Abnormal Liver Tests during Hospitalization Predict Mortality in Patients with COVID-19: A Multicenter Study from South America.
Journal
Canadian journal of gastroenterology & hepatology
ISSN: 2291-2797
Titre abrégé: Can J Gastroenterol Hepatol
Pays: Egypt
ID NLM: 101623613
Informations de publication
Date de publication:
2021
2021
Historique:
received:
14
07
2021
revised:
15
09
2021
accepted:
22
09
2021
entrez:
8
10
2021
pubmed:
9
10
2021
medline:
16
10
2021
Statut:
epublish
Résumé
The role of liver function tests (LFT) as prognostic factors in patients admitted with COVID-19 has not been fully investigated, particularly outside resource-rich countries. We aimed at evaluating the prognostic value of abnormal LFT on admission and during hospitalization of patients with COVID-19. We performed a retrospective study that included 298 adult patients hospitalized for COVID-19, between 05/2020 and 02/2021, in 6 hospitals from 5 countries in South America. We analyzed demographic and comorbid variables and laboratory tests on admission and during hospitalization. LFT over twice the upper limit of normal (ALEx2) were also evaluated in relation to a variety of factors on admission and during hospitalization. De novo-ALEx2 was defined as the presence of ALEx2 at one week of hospitalization in patients without ALEx2 on admission. Patients were followed until hospital discharge or death. Multivariable analysis was used to evaluate the association between ALEx2 on admission and during hospitalization and mortality. Of the total of 298 patients, 60% were male, with a mean age of 60 years, and 74% of patients had at least one comorbidity. Of those, 137 (46%) patients were transferred to the intensive care unit and 66 (22.1%) patients died during hospitalization. ALEx2 on admission was present in 87 (29.2%) patients and was found to be independently associated with 1-week mortality (odds ratio (OR) = 3.55; 95% confidence interval (95%CI) 1.05-12.05). Moreover, 84 (39.8%) out of 211 patients without ALEx2 at admission developed de novo-ALEx2, which was independently associated with mortality during second week of hospitalization (OR = 6.09; 95%CI 1.28-29) and overall mortality (OR = 2.93, 95%CI 1.05-8.19). A moderate elevation of LFT during admission was associated with a poor short-term prognosis in patients hospitalized with COVID-19. In addition, moderate elevation of LFT at one week of hospitalization was an independent risk factor for overall mortality in these patients.
Sections du résumé
Background
The role of liver function tests (LFT) as prognostic factors in patients admitted with COVID-19 has not been fully investigated, particularly outside resource-rich countries. We aimed at evaluating the prognostic value of abnormal LFT on admission and during hospitalization of patients with COVID-19.
Methods
We performed a retrospective study that included 298 adult patients hospitalized for COVID-19, between 05/2020 and 02/2021, in 6 hospitals from 5 countries in South America. We analyzed demographic and comorbid variables and laboratory tests on admission and during hospitalization. LFT over twice the upper limit of normal (ALEx2) were also evaluated in relation to a variety of factors on admission and during hospitalization. De novo-ALEx2 was defined as the presence of ALEx2 at one week of hospitalization in patients without ALEx2 on admission. Patients were followed until hospital discharge or death. Multivariable analysis was used to evaluate the association between ALEx2 on admission and during hospitalization and mortality.
Results
Of the total of 298 patients, 60% were male, with a mean age of 60 years, and 74% of patients had at least one comorbidity. Of those, 137 (46%) patients were transferred to the intensive care unit and 66 (22.1%) patients died during hospitalization. ALEx2 on admission was present in 87 (29.2%) patients and was found to be independently associated with 1-week mortality (odds ratio (OR) = 3.55; 95% confidence interval (95%CI) 1.05-12.05). Moreover, 84 (39.8%) out of 211 patients without ALEx2 at admission developed de novo-ALEx2, which was independently associated with mortality during second week of hospitalization (OR = 6.09; 95%CI 1.28-29) and overall mortality (OR = 2.93, 95%CI 1.05-8.19).
Conclusions
A moderate elevation of LFT during admission was associated with a poor short-term prognosis in patients hospitalized with COVID-19. In addition, moderate elevation of LFT at one week of hospitalization was an independent risk factor for overall mortality in these patients.
Identifiants
pubmed: 34621710
doi: 10.1155/2021/1622533
pmc: PMC8492276
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1622533Informations de copyright
Copyright © 2021 Domingo Balderramo et al.
Déclaration de conflit d'intérêts
The authors declare that they have no conflicts of interest.
Références
PLoS One. 2021 Feb 11;16(2):e0246793
pubmed: 33571300
Mini Rev Med Chem. 2009 Jun;9(7):847-60
pubmed: 19519509
Liver Int. 2020 Sep;40(9):2095-2103
pubmed: 32239796
Hepatology. 2020 Aug;72(2):389-398
pubmed: 32359177
Liver Int. 2021 Jan;41(1):20-32
pubmed: 33190346
Front Physiol. 2021 Mar 17;12:642922
pubmed: 33815147
Gut. 2021 Oct;70(10):1925-1932
pubmed: 33514597
Hepatology. 2021 Apr;73(4):1509-1520
pubmed: 32602604
JAMA Intern Med. 2020 Jul 1;180(7):934-943
pubmed: 32167524
Aliment Pharmacol Ther. 2006 Dec;24(11-12):1575-83
pubmed: 17206945
J Med Virol. 2021 Feb;93(2):1045-1056
pubmed: 32749705
JAMA. 2020 May 26;323(20):2052-2059
pubmed: 32320003
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
Clin Gastroenterol Hepatol. 2021 Jul;19(7):1469-1479.e19
pubmed: 32950749
PLoS One