Gut:入院时肝功能异常与SARS-CoV-2感染严重病程相关

2021-06-22 MedSci原创 MedSci原创

入院时肝功能异常,尤其是GGT和白蛋白异常,与SARS-CoV-2感染患者的严重病程相关。

COVID-19患者经常发生肝损伤。SARS-CoV-2感染相关肝损伤的临床相关性尚未明确,需要对基线肝功能检测(LFT)异常的效应进行前瞻性分析。

近日,消化病领域权威杂志Gut上发表了一篇研究文章,研究人员从LMU大学医院前瞻性地纳入了COVID-19登记中心217例无既往肝病患者的资料进行了分析,旨在评估入院时肝功能异常与COVID-19疾病病程之间的关系。重症病程定义为入住重症监护病房(ICU)或COVID-19相关死亡。

58%的COVID-19患者伴有基线时肝功能异常,谷氨酰转氨酶(AST)(42%)、γ -谷氨酰转氨酶(GGT)(37%)、丙氨酸转氨酶(ALT)(27%)显著升高,33%的患者出现低白蛋白血症。ALT和GGT升高以及低白蛋白血症与需要入住ICU治疗和机械通气的患者比例较高相关。

受试者操作特征曲线

在调整了年龄、性别和并发症,低白蛋白血症结合AST或GGT异常住院是入住ICU(OR为46.22和38.8)和入住ICU和/或COVID-19相关死亡复合终点(OR为42.0和26.9)一个非常重要的独立危险因素。

由此可见,入院时肝功能异常,尤其是GGT和白蛋白异常,与SARS-CoV-2感染患者的严重病程相关

原始出处:

Sabine Weber.et al.Liver function test abnormalities at hospital admission are associated with severe course of SARS-CoV-2 infection: a prospective cohort study.Gut.2021.https://gut.bmj.com/content/early/2021/06/21/gutjnl-2020-323800

