Liver Function Abnormalities in Patients with Chlamydia psittaci Pneumonia: A Multicenter Retrospective Study

Some patients with Chlamydia psittaci pneumonia exhibit liver function abnormalities. In this study, we aimed to elucidate the characteristics of liver function changes and the factors influencing liver injury in patients with Chlamydia psittaci pneumonia, providing a reference for clinical treatment.

The clinical data of patients with Chlamydia psittaci pneumonia admitted to three tertiary Grade A hospitals in Guangdong Province, China, from January 2020 to February 2025 were retrospectively collected. Changes in liver parameters and related influencing factors upon admission were analyzed.

Overall, 120 cases were included: 100 (83.3%) exhibited liver function abnormalities and 55 (45.8%) had liver injury. The incidence of liver function abnormalities and liver injury was significantly higher in the severe group than that in the mild group. Liver function abnormalities and injury associated with Chlamydia psittaci pneumonia were characterized by elevations in alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyltransferase (GGT) levels. AST and ALT levels exceeded three times the upper limit of normal (ULN) in 43 (35.8%) and 20 (16.7%) cases, respectively, while GGT exceeded twice the ULN in 25 (20.8%) cases. ALT (70 [47-115] vs 51 [26-73] U/L, p = 0.002) and AST (122 [72-252] vs 52 [30-76] U/L, p = 0.000) were significantly different between the severe and mild groups. Hepatocellular injury was the most common type of liver injury upon admission, followed by mixed and cholestatic types. Compared to patients without liver injury, those with liver injury had a higher prevalence of alcohol consumption history, dyspnea, higher pneumonia severity index scores, and longer hospital stays.

Patients with Chlamydia psittaci pneumonia, particularly severe cases, are prone to concurrent liver function abnormalities and liver injury. Liver injury, predominantly hepatocellular injury, was associated with factors such as alcohol consumption history, pneumonia severity, and elevated inflammatory responses, leading to prolonged hospital stays. Monitoring liver function may aid in early identification of severe cases.