tetano
Editor, Senior Moderator
Eur J Gastroenterol Hepatol
. 2020 Oct 29.
doi: 10.1097/MEG.0000000000001968. Online ahead of print.
The indicative role of markers for liver injury on the severity and prognosis of coronavirus disease 2019 patients
Rongrong Yang[SUP] 1 [/SUP], Xien Gui, Hengning Ke, Shicheng Gao, Mingqi Luo, Yong Xiong
Affiliations
Abstract
Background: Liver injury in coronavirus disease 2019 (COVID-19) patients was poorly understood.
Methods: The markers of liver injury, severity of disease and prognosis among 495 COVID-19 patients in Zhongnan Hospital of Wuhan University from 1st January 2019 to 11th March 2019 were retrospectively analyzed.
Results: The levels of aspartate aminotransferase (AST) (50.1 ? 38.4 vs. 31.4 ? 39.1, P < 0.001), gamma-glutamyl transpeptidase (GGT) (70.3 ? 70.2 vs. 34.1 ? 34.7, P < 0.001) and fibrinogen-to-albumin-ratio (FAR) (13.4 ? 4.0 vs. 10.4 ? 3.4, P < 0.001) were greater than mild COVID-19 patients, whereas the levels of albumin(35.0 ? 6.2 vs. 39.9 ? 3.7, P < 0.001) and albumin/globulin (A/G) ratio (1.21 ? 0.24 vs. 1.50 ? 0.31, P < 0.001) were lower in severe COVID-19 patients. By comparing the changes of liver injury markers 7-10 days after hospitalization, the level of albumin deteriorated from 35.0 ? 6.2 to 30.20 ? 5.5 (P < 0.001), A/G ratio from 1.21 ? 0.24 to 1.06 ? 0.25 (P < 0.001), and FAR from 13.4 ? 4.0 to 15.4 ? 2.9(P < 0.001) in severe COVID-19 patients, while the changes of albumin, A/G ratio and FAR showed opposite patterns in mild COVID-19 patients. FAR > 12 [2.566 (1.410-4.670), P = 0.012) on admission and changes of albumin >5g/l [22.489 (6.422-78.757), P = 0.001] were two risk factors for death, and the sensitivity and specificity for the poor prognosis were 80.8% and 64.0%, 82.6% and 76.3%, respectively.
Conclusion: The levels of AST, GGT, albumin and FAR are correlated with disease severity after severe acute respiratory syndrome coronavirus-2 infection. FAR > 12 on admission and changes of albumin > 5 g/l were good predictors for the prognosis of COVID-19 patients.
. 2020 Oct 29.
doi: 10.1097/MEG.0000000000001968. Online ahead of print.
The indicative role of markers for liver injury on the severity and prognosis of coronavirus disease 2019 patients
Rongrong Yang[SUP] 1 [/SUP], Xien Gui, Hengning Ke, Shicheng Gao, Mingqi Luo, Yong Xiong
Affiliations
- PMID: 33136731
- DOI: 10.1097/MEG.0000000000001968
Abstract
Background: Liver injury in coronavirus disease 2019 (COVID-19) patients was poorly understood.
Methods: The markers of liver injury, severity of disease and prognosis among 495 COVID-19 patients in Zhongnan Hospital of Wuhan University from 1st January 2019 to 11th March 2019 were retrospectively analyzed.
Results: The levels of aspartate aminotransferase (AST) (50.1 ? 38.4 vs. 31.4 ? 39.1, P < 0.001), gamma-glutamyl transpeptidase (GGT) (70.3 ? 70.2 vs. 34.1 ? 34.7, P < 0.001) and fibrinogen-to-albumin-ratio (FAR) (13.4 ? 4.0 vs. 10.4 ? 3.4, P < 0.001) were greater than mild COVID-19 patients, whereas the levels of albumin(35.0 ? 6.2 vs. 39.9 ? 3.7, P < 0.001) and albumin/globulin (A/G) ratio (1.21 ? 0.24 vs. 1.50 ? 0.31, P < 0.001) were lower in severe COVID-19 patients. By comparing the changes of liver injury markers 7-10 days after hospitalization, the level of albumin deteriorated from 35.0 ? 6.2 to 30.20 ? 5.5 (P < 0.001), A/G ratio from 1.21 ? 0.24 to 1.06 ? 0.25 (P < 0.001), and FAR from 13.4 ? 4.0 to 15.4 ? 2.9(P < 0.001) in severe COVID-19 patients, while the changes of albumin, A/G ratio and FAR showed opposite patterns in mild COVID-19 patients. FAR > 12 [2.566 (1.410-4.670), P = 0.012) on admission and changes of albumin >5g/l [22.489 (6.422-78.757), P = 0.001] were two risk factors for death, and the sensitivity and specificity for the poor prognosis were 80.8% and 64.0%, 82.6% and 76.3%, respectively.
Conclusion: The levels of AST, GGT, albumin and FAR are correlated with disease severity after severe acute respiratory syndrome coronavirus-2 infection. FAR > 12 on admission and changes of albumin > 5 g/l were good predictors for the prognosis of COVID-19 patients.