Department of Gastroenterology, Jingzhou of Hubei Province, First Hospital of Yangtze University, Jingzhou, China.
Digestive Disease Research Institution of Yangtze University, Jingzhou, China.
BMC Gastroenterol. 2023 Aug 8;23(1):271. doi: 10.1186/s12876-023-02907-z.
The purpose of this study was to investigate the differences between the clinical characteristics and the factors influencing liver injury in patients with the Omicron subvariant BA.5.2 (Omicron BA.5.2) and the prototype of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Between December 30, 2019 and November 30, 2022, 157 patients infected with the SARS-CoV-2 prototype and 199 patients infected with the Omicron BA.5.2 were included in this case-control, single-center, retrospective study. Differences in clinical characteristics and liver injury between the Omicron BA.5.2 patients and the prototype patients were subsequently analyzed.
None of the Omicron BA.5.2 patients reached the critical state, and showed relatively milder symptoms including fever, cough, headache, muscle soreness, nausea or vomiting, diarrhea, anorexia and hypoxia. The Omicron BA.5.2 had a lower effect on body temperature (T), white blood cell (WBC) count, hematocrit (HCT), C-reactive protein (CRP) level, D-dimer, finger pulse oxygen saturation (SpO) and lung lesions. The differences in liver injury between the two groups were related to the severity of the disease, T, blood oxygen levels, albumin (ALB), CRP, and medication usage. Gender, body mass index, and CRP levels influenced liver damage in the Omicron BA.5.2 patients. In particular, CRP was an independent risk factor for liver injury. Because the severity of liver function damage was considerably low, only a small number of Omicron BA.5.2 patients required liver-protective treatment.
Liver injury is expected in the COVID-19 patients. The Omicron BA.5.2 patients showed milder symptoms of liver injury than the prototype patients. However, dynamic monitoring of liver function is warranted, especially for individuals presenting with elevated levels of CRP.
本研究旨在探讨奥密克戎变异株 BA.5.2（Omicron BA.5.2）与严重急性呼吸综合征冠状病毒 2 原型（SARS-CoV-2）患者的临床特征差异及其影响肝损伤的因素。
本病例对照、单中心、回顾性研究纳入了 2019 年 12 月 30 日至 2022 年 11 月 30 日期间感染 SARS-CoV-2 原型的 157 例患者和感染奥密克戎 BA.5.2 的 199 例患者。随后分析了奥密克戎 BA.5.2 患者与原型患者之间的临床特征和肝损伤差异。
奥密克戎 BA.5.2 患者无一例达到危急状态，表现为相对较轻的症状，包括发热、咳嗽、头痛、肌肉酸痛、恶心或呕吐、腹泻、厌食和缺氧。奥密克戎 BA.5.2 对体温（T）、白细胞（WBC）计数、红细胞压积（HCT）、C 反应蛋白（CRP）水平、D-二聚体、指脉搏血氧饱和度（SpO）和肺部病变的影响较低。两组间肝损伤的差异与疾病严重程度、T、血氧水平、白蛋白（ALB）、CRP 和用药有关。性别、体重指数和 CRP 水平影响奥密克戎 BA.5.2 患者的肝损伤。特别是 CRP 是肝损伤的独立危险因素。由于肝功能损伤程度相当低，只有少数奥密克戎 BA.5.2 患者需要进行保肝治疗。
COVID-19 患者可能会出现肝损伤。奥密克戎 BA.5.2 患者的肝损伤症状较原型患者轻。然而，需要对肝功能进行动态监测，尤其是对 CRP 水平升高的患者。
