Liver dysfunction on admission worsens clinical manifestations and outcomes of coronavirus disease 2019

作     者：Fangying Lu Rong Chen Kandi Xu Jie Huang Dexiang Yang Tao Bai Yusang Xie Yun Ling Kui Liu Wei Du Jiayang Yan Huihuang Lin Jian Li Yun Feng Min Zhou Yi Guo Fangying Lu;Rong Chen;Kandi Xu;Jie Huang;Dexiang Yang;Tao Bai;Yusang Xie;Yun Ling;Kui Liu;Wei Du;Jiayang Yan;Huihuang Lin;Jian Li;Yun Feng;Min Zhou;Yi Guo

作者机构：Department of Respiratory and Critical Care MedicineRuijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China Institute of Respiratory DiseasesShanghai Jiao Tong University School of MedicineShanghai 200025China Department of Critical MedicineRuijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China Department of Respiratory DiseasesTongling People’s HospitalTonglingAnhui 244099China Department of Infectious DiseaseWuhan Jinyintan HospitalWuhanHubei 430048China Department of Infectious DiseaseShanghai Public Health Clinical CenterShanghai 200025China Department of Respiratory and Critical Care MedicineTongji HospitalTongji Medical College of Huazhong University of Science and TechnologyWuhanHubei 430030China Clinical Research CenterRuijin HospitalShanghai Jiao Tong University School of MedicineShanghai 200025China 

出 版 物：《Chinese Medical Journal Pulmonary and Critical Care Medicine》 (呼吸与危重症医学（英文）)

年 卷 期：2023年第1卷第3期

页      面：181-187页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：This study was supported by the National Natural Science Foun-dation of China(No.81630001) the Shanghai Municipal Key Clini-cal Specialty(No.shslczdzk02202) the Shanghai Top-Priority Clinical Key Disciplines Construction Project(No.2017ZZ02014) the Shanghai Shenkang Hospital Development Center Clinical Science and Technol-ogy Innovation Project(No.SHDC12018102) the Innovative Re-search Team of High-level Local Universities in Shanghai and Zhejiang University special scientific research fund for COVID-19 prevention and control(No.2020XGZX011) 

主　　题：COVID-19 Liver dysfunction Clinical manifestation Outcomes Mortality 

摘      要：Background:Liver dysfunction was common in coronavirus disease 2019(COVID-19),but its association with clinical features and poor prognosis has not been fully *** study aimed to determine the role of liver dysfunction in COVID-19 and understand the predictors for worse outcomes in patients with liver ***:We conducted this multicenter,retrospective study in five designated hospitals for COVID-19 ***-confirmed COVID-19 patients were enrolled and classified into the normal live function group and liver dysfunction group according to liver enzymes,bilirubin,and albumin on admission,*** of baseline,clinical manifestations,and outcomes were collected and compared in the paired ***:Of the 649 included COVID-19 patients,200(30.8%),69(10.6%),and 267(41.1%)patients had elevated liver enzymes,increased bilirubin,and low-level albumin,***,cough,and dyspnea were the most common symptoms and showed an increased proportion in the liver dysfunction *** with patients in the normal liver function group,patients with liver dysfunction manifested decreased lymphocytes,higher level of leukocytes,neutrophils,inflammatory indicators,and cytokines,as well as more severe impairment in kidney function and *** were more likely to show bilateral involvement and more pulmonary lobes involved according to chest *** increased proportion of patients who developed severe/critical conditions and needed mechanical ventilation and systemic glucocorticoid therapy,patients with liver dysfunc-tion on admission showed significantly higher in-hospital ***,cardiac troponin I≥1.5 ng/mL was identified as an independent mortality predictor in the elevated liver enzymes ***:Patients with liver dysfunction on admission had worse clinical manifestation,and resulted in higher rate of severe/critical type,receiving mechanical ventilation and in-hospital mortality.