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Pattern of liver injury in adult patients with COVID-19: a retrospective analysis of 105 patients.

成人新型冠状病毒肺炎患者的肝损伤模式: 105 例患者的回顾性分析。

  • 影响因子:1.61
  • DOI:10.1186/s40779-020-00256-6
  • 作者列表:"Wang Q","Zhao H","Liu LG","Wang YB","Zhang T","Li MH","Xu YL","Gao GJ","Xiong HF","Fan Y","Cao Y","Ding R","Wang JJ","Cheng C","Xie W
  • 发表时间:2020-06-07
Abstract

BACKGROUND:Recent studies reported that patients with coronavirus disease-2019 (COVID-19) might have liver injury. However, few data on the combined analysis and change patterns of alanine aminotransferase (ALT), aspartate aminotransferase (AST) and total bilirubin (TBil) have been shown. METHODS:This is a single-center retrospective study. A total of 105 adult patients hospitalized for confirmed COVID-19 in Beijing Ditan Hospital between January 12, and March 17, 2020 were included, and divided into mild group (n = 79) and severe group(n = 26). We compared liver functional test results between the two groups. Category of ALT change during the disease course was also examined. RESULTS:56.2% (59/105) of the patients had unnormal ALT, AST, or total TBil throughout the course of the disease, but in 91.4% (96/105) cases the level of ALT, AST or TBil ≤3 fold of the upper limit of normal reference range (ULN). The overall distribution of ALT, AST, and TBil were all significantly difference between mild and severe group (P <  0.05). The percentage of the patients with elevated both ALT and AST was 12.7% (10/79) in mild cases vs. 46.2% (12/26) in severe cases (P = 0.001). 34.6% (9/26) severe group patients started to have abnormal ALT after admission, and 73.3% (77/105) of all patients had normal ALT before discharge. CONCLUSIONS:Elevated liver function index is very common in patients with COVID-19 infection, and the level were less than 3 × ULN, but most are reversible. The abnormality of 2 or more indexes is low in the patients with COVID-19, but it is more likely to occur in the severe group.

摘要

背景: 最近的研究报道冠状病毒病-2019 (新型冠状病毒肺炎) 患者可能有肝损伤。然而,关于丙氨酸氨基转移酶 (ALT) 、天冬氨酸氨基转移酶 (AST) 和总胆红素 (TBil) 的联合分析和变化模式的数据很少。 方法: 本研究为单中心回顾性研究。纳入 2020 年 1 月 12 日至 3 月 17 日在北京地坛医院确诊为新型冠状病毒肺炎的成人患者 105 例,分为轻度组 (n = 79)。重度组 (n = 26)。比较两组肝功能test结果。还检查了病程中ALT变化的类别。 结果: 56.2% (59/105) 的患者在整个病程中ALT、AST或总TBil异常,但 91.4% (96/105) 的患者ALT、AST或TBil ≤ 正常参考范围上限 (ULN) 的 3 倍。ALT、AST、TBil的总体分布在轻度组和重度组间差异均有统计学意义 (p <0.05)。轻症组ALT和AST均升高的比例为 12.7% (10/79),重症组为 46.2% (12/26) (p = 0.001)。34.6% (9/26) 重症组患者入院后开始出现ALT异常,所有患者中 73.3% (77/105) 患者出院前ALT正常。 结论: 肝功能指标升高在新型冠状病毒肺炎感染患者中非常常见,其水平均小于 3 × uln,但多数是可逆的。2 项及以上指标的异常在新型冠状病毒肺炎患者中较低,但在重症组更容易发生。

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影响因子:4.36
发表时间:2020-02-17
DOI:10.1080/22221751.2020.1729071
作者列表:["Zhang W","Du RH","Li B","Zheng XS","Yang XL","Hu B","Wang YY","Xiao GF","Yan B","Shi ZL","Zhou P"]

METHODS::In December 2019, a novel coronavirus (2019-nCoV) caused an outbreak in Wuhan, China, and soon spread to other parts of the world. It was believed that 2019-nCoV was transmitted through respiratory tract and then induced pneumonia, thus molecular diagnosis based on oral swabs was used for confirmation of this disease. Likewise, patient will be released upon two times of negative detection from oral swabs. However, many coronaviruses can also be transmitted through oral-fecal route by infecting intestines. Whether 2019-nCoV infected patients also carry virus in other organs like intestine need to be tested. We conducted investigation on patients in a local hospital who were infected with this virus. We found the presence of 2019-nCoV in anal swabs and blood as well, and more anal swab positives than oral swab positives in a later stage of infection, suggesting shedding and thereby transmitted through oral-fecal route. We also showed serology test can improve detection positive rate thus should be used in future epidemiology. Our report provides a cautionary warning that 2019-nCoV may be shed through multiple routes.

翻译标题与摘要 下载文献
影响因子:2.48
发表时间:2020-04-01
来源期刊:Infection
DOI:10.1007/s15010-020-01401-y
作者列表:["Cheng ZJ","Shan J"]

METHODS::There is a current worldwide outbreak of a new type of coronavirus (2019-nCoV), which originated from Wuhan in China and has now spread to 17 other countries. Governments are under increased pressure to stop the outbreak spiraling into a global health emergency. At this stage, preparedness, transparency, and sharing of information are crucial to risk assessments and beginning outbreak control activities. This information should include reports from outbreak sites and from laboratories supporting the investigation. This paper aggregates and consolidates the virology, epidemiology, clinical management strategies from both English and Chinese literature, official news channels, and other official government documents. In addition, by fitting the number of infections with a single-term exponential model, we report that the infection is spreading at an exponential rate, with a doubling period of 1.8 days.

呼吸道感染方向

呼吸道感染分为上呼吸道感染与下呼吸道感染。上呼吸道感染是指自鼻腔至喉部之间的急性炎症的总称,是最常见的感染性疾病。下呼吸道感染是最常见的感染性疾患,治疗时必须明确引起感染的病原体以选择有效的抗生素。

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