版权声明:
本网站所有内容来源注明为“梅斯医学”或“MedSci原创”的文字、图片和音视频资料,版权均属于梅斯医学所有。非经授权,任何媒体、网站或个人不得转载,授权转载时须注明来源为“梅斯医学”。其它来源的文章系转载文章,或“梅斯号”自媒体发布的文章,仅系出于传递更多信息之目的,本站仅负责审核内容合规,其内容不代表本站立场,本站不负责内容的准确性和版权。如果存在侵权、或不希望被转载的媒体或个人可与我们联系,我们将立即进行删除处理。
在此留言
评论区 (5)
#插入话题
  1. [GetPortalCommentsPageByObjectIdResponse(id=1935977, encodeId=f0f519359e7fc, content=<a href='/topic/show?id=31c9811912e' target=_blank style='color:#2F92EE;'>#肝功能异常#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81191, encryptionId=31c9811912e, topicName=肝功能异常)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/JicbM9ddhTaNkKdhKQ8adCYWzVJQKZXsqSTg3ia12tmdibiaoTZTEjBqfVvmfODz1KpD73pKy4h1W0fAXj62kxGbQA/132, createdBy=d2132500095, createdName=ms5768352621950538, createdTime=Wed Aug 04 17:04:53 CST 2021, time=2021-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914387, encodeId=25d8191438ea4, content=<a href='/topic/show?id=7c90328e6f1' target=_blank style='color:#2F92EE;'>#功能异常#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32876, encryptionId=7c90328e6f1, topicName=功能异常)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sun May 01 15:04:53 CST 2022, time=2022-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938018, encodeId=1a171938018b2, content=<a href='/topic/show?id=02de15902d3' target=_blank style='color:#2F92EE;'>#SARS-CoV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15902, encryptionId=02de15902d3, topicName=SARS-CoV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, createdName=hukaixun, createdTime=Sat Sep 11 23:04:53 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1321285, encodeId=1d1e1321285c1, content=<a href='/topic/show?id=ac0d159007f' target=_blank style='color:#2F92EE;'>#SARS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15900, encryptionId=ac0d159007f, topicName=SARS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8306486, createdName=小刀医生, createdTime=Thu Jun 24 14:04:53 CST 2021, time=2021-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366744, encodeId=92751366e4497, content=<a href='/topic/show?id=8b4181188f5' target=_blank style='color:#2F92EE;'>#肝功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81188, encryptionId=8b4181188f5, topicName=肝功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Thu Jun 24 14:04:53 CST 2021, time=2021-06-24, status=1, ipAttribution=)]
  2. [GetPortalCommentsPageByObjectIdResponse(id=1935977, encodeId=f0f519359e7fc, content=<a href='/topic/show?id=31c9811912e' target=_blank style='color:#2F92EE;'>#肝功能异常#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81191, encryptionId=31c9811912e, topicName=肝功能异常)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/JicbM9ddhTaNkKdhKQ8adCYWzVJQKZXsqSTg3ia12tmdibiaoTZTEjBqfVvmfODz1KpD73pKy4h1W0fAXj62kxGbQA/132, createdBy=d2132500095, createdName=ms5768352621950538, createdTime=Wed Aug 04 17:04:53 CST 2021, time=2021-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914387, encodeId=25d8191438ea4, content=<a href='/topic/show?id=7c90328e6f1' target=_blank style='color:#2F92EE;'>#功能异常#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32876, encryptionId=7c90328e6f1, topicName=功能异常)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sun May 01 15:04:53 CST 2022, time=2022-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938018, encodeId=1a171938018b2, content=<a href='/topic/show?id=02de15902d3' target=_blank style='color:#2F92EE;'>#SARS-CoV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15902, encryptionId=02de15902d3, topicName=SARS-CoV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, createdName=hukaixun, createdTime=Sat Sep 11 23:04:53 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1321285, encodeId=1d1e1321285c1, content=<a href='/topic/show?id=ac0d159007f' target=_blank style='color:#2F92EE;'>#SARS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15900, encryptionId=ac0d159007f, topicName=SARS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8306486, createdName=小刀医生, createdTime=Thu Jun 24 14:04:53 CST 2021, time=2021-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366744, encodeId=92751366e4497, content=<a href='/topic/show?id=8b4181188f5' target=_blank style='color:#2F92EE;'>#肝功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81188, encryptionId=8b4181188f5, topicName=肝功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Thu Jun 24 14:04:53 CST 2021, time=2021-06-24, status=1, ipAttribution=)]
  3. [GetPortalCommentsPageByObjectIdResponse(id=1935977, encodeId=f0f519359e7fc, content=<a href='/topic/show?id=31c9811912e' target=_blank style='color:#2F92EE;'>#肝功能异常#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81191, encryptionId=31c9811912e, topicName=肝功能异常)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/JicbM9ddhTaNkKdhKQ8adCYWzVJQKZXsqSTg3ia12tmdibiaoTZTEjBqfVvmfODz1KpD73pKy4h1W0fAXj62kxGbQA/132, createdBy=d2132500095, createdName=ms5768352621950538, createdTime=Wed Aug 04 17:04:53 CST 2021, time=2021-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914387, encodeId=25d8191438ea4, content=<a href='/topic/show?id=7c90328e6f1' target=_blank style='color:#2F92EE;'>#功能异常#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32876, encryptionId=7c90328e6f1, topicName=功能异常)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sun May 01 15:04:53 CST 2022, time=2022-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938018, encodeId=1a171938018b2, content=<a href='/topic/show?id=02de15902d3' target=_blank style='color:#2F92EE;'>#SARS-CoV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15902, encryptionId=02de15902d3, topicName=SARS-CoV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, createdName=hukaixun, createdTime=Sat Sep 11 23:04:53 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1321285, encodeId=1d1e1321285c1, content=<a href='/topic/show?id=ac0d159007f' target=_blank style='color:#2F92EE;'>#SARS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15900, encryptionId=ac0d159007f, topicName=SARS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8306486, createdName=小刀医生, createdTime=Thu Jun 24 14:04:53 CST 2021, time=2021-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366744, encodeId=92751366e4497, content=<a href='/topic/show?id=8b4181188f5' target=_blank style='color:#2F92EE;'>#肝功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81188, encryptionId=8b4181188f5, topicName=肝功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Thu Jun 24 14:04:53 CST 2021, time=2021-06-24, status=1, ipAttribution=)]
    2021-09-11 hukaixun
  4. [GetPortalCommentsPageByObjectIdResponse(id=1935977, encodeId=f0f519359e7fc, content=<a href='/topic/show?id=31c9811912e' target=_blank style='color:#2F92EE;'>#肝功能异常#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81191, encryptionId=31c9811912e, topicName=肝功能异常)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/JicbM9ddhTaNkKdhKQ8adCYWzVJQKZXsqSTg3ia12tmdibiaoTZTEjBqfVvmfODz1KpD73pKy4h1W0fAXj62kxGbQA/132, createdBy=d2132500095, createdName=ms5768352621950538, createdTime=Wed Aug 04 17:04:53 CST 2021, time=2021-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914387, encodeId=25d8191438ea4, content=<a href='/topic/show?id=7c90328e6f1' target=_blank style='color:#2F92EE;'>#功能异常#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32876, encryptionId=7c90328e6f1, topicName=功能异常)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sun May 01 15:04:53 CST 2022, time=2022-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938018, encodeId=1a171938018b2, content=<a href='/topic/show?id=02de15902d3' target=_blank style='color:#2F92EE;'>#SARS-CoV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15902, encryptionId=02de15902d3, topicName=SARS-CoV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, createdName=hukaixun, createdTime=Sat Sep 11 23:04:53 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1321285, encodeId=1d1e1321285c1, content=<a href='/topic/show?id=ac0d159007f' target=_blank style='color:#2F92EE;'>#SARS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15900, encryptionId=ac0d159007f, topicName=SARS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8306486, createdName=小刀医生, createdTime=Thu Jun 24 14:04:53 CST 2021, time=2021-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366744, encodeId=92751366e4497, content=<a href='/topic/show?id=8b4181188f5' target=_blank style='color:#2F92EE;'>#肝功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81188, encryptionId=8b4181188f5, topicName=肝功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Thu Jun 24 14:04:53 CST 2021, time=2021-06-24, status=1, ipAttribution=)]
    2021-06-24 小刀医生
  5. [GetPortalCommentsPageByObjectIdResponse(id=1935977, encodeId=f0f519359e7fc, content=<a href='/topic/show?id=31c9811912e' target=_blank style='color:#2F92EE;'>#肝功能异常#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81191, encryptionId=31c9811912e, topicName=肝功能异常)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/JicbM9ddhTaNkKdhKQ8adCYWzVJQKZXsqSTg3ia12tmdibiaoTZTEjBqfVvmfODz1KpD73pKy4h1W0fAXj62kxGbQA/132, createdBy=d2132500095, createdName=ms5768352621950538, createdTime=Wed Aug 04 17:04:53 CST 2021, time=2021-08-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1914387, encodeId=25d8191438ea4, content=<a href='/topic/show?id=7c90328e6f1' target=_blank style='color:#2F92EE;'>#功能异常#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=37, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=32876, encryptionId=7c90328e6f1, topicName=功能异常)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sun May 01 15:04:53 CST 2022, time=2022-05-01, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1938018, encodeId=1a171938018b2, content=<a href='/topic/show?id=02de15902d3' target=_blank style='color:#2F92EE;'>#SARS-CoV#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15902, encryptionId=02de15902d3, topicName=SARS-CoV)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=6ab940, createdName=hukaixun, createdTime=Sat Sep 11 23:04:53 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1321285, encodeId=1d1e1321285c1, content=<a href='/topic/show?id=ac0d159007f' target=_blank style='color:#2F92EE;'>#SARS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=15900, encryptionId=ac0d159007f, topicName=SARS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8306486, createdName=小刀医生, createdTime=Thu Jun 24 14:04:53 CST 2021, time=2021-06-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1366744, encodeId=92751366e4497, content=<a href='/topic/show?id=8b4181188f5' target=_blank style='color:#2F92EE;'>#肝功能#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=81188, encryptionId=8b4181188f5, topicName=肝功能)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8942242, createdName=jj000001, createdTime=Thu Jun 24 14:04:53 CST 2021, time=2021-06-24, status=1, ipAttribution=)]

