The Liver Injury and Coagulation Dysfunction in the Patients with Severe/Critical COVID-19.
10.19746/j.cnki.issn.1009-2137.2021.05.033
- Author:
Jie ZHANG
1
;
Xiao-Ling GAO
2
;
Yan LIU
3
;
Yi JIANG
4
;
Zhi-Mei JIA
2
;
Fang-Fang ZHAO
2
;
Dong XU
5
;
Li-Juan HUO
6
;
Lin-Hua YANG
7
,
8
Author Information
1. Shanxi Medical University Taiyuan 030001, Shanxi Province, China,Department of Gastroenterology, The First Hospital of Shanxi Medical University Taiyuan 030001, Shanxi Province, China.
2. Department of Respiratory and Critical Care Medicine, The Second Hospital of Shanxi Medical University Taiyuan 030001, Shanxi Province, China.
3. Department of Critical Care Medicine, The First Hospital of Shanxi Medical University Taiyuan 030001, Shanxi Province, China.
4. Department of Respiratory and Critical Care Medicine, The First Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China.
5. Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China.
6. Department of Gastroenterology, The First Hospital of Shanxi Medical University Taiyuan 030001, Shanxi Province, China.
7. Department of Hematology, The Second Hospital of Shanxi Medical University, Taiyuan 030001, Shanxi Province, China,E-mail: yanglh5282@
8. com.
- Publication Type:Journal Article
- MeSH:
Aged;
Aged, 80 and over;
Blood Coagulation Disorders;
COVID-19;
Female;
Humans;
Liver;
Male;
Middle Aged;
Retrospective Studies;
SARS-CoV-2
- From:
Journal of Experimental Hematology
2021;29(5):1582-1588
- CountryChina
- Language:Chinese
-
Abstract:
METHODS:The clinical data of 53 COVID-19 patients were collected from a single center in Wuhan from February 8, 2020 to March 25, 2020. The patients were divided into severe type group (38 patients) and critical type group (15 patients). The clinical characteristics, indexes of liver function, coagulation function and inflammatory markers were analyzed retrospectively. According to the degree of abnormal liver function in the process of diagnosis and treatment, the patients were divided into three groups: combined liver injury, mild abnormal liver function and normal liver function group. Statistical analysis was performed by using Student t test, Mann-Whitney U test, Kruskal-Wallis test and Chi-square test.
RESULTS:Among the 53 patients, 29 were male (54.7%) and 24 were female (45.3%), the median age was 57(27－80) years old. The time from onset to admission was (11.5±7.7) days. The levels of AST, TBIL, DBIL, ALP, GGT, LDH, D-dimer, PCT and hsCRP in critical patients were higher than those in severe patients (P<0.05). The levels of Alb in critical patients was lower than those in severe patients (P<0.05). Among the 53 patients, 34 (64%) patients showed abnormal elevation of ALT, AST or TBIL, while 4 (7.5%) patients showed the criteria of COVID-19 with liver injury. After the patients were grouping according to the degree of liver dysfunction, the levels of ALP, GGT and D-dimer of the patients in the liver injury group were significantly higher than those in the normal liver function group, D-dimer levels of the patients in the liver injury group was significantly higher than those in the mild abnormal liver function group, while the levels of ALP and GGT in the mild abnormal liver function group were significantly higher than those in the normal liver function group, and the differences were statistically significant(P<0.05).
CONCLUSION:In this group, the patients with COVID-19 severe/critical type have a certain proportion of liver injury accompanied by significantly increased D-dimer levels, critical type patients have more severe liver function and coagulation dysfunction, which may promote the progression of COVID-19.
