新型冠状病毒德尔塔株和奥密克戎变异株感染患者肝损伤的临床特征及相关预测因素。

Clinical features and predictive factors related to liver injury in SARS-CoV-2 Delta and Omicron variant-infected patients.

机构信息

Infectious Disease Center.

Research Institute of Infectious Disease, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.

出版信息

Eur J Gastroenterol Hepatol. 2022 Sep 1;34(9):933-939. doi: 10.1097/MEG.0000000000002381. Epub 2022 Apr 29.

DOI:10.1097/MEG.0000000000002381

PMID:35482929

Abstract

BACKGROUND

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta and Omicron variants have become the dominant variants worldwide, and studies focused on liver injury in these patients are limited.

MATERIALS AND METHODS

In this study, 157 SARS-CoV-2-infected patients were enrolled, including 77 Delta variant-infected patients and 80 Omicron variant-infected patients. Liver injury data and clinical data were summarized and compared between patients infected with the two variants, additionally, patients with or without liver injury were also compared and multivariate analysis was performed to explore the predictive factors related to liver injury in SARS-CoV-2-infected patients.

RESULTS

Liver injury was found in 18 (23.4%)/15 (18.8%) in Delta/Omicron variant-infected patients on admission, and 4 (5.2%)/1 (1.3%) in Delta/Omicron variant-infected patients during hospitalization, respectively. The ratios of liver injury did not differ between the two groups ( χ2 = 1.571; P = 0.210). Among these patients, 17 (77.3%) and 12 (75.0%) Delta and Omicron variant-infected patients were considered to be related to SARS-CoV-2 infection, the biomarkers of liver function were mildly elevated, dominated by the parameter of cholangiocyte injury: 76.5% (13/17) and 83.3% (10/12) in Delta and Omicron variant-infected patients, and most of these patients recovered to normal during follow-up. Multivariate analysis showed that male sex [odds ratio (OR), 4.476; 95% confidence interval (CI), 1.235-16.222; P = 0.023] and high levels of peak viral load in the nasopharynx (OR, 3.022; 95% CI, 1.338-6.827; P = 0.008) were independent factors related to liver injury.

CONCLUSION

Cholangiocyte injury biomarkers are dominated in Delta and Omicron variant-infected patients, male sex and high levels of peak viral load in the nasopharynx are predictive factors related to liver injury in SARS-CoV-2-infected patients.

摘要

背景

严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）Delta 和奥密克戎变异株已成为全球主要流行株，针对这些患者肝损伤的研究较少。

材料与方法

本研究纳入了 157 例 SARS-CoV-2 感染患者，包括 77 例 Delta 变异株感染患者和 80 例奥密克戎变异株感染患者。总结并比较了两组患者的肝损伤数据和临床资料，此外，还比较了有肝损伤和无肝损伤患者的情况，并进行多因素分析以探讨与 SARS-CoV-2 感染患者肝损伤相关的预测因素。

结果

入院时，Delta/Omicron 变异株感染患者中分别有 18 例（23.4%）/15 例（18.8%）和住院期间分别有 4 例（5.2%）/1 例（1.3%）发生肝损伤。两组间肝损伤发生率无差异（ χ2 = 1.571；P = 0.210）。在这些患者中，17 例（77.3%）和 12 例（75.0%）Delta 和奥密克戎变异株感染患者被认为与 SARS-CoV-2 感染相关，肝功能标志物轻度升高，以胆管细胞损伤标志物为主：Delta 和奥密克戎变异株感染患者分别为 76.5%（13/17）和 83.3%（10/12），大多数患者在随访期间恢复正常。多因素分析显示，男性（比值比[OR]，4.476；95%置信区间[CI]，1.235-16.222；P = 0.023）和鼻咽部病毒载量峰值较高（OR，3.022；95%CI，1.338-6.827；P = 0.008）是与 SARS-CoV-2 感染患者肝损伤相关的独立因素。