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Clinical characteristics and risk factors of liver injury in COVID-19: a retrospective cohort study from Wuhan, China

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单位: [1]Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China [2]Department of Paediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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关键词: COVID-19 Liver damage Clinical course Alanine aminotransferase Total bilirubin Cytokine storm Hypersensitive C-reactive protein Neutrophil-to-lymphocyte ratio Multivariate regression analysis Retrospective cohort study

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Background Coronavirus disease 2019 (COVID-19) has rapidly become a major international public health concern. This study was designed to evaluate the clinical characteristics and risk factors of COVID-19-associated liver injury. Methods A fraction of 657 COVID-19 patients were retrospectively analyzed. Clinical and laboratory data were derived from electronic medical records and compared between patients with or without liver injury. Multivariate logistic regression method was used to analyze the risk factors for liver injury. Results Among 657 patients, 303 (46.1%) patients had liver injury with higher rate in severe/critically ill patients [148/257 (57.6%)] than those in moderate cases [155/400 (38.8%)]. The incidence of liver injury was much higher in male [192/303 (63.4%)] than female [111/303 (36.6%)], and in severe/critical patients [148/303 (48.8%)] with percutaneous oxygen saturation <= 93% [89/279 (31.9%)] or peak body temperature >= 38.5 degrees C [185/301 (61.5%)] on admission. Liver injury-related inflammations included increased white blood cells, neutrophils and decreased lymphocytes. More patients with liver injury than without had increased serum IL-2R, TNF alpha, ferritin, hsCRP, PCT, ESR, gamma-GT, and LDH. Multivariate regression analysis revealed that increasing odds of liver injury were related to male, higher serum hsCRP (>= 10 mg/L), and neutrophil-to-lymphocyte ratio (NLR) (>= 5). Moreover, more deceased patients (14/82 (17%)) had significantly elevated serum TBIL than discharged patients [25/532 (4.7%)]. Conclusion Liver injury is a common complication in COVID-19 patients. The potential risk factors of liver injury include male, hsCRP and NLR score. A close monitor of liver function should be warned in COVID-19 patients, especially in severe/critical individuals.

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基金编号: 2017ZX10202201 2018ZX09733001-002-006

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出版当年[2019]版:
大类 | 2 区 医学
小类 | 3 区 胃肠肝病学
最新[2025]版:
大类 | 1 区 医学
小类 | 2 区 胃肠肝病学
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出版当年[2018]版:
Q1 GASTROENTEROLOGY & HEPATOLOGY
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Q1 GASTROENTEROLOGY & HEPATOLOGY

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第一作者单位: [1]Department and Institute of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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