机构：[1]Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China[2]Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China[3]Institute of Model Animal of Wuhan University, Wuhan, China[4]Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China[5]Department of Cardiology, Central South University, The Third Xiangya Hospital, Changsha, China[6]Basic Medical School of Wuhan University, Wuhan, China[7]Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan, China[8]Department of Urology Surgery, Renmin Hospital of Wuhan University, Eastern Campus, Wuhan, China[9]Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China[10]Department of Urology, Wuhan Third Hospital & Tongren Hospital of Wuhan University, Wuhan, China[11]Department of Intensive Care Unit, Wuhan Third Hospital & Tongren Hospital of Wuhan University, Wuhan, China[12]Wuhan Ninth Hospital, Wuhan, China[13]Department of Cardiology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China[14]Department of Stomatology, Xiantao First People’s Hospital, Xiantao, China[15]Department of General Surgery, Huanggang Central Hospital, Huanggang, China[16]Department of General Surgery, Ezhou Central Hospital, Ezhou, China[17]Wuhan Seventh Hospital, Department of Hepatology, Wuhan, China[18]Eye Center, Renmin Hospital of Wuhan University, Wuhan, China[19]Department of Neurology, Wuhan No. 1 Hospital/Wuhan Hospital of Traditional Chinese and Western Medicine, Wuhan, China[20]Department of Gastroenterology, Wuhan Third Hospital & Tongren Hospital of Wuhan University, Wuhan, China[21]Department of Neonatology, Renmin Hospital of Wuhan University, Wuhan, China.
Background and Aims Coronavirus disease 2019 (COVID-19) is a new infectious disease. To reveal the hepatic injury related to this disease and its clinical significance, we conducted a multicenter retrospective cohort study that included 5,771 adult patients with COVID-19 pneumonia in Hubei Province. Approach and Results We reported the distributional and temporal patterns of liver injury indicators in these patients and determined their associated factors and death risk. Longitudinal liver function tests were retrospectively analyzed and correlated with the risk factors and death. Liver injury dynamic patterns differed in alanine aminotransferase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP), and total bilirubin (TBIL). AST elevated first, followed by ALT, in severe patients. ALP modestly increased during hospitalization and largely remained in the normal range. The fluctuation in TBIL levels was mild in the non-severe and the severe groups. AST abnormality was associated with the highest mortality risk compared with the other indicators of liver injury during hospitalization. Common factors associated with elevated liver injury indicators were lymphocyte count decrease, neutrophil count increase, and male gender. Conclusion The dynamic patterns of liver injury indicators and their potential risk factors may provide an important explanation for the COVID-19-associated liver injury. Because elevated liver injury indicators, particularly AST, are strongly associated with the mortality risk, our study indicates that these parameters should be monitored during hospitalization.
基金：
This study was supported by a grant from the National Key Research and Development Program of China (2020YFC0845500 to Y.Y.).
第一作者机构：[1]Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China[2]Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China[3]Institute of Model Animal of Wuhan University, Wuhan, China
共同第一作者：
通讯作者：
通讯机构：[1]Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, China[2]Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China[3]Institute of Model Animal of Wuhan University, Wuhan, China[4]Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China[6]Basic Medical School of Wuhan University, Wuhan, China[20]Department of Gastroenterology, Wuhan Third Hospital & Tongren Hospital of Wuhan University, Wuhan, China[21]Department of Neonatology, Renmin Hospital of Wuhan University, Wuhan, China.[*1]Department of Cardiology,Renmin Hospital of Wuhan University,238 Jiefang Road,Wuhan 430060, China[*2]Department of Neonatology, Renmin Hospital of Wuhan University, 238 Jiefang Road, Wuhan 430060, China[*3]Department of Gastroenterology, Wuhan Third Hospital & Tongren Hospital of Wuhan University, 241 Pengliuyang Road, Wuhan 430072, China[*4]Department of Hepatobiliary and Pancreatic Surgery, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan 430072, China
推荐引用方式(GB/T 7714)：
Lei Fang,Liu Ye-Mao,Zhou Feng,et al.Longitudinal Association Between Markers of Liver Injury and Mortality in COVID-19 in China[J].HEPATOLOGY.2020,72(2):389-398.doi:10.1002/hep.31301.
APA：
Lei, Fang,Liu, Ye-Mao,Zhou, Feng,Qin, Juan-Juan,Zhang, Peng...&Yuan, Yufeng.(2020).Longitudinal Association Between Markers of Liver Injury and Mortality in COVID-19 in China.HEPATOLOGY,72,(2)
MLA：
Lei, Fang,et al."Longitudinal Association Between Markers of Liver Injury and Mortality in COVID-19 in China".HEPATOLOGY 72..2(2020):389-398
医学