Departments of Infectology, Rīga Stradiņš University, Riga, Latvia.
Institute of Microbiology and Virology, Joint Laboratory of Immunology and Immunogenetics, Rīga Stradiņš University, 5 Ratsupites Street, Riga, 1067, Latvia.
BMC Gastroenterol. 2021 Oct 11;21(1):370. doi: 10.1186/s12876-021-01939-7.
Studies on a new coronavirus disease (COVID-19) show the elevation of liver enzymes and liver fibrosis index (FIB-4) independently on pre-existing liver diseases. It points to increased liver fibrogenesis during acute COVID-19 with possible long-term consequences. This study aimed to assess liver fibrosis in COVID-19 patients by serum hyaluronic acid (HA) and FIB-4.
The study included the acute COVID-19 group (66 patients, 50% females, mean age 58.3 ± 14.6), the post-COVID group (58 patients in 3-6 months after the recovery, 47% females, mean age 41.2 ± 13.4), and a control group (17 people, 47% females, mean age 42.8 ± 11.0). Ultrasound elastography was performed in the post-COVID and control groups.
Sixty-five percent of the acute COVID-19 group had increased FIB-4 (> 1.45), and 38% of patients had FIB-4 ≥ 3.25. After matching by demographics, 52% of acute COVID-19 and 5% of the post-COVID group had FIB-4 > 1.45, and 29% and 2% of patients had FIB-4 ≥ 3.25, respectively. Increased serum HA (≥ 75 ng/ml) was observed in 54% of the acute COVID-19 and 15% of the post-COVID group. In the acute COVID-19 group, HA positively correlated with FIB-4, AST, ALT, LDH, IL-6, and ferritin and negatively with blood oxygen saturation. In the post-COVID group, HA did not correlate with FIB-4, but it was positively associated with higher liver stiffness and ALT.
More than half of acute COVID-19 patients had increased serum HA and FIB-4 related to liver function tests, inflammatory markers, and blood oxygen saturation. It provides evidence for the induction of liver fibrosis by multiple factors during acute COVID-19. Findings also indicate possible liver fibrosis in about 5% of the post-COVID group.
关于新型冠状病毒疾病 (COVID-19) 的研究表明，肝脏酶和肝纤维化指数 (FIB-4) 升高与预先存在的肝病无关。这表明 COVID-19 期间肝纤维化生成增加，可能会产生长期影响。本研究旨在通过血清透明质酸 (HA) 和 FIB-4 评估 COVID-19 患者的肝纤维化情况。
本研究纳入了急性 COVID-19 组（66 例患者，50%为女性，平均年龄 58.3±14.6 岁）、新冠后组（58 例患者，在康复后 3-6 个月时纳入，47%为女性，平均年龄 41.2±13.4 岁）和对照组（17 人，47%为女性，平均年龄 42.8±11.0 岁）。对新冠后组和对照组进行了超声弹性成像检查。
65%的急性 COVID-19 组 FIB-4 升高（>1.45），38%的患者 FIB-4≥3.25。在按人口统计学因素匹配后，52%的急性 COVID-19 组和 5%的新冠后组 FIB-4>1.45，29%和 2%的患者 FIB-4≥3.25。54%的急性 COVID-19 组和 15%的新冠后组患者血清 HA（≥75ng/ml）升高。在急性 COVID-19 组中，HA 与 FIB-4、AST、ALT、LDH、IL-6 和铁蛋白呈正相关，与血氧饱和度呈负相关。在新冠后组中，HA 与 FIB-4 无相关性，但与较高的肝硬度和 ALT 呈正相关。
超过一半的急性 COVID-19 患者的血清 HA 和 FIB-4 升高，与肝功能试验、炎症标志物和血氧饱和度相关。这为 COVID-19 期间多种因素诱导肝纤维化提供了证据。研究结果还表明，新冠后组中约有 5%的患者可能存在肝纤维化。
