Liver International · 2020 · 491 citations · 16 references
MedicineInfectious DiseasesInternal MedicineClinical EpidemiologyHepatologyPulmonologyAcute Liver FailureHepatic Function TestingHepatic ImpairmentHepatic PathologyLiver DiseaseLiver Function TestsBiomarkers Of SeverityHepatic Impairment GradingHepatic ManifestationsIndexesLiver Disease Severity CriteriaPlasma Albumin
BACKGROUND: The SARS-CoV-2 pandemic is an ongoing global health emergency. The aim of our study was to investigate the changes of liver function and its clinical significance in COVID-19 patients. METHOD: This retrospective, single-centre study was conducted on 115 confirmed cases of COVID-19 in Zhongnan hospital of Wuhan University from 18 January 2020 to 22 February 2020. Liver function and related indexes were analysed to evaluate its relationship with disease progression in COVID-19 patients. RESULTS: Part of the COVID-19 patients presented with varying degrees of abnormality in liver function indexes. However, the levels of ALT, AST, TBIL, GGT and LDH in COVID-19 patients were not significantly different when compared with hospitalised community-acquired pneumonia patients, and the levels of albumin is even significantly higher. The levels of ALT, AST, TBIL, LDH and INR showed statistically significant elevation in severe COVID-19 cases compared with that in mild cases. However, the clinical significance of the elevation is unremarkable. Majority of severe COVID-19 patients showed significantly decreasing in albumin level and continuously decreasing in the progress of illness. Most of the liver function indexes in COVID-19 patients were correlated with CRP and NLR, the markers of inflammation. Logistic regression analysis further identified NLR as the independent risk factor for severe COVID-19, as well as age. CONCLUSIONS: Although abnormalities of liver function indexes are common in COVID-19 patients, the impairment of liver function is not a prominent feature of COVID-19, and also may not have serious clinical consequences.
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A pneumonia outbreak associated with a new coronavirus of probable bat origin
Peng Zhou, Xing‐Lou Yang, Xian-Guang Wang et al. · Nature · 2020 · 23.3K citations · Full text
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