Liver Injury Is Related to the Severity and Prognosis of Novel Coronavirus Disease 2019 (preprint)

Background: Previous studies revealed that liver injury is common in the novel coronavirus disease 2019 (COVID-19) patients. However, risk factors of liver injury and whether liver injury is related to the severity or prognosis of COVID-19 is unclarified. Methods: COVID-19 patients were retrospectively recruited from a tertiary hospital in Wuhan, China. General information, past medical history, symptoms, signs, laboratory examination results and clinical outcomes were collected. Incidence and potential risk factors of liver injury were analyzed. Laboratory examination results, incidence of other symptoms and the incidence of the main outcomes, disease progression and death, were compared between patients with or without liver injury. Findings: About 57·7% patients showed liver injury. The incidence of liver injury was higher in male patients. More patients with liver injury were diagnosed as critically ill at admission. Patients with liver injury had higher incidence of dyspnea, lower SpO2 and higher maximum body temperature. They also had many worse laboratory examination results regarding inflammation, cytokines, renal function, coagulation function and myocardial injury. And, the incidence of disease progression and mortality was much higher in patients with liver injury. In further multivariable logistic analysis, direct bilirubin, hs-CRP and NT-proBNP were independent predictors for disease progression, and chronic pulmonary disease, hemoptysis, cholesterol and IL-2R were independent predictors for death. Interpretation: Liver injury is common in COVID-19 patients, and male patients are at higher risk to have liver injury. Patients with liver injury can be severer and have a higher incidence of disease progression than those without. Funding: The present study was not supported by any funding.Declaration of Interests: All the authors declare no conflicts of interests.Ethics Approval Statement: The study protocol is approved by the Institutional Ethics Committee of Peking University First Hospital and all the methods were carried out in accordance with the approved guidelines of the committee and with the Helsinki Declaration. Informed consent is waived.

Influence of influenza A virus in COVID-19 patients: A retrospective cohort study (preprint)

Background and objective: Coronavirus disease (COVID-19) is currently an urgent global issue, but we cannot ignore the impact of influenza A since there is an overlap of infection time and region and similar clinical manifestations and chest computed tomography (CT) images for influenza A and COVID-19 infections. We compared patients who had a COVID-19 infection and co-infection with the influenza A virus.Methods: We retrospectively reviewed patients who met the inclusion criteria for this study.Results: There were 213 patients included in this study, of whom 106 were females and 107 were males, with a median age of 63 years. All patients were diagnosed with COVID-19 and were subsequently divided into influenza positive (n = 97) and influenza negative (n = 116) groups according to the serum test results for the influenza A IgM antibody. The two groups had similar symptoms, outcomes, CT manifestation and CT scores, except for lymphadenopathy (6.2% in the influenza positive group vs. 14.7% in the negative group, P = 0.047). However, in the subgroup analysis, male or younger patients (age <= 60 years) in the influenza negative group had higher CT scores than patients in the influenza positive group (P < 0.05).Conclusions: COVID-19 patients who had co-infection with the influenza A virus showed similar symptoms, outcomes, CT manifestation and CT scores to influenza negative patients. However, male patients and younger patients had higher CT scores in the influenza negative group.