Clinical characteristics of liver damage in 30 patients with severe coronavirus disease 2019 in Sichuan area

OBJECTIVE: To describe the characteristics of liver damage in severe coronavirus disease 2019 (COVID-19) patients in Sichuan area and the effect of antiviral drugs on liver function.

METHODS: The clinical data of severe COVID-19 patients admitted to Chengdu Public Health Clinical Medical Center from January 21 to February 24, 2020 were retrospectively collected, including demographic data, clinical manifestations and liver function changes within 1 week after admission to intensive care unit (ICU). The changes of liver function during the course of disease in severe COVID-19 patients were analyzed and summarized, and group analysis was performed.

RESULTS: A total of 30 COVID-19 patients with complete clinical data were enrolled. The incidence of severe COVID-19 in elderly men was higher (60.0%), with median age of 61 (47, 79) years old, and those aged 80 or above accounted for 23.3%. The severe COVID-19 patients mainly presented with respiratory symptoms such as fever (96.7%), cough (80.0%) and dyspnea (66.7%). The alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) and prothrombin time (PT) of 30 patients were increased to various degrees within 1 week after ICU admission, and albumin (ALB) was decreased. (1) The patients were divided into two groups according to whether to take lopinavir/ritonavir (kaletra). It was shown that the incidence of liver dysfunction in patients taking kaletra was significantly higher than those who did not take kaletra (7-day abnormal rate of ALT was 54% vs. 33%, the abnormal rate of AST was 38% vs. 33%, the abnormal rate of TBil was 8% vs. 0%), but there were no statistical differences (all P > 0.05). (2) The patients were divided into normal dose group (500 mg, twice a day, n = 19) and reduced dose group (250 mg, twice a day, n = 5) according to the dosage of kaletra. It was shown that patients taking low-dose kaletra had a smaller effect on liver function within 1 week after ICU admission than those receiving normal dosage, and ALB, TBil in the reduced dose group were significantly lower than those in the normal dose group on the 2nd day after ICU admission [ALB (g/L): 33.3±2.0 vs. 37.5±4.0, TBil (μmol/L): 6.3±3.3 vs. 11.3±4.8, both P < 0.05].

CONCLUSIONS: Severe COVID-19 patients in Sichuan area suffered obvious liver damage in the early course of the disease and have a slower recovery. It is important to pay attention to avoid using drugs that can aggravate liver damage while treating the disease. If there is no alternative drug, liver protection treatment should be considered appropriately.

Medienart:

E-Artikel

Erscheinungsjahr:

2020

Erschienen:

2020

Enthalten in:

Zur Gesamtaufnahme - volume:32

Enthalten in:

Zhonghua wei zhong bing ji jiu yi xue - 32(2020), 8 vom: 01. Aug., Seite 928-932

Sprache:

Chinesisch

Beteiligte Personen:

Li, Tianlong [VerfasserIn]
Deng, Chao [VerfasserIn]
Du, Qing [VerfasserIn]
Yue, Ruiming [VerfasserIn]
Lu, Sen [VerfasserIn]
Chen, Hong [VerfasserIn]
Guo, Yang [VerfasserIn]
Huang, Xiaobo [VerfasserIn]

Links:

Volltext

Themen:

2494G1JF75
Antiviral Agents
Drug Combinations
Journal Article
Lopinavir
Lopinavir-ritonavir drug combination
O3J8G9O825
Ritonavir

Anmerkungen:

Date Completed 16.09.2020

Date Revised 18.12.2020

published: Print

Citation Status MEDLINE

doi:

10.3760/cma.j.cn121430-20200513-00656

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM314846077