Singhai Abhishek, Pavan G Sai, Panda Smritimayee
Department of Medicine, All India Institute of Medical Sciences, Bhopal, India.
J Family Med Prim Care. 2021 Sep;10(9):3252-3256. doi: 10.4103/jfmpc.jfmpc_2527_20. Epub 2021 Sep 30.
The coronavirus disease 2019 (COVID-19) is a viral respiratory illness which was first detected in Wuhan, Hubei Province, China. A few case studies demonstrated that 14-53% of the cases of COVID-19 reported abnormal levels of liver enzymes during disease progression. Patients with severe COVID-19 seem to have higher rates of hepatic dysfunction.
Our aim was to investigate the changes in the liver function test in COVID-19 patients admitted to hospital and its association with the severity of the disease, length of hospital stay, and outcome of patients.
This was a cross-sectional study involving 678 COVID-19 patients, who were admitted at AIIMS, Bhopal.
The case records of 678 patients were evaluated by the research team from the Department of Medicine, AIIMS, Bhopal, and data were analyzed. All laboratory data were obtained. The liver function tests (LFT) including alanine aminotransferase, aspartate aminotransferase, and total bilirubin values were recorded, and liver dysfunction defined as any parameter having more than the upper limit of normal value.
From April 2020 to September 2020, a total of 678 COVID-19 patients were screened, and 600 were assessed for eligibility; 78 were excluded due to either significant alcohol history or due to prior liver disease. Among the 600 patients, 265 patients (44.16%) had liver dysfunction while 335 patients (55.83%) had a normal liver function. The patients having a severe disease were more affected by liver dysfunction than the mild disease patients. The average hospital stay was more in those patients having liver dysfunction than in those patients with normal liver function. Among the patients with normal LFT on admission, 97.9% got cured while 2.1% died. Among the patients with liver dysfunction, 80.4% got cured and 19.6% died.
Hepatic injury is common in severe COVID-19 patients, which may be caused by direct injury to the bile duct cells by a virus or indirectly by a cytokine storm. The liver function should be evaluated in all symptomatic COVID-19 patients. In patients with pre-existing liver diseases, special attention should be paid to monitoring and treatment.
2019冠状病毒病（COVID-19）是一种病毒性呼吸道疾病，最早在中国湖北省武汉市被发现。一些病例研究表明，14%-53%的COVID-19病例在疾病进展过程中肝酶水平异常。重症COVID-19患者的肝功能障碍发生率似乎更高。
我们的目的是调查入住医院的COVID-19患者的肝功能检查变化及其与疾病严重程度、住院时间和患者预后的关系。
这是一项横断面研究，涉及678名在博帕尔全印医学科学研究所住院的COVID-19患者。
博帕尔全印医学科学研究所医学部的研究团队对678例患者的病历进行了评估，并对数据进行了分析。获取了所有实验室数据。记录了包括丙氨酸氨基转移酶、天冬氨酸氨基转移酶和总胆红素值在内 的肝功能检查（LFT）结果，肝功能障碍定义为任何参数超过正常值上限。
2020年4月至2020年9月，共筛查了678例COVID-19患者 , 其中600例接受了资格评估；78例因有大量饮酒史或既往有肝病而被排除。在这600例患者中，265例（44.16%）有肝功能障碍，335例（55.83%）肝功能正常。重症患者比轻症患者受肝功能障碍的影响更大。肝功能障碍患者的平均住院时间比肝功能正常的患者更长。入院时肝功能检查正常的患者中，97.9%治愈，2.1%死亡。肝功能障碍的患者中，8 , 4%治愈，19.6%死亡。
肝损伤在重症COVID-19患者中很常见，这可能是由病毒对胆管细胞的直接损伤或细胞因子风暴间接引起的。所有有症状的COVID-19患者都应评估肝功能。对于有肝病病史的患者，应特别注意监测和治疗。
