Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients

Qi Wang; Hong Zhao; Li-Gai Liu; Yan-Bin Wang; Ting Zhang; Ming-Hui Li; Yan-Li Xu; Gui-Ju Gao; Hao-Feng Xiong; Ying Fan; Ying Cao; Rui Ding; Jing-Jing Wang; Cheng Cheng; Wen Xie

doi:10.1186/s40779-020-00256-6

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Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients

RESEARCH | Updated：2023-02-28

- Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients
- Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients
- 解放军医学杂志（英文版） 2021年8卷第1期页码：9-16
- Affiliations：
  
  1.Center of Liver Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
  2.Beijing Key Laboratory of Emerging Infectious Diseases, Beijing 100015, China
  3.Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
  4.Department of Critical Care Medicine, Beijing Ditan Hospital, Capital Medical University, Beijing 100015, China
- Author bio：
  
  * xiewen6218@163.com
- Funds：
  
  Scientific Research Projects of Beijing Ditan Hospital, Capital Medical University, and Projects from Beijing Municipal Science and Technology Commission(D171100003117005);Digestive Medical Coordinated Development Center of Beijing Hospitals Authority(XXZ0402)
- DOI：10.1186/s40779-020-00256-6
  中图分类号：
- 纸质出版：2021-03
- Accepted：
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Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients[J]. 解放军医学杂志（英文版）, 2021,8(1):9-16.

Wang et al.: Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients. Mil Med Res, 2020, 7: 28.
Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients[J]. 解放军医学杂志（英文版）, 2021,8(1):9-16. DOI： 10.1186/s40779-020-00256-6.

Wang et al.: Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients. Mil Med Res, 2020, 7: 28. DOI： 10.1186/s40779-020-00256-6.

摘要

Abstract

Background:

Recent studies reported that patients with coronavirus disease-2019 (COVID-19) might have liver injury. However

few data on the combined analysis and change patterns of alanine aminotransferase (ALT)

aspartate aminotransferase (AST) and total bilirubin (TBil) have been shown.

Methods:

This is a single-center retrospective study. A total of 105 adult patients hospitalized for confirmed COVID-19 in Beijing Ditan Hospital between January 12

and March 17

2020 were included

and divided into mild group (

=79) and severe group (

=26). We compared liver functional test results between the two groups. Category of ALT change during the disease course was also examined.

Results:

56.2%(59/105) of the patients had unnormal ALT

AST

or total TBil throughout the course of the disease

but in 91.4%(96/105) cases the level of ALT

AST or TBil ≤3 fold of the upper limit of normal reference range (ULN). The overall distribution of ALT

AST

and TBil were all significantly difference between mild and severe group (

0.05). The percentage of the patients with elevated both ALT and AST was 12.7%(10/79) in mild cases

. 46.2%(12/26) in severe cases (

=0.001). 34.6%(9/26) severe group patients started to have abnormal ALT after admission

and 73.3%(77/105) of all patients had normal ALT before discharge.

Conclusions:

Elevated liver function index is very common in patients with COVID-19 infection

and the level were less than 3×ULN

but most are reversible. The abnormality of 2 or more indexes is low in the patients with COVID-19

but it is more likely to occur in the severe group.

关键词

Keywords

references

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Chen N , Zhou M , Dong X , Qu J , Gong F , Han Y , et al . Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study . Lancet. 2020 ; 395 : 507 – 13 .

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Yan J , Xie W , Ou WN , Zhao H , Wang SY , Wang JH , et al . Epidemiological survey and risk factor analysis of fatty liver disease of adult residents, Beijing, China . J Gastroenterol Hepatol. 2013 ; 28 : 1654 – 9 .

Guan GW , Gao L , Wang JW , Wen XJ , Mao TH , Peng SW , et al . Exploring the mechanism of liver enzyme abnormalities in patients with novel coronavirus-infected pneumonia . Zhonghua Gan Zang Bing Za Zhi. 2020 ; 28 ( 2 ): 100 – 6 .

Xu Z , Shi L , Wang Y , Zhang J , Huang L , Zhang C , et al . Pathological findings of COVID-19 associated with acute respiratory distress syndrome . Lancet Respir Med. 2020 ; 8 ( 4 ): 420 – 2 .

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Yao N , Wang SN , Lian JQ , Sun YT , Zhang GF , Kang WZ , et al . Clinical characteristics and influencing factors of patients with novel coronavirus pneumonia combined with liver injury in Shaanxi region . Zhonghua Gan Zang Bing Za Zhi. 2020 ; 28 ( 3 ): 234 – 9 .

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