Department of Surgery, Transplantation and Gastroenterology, Semmelweis University, Üllői út 26, 1085 Budapest, Hungary.
Viruses. 2022 Oct 26;14(11):2360. doi: 10.3390/v14112360.
Liver damage in COVID-19 patients was documented as increased alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels or an elevated AST/ALT ratio, known as the De Ritis ratio. However, the prognostic value of the elevated De Ritis ratio in COVID-19 patients is still unknown. The aim of our study was to evaluate the prognostic value of the De Ritis ratio compared to other abnormal laboratory parameters and its relation to mortality. We selected 322 COVID-19 patients in this retrospective study conducted between November 2020 and March 2021. The laboratory parameters were measured on admission and followed till patient discharge or death. Of the 322 COVID-19 patients, 57 (17.7%) had gastrointestinal symptoms on admission. The multivariate analysis showed that the De Ritis ratio was an independent risk factor for mortality, with an OR of 29.967 (95% CI 5.266-170.514). In ROC analysis, the AUC value of the the De Ritis ratio was 0.85 (95% CI 0.777-0.923, < 0.05) with sensitivity and specificity of 80.6% and 75.2%, respectively. A De Ritis ratio ≥1.218 was significantly associated with patient mortality, disease severity, higher AST and IL-6 levels, and a lower ALT level. An elevated De Ritis ratio on admission is independently associated with mortality in COVID-19 patients, indicating liver injury and cytokine release syndrome.
在 COVID-19 患者中，肝损伤表现为丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）水平升高，或 AST/ALT 比值升高，即德赖蒂斯（De Ritis）比值升高。然而，COVID-19 患者中德赖蒂斯比值升高的预后价值尚不清楚。本研究旨在评估德赖蒂斯比值与其他异常实验室参数相比的预后价值及其与死亡率的关系。我们在 2020 年 11 月至 2021 年 3 月期间进行了这项回顾性研究，共选择了 322 名 COVID-19 患者。入院时测量实验室参数，并随访至患者出院或死亡。在 322 名 COVID-19 患者中，57 名（17.7%）入院时有胃肠道症状。多变量分析显示，德赖蒂斯比值是死亡的独立危险因素，比值比为 29.967（95%可信区间 5.266-170.514）。在 ROC 分析中，德赖蒂斯比值的 AUC 值为 0.85（95%可信区间 0.777-0.923， < 0.05），灵敏度和特异性分别为 80.6%和 75.2%。德赖蒂斯比值≥1.218 与患者死亡率、疾病严重程度、AST 和 IL-6 水平升高以及 ALT 水平降低显著相关。入院时德赖蒂斯比值升高与 COVID-19 患者的死亡率独立相关，提示肝损伤和细胞因子释放综合征。
