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Clinical characteristics of liver injury in SARS-CoV-2 Omicron variant- and Omicron subvariant-infected patients
Institution:Department of Infectious Disease Center, Guangzhou Eighth People''s Hospital, Guangzhou Medical University, Guangdong Province, China
Abstract:Introduction and ObjectivesLiver injury in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant- and Omicron subvariant-infected patients is unknown at present, and the aim of this study is to summarize liver injury in these patients.Patients and MethodsIn this study, 460 SARS-CoV-2-infected patients were enrolled. Five severe or critical patients were excluded, and 34 patients were also excluded because liver injury was not considered to be related to SARS-CoV-2 infection. Liver injury was compared between Omicron and non-Omicron variants- and between Omicron subvariant-infected patients; additionally, the clinical data related to liver injury were also analyzed.ResultsAmong the 421 patients enrolled for analysis, liver injury was detected in 76 (18.1%) patients, including 46 Omicron and 30 non-Omicron variant-infected patients. The ratios did not differ between Omicron and non-Omicron variant-, Omicron BA.1, BA.2 and BA.5 subvariant-infected patients (P>0.05). The majority of abnormal parameters of liver function tests were mildly elevated (1-3 × ULN), the most frequently elevated parameter of liver function test was γ-glutamyl transpeptidase (GGT, 9.5%, 40/421), and patients with cholangiocyte or biliary duct injury markers were higher than with hepatocellular injury markers. Multivariate analysis showed that age (>40 years old, OR=1.898, 95% CI=1.058–3.402, P=0.032), sex (male gender, OR=2.031, 95% CI=1.211–3.408, P=0.007), serum amyloid A (SAA) level (>10 mg/ml, OR=3.595, 95% CI=1.840–7.026, P<0.001) and vaccination status (No, OR=2.131, 95% CI=1.089–4.173, P=0.027) were independent factors related to liver injury.ConclusionsLiver injury does not differ between Omicron and non-Omicron variants or between Omicron subvariant-infected patients. The elevations of cholangiocyte or biliary duct injury biomarkers are dominant in SARS-CoV-2-infected patients.
Keywords:SARS-CoV-2"}  {"#name":"keyword"  "$":{"id":"pc_z2vSi8jhcN"}  "$$":[{"#name":"text"  "_":"severe acute respiratory syndrome coronavirus 2  COVID-19"}  {"#name":"keyword"  "$":{"id":"pc_FTSWRU5bKn"}  "$$":[{"#name":"text"  "_":"coronavirus disease 2019  Ct"}  {"#name":"keyword"  "$":{"id":"pc_5BbsRVnDpU"}  "$$":[{"#name":"text"  "_":"cycle threshold  ALT"}  {"#name":"keyword"  "$":{"id":"pc_X0onpfeUdN"}  "$$":[{"#name":"text"  "_":"alanine aminotransferase  AST"}  {"#name":"keyword"  "$":{"id":"pc_9kYx2QAtMi"}  "$$":[{"#name":"text"  "_":"aspartate aminotransferase  TBA"}  {"#name":"keyword"  "$":{"id":"pc_hx96R3GpAs"}  "$$":[{"#name":"text"  "_":"total bile acid  ALP"}  {"#name":"keyword"  "$":{"id":"pc_qb04p3UGzY"}  "$$":[{"#name":"text"  "_":"alkaline phosphatase  GGT"}  {"#name":"keyword"  "$":{"id":"pc_leD1Yd47Yj"}  "$$":[{"#name":"text"  "_":"γ-glutamyl transpeptidase  TBIL"}  {"#name":"keyword"  "$":{"id":"pc_VWGx4LAwW5"}  "$$":[{"#name":"text"  "_":"total bilirubin  ALB"}  {"#name":"keyword"  "$":{"id":"pc_W5VOegNExD"}  "$$":[{"#name":"text"  "_":"albumin  ULN"}  {"#name":"keyword"  "$":{"id":"pc_4JZ5vrlDzY"}  "$$":[{"#name":"text"  "_":"upper limit of normal value  BMI"}  {"#name":"keyword"  "$":{"id":"pc_QbDJeB5N4q"}  "$$":[{"#name":"text"  "_":"body mass index  NAFLD"}  {"#name":"keyword"  "$":{"id":"pc_grABFUmxhe"}  "$$":[{"#name":"text"  "_":"nonalcoholic fatty liver disease  HBV"}  {"#name":"keyword"  "$":{"id":"pc_gomHWzwxUf"}  "$$":[{"#name":"text"  "_":"hepatitis B virus  SAA"}  {"#name":"keyword"  "$":{"id":"pc_2jUlxt6Dta"}  "$$":[{"#name":"text"  "_":"serum amyloid A  CRP"}  {"#name":"keyword"  "$":{"id":"pc_ysdbJbSoyC"}  "$$":[{"#name":"text"  "_":"C-reactive protein
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