相关资讯

Circulation:感染SARS-CoV-2的年轻运动员心脏受累情况

SARS-CoV-2感染的年轻运动员短期随访中心脏受累患病率和临床事件风险均较低。

JAMA Neurology: SARS-CoV-2感染可能引起免疫性肌病

大多数COVID-19重症患者表现出从轻微到严重的肌炎症状。骨骼肌的炎症与疾病的持续时间有关,并且比心脏炎症更明显。SARS-CoV-2可能与一种感染后免疫介导的肌病有关。

SCIENCE: SARS-CoV-2开始是如何适应人类的

病毒需要侵入蛋白来穿透细胞进行复制。SARS-CoV-2版本被称为刺突蛋白或S蛋白。S蛋白也是目前疫苗的目标,正在迅速适应新的人类宿主。

BMJ:30岁以上感染SARS-CoV-2变体B.1.1.7的患者入院风险更高

与野生型SARS-CoV-2相比,感染B.1.1.7变种的人住院的风险更高,可能反映了更严重的疾病。这种较高的严重程度可能只适用于30岁以上的成年人。

BMJ:SARS-CoV-2急性期后4个月内后遗症发病风险很高

SARS-CoV-2感染的急性期之后出现新的临床后遗症的风险过高,包括在其他病毒疾病中不太常见的特定类型的后遗症。

J INTERN MED:脂蛋白(a)和SARS-CoV-2感染的关系

SARS-CoV-2感染强化了高Lp(a)水平与IHD之间的相关性,但Lp(a)不影响血栓栓塞事件的风险。