新型冠状病毒Delta和Omicron变异株感染的儿童肝功能特征分析

Features of liver function in pediatric patients infected with Delta variant versus Omicron variant of severe acute respiratory syndrome coronavirus 2

目的总结和分析新型冠状病毒(SARS-CoV-2)Delta与Omicron变异株感染儿童的肝功能特征。方法对2021年5月21日起广州医科大学附属市八医院收治的本土或入境SARS-CoV-2感染的儿童住院隔离期间肝功能检查结果进行总结分析,并比较SARS-CoV-2 Delta和Omicron变异株感染的儿童各临床资料以及肝损伤的构成比。计量资料两组间比较采用独立样本t检验或Mann-Whitney U检验;计数资料两组间比较采用χ^(2)检验或Fisher’s精确检验。结果共纳入85例SARS-CoV-2感染的儿童,其中包括32例(37.6%)Delta和53例(62.4%)Omicron变异株感染者,两组患儿年龄、性别、身高、体质量和合并疾病比较,差异均无统计学意义(P值均>0.05)。SARS-CoV-2 Delta和Omicron变异株感染的儿童ALT、AST、ALP、GGT、TBil、Alb和ChE差异均无统计学意义(P值均>0.05);Omicron变异株感染的儿童其TBA水平显著高于Delta变异株感染的儿童(Z=-2.336,P=0.020)。但两组患儿TBA中位数均在正常范围内,且异常的TBA构成比在两组间比较,差异无统计学意义(P>0.05)。85例儿童中10例(11.8%)出现肝功能指标轻度升高,其中7例TBA水平升高,1例ALT水平升高,1例ALT和AST水平升高,1例ALP水平升高。对SARS-CoV-2 Delta和Omicron变异株感染的儿童肝损伤分析结果显示,两种SARS-CoV-2变异株感染所致肝损伤的构成比差异无统计学意义(6.3%vs 15.1%,χ^(2)=0.691,P=0.406)。结论SARS-CoV-2 Delta和Omicron变异株感染的儿童近期肝损伤较轻,但其感染所致远期肝功能损伤的影响有待进一步评估。

Objective To summarize and analyze the features of liver function in pediatric patients infected with Delta variant versus Omicron variant of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Methods In this study,an analysis was performed for the liver function test results of the locally transmitted or imported pediatric patients with SARS-CoV-2 infection during isolation who were admitted to Guangzhou Eighth People’s Hospital,Guangzhou Medical University,since May 21,2021,and the clinical data and the constituent ratio of liver injury were compared between the pediatric patients infected with Delta variant and those infected with Omicron variant.The independent samples t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups,and the chi-square test or the Fisher’s exact test was used for comparison of categorical data between two groups.Results A total of 85 pediatric patients infected with SARS-CoV-2 were enrolled,among whom there were 32(37.6%)pediatric patients infected with Delta variant and 53(62.4%)pediatric patients infected with Omicron variant,and there were no significant differences between the two groups in age,sex,body height,body weight,and comorbidities(all P>0.05).There were no significant differences between the two groups in alanine aminotransferase(ALT),aspartate aminotransferase(AST),alkaline phosphatase(ALP),gamma-glutamyl transpeptidase,total bilirubin,albumin,and cholinesterase(all P>0.05),and the pediatric patients infected with Omicron variant had a significantly higher level of total bile acid(TBA)than those infected with Delta variant(Z=-2.336,P=0.020).However,the median values of TBA were within the normal range and the ratios of abnormal TBA were no significant difference between the two groups(P>0.05).Among the 85 pediatric patients,10(11.8%)had a mild increase in liver function parameters,among whom 7 had an increase in TBA,1 had an increase in ALT,1 had increases in ALT and AST,and 1 had an increase in ALP.The analysis of liver injury in the pediatric patients infected with Delta variant or Omicron variant showed that there was no significant difference in the constituent ratio of liver injury caused by the two variants(6.3%vs 15.1%,χ^(2)=0.691,P=0.406).Conclusion Mild liver injury is observed in pediatric patients infected with Delta and Omicron variants of SARS-CoV-2,but further studies are needed to evaluate the long-term influence of such infection on liver function.