Coronavirus Disease 2019 and Liver Injury:A Retrospective Analysis of Hospitalized Patients in New York City  

作　　者：Joshua M.Bender Howard J.Worman 

机构地区：[1]Department of Medicine,Vagelos College of Physicians&Surgeons,Columbia University,New York,NY,USA [2]Department of Pathology and Cell Biology,Vagelos College of Physicians&Surgeons,Columbia University,New York,NY,USA

出　　处：《Journal of Clinical and Translational Hepatology》2021年第4期551-558,共8页临床与转化肝病杂志（英文版）

基　　金：National Institute of Diabetes and Digestive and Kidney Disease(No.T35DK93430)to JMB and the National Center for Advancing Translational Sciences(No.UL1TR001873)of the National Institutes of Health to support the Irving Center for Clinical and Translational Research at Columbia University;The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

摘　　要：Background and Aims:Coronavirus disease 2019(COVID-19)is a global threat,affecting more than 100 million people and causing over 2 million deaths.Liver laboratory test abnormalities are an extrapulmonary manifestation of COVID-19,yet characterization of hepatic injury is incomplete.Our objective was to further characterize and identify causes of liver injury in patients with COVID-19.Methods:We conducted a retrospective cohort study of 551 patients hospitalized with COVID-19 at NewYork-Presbyterian Hospital/Columbia University Irving Medical Center between March 1,2020 and May 31,2020.We analyzed patient demographics,liver laboratory test results,vital signs,other relevant test results,and clinical outcomes(mortality and intensive care unit admission).Results:Abnormal liver laboratory tests were common on hospital admission for COVID-19 and the incidence increased during hospitalization.Of those with elevated serum alanine aminotransferase and/or alkaline phosphatase activities on admission,58.2%had a cholestatic injury pattern,35.2%mixed,and 6.6%hepatocellular.Comorbid liver disease was not associated with outcome;however,abnormal direct bilirubin or albumin on admission were associated with intensive care unit stay and mortality.On average,patients who died had greater magnitudes of abnormalities in all liver laboratory tests than those who survived.Ischemic hepatitis was a mechanism of severe hepatocellular injury in some patients.Conclusions:Liver laboratory test abnormalities are common in hospitalized patients with COVID-19,and some are associated with increased odds of intensive care unit stay or death.Severe hepatocellular injury is likely attributable to secondary effects such as systemic inflammatory response syndrome,sepsis,and ischemic hepatitis.

关 键 词：AMINOTRANSFERASE BILIRUBIN Ischemic hepatitis SARS-CoV-2 

分 类 号：R57[医药卫生—消化系统]