Clinical Features of Patients With COVID-19 With Nonalcoholic Fatty Liver Disease

被引：60

作者：

Huang, Rui ^{[1
]}

Zhu, Li ^{[2
]}

Wang, Jian ^{[1
]}

Xue, Leyang ^{[3
]}

Liu, Longgen ^{[4
]}

Yan, Xuebing ^{[5
]}

Huang, Songping ^{[6
]}

Li, Yang ^{[7
]}

Yan, Xiaomin ^{[1
]}

Zhang, Biao ^{[8
]}

Xu, Tianmin ^{[4
]}

Li, Chunyang ^{[5
]}

Ji, Fang ^{[5
]}

Ming, Fang ^{[6
]}

Zhao, Yun ^{[9
]}

Cheng, Juan ^{[10
]}

Wang, Yinling ^{[2
]}

Zhao, Haiyan ^{[11
]}

Hong, Shuqin ^{[12
]}

Chen, Kang ^{[13
]}

Zhao, Xiang-an ^{[14
]}

Zou, Lei ^{[10
]}

Sang, Dawen ^{[10
]}

Shao, Huaping ^{[11
]}

Guan, Xinying ^{[15
]}

Chen, Xiaobing ^{[16
]}

Chen, Yuxin ^{[17
]}

Wei, Jie ^{[18
]}

Zhu, Chuanwu ^{[2
]}

Wu, Chao ^{[1
]}

机构：

[1] Nanjing Univ, Dept Infect Dis, Nanjing Drum Tower Hosp, Affiliated Hosp,Med Sch, 321 Zhongshan Rd, Nanjing 210008, Peoples R China

[2] Soochow Univ, Dept Infect Dis, Affiliated Infect Dis Hosp, 10 Guangqian Rd, Suzhou, Peoples R China

[3] Huaian 4 Peoples Hosp, Dept Crit Med, Huaian, Peoples R China

[4] Third Peoples Hosp Changzhou, Dept Infect Dis, Changzhou, Peoples R China

[5] Xuzhou Med Univ, Affiliated Hosp, Dept Infect Dis, Xuzhou, Jiangsu, Peoples R China

[6] Nantong Univ, Nantong Peoples Hosp 3, Dept Infect Dis, Nantong, Peoples R China

[7] Taizhou Peoples Hosp, Dept Infect Dis, Taizhou, Peoples R China

[8] Huaian 4 Peoples Hosp, Dept Qual Control Off, Huaian, Peoples R China

[9] Third Peoples Hosp Yangzhou, Dept Infect Dis, Yangzhou, Jiangsu, Peoples R China

[10] Yancheng Second Peoples Hosp, Dept Infect Dis, Yancheng, Peoples R China

[11] Peoples Hosp Suqian, Dept Infect Dis, Suqian, Peoples R China

[12] Huaian 4 Peoples Hosp, Nursing Dept, Huaian, Peoples R China

[13] Third Peoples Hosp Changzhou, Dept TB, Changzhou, Peoples R China

[14] Yangzhou Univ, Northern Jiangsu Peoples Hosp, Dept Gastroenterol, Clin Med Coll, Yangzhou, Jiangsu, Peoples R China

[15] Nanjing Med Univ, Kangda Coll, Affiliated Hosp, Dept Neurol,Peoples Hosp Lianyungang 1, Lianyungang, Peoples R China

[16] Nanjing Med Univ, Kangda Coll, Affiliated Hosp, Peoples Hosp Lianyungang 1,Dept Emergency, Lianyungang, Peoples R China

[17] Nanjing Univ, Med Sch, Affiliated Hosp, Nanjing Drum Tower Hosp,Dept Lab Med, Nanjing, Peoples R China

[18] Nanjing Med Univ, Nanjing Drum Tower Hosp, Clin Coll, Dept Infect Dis, Nanjing, Peoples R China

来源：

HEPATOLOGY COMMUNICATIONS | 2020年 / 4卷 / 12期

关键词：

HEPATIC STEATOSIS INDEX; GUIDELINES; MANAGEMENT; INJURY;

D O I：

10.1002/hep4.1592

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Previous studies reported that coronavirus disease 2019 (COVID-19) was likely to result in liver injury. However, few studies investigated liver injury in patients with COVID-19 with chronic liver diseases. We described the clinical features in patients with COVID-19 with nonalcoholic fatty liver disease (NAFLD). Confirmed patients with COVID-19 from hospitals in 10 cities of Jiangsu Province, China, were retrospectively included between January 18, 2020, and February 26, 2020. The hepatic steatosis index (HSI) was used to defined NAFLD. A total of 280 patients with COVID-19 were enrolled. Eighty-six (30.7%) of 280 patients with COVID-19 were diagnosed as NAFLD by HSI. One hundred (35.7%) patients presented abnormal liver function on admission. The median alanine aminotransferase (ALT) levels (34.5 U/L vs. 23.0 U/L;P < 0.001) and the proportion of elevated ALT (>40 U/L) (40.7% vs. 10.8%;P < 0.001) were significantly higher in patients with NAFLD than in patients without NAFLD on admission. The proportion of elevated ALT in patients with NAFLD was also significantly higher than patients without NAFLD (65.1% vs. 38.7%;P < 0.001) during hospitalization. Multivariate analysis showed that age over 50 years (odds ratio [OR], 2.077; 95% confidence interval [CI], 1.183, 3.648;P = 0.011) and concurrent NAFLD (OR, 2.956; 95% CI, 1.526, 5.726;P = 0.001) were independent risk factors of ALT elevation in patients with COVID-19, while the atomized inhalation of interferon alpha-2b (OR, 0.402; 95% CI, 0.236, 0.683;P = 0.001) was associated with a reduced risk of ALT elevation during hospitalization. No patient developed liver failure or death during hospitalization. The complications and clinical outcomes were comparable between patients with COVID-19 with and without NAFLD.Conclusion:Patients with NAFLD are more likely to develop liver injury when infected by COVID-19. However, no patient developed severe liver-related complications during hospitalization.

引用

页码：1758 / 1768

页数：11

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