Abstract
Background: A cytokine storm conceivably contributes to manifestations of corona virus disease (COVID-19). Inflammatory cytokines such as interleukin-6 (IL-6) cause acute liver injury while serum detectability indicates systemic inflammation.
Aims: We explored a link between systemic IL-6, related acute phase proteins and liver injury in hospitalized COVID-19 patients.
Methods: 655 patients with suspected COVID-19 were screened in the emergency department at the University Hospital of Innsbruck, Austria, between February and April 2020. 96 patients (∼15%) were hospitalized with COVID-19. 15 patients required intensive-care treatment (ICT). Plasma aminotransferases, alkaline phosphatase, bilirubin, and gamma glutamyl transferase, as well as IL-6, C-reactive protein (CRP), ferritin and lactate dehydrogenase (LDH) were determined by standard clinical assays.
Results: Of all hospitalized COVID-19 patients, 41 (42%) showed elevated aspartate aminotransferase (AST) concentration. COVID-19 patients with elevated AST exhibited significantly higher IL-6 (p < 0.001), ferritin (p < 0.001), LDH (p < 0.001) and CRP (p < 0.05) serum concentrations compared to patients with normal AST. Liver injury correlated with systemic IL-6 (p < 0.001), CRP (p < 0.001), ferritin (p < 0.001) and LDH (p < 0.001) concentration. In COVID-19 patients requiring ICT, correlations were more pronounced.
Conclusion: Systemic inflammation could be a fuel for hepatic injury in COVID-19.
Keywords: Acute phase protein; COVID-19; Cytokines; Interleukin-6; Liver damage; SARS-CoV2.
【저자키워드】 COVID-19, Cytokines, interleukin-6, SARS-CoV2., Acute phase protein, Liver damage, 【초록키워드】 Inflammation, Cytokine storm, SARS-CoV2, Cytokines, Hospitalized, IL-6, interleukin-6, LDH, C-reactive protein, CRP, ferritin, cytokine, lactate dehydrogenase, emergency department, Protein, serum, interleukin, Patient, Aspartate aminotransferase, Liver injury, AST, Manifestations, Inflammatory cytokines, systemic inflammation, correlation, university, COVID-19 patients, Liver damage, Lactate, Concentration, Injury, Bilirubin, COVID-19 patient, manifestation, systemic, Virus Disease, determined by, phosphatase, alkaline phosphatase, Acute liver injury, hospitalized COVID-19 patients, acute phase, university hospital, aspartate, serum concentrations, correlations, dehydrogenase, hepatic injury, fuel, intensive-care treatment, assays, required, elevated, screened, exhibited, indicate, contribute, correlated, significantly higher, with COVID-19, 【제목키워드】 Inflammation, systemic inflammation, systemic,