Clinical features of liver injury in patients with coronavirus disease 2019: An analysis of 201 cases
10.3969/j.issn.1001-5256.2020.07.023
- VernacularTitle:201例新型冠状病毒肺炎患者肝损害临床特征分析
- Author:
Dan LONG
1
,
2
;
Linghui QIN
2
;
Shan GAO
1
Author Information
1. Department of Gastroenterology
2. Department of Urology, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, Xiangyang, Hubei 441021, China
- Publication Type:Research Article
- Keywords:
coronavirus disease 2019;
liver injury;
serum albumin
- From:
Journal of Clinical Hepatology
2020;36(7):1567-1570
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the features of liver injury in patients with coronavirus disease 2019 (COVID-19), and to provide a reference for clinical diagnosis and treatment. MethodsMedical records were collected from 201 patients with COVID-19 who were admitted to Xiangyang Central Hospital from January 19 to March 5, 2020, and these patients were divided into non-critical (mild/common type) group with 173 patients and critical (severe/critical type) group with 28 patients. The data on alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil), direct bilirubin (DBil), and albumin (Alb) were collected. The t-test was used for comparison of normally distributed continuous data between groups, the chi-square test was used for comparison of categorical data between groups, and the Wilcoxon rank-sum test was used for comparison of ranked data between groups. ResultsAmong the 201 patients, 37 (18.4%) had liver injury, with 19 in the critical group and 18 in the non-critical group, and there was a significant difference in the incidence rate of liver injury between the two groups (67.9% vs 10.4%, χ2=52.963, P＜0.05). There were significant differences between the 19 patients with liver injury in the critical group and the 18 patients with liver injury in the non-critical group in the duration of abnormal ALT and/or AST (on admission and during hospitalization) (χ2=11.906, P＜0.05) and the increase in ALT and/or AST (Z=-2.869, P＜0.05), and most patients had mild or moderate liver injury. Among the 201 patients, only one patient had elevated bilirubin (TBil ＜2 × upper limit of normal, mainly indirect bilirubin) and had non-critical liver injury. The critical group had a significantly lower level of Alb than the non-critical group (t=-8.002, P＜0.05). Among the 201 patients, 75 had a reduction in Alb, among whom 50 (50/201, 24.9%) had a reduction on admission and 25 (25/201, 12.4%) had a reduction during hospitalization, and there were significant differences in Alb (t=-4.967, P＜0.05) and hypoalbuminemia (χ2=26.645, P＜0.05) between the two periods of time. ConclusionLiver injury is relatively common in patients with COVID-19, mainly mild or moderate liver injury. There is a low incidence rate of abnormal bilirubin and a high incidence rate of the reduction in Alb. There are significant differences in the incidence rate and severity of liver injury between the crucial and non-critical patients. Alb level can be used as one of the indicators to evaluate and predict the severity of COVID-19 patients.
