PDF(Pubmed)
Abstract：
UNASSIGNED: The most dreaded pandemic grappling world now, the Coronavirus Disease 2019 (COVID-19), chiefly involves the respiratory system; nevertheless, it is a multisystem disorder. Its involvement of the hepatic system is considerable; however, still emerging are its clinical implications and the effects on morbidity and mortality.
UNASSIGNED: The aim of this study is to report on the various aspects of its hepatic involvement by describing the alterations in tests of liver function and its significance in the disease outcome in a cohort of hospitalized COVID-19 patients at a tertiary center in northern India.
UNASSIGNED: This is a retrospective cohort study conducted in a tertiary-care hospital in northern India. All confirmed hospitalized COVID-19 cases aged 15 and above from Apr to Oct 2020 with no pre-existing liver disease were included. The primary endpoint was death at 28 days. Statistical analysis included descriptive analysis, sensitivity-specificity, and univariable and multivariable regression analysis as well as survival analysis.
UNASSIGNED: A total of 708 patients with COVID-19 fulfilled the inclusion criteria included 561 (79.2%) males and 147 (20.8%) females. The median age was 49 (IQR = 25) years. Mild and moderate/severe disease were seen in 508 (71.8%) and 200 (28.2) patients, respectively. Serum bilirubin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were elevated in 6.92%, 69.91%, and 80.22% of patients, respectively. In univariable logistic regression, AST [odds ratio; OR 1.008 95% CI (1.005-1.012) per 1 IU/L increase] and ALT [OR 1.005 95% CI (1.002-1.007) per 1 IU/L increase] were significantly associated with the odds of moderate to severe disease but only AST was significant after adjustment to age, sex, and comorbidity [adjusted odds ratio; aOR 1.007 95% CI (1.003-1.011) per 1 IU/L increase]. Serum albumin was negatively associated with the odds of moderate to severe disease and remained significant in the adjusted model [aOR 0.217 95%CI (0.149-0.316) per 1 g/dL increase].Ninety-six patients succumbed to illness [case fatality rate; CFR 13.6%). In adjusted Cox Proportional-Hazards Model for mortality, AST [adjusted hazard ratio; aHR 1.002 95% CI (1.000-1.003) per 1 IU/L increase] and serum albumin [aHR 0.396 95% CI (0.285-0.549) per 1 g/dL increase] showed significant association with mortality.
UNASSIGNED: Liver function abnormalities are common in patients with COVID-19. In particular, AST and serum albumin levels are effective predictors of disease severity and mortality and can be used as markers of fatal disease in the management as well as prognostication of COVID-19.
UNASSIGNED: The aim of this study is to report on the various aspects of its hepatic involvement by describing the alterations in tests of liver function and its significance in the disease outcome in a cohort of hospitalized COVID-19 patients at a tertiary center in northern India.
UNASSIGNED: This is a retrospective cohort study conducted in a tertiary-care hospital in northern India. All confirmed hospitalized COVID-19 cases aged 15 and above from Apr to Oct 2020 with no pre-existing liver disease were included. The primary endpoint was death at 28 days. Statistical analysis included descriptive analysis, sensitivity-specificity, and univariable and multivariable regression analysis as well as survival analysis.
UNASSIGNED: A total of 708 patients with COVID-19 fulfilled the inclusion criteria included 561 (79.2%) males and 147 (20.8%) females. The median age was 49 (IQR = 25) years. Mild and moderate/severe disease were seen in 508 (71.8%) and 200 (28.2) patients, respectively. Serum bilirubin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT) were elevated in 6.92%, 69.91%, and 80.22% of patients, respectively. In univariable logistic regression, AST [odds ratio; OR 1.008 95% CI (1.005-1.012) per 1 IU/L increase] and ALT [OR 1.005 95% CI (1.002-1.007) per 1 IU/L increase] were significantly associated with the odds of moderate to severe disease but only AST was significant after adjustment to age, sex, and comorbidity [adjusted odds ratio; aOR 1.007 95% CI (1.003-1.011) per 1 IU/L increase]. Serum albumin was negatively associated with the odds of moderate to severe disease and remained significant in the adjusted model [aOR 0.217 95%CI (0.149-0.316) per 1 g/dL increase].Ninety-six patients succumbed to illness [case fatality rate; CFR 13.6%). In adjusted Cox Proportional-Hazards Model for mortality, AST [adjusted hazard ratio; aHR 1.002 95% CI (1.000-1.003) per 1 IU/L increase] and serum albumin [aHR 0.396 95% CI (0.285-0.549) per 1 g/dL increase] showed significant association with mortality.
