Clinical characteristics and risk factors of liver injury in COVID-19: a retrospective cohort study from Wuhan, China
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ORIGINAL ARTICLE
Clinical characteristics and risk factors of liver injury in COVID‑19: a retrospective cohort study from Wuhan, China Ming Wang1 · Weiming Yan1 · Weipeng Qi1 · Di Wu1 · Lin Zhu1 · Weina Li1 · Xiaojing Wang1 · Ke Ma1 · Ming Ni1 · Dong Xu1 · Hongwu Wang1 · Guang Chen1 · Haijing Yu1 · Hongfang Ding1 · Mingyou Xing1 · Meifang Han1 · Xiaoping Luo2 · Tao Chen1 · Wei Guo1 · Dong Xi1 · Qin Ning1 Received: 26 May 2020 / Accepted: 11 July 2020 © The Author(s) 2020
Abstract 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 °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, TNFα, ferritin, hsCRP, PCT, ESR, γ-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-tolymphocyte 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. Keywords 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
Introduction Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12072-020-10075-5) contains supplementary material, which is available to authorized users. Ming Wang and Weiming Yan contributed equally to this work. * Wei Guo [email protected] * Dong Xi [email protected] * Qin Ning [email protected]
The ongoing outbreak of Coronavirus disease 2019 (COVID-19) has been recently becoming a pandemic [1]. At present, it is believed that SARS-CoV-2 mainly invades the respirator
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