Pott-Junior Henrique, Bittencourt Natália Queiroz Prado, Chacha Silvana F G, Luporini Rafael Luís, Cominetti Marcia Regina, Anibal Fernanda de Freitas
Department of Medicine, Federal University of São Carlos, São Carlos, Brazil.
Biotechnology Graduate Program, Federal University of São Carlos, São Carlos, Brazil.
Front Med (Lausanne). 2021 Jul 15;8:705247. doi: 10.3389/fmed.2021.705247. eCollection 2021.
Liver involvement in COVID-19 is not yet well-understood, but elevations in liver transaminases have been described to occur in 14-53% of the cases and are more frequently seen in severe disease. This cross-sectional study explored the relationship between the elevations in liver transaminases and inflammatory parameters in 209 adults with COVID-19. Demographic and clinical data, serum levels of inflammatory cytokines and liver aminotransferases were analyzed. Three groups were formed according to the liver transaminase abnormalities: (I) Normal transaminases, (II) Borderline transaminases elevation, and (III) Mild to severe transaminases elevation. Altered liver transaminases were directly related to disease severity, showing association with the NEWS2 score at admission and greater need for ICU or death. Moreover, higher levels of IL-2 and CRP were associated with borderline transaminases elevations, whereas higher levels of IL-10 and Neutrophil to Lymphocyte ratio were associated with mild to severe transaminases elevation. These results reinforce the importance of liver transaminases in patients with COVID-19 as a complementary marker for disease severity and also point to them as a parameter reflecting the continuous dynamics between viral infection and the immune response.
肝脏在新冠病毒疾病（COVID-19）中的受累情况尚未得到充分了解，但据描述，14%-53%的病例会出现肝转氨酶升高，且在重症病例中更为常见。这项横断面研究探讨了209例COVID-19成年患者肝转氨酶升高与炎症参数之间的关系。分析了人口统计学和临床数据、血清炎症细胞因子水平和肝转氨酶。根据肝转氨酶异常情况分为三组：（I）转氨酶正常，（II）转氨酶临界升高，（III）轻度至重度转氨酶升高。肝转氨酶改变与疾病严重程度直接相关，表现为与入院时的NEWS2评分相关，以及对重症监护病房（ICU）的需求增加或死亡风险增加。此外，较高水平的白细胞介素-2（IL-2）和C反应蛋白（CRP）与转氨酶临界升高相关，而较高水平的白细胞介素-10（IL-10）和中性粒细胞与淋巴细胞比值与轻度至重度转氨酶升高相关。这些结果强化了肝转氨酶在COVID-19患者中作为疾病严重程度补充标志物的重要性，也表明它们是反映病毒感染与免疫反应之间持续动态变化的一个参数。
