基线肝酶异常对COVID-19感染结局的影响

IF 3 4区 医学 Q1 Medicine Translational gastroenterology and hepatology Pub Date : 2023-01-01 DOI:10.21037/tgh-22-41
João Pedro Farias, Liana Codes, Diana Vinhaes, Ana Paula Amorim, Ricardo Cruz D'Oliveira, Alberto Queiroz Farias, Paulo Lisboa Bittencourt
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摘要

背景:目前对COVID-19患者肝功能检查(LFT)异常的意义及其对疾病结局的影响知之甚少。本研究的目的是评估COVID-19患者LFT异常及其对疾病严重程度、死亡率的影响,以及与白细胞炎症标志物的相关性。方法:回顾性分析单一参考中心急诊科收治的所有COVID-19患者。使用电子医疗数据库收集数据,包括以下变量:人口统计学、基线全血细胞计数(CBC)和比率、中性粒细胞-淋巴细胞(NLR)和单核细胞-淋巴细胞比率(MLR)、全身免疫炎症指数(SII)、天冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)水平。疾病严重程度由器官衰竭(of)或需要重症监护病房(ICU)支持来定义。死亡率被认为是病人在住院期间的死亡。结果:共纳入新冠肺炎1539例(女性799例,平均年龄57±18岁)。50%的患者出现AST和/或ALT异常,其频率和幅度与白细胞计数和比值显著相关。两种LFT均与住院和ICU住院需求及死亡率显著相关。高AST水平与OFs的存在、数量和类型以及住院时间(LOS)显著相关。除了OFs存在、循环衰竭和LOS外,ALT升高也与上述变量显著相关。结论:LFT异常在COVID-19患者中常见,反映了SARS-CoV-2相关炎症,可能预测不良结局。LFT可能有助于急诊科对住院或门诊再评估的决策。
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Impact of baseline abnormal liver enzymes in the outcome of COVID-19 infection.

Background: Little is known about the significance of liver function tests (LFT) abnormalities in COVID-19 and their impact on disease outcomes. The aims of the study were to evaluate abnormalities of LFT in patients with COVID-19 and their impact on disease severity, mortality, and correlation with leukocyte markers of inflammation.

Methods: All patients with COVID-19 admitted to the emergency department (ED) of a single reference center were retrospectively evaluated. Data were collected using an electronic medical database covering the following variables: demographics, baseline complete blood count (CBC) and ratios, neutrophil-lymphocyte (NLR) and monocyte-lymphocyte ratios (MLR), systemic immune-inflammation index (SII), aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. Disease severity was defined by the presence of organ failure (OF) or requirement for intensive care unit (ICU) support. Mortality was considered as patient death during hospitalization.

Results: A total of 1,539 subjects (799 women, mean age 57±18 years) with COVID-19 were evaluated. Abnormal AST and/or ALT were seen in 50% of them, with a frequency and magnitude that significantly correlated with leukocyte count and ratios. Both LFT were significantly associated with requirement for hospital and ICU admission and mortality. High AST levels were significantly associated with the presence, number, and types of OFs and in-hospital length of stay (LOS). Elevated ALT was also significantly associated with the aforementioned variables, with the exception of OFs presence, circulatory failure and LOS.

Conclusions: LFT abnormalities are frequently seen in COVID-19 patients, reflect SARS-CoV-2 associated inflammation and may predict adverse outcomes. LFT may be useful to aid decision-making in the ED for hospital admission or scheduled outpatient reevaluation.

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来源期刊
CiteScore
8.20
自引率
0.00%
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1
期刊介绍: Translational Gastroenterology and Hepatology (Transl Gastroenterol Hepatol; TGH; Online ISSN 2415-1289) is an open-access, peer-reviewed online journal that focuses on cutting-edge findings in the field of translational research in gastroenterology and hepatology and provides current and practical information on diagnosis, prevention and clinical investigations of gastrointestinal, pancreas, gallbladder and hepatic diseases. Specific areas of interest include, but not limited to, multimodality therapy, biomarkers, imaging, biology, pathology, and technical advances related to gastrointestinal and hepatic diseases. Contributions pertinent to gastroenterology and hepatology are also included from related fields such as nutrition, surgery, public health, human genetics, basic sciences, education, sociology, and nursing.
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