Qu Jian, Zhu Hai-Hong, Huang Xue-Jian, He Ge-Fei, Liu Ji-Yang, Huang Juan-Juan, Chen Ying, Qu Qiang, Wu Ya-Li, Chen Xiang-Yu, Lu Qiong
Department of Pharmacy, the Second Xiangya Hospital, Central South University; Institute of Clinical Pharmacy, Central South University, Changsha, 410011, People's Republic of China.
Department of Pharmacy, The First Hospital of Changsha, Changsha, 410005, People's Republic of China.
Infect Drug Resist. 2021 Aug 10;14:3029-3040. doi: 10.2147/IDR.S321915. eCollection 2021.
SARS-CoV-2 can damage not only the lungs but also the liver and kidney. Most critically ill patients with coronavirus disease 2019 (COVID-19) have liver and kidney dysfunction. We aim to investigate the levels of liver and kidney function indexes in mild and severe COVID-19 patients and their capability to predict the severity of the disease.
The characteristics and laboratory indexes were compared between patients with different conditions. We applied binary logistic regression to find the independent risk factors of severe patients. Receiver operating characteristic (ROC) analysis was used to predict the severity of COVID-19 using the liver and kidney function indexes.
This study enrolled 266 COVID-19 patients, including 235 mild patients and 31 severe patients. Compared with mild patients, severe patients had lower albumin (ALB) and higher alanine aminotransferase (ALT), aspartate aminotransferase (AST), and urea nitrogen (BUN) (all p<0.001). Binary logistic regression analysis also identified ALB [OR=0.273 (0.079-0.947), p=0.041] and ALT [OR=2.680 (1.036-6.934), p=0.042] as independent factors of severe COVID-19 patients. Combining ALB, ALT, BUN, and LDH exhibited the area under ROC at 0.914, with a sensitivity of 86.7% and specificity of 83.0%.
COVID-19 patients, especially severe patients, have damage to liver and kidney function. ALT, AST, LDH, and BUN could be independent factors for predicting the severity of COVID-19. Combining the ALB, ALT, BUN, and LDH could predict the transition from mild to severe in COVID-19 patients.
严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）不仅会损害肺部，还会损害肝脏和肾脏。大多数新型冠状病毒肺炎（COVID-19）危重症患者存在肝肾功能障碍。我们旨在研究轻型和重型COVID-19患者的肝肾功能指标水平及其预测疾病严重程度的能力。
比较不同病情患者的特征和实验室指标。应用二元逻辑回归分析找出重症患者的独立危险因素。采用受试者工作特征（ROC）分析，利用肝肾功能指标预测COVID-19的严重程度。
本研究纳入266例COVID-19患者，其中轻型患者235例，重型患者31例。与轻型患者相比，重型患者白蛋白（ALB）水平较低，丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）和尿素氮（BUN）水平较高（均p<0.001）。二元逻辑回归分析还确定ALB[比值比（OR）=0.273（0.079-0.947），p=0.041]和ALT[OR=2.680（1.036-6.934），p=0.042]是重型COVID-19患者的独立因素。联合ALB、ALT、BUN和乳酸脱氢酶（LDH）时，ROC曲线下面积为0.914，灵敏度为86.7%，特异度为83.0%。
COVID-19患者，尤其是重症患者，存在肝肾功能损害。ALT、AST、LDH和BUN可能是预测COVID-19严重程度的独立因素。联合ALB、ALT、BUN和LDH可预测COVID-19患者从轻症向重症的转变。
