Abdellatif Zeinab, Abdel-Haleem Hanan, Abdalaziz Rasha Ahmed, Ramadan Ahmed, Al-Sharif Aya Mohamed, El-Korashy Reem Ibrahim Mohamed, Soliman Youssef Mohamed Amin, Hussein Sabah Ahmed, Kamal Manal Mohamed, Abdullatif Mona Mohsen Abdulsalam, AbdelRazik Mohammed Mustafa, Eldessouky Noha Mohamed Tarek, Atef Mira
Hepatogastroenterology and Endemic Medicine Department - Faculty of Medicine, Cairo University, Egypt.
Hepatogastroenterology and Endemic Medicine Department - Faculty of Medicine, Cairo University, Egypt.
Arab J Gastroenterol. 2024 May;25(2):170-175. doi: 10.1016/j.ajg.2024.01.008. Epub 2024 Feb 19.
Liver dysfunction is a common manifestation of the COVID-19 infection. We aimed to study transaminase abnormalities through different waves of COVID-19 and their relations to disease severity or mortality.
A retrospective study included 521 Egyptian patients diagnosed with COVID-19. Data was retrieved from the medical records of patients who were admitted from April 2020 to October 2021 in Kasr Al-Ainy Hospitals, Cairo University, with categorization according to disease severity in correspondence to the four waves.
The median age was lower in the first wave compared to other waves, with male predominance across all waves. The most commonly encountered comorbidity overall was hypertension, followed by diabetes mellitus. White blood cells, ferritin, and interleukin-6 showed the highest median values in the second wave, with significantly higher median C-reactive protein on day 1 in the first wave. Forty percent of the patients showed elevated hepatic transaminases on admission in four waves, with no statistically significant difference between waves. On day 5, around half of the patients had elevated transaminases, with no significant difference between waves. Most CT findings were of moderate severity. Clinical severity was higher in the second wave. It was observed that the higher the disease severity, the greater the proportion of patients with elevated hepatic transaminases. The mortality rate was markedly high in cases who had elevated ALT or AST on day 5. The association between elevated enzymes on admission and mortality was seen in the first wave only, with a fatality rate of 22.5% in cases with increased baseline ALT and AST versus 5% in those with normal baseline enzymes.
There was no significant difference in transaminases between the four waves. Elevated transaminases were positively associated with increased mortality and severity, reflecting their prognostic value.
肝功能障碍是新型冠状病毒肺炎（COVID-19）感染的常见表现。我们旨在研究不同波次COVID-19患者的转氨酶异常情况及其与疾病严重程度或死亡率的关系。
一项回顾性研究纳入了521例确诊为COVID-19的埃及患者。数据取自2020年4月至2021年10月在开罗大学卡斯尔·艾尼医院住院患者的病历，并根据与四波疫情相对应的疾病严重程度进行分类。
与其他波次相比，第一波患者的年龄中位数较低，各波次均以男性为主。总体上最常见的合并症是高血压，其次是糖尿病。白细胞、铁蛋白和白细胞介素-6在第二波中的中位数最高，第一波第1天的C反应蛋白中位数显著更高。四波疫情中，40%的患者入院时肝转氨酶升高，各波次之间无统计学显著差异。在第5天，约一半的患者转氨酶升高，各波次之间无显著差异。大多数CT表现为中度严重程度。第二波的临床严重程度更高。观察到疾病严重程度越高，肝转氨酶升高的患者比例越大。第5天谷丙转氨酶（ALT）或谷草转氨酶（AST）升高的病例死亡率明显较高。入院时酶升高与死亡率之间的关联仅在第一波中可见，基线ALT和AST升高的病例死亡率为22.5%，而基线酶正常的病例死亡率为5%。
四波疫情之间转氨酶无显著差异。转氨酶升高与死亡率和严重程度增加呈正相关，反映了它们的预后价值。
