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Association of liver abnormalities with in-hospital mortality in patients with COVID-19.

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单位: [1]Hepatic Surgery Center,and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China [2]Department of Gastroenterology and Hepatology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China [3]Department of Nephrology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430033, Hubei, China [4]Department of Anesthesiology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China [5]Department of Emergency and Critical Care Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China [6]Department of Respiratory and Critical Care Medicine,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China [7]Department and Institute of Urology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China [8]Medical team supporting Hubei and Department of Hepatobiliary Surgery, ZhongShan Hospital of Xiamen University, Xiamen 361004, Fujian, China [9]First branch of medical teams from Nanjing to support Hubei and Department of Critical Care Medicine, the Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu, China [10]Medical team supporting Hubei and Department of Hepatic Surgery and Liver transplantation Center, the Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China [11]Department of Neurosurgery, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China [12]Department of Neurology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China [13]Department of Gynecological Oncology, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei, China [14]Department of Gastrointestinal Surgery, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430033, Hubei, China [15]Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
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关键词: COVID-19 aspartate aminotransferase direct bilirubin hepatitis B liver injury

摘要:
The evolution and clinical significance of abnormal liver chemistries and the impact of hepatitis B infection on outcome in patients with COVID-19 is not well characterized. This study aimed to explore these issues. This large retrospective cohort study included 2073 patients with COVID-19 having definite outcomes in Wuhan, China. Longitudinal liver function tests were conducted and determined their associated factors and death risk by multivariate regression analyses. A prognostic nomogram was formulated to predict the survival of patients with COVID-19. The characteristics of liver abnormalities and outcomes of patients with COVID-19 with and without hepatitis B were compared after 1:3 propensity score matching. Of the 2073 patients, 1282 (61.8%) had abnormal liver chemistries during hospitalization, and 297 (14.3%) had a liver injury. The mean levels of AST and D-Bil increased early after symptom onset in deceased patients and showed disparity compared with that in discharged patients throughout the clinical course of the disease. Abnormal admission AST (adjusted hazard ratio [HR]: 1.39, 95%CI: 1.04-1.86, P=0.027) and D-Bil (adjusted HR: 1.66, 95%CI: 1.22-2.26, P=0.001) levels were independent risk factors for mortality due to COVID-19. A nomogram was established based on the results of multivariate analysis and showed sufficient discriminatory power and good consistency between the prediction and the observation. HBV infection in patients did not increase the risk of COVID-19-associated poor outcomes. Abnormal AST and D-Bil levels at admission were independent predictors of COVID-19 mortality. Therefore, monitoring liver chemistries, especially AST and D-Bil levels, in hospitalized patients with COVID-19, is necessary. Copyright © 2020 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

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基金编号: 81874065 81874189 XXGZBDYJ007 XXGZBDYJ008 2018ZX10723204-003 CXPJJH11800001-2018356

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出版当年[2020]版:
大类 | 1 区 医学
小类 | 1 区 胃肠肝病学
最新[2025]版:
大类 | 1 区 医学
小类 | 1 区 胃肠肝病学
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出版当年[2019]版:
Q1 GASTROENTEROLOGY & HEPATOLOGY
最新[2023]版:
Q1 GASTROENTEROLOGY & HEPATOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2019版] 出版当年五年平均 出版前一年[2018版] 出版后一年[2020版]

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第一作者单位: [1]Hepatic Surgery Center,and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China
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通讯机构: [1]Hepatic Surgery Center,and Hubei Key Laboratory of Hepato-Pancreatic-Biliary Diseases,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China [7]Department and Institute of Urology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China [14]Department of Gastrointestinal Surgery, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430033, Hubei, China [15]Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China [*1]Hepatic Surgery Center and Hubei Key Laboratory of Hepato-Biliary-Pancreatic Diseases,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,1095 Jiefang Avenue,Wuhan 430030,Hubei,China. [*2]Hepatic Surgery Center and Hubei Key Laboratory of Hepato-Biliary-Pancreatic Diseases,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,1095 Jiefang Avenue,Wuhan 430030,Hubei,China. [*3]Department of Epidemiology and Biostatistics and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, HUST, Wuhan 430030, China. [*4]Department and Institute of Urology,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430033,Hubei,China. [*5]Department of Gastrointestinal Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,Hubei,China.
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