Ludovica Esposito, Matteo Guarino, Benedetta Perna, Andrea Ciccarone, Alice Eleonora Cesaro, Francesca Manza, Adriana Pretula, Anna Costanzini, Martina Maritati, Elena Forini, Michele Domenico Spampinato, Roberto De Giorgio, Carlo Contini
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The present study aims to describe the correlation between the increase of liver damage markers (<i>i.e</i>. alanine aminotransferase [ALT], aspartate aminotransferase [AST], total bilirubin [TB]) and COVID-19 outcomes (<i>i.e</i>., in-hospital mortality [IHM] and intensive care unit [ICU] transfer).</p><p><strong>Methods: </strong>All patients with confirmed SARS-CoV-2 infection admitted to the Infectious Diseases Unit of the St. Anna University-Hospital of Ferrara from March 2020 to October 2021 were retrospectively included in this single-centre study. ALT, AST and TB levels were tested in all patients and IHM or ICU transfer were considered as main outcomes. Co-morbidities were assessed using Charlson Comorbidity Index.</p><p><strong>Results: </strong>A total of 106 patients were retrieved. No hepatic marker was able to predict IHM, whereas all of them negatively predicted ICU transfer (ALT: OR 1.005, 95%CI 1.001-1.009, p= 0.011; AST: OR 1.018, 95%CI 1.006-1.030, p= 0.003; TB: OR 1.329, 95%CI 1.025-1.724, p= 0.032). 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引用次数: 0
摘要
背景:严重急性呼吸综合征冠状病毒2 (SARS-CoV-2)大流行是已知的主要呼吸道疾病,尽管也可能发生肺外表现。2019冠状病毒病(COVID-19)的目标之一是肝胆系统。本研究旨在探讨肝损伤标志物(如谷丙转氨酶(ALT)、天冬氨酸转氨酶(AST)、总胆红素(TB))升高与COVID-19结局(即住院死亡率(IHM)和重症监护病房(ICU)转院)之间的相关性。方法:回顾性纳入2020年3月至2021年10月在费拉拉圣安娜大学医院传染病科收治的所有确诊的SARS-CoV-2感染患者。所有患者均检测ALT、AST和TB水平,并将IHM或ICU转移视为主要结局。采用Charlson合并症指数评估合并症。结果:共检索到106例患者。肝脏指标均不能预测IHM,但均阴性预测ICU转移(ALT: OR 1.005, 95%CI 1.001 ~ 1.009, p= 0.011;AST: OR 1.018, 95%CI 1.006-1.030, p= 0.003;TB: OR 1.329, 95%CI 1.025-1.724, p= 0.032)。年龄是唯一与死亡率显著相关的参数。结论:本研究通过将肝损伤标志物与COVID-19预后相关联,表明ALT、AST和TB的升高预测了患者的严重程度,但不能预测死亡率。
Markers of liver function as potential prognostic indicators of SARS-CoV-2 infection: A retrospective analysis during the first and second waves of COVID-19 pandemic.
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is known to cause a predominant respiratory disease, although extrapulmonary manifestations can also occur. One of the targets of Coronavirus disease 2019 (COVID-19) is the hepatobiliary system. The present study aims to describe the correlation between the increase of liver damage markers (i.e. alanine aminotransferase [ALT], aspartate aminotransferase [AST], total bilirubin [TB]) and COVID-19 outcomes (i.e., in-hospital mortality [IHM] and intensive care unit [ICU] transfer).
Methods: All patients with confirmed SARS-CoV-2 infection admitted to the Infectious Diseases Unit of the St. Anna University-Hospital of Ferrara from March 2020 to October 2021 were retrospectively included in this single-centre study. ALT, AST and TB levels were tested in all patients and IHM or ICU transfer were considered as main outcomes. Co-morbidities were assessed using Charlson Comorbidity Index.
Results: A total of 106 patients were retrieved. No hepatic marker was able to predict IHM, whereas all of them negatively predicted ICU transfer (ALT: OR 1.005, 95%CI 1.001-1.009, p= 0.011; AST: OR 1.018, 95%CI 1.006-1.030, p= 0.003; TB: OR 1.329, 95%CI 1.025-1.724, p= 0.032). Age was the only parameter significantly related to mortality.
Conclusions: The present study, by correlating liver damage markers with COVID-19 outcome, showed that an increase of ALT, AST and TB predicted patients' severity, although not mortality.
期刊介绍:
The Journal publishes original papers, in Italian or in English, on topics concerning aetiopathogenesis, prevention, epidemiology, diagnosis, clinical features and therapy of infections, whose acceptance is subject to the referee’s assessment. The Journal is of interest not only to infectious disease specialists, microbiologists and pharmacologists, but also to internal medicine specialists, paediatricians, pneumologists, and to surgeons as well. The Editorial Board includes experts in each of the above mentioned fields.