Institute for Hepatology, National Clinical Research Center for Infectious Disease, Shenzhen Third People's Hospital, The Second Affiliated Hospital, School of Medicine, Southern University of Science and Technology, Shenzhen, China.
Shenzhen Research Center for Communicable Disease Diagnosis and Treatment of Chinese Academy of Medical Science, Shenzhen, China.
Front Cell Infect Microbiol. 2022 Apr 14;12:864933. doi: 10.3389/fcimb.2022.864933. eCollection 2022.
The longitudinal effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the liver are unknown. This study aimed to characterize dynamic changes in liver function test abnormalities in patients with COVID-19 at the acute phase and recovery phase.
A prospective cohort study involved patients with COVID-19 who were admitted to Shenzhen Third People's Hospital between January 11, 2020, and April 27, 2020. Patients underwent liver function tests at hospitalization and at the outpatient visit at the 1-month, 3-month, 6-month, and 12-month follow-ups.
Among 461 patients, 28.4% of patients had any kind of liver function tests abnormality at admission, manifested as elevated ALT (13.0%), AST (17.6%), and GGT (15.8%) levels. The trajectory analysis indicated a marked improvement in liver function after discharge, with any kind of liver function test abnormalities of 25.1% at 1 month, 13.2% at 3 months, 16.7% at 6 months, and 13.2% at 12 months after discharge. Persistent liver function abnormalities were observed in patients with pre-existing conditions during follow-up. A significantly higher prevalence of ultrasound determined fatty liver disease was found in those patients with more frequent LFT abnormalities at follow-up.
In this study of patients with COVID-19, liver damage in COVID-19 was usually temporary and could return to normal at the end of the 12-month follow-up.
严重急性呼吸综合征冠状病毒 2(SARS-CoV-2)感染对肝脏的纵向影响尚不清楚。本研究旨在描述 COVID-19 患者在急性期和恢复期肝功能检查异常的动态变化。
前瞻性队列研究纳入 2020 年 1 月 11 日至 4 月 27 日期间入住深圳市第三人民医院的 COVID-19 患者。患者在住院时和出院后 1 个月、3 个月、6 个月和 12 个月的门诊就诊时进行肝功能检查。
在 461 例患者中,28.4%的患者在入院时存在任何类型的肝功能检查异常,表现为 ALT(13.0%)、AST(17.6%)和 GGT(15.8%)水平升高。轨迹分析表明,出院后肝功能明显改善,出院后 1 个月、3 个月、6 个月和 12 个月时任何类型的肝功能检查异常分别为 25.1%、13.2%、16.7%和 13.2%。在随访期间,有基础疾病的患者仍存在持续的肝功能异常。在随访中肝功能检查异常更频繁的患者中,超声确定的脂肪肝疾病的患病率显著更高。
在这项 COVID-19 患者的研究中,COVID-19 患者的肝损伤通常是暂时的,在 12 个月的随访结束时可以恢复正常。