Abstract

Background

The novel coronavirus disease 2019 (COVID-19) is currently breaking out worldwide. COVID-19 patients may have different degrees of coagulopathy, but the mechanism is not yet clear. We aimed to analyse the relationship between coagulation dysfunction and liver damage in patients with COVID-19.

Methods

A retrospective analysis of 74 patients with COVID-19 admitted to the First People’s Hospital of Yueyang from 1 January to 30 March 2020 was carried out. According to the coagulation function, 27 cases entered the coagulopathy group and 47 cases entered the control group. A case control study was conducted to analyse the correlation between the occurrence of coagulation dysfunction and liver damage in COVID-19 patients.

Results

Alanine aminotransferase (ALT) and aspartate aminotransferase (AST), markers of liver damage, were positively correlated with coagulopathy (p = 0.039, OR 2.960, 95% CI 1.055–8.304; and p = 0.028, OR 3.352, 95% CI 1.137–9.187). Alkaline phosphatase (ALP), γ-glutamyl transpeptidase (γ-GT), and total bilirubin (TBIL) were not statistically correlated with coagulopathy. According to the diagnosis and treatment plan, the included cases were classified into mild, moderate, severe, and critical. The results showed that the occurrence of coagulation dysfunction had no statistical correlation with the severity of COVID-19.

Conclusion

Coagulation dysfunction in patients with COVID-19 is closely related to liver damage. A longer course of the disease may cause a vicious circle of coagulopathy and liver damage. Clinicians need to closely monitor coagulation and liver function tests and to give prophylactic or supportive therapy when needed.

中文翻译：

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新型冠状病毒性肺炎患者凝血功能障碍与肝损害的相关性分析：一项单中心，回顾性观察研究

摘要

背景

新型冠状病毒病2019（COVID-19）目前正在全球范围内流行。COVID-19患者可能患有不同程度的凝血病，但机制尚不清楚。我们旨在分析COVID-19患者的凝血功能障碍与肝损害之间的关系。

方法

回顾性分析了2020年1月1日至3月30日入岳阳市第一人民医院的74例COVID-19患者。根据凝血功能，进入凝血病组27例，进入对照组47例。病例对照研究分析了COVID-19患者凝血功能障碍的发生与肝损害之间的相关性。

结果

丙氨酸氨基转移酶（ALT）和天冬氨酸氨基转移酶（AST）是肝损伤的标志物，与凝血病呈正相关（p  = 0.039，或2.960，95％CI 1.055–8.304；p  = 0.028，或3.352，95％CI 1.137– 9.187）。碱性磷酸酶（ALP），γ-谷氨酰转肽酶（γ-GT）和总胆红素（TBIL）与凝血病无统计学相关性。根据诊断和治疗计划，将纳入的病例分为轻度，中度，重度和危重。结果表明，凝血功能障碍的发生与COVID-19的严重程度无统计学意义。

结论

COVID-19患者的凝血功能障碍与肝损害密切相关。病程较长可能会导致凝血病和肝脏损害的恶性循环。临床医生需要密切监测凝血和肝功能检查，并在需要时进行预防或支持治疗。