Dynamic Changes in Liver Function Tests and Their Correlation with Illness Severity and Mortality in Patients with COVID-19: A Retrospective Cohort Study

Dynamic Changes in Liver Function Tests and Their Correlation with Illness Severity and Mortality in Patients with COVID-19: A Retrospective Cohort Study

Wei Xu,* Chenlu Huang,* Ling Fei,* Qiang Li, Liang Chen Department of Liver Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qiang Li; Liang Chen Email liqiang66601...

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Autores principales: Xu W, Huang C, Fei L, Li Q, Chen L
Formato: article
Lenguaje:EN
Publicado: Dove Medical Press 2021
Materias:
covid-19
sars-cov-2
liver function parameters
liver injury
clinical outcomes
Geriatrics
RC952-954.6
Acceso en línea:https://doaj.org/article/9c57f3964f964c70883b6ff8a6b53deb
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spelling oai:doaj.org-article:9c57f3964f964c70883b6ff8a6b53deb2021-12-02T13:29:33ZDynamic Changes in Liver Function Tests and Their Correlation with Illness Severity and Mortality in Patients with COVID-19: A Retrospective Cohort Study1178-1998https://doaj.org/article/9c57f3964f964c70883b6ff8a6b53deb2021-04-01T00:00:00Zhttps://www.dovepress.com/dynamic-changes-in-liver-function-tests-and-their-correlation-with-ill-peer-reviewed-fulltext-article-CIAhttps://doaj.org/toc/1178-1998Wei Xu,* Chenlu Huang,* Ling Fei,* Qiang Li, Liang Chen Department of Liver Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qiang Li; Liang Chen Email liqiang66601@163.com; chenliang@shphc.org.cnObjective: To describe the longitudinal changes in liver function tests, and their association with illness severity and mortality in patients with COVID-19.Methods: A retrospective cohort study of 1003 hospitalized patients with COVID-19 was conducted. Longitudinal liver function tests and clinical outcomes were analyzed.Results: Abnormal liver function parameters were observed, both at admission (ALT 13.2%, AST 8.5%, ALP 2.0%, GGT 7.4%, LDH 37.6%, TBIL 4.0%, DBIL 7.8%, Albumin 10.1%) and peak hospitalization (ALT 29.4%, AST 17.5%, ALP 2.6%, GGT 13.4%, LDH 49.4%, TBIL 10.1%, DBIL 18.0%, Albumin 30.6%) in patients with COVID-19. Compared with non-severe patients, severe patients had markedly higher liver function parameters from baseline to 30 days after hospital admission. Abnormal ALT and LDH at hospital admission and some medications use (Hydroxychloroquine, Lopinavir/Ritonavir, and Traditional Chinese medicines) were associated with peak hospitalization ALT > 5× the upper limit unit of normal (ULN). On multivariate analysis, age > 60 years, male, obesity, comorbidity, abnormal LDH and albumin at hospital admission and peak hospitalization were associated with progression to severe COVID-19 (OR > 1; p < 0.05). COX analysis revealed that ALT > 2 ULN (HR=7.0, p=0.011), AST > 2 ULN (HR=34.7, p < 0.001), and TBIL > 2 ULN (HR=54.6, p < 0.001) were associated with a higher mortality.Conclusion: Dynamic abnormalities of liver function parameters are common in hospitalized patients with COVID-19, and associated with illness severity and mortality.Keywords: COVID-19, SARS-CoV-2, liver function parameters, liver injury, clinical outcomesXu WHuang CFei LLi QChen LDove Medical Pressarticlecovid-19sars-cov-2liver function parametersliver injuryclinical outcomesGeriatricsRC952-954.6ENClinical Interventions in Aging, Vol Volume 16, Pp 675-685 (2021)
institution DOAJ
collection DOAJ
language EN
topic covid-19
sars-cov-2
liver function parameters
liver injury
clinical outcomes
Geriatrics
RC952-954.6
spellingShingle covid-19
sars-cov-2
liver function parameters
liver injury
clinical outcomes
Geriatrics
RC952-954.6
Xu W
Huang C
Fei L
Li Q
Chen L
Dynamic Changes in Liver Function Tests and Their Correlation with Illness Severity and Mortality in Patients with COVID-19: A Retrospective Cohort Study
description Wei Xu,* Chenlu Huang,* Ling Fei,* Qiang Li, Liang Chen Department of Liver Diseases, Shanghai Public Health Clinical Center, Fudan University, Shanghai, 201508, People’s Republic of China*These authors contributed equally to this workCorrespondence: Qiang Li; Liang Chen Email liqiang66601@163.com; chenliang@shphc.org.cnObjective: To describe the longitudinal changes in liver function tests, and their association with illness severity and mortality in patients with COVID-19.Methods: A retrospective cohort study of 1003 hospitalized patients with COVID-19 was conducted. Longitudinal liver function tests and clinical outcomes were analyzed.Results: Abnormal liver function parameters were observed, both at admission (ALT 13.2%, AST 8.5%, ALP 2.0%, GGT 7.4%, LDH 37.6%, TBIL 4.0%, DBIL 7.8%, Albumin 10.1%) and peak hospitalization (ALT 29.4%, AST 17.5%, ALP 2.6%, GGT 13.4%, LDH 49.4%, TBIL 10.1%, DBIL 18.0%, Albumin 30.6%) in patients with COVID-19. Compared with non-severe patients, severe patients had markedly higher liver function parameters from baseline to 30 days after hospital admission. Abnormal ALT and LDH at hospital admission and some medications use (Hydroxychloroquine, Lopinavir/Ritonavir, and Traditional Chinese medicines) were associated with peak hospitalization ALT > 5× the upper limit unit of normal (ULN). On multivariate analysis, age > 60 years, male, obesity, comorbidity, abnormal LDH and albumin at hospital admission and peak hospitalization were associated with progression to severe COVID-19 (OR > 1; p < 0.05). COX analysis revealed that ALT > 2 ULN (HR=7.0, p=0.011), AST > 2 ULN (HR=34.7, p < 0.001), and TBIL > 2 ULN (HR=54.6, p < 0.001) were associated with a higher mortality.Conclusion: Dynamic abnormalities of liver function parameters are common in hospitalized patients with COVID-19, and associated with illness severity and mortality.Keywords: COVID-19, SARS-CoV-2, liver function parameters, liver injury, clinical outcomes
format article
author Xu W
Huang C
Fei L
Li Q
Chen L
author_facet Xu W
Huang C
Fei L
Li Q
Chen L
author_sort Xu W
title Dynamic Changes in Liver Function Tests and Their Correlation with Illness Severity and Mortality in Patients with COVID-19: A Retrospective Cohort Study
title_short Dynamic Changes in Liver Function Tests and Their Correlation with Illness Severity and Mortality in Patients with COVID-19: A Retrospective Cohort Study
title_full Dynamic Changes in Liver Function Tests and Their Correlation with Illness Severity and Mortality in Patients with COVID-19: A Retrospective Cohort Study
title_fullStr Dynamic Changes in Liver Function Tests and Their Correlation with Illness Severity and Mortality in Patients with COVID-19: A Retrospective Cohort Study
title_full_unstemmed Dynamic Changes in Liver Function Tests and Their Correlation with Illness Severity and Mortality in Patients with COVID-19: A Retrospective Cohort Study
title_sort dynamic changes in liver function tests and their correlation with illness severity and mortality in patients with covid-19: a retrospective cohort study
publisher Dove Medical Press
publishDate 2021
url https://doaj.org/article/9c57f3964f964c70883b6ff8a6b53deb
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