COVID-19和慢性肝病:来自法国注册1219名患者的结果
L Blaise1,2, F Lebossé3, C Costentin4
1CHU Avicenne, AP-HP, Bobigny, France. lorraine.blaise27@gmail.com.
Scientific reports
|October 7, 2025
概括
患有慢性肝病 (CLD) 的患者面临更高的COVID-19死亡率,特别是那些患有晚期或失补偿疾病的患者. 免疫抑制并没有增加这种脆弱的COVID-19患者群体的死亡风险.
科学领域:
- 肝病学 肝病学是一种肝病学.
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- 冠状病毒SARS CoV-2相关疾病 (COVID-19) 对慢性肝病 (CLD) 患者的影响是一个重大问题.
- 之前的研究表明,CLD患者的脆弱性增加,但大规模的真实世界数据有限.
研究的目的:
- 分析COVID-19的结果,并确定一个大型的法国队列的患者和肝脏移植接受者的预后因素.
- 评估与晚期肝纤维化,脱补偿,肥胖和免疫抑制相关的特定风险.
主要方法:
- 一项现实世界队列研究,包括2020年8月至2021年12月期间被诊断患有COVID-19的1219名CLD患者或肝移植接受者.
- 在移植和非移植子组中使用单变体和多变体模型分析30天死亡率和预后因素.
- 包括标准涉及通过PCR和/或胸部CT扫描确认COVID-19.
主要成果:
- 整体30天死亡率为13%,其中62%的死亡归因于肝外原因.
- 在非移植患者中,晚期肝纤维化 (F3/F4),肥胖和年龄是独立的预后因素.
- 在先进的CLD患者中,脱补偿 (Child-Pugh B/C) 是死亡率的显著预测因素 (HR 3.8);免疫抑制不是一个独立的因素.
结论:
- 晚期CLD患者,特别是脱补偿性疾病患者,表现出COVID-19的脆弱性和死亡风险增加.
- 该研究证实,免疫抑制,特别是在器官移植接受者中,似乎不是COVID-19过度死亡的独立风险因素.
- 研究结果强调,在COVID-19大流行期间,需要针对CLD患者制定有针对性的管理策略.
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