续入住武汉火神山医院的17例COVID-19合并肝硬化患者。同时，选取17例年龄、性别和病情严重程度匹配的未合并肝硬化的COVID-19患者作为对照组；选取连续入住北部战区总医院消化内科的14例未感染COVID-19的肝硬化患者作为另一对照组。主要比较肝脏生化异常和失代偿事件的发生率。在COVID-19合并肝硬化患者中，入院时和住院期间肝脏生化异常的发生率分别为76.50%和84.60%；7例（41.20%）入院时发生失代偿事件；1例因消化道出血转入重症监护病房。在未合并肝硬化的COVID-19患者中，入院时和住院期间肝脏生化异常的发生率分别为58.80%（P = 0.271）和60.00%（P = 0.150）。在未感染COVID-19的肝硬化患者中，入院时和住院期间肝脏生化异常的发生率分别为69.20%（P = .657）和81.80%（P = .855）；11例（78.60%）入院时发生失代偿事件（P = 0.036）。三组患者住院期间均无死亡病例。肝脏生化异常在COVID-19合并肝硬化患者中很常见。在COVID-19大流行期间，不应忽视未感染COVID-19的肝硬化患者失代偿事件的管理。
