新冠肺炎患者肝功能障碍的临床特点及危险因素分析

Xiaofang Jiang, Jiahao Zhang, Cheng Yang, Qin-jing Xie, G. Xiao, Fengqin Wang, Sanying Shen, L. Su, Z. Peng
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摘要

背景:新冠肺炎疫情已在全球蔓延。COVID-19患者肝功能障碍与高死亡率相关。方法:纳入425例连续住院的COVID-19患者的回顾性、单中心研究病例系列。收集了人口统计学、临床、实验室和治疗数据。结果:本研究共纳入425例患者,其中LD 145例,总死亡率为8.9%,LD组为17.9%,非肝功能障碍(NLD)组为4.3%。年龄、性别、高血压是LD的独立危险因素,LD是重症、急性呼吸窘迫综合征、死亡的独立危险因素。LD组患者生存率低于NLD组(P < 0.001)。多因素回归分析也发现了类似的趋势(校正风险比为3.52;95%置信区间[CI], 1.69-7.33;P = 0.001)。血管紧张素转换酶抑制剂/血管紧张素II受体阻滞剂可降低LD(优势比0.48 [95% CI, 0.232-0.989;P = 0.045])。结论:LD是新冠肺炎住院患者的主要特征之一,预后较差。新冠肺炎合并LD患者入院时应更加谨慎。
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Clinical Characteristics and Risk Factors of Liver Dysfunction in COVID-19 Patients
ABSTRACT Background: COVID-19 outbreak has spread around the world. Liver dysfunction (LD) was related with high mortality in COVID-19. Methods: Retrospective, single-center study case series of 425 consecutive hospitalized COVID-19 patients were enrolled. Demographic, clinical, laboratory, and treatment data were collected. Results: A total of 425 patients were included in this study, 145 of whom had LD. The overall mortality rate was 8.9%, while 17.9% in the LD group and 4.3% in the nonliver dysfunction (NLD) group. Age, sex, and hypertension were the independent risk factors of LD. LD was an independent risk factor for incidence of severe illness, acute respiratory distress syndrome, and death. The survival rate of patients in LD group was lower than that in NLD group (P < 0.001). A similar trend was observed by the multivariate regression analysis (adjusted hazard ratio, 3.52; 95% confidence interval [CI], 1.69–7.33; P = 0.001). Angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers had effect to reduce LD (odds ratio of 0.48 [95% CI, 0.232–0.989; P = 0.045]). Conclusions: LD is one of the main features of hospitalized patients of COVID-19, with a worse prognosis. Patients of COVID-19 with LD on admission should be more cautions.
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