UNASSIGNED: Liver function abnormalities are common in patients with COVID-19. In particular, AST and serum albumin levels are effective predictors of disease severity and mortality and can be used as markers of fatal disease in the management as well as prognostication of COVID-19.
摘要：
未经批准：现在世界上最可怕的流行病，2019年冠状病毒病（COVID-19），主要涉及呼吸系统；尽管如此，这是一个多系统疾病。它对肝脏系统的影响相当大；然而，其临床意义以及对发病率和死亡率的影响仍在出现。
UNASSIGNED：这项研究的目的是通过描述在印度北部三级中心住院的一组COVID-19患者中肝功能测试的变化及其在疾病结局中的重要性来报告其肝脏受累的各个方面。
UNASSIGNED：这是一项在印度北部一家三级保健医院进行的回顾性队列研究。包括2020年4月至2020年10月所有确诊的15岁及以上无肝脏疾病的住院COVID-19病例。主要终点是28天的死亡。统计分析包括描述性分析，敏感性-特异性，单变量和多变量回归分析以及生存分析。
未经证实：共708例符合纳入标准的COVID-19患者，其中男性561例（79.2%），女性147例（20.8%）。中位年龄为49岁（IQR=25）。轻度和中度/重度疾病见于508例（71.8%）和200例（28.2）患者，分别。血清胆红素,天冬氨酸转氨酶（AST），丙氨酸转氨酶(ALT)升高6.92%,69.91%,80.22%的患者，分别。在单变量逻辑回归中，AST[比值比;每1IU/L增加1.00895％CI（1.005-1.012）]和ALT[每1IU/L增加1.00595％CI（1.002-1.007）]与中度至重度疾病的几率显着相关，但只有AST在调整年龄后才显着，性别,和合并症[调整后的比值比；每1IU/L增加1.00795%CI（1.003-1.011）]。血清白蛋白与中度至重度疾病的几率呈负相关，并且在校正模型中仍然显着[每1g/dL增加0.21795CI（0.149-0.316）]。96名患者死于疾病[病死率；CFR13.6%)。在死亡率的校正Cox比例-危险模型中，AST[校正危险比;每1IU/L增加aHR1.00295%CI(1.000-1.003)]和血清白蛋白[每1g/dL增加aHR0.39695%CI(0.285-0.549)]显示与死亡率显著相关。
未经证实：肝功能异常在COVID-19患者中很常见。特别是,AST和血清白蛋白水平是疾病严重程度和死亡率的有效预测指标，可作为COVID-19治疗和预后中致命疾病的标志物。
UNASSIGNED：这项研究的目的是通过描述在印度北部三级中心住院的一组COVID-19患者中肝功能测试的变化及其在疾病结局中的重要性来报告其肝脏受累的各个方面。
UNASSIGNED：这是一项在印度北部一家三级保健医院进行的回顾性队列研究。包括2020年4月至2020年10月所有确诊的15岁及以上无肝脏疾病的住院COVID-19病例。主要终点是28天的死亡。统计分析包括描述性分析，敏感性-特异性，单变量和多变量回归分析以及生存分析。
未经证实：共708例符合纳入标准的COVID-19患者，其中男性561例（79.2%），女性147例（20.8%）。中位年龄为49岁（IQR=25）。轻度和中度/重度疾病见于508例（71.8%）和200例（28.2）患者，分别。血清胆红素,天冬氨酸转氨酶（AST），丙氨酸转氨酶(ALT)升高6.92%,69.91%,80.22%的患者，分别。在单变量逻辑回归中，AST[比值比;每1IU/L增加1.00895％CI（1.005-1.012）]和ALT[每1IU/L增加1.00595％CI（1.002-1.007）]与中度至重度疾病的几率显着相关，但只有AST在调整年龄后才显着，性别,和合并症[调整后的比值比；每1IU/L增加1.00795%CI（1.003-1.011）]。血清白蛋白与中度至重度疾病的几率呈负相关，并且在校正模型中仍然显着[每1g/dL增加0.21795CI（0.149-0.316）]。96名患者死于疾病[病死率；CFR13.6%)。在死亡率的校正Cox比例-危险模型中，AST[校正危险比;每1IU/L增加aHR1.00295%CI(1.000-1.003)]和血清白蛋白[每1g/dL增加aHR0.39695%CI(0.285-0.549)]显示与死亡率显著相关。
未经证实：肝功能异常在COVID-19患者中很常见。特别是,AST和血清白蛋白水平是疾病严重程度和死亡率的有效预测指标，可作为COVID-19治疗和预后中致命疾病的标志物。
