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天门冬氨酸氨基转移酶升高可预测 COVID-19 肺炎严重程度。

Elevated Transaminases as Predictors of COVID-19 Pneumonia Severity.

机构信息

University Hospital Medical Center Bežanijska Kosa, 11000 Belgrade, Serbia.

Faculty of Medicine, Institute for Medical Statistics and Informatics, University of Belgrade, 11000 Belgrade, Serbia.

出版信息

Medicina (Kaunas). 2022 Jun 23;58(7):842. doi: 10.3390/medicina58070842.

Abstract

BACKGROUND

This study aimed to calculate the frequency of elevated liver enzymes in hospitalized patients with coronavirus disease 2019 (COVID-19) infection and to test if liver enzyme biochemistry levels on admission could predict the computed tomography (CT) scan severity score of bilateral interstitial pneumonia.

METHODS

This single-center study comprised of 323 patients including their demographic data, laboratory analyses, and radiological findings. All the information was taken from electronic health records, followed by statistical analysis.

RESULTS

Out of 323 patients, 115 of them (35.60%) had aspartate aminotransferase (AST) and/or alanine aminotransferase (ALT) over 40 U/L on admission. AST was the best predictor of CT scan severity score of bilateral interstitial pneumonia (R = 0.313, Adjusted R = 0.299). CT scan severity score in the peak of the infection could be predicted with the value of AST, neutrophils, platelets, and monocytes count (R = 0.535, Adjusted R = 0.495).

CONCLUSION

AST, neutrophils, platelets, and monocytes count on admission can account for almost half (49.5%) of the variability in CT scan severity score at peak of the disease, predicting the extensiveness of interstitial pneumonia related to COVID-19 infection. Liver enzymes should be closely monitored in order to stratify COVID-19 patients with a higher risk of developing severe forms of the disease and to plan the beforehand step-up treatment.

摘要

背景

本研究旨在计算新冠肺炎(COVID-19)住院患者肝酶升高的频率,并检验入院时肝酶生化水平是否能预测双肺间质病变的 CT 扫描严重程度评分。

方法

这是一项单中心研究,共纳入 323 名患者,包括他们的人口统计学数据、实验室分析和影像学结果。所有信息均取自电子病历,随后进行统计分析。

结果

323 名患者中,115 名(35.60%)患者入院时天门冬氨酸氨基转移酶(AST)和/或丙氨酸氨基转移酶(ALT)超过 40U/L。AST 是预测双肺间质病变 CT 扫描严重程度评分的最佳指标(R = 0.313,调整后 R = 0.299)。可通过 AST、中性粒细胞、血小板和单核细胞计数预测感染高峰期的 CT 扫描严重程度评分(R = 0.535,调整后 R = 0.495)。

结论

入院时的 AST、中性粒细胞、血小板和单核细胞计数可解释疾病高峰期 CT 扫描严重程度评分约一半(49.5%)的变异性,预测与 COVID-19 感染相关的间质性肺炎的严重程度。应密切监测肝酶,以便对 COVID-19 患者进行分层,评估其发生严重疾病的风险,并提前制定治疗计划。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/21db/9319887/86b15a01deba/medicina-58-00842-g001.jpg

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