Emami Amir, Javanmardi Fatemeh, Akbari Ali, Yeganeh Babak Shirazi, Rezaei Tahereh, Bakhtiari Hamid, Pirbonyeh Neda
Department of Microbiology, Burn & Wound Healing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Department of Biostatistics, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Iran J Public Health. 2022 Jan;51(1):172-177. doi: 10.18502/ijph.v51i1.8309.
Identifying effective biomarkers plays a critical role on screening; rapid diagnosis; proper managements and therapeutic options, which is helpful in preventing serious complications. The present study aimed to compare the liver laboratory tests between alive and dead hospitalized cases for prediction and proper management of the patients.
This retrospective, cross sectional study consists of all deceased patients admitted in one center in Shiraz, Iran during 19 Feb 2020 to 22 Aug 2021. For further comparison, we selected a 1:2 ratios alive group randomly.
Overall, 875 hospitalized cases died due to COVID-19. We selected 1750 alive group randomly. The median age was significantly higher in died group (65.96 vs 51.20). Regarding the laboratory findings during the hospitalization ALT, AST, Bili.D were significantly higher in non-survivors than survivors but Albumin was less in deceased patients. It was revealed elevated levels of Albumin, AST, Bili.T and Bili.D were associated with increasing the risk of in hospital death. Moreover, the predictive effect of ALP and Bili.D had significantly more than others with high sensitivity and specify.
We found patients with COVID-19 have reduced serum albumin level, and increase ALT and AST. The current results revealed abnormal liver chemistries is associated with poor outcome, which highlighted the importance of monitoring these patients more carefully and should be given more caution.
识别有效的生物标志物在筛查、快速诊断、合理管理及治疗选择中起着关键作用，有助于预防严重并发症。本研究旨在比较住院存活和死亡病例的肝脏实验室检查结果，以对患者进行预测和合理管理。
这项回顾性横断面研究纳入了2020年2月19日至2021年8月22日期间在伊朗设拉子一个中心住院的所有死亡患者。为了进行进一步比较，我们随机选择了一个1:2比例的存活组。
总体而言，875例住院病例死于新冠肺炎。我们随机选择了1750例存活组。死亡组的中位年龄显著更高（65.96对51.20）。关于住院期间的实验室检查结果，非幸存者的谷丙转氨酶（ALT）、谷草转氨酶（AST）、胆红素（Bili.D）显著高于幸存者，但死亡患者的白蛋白水平较低。结果显示，白蛋白、AST、总胆红素（Bili.T）和直接胆红素（Bili.D）水平升高与住院死亡风险增加有关。此外，碱性磷酸酶（ALP）和直接胆红素（Bili.D）的预测效果显著优于其他指标，具有较高的敏感性和特异性。
我们发现新冠肺炎患者血清白蛋白水平降低，ALT和AST升高。目前的结果表明，肝脏生化指标异常与不良预后相关，这突出了更仔细监测这些患者的重要性，应给予更多关注。
