Liver Section, Gastroenterology Department, Hospital del Mar, Barcelona, Spain.
IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
J Viral Hepat. 2022 Sep;29(9):823-834. doi: 10.1111/jvh.13718. Epub 2022 Jun 26.
Abnormal liver function tests (A-LFTs) during admission for coronavirus disease-19 (COVID-19) are frequent, but its evolution after COVID-19 resolution remains unexplored. We evaluated factors related to A-LFTs during COVID-19 and assessed the liver outcome after patients' discharge. This is a observational study including: (1) retrospective analysis of variables related to A-LFTs during COVID-19; and (2) follow-up evaluation with blood test, transient elastography and liver biopsy in those with persistent A-LFTs. A-LFTs were defined according to CTCAEv4.0. Among 595 patients, 366 (61.5%) showed A-LFTs. The ratio of partial pressure of oxygen and inspired oxygen fraction (P/F) below 200, ferritin ≥1000 ng/mL, male gender and antibiotic and immunomodulatory treatments were related to A-LFTs. Follow-up evaluation was performed in 153 individuals. Persistent A-LFTs at follow-up was similar in patients with/without A-LFTs during admission (14.1% vs. 4.9%, p = 0.104). Fifteen (93%) and 58 (39%) patients with/without A-LFTs at follow-up showed metabolic fatty liver disease criteria (p < 0.001), which were histologically confirmed. In conclusion, A-LFTs during COVID-19 were related to infection severity. Abnormalities remitted at follow-up in >80% of patients, and no correlation between A-LFTs at admission and at follow-up was found. Most patients with A-LFTs at follow-up had non-invasive and histologically proven fatty liver disease.
入院时的肝功能异常（A-LFTs）在新型冠状病毒疾病-19（COVID-19）中很常见，但 COVID-19 治愈后其演变仍不清楚。我们评估了 COVID-19 期间与 A-LFTs 相关的因素，并评估了患者出院后的肝脏结局。这是一项观察性研究，包括：（1）COVID-19 期间与 A-LFTs 相关的变量的回顾性分析；（2）在 A-LFTs 持续存在的患者中进行血液检查、瞬时弹性成像和肝活检的随访评估。A-LFTs 根据 CTCAEv4.0 定义。在 595 例患者中，366 例（61.5%）出现 A-LFTs。氧分压与吸入氧分数（P/F）比值低于 200、铁蛋白≥1000ng/ml、男性和抗生素及免疫调节剂治疗与 A-LFTs 相关。对 153 名患者进行了随访评估。随访时持续存在的 A-LFTs 在入院时存在/不存在 A-LFTs 的患者中相似（14.1%比 4.9%，p=0.104）。随访时存在/不存在 A-LFTs 的患者中有 15 名（93%）和 58 名（39%）符合代谢性脂肪肝疾病标准（p<0.001），这在组织学上得到了证实。结论：COVID-19 期间的 A-LFTs 与感染严重程度有关。超过 80%的患者在随访时异常情况得到缓解，且入院时和随访时的 A-LFTs 之间无相关性。随访时存在 A-LFTs 的患者中，大多数有非侵入性和组织学证实的脂肪性肝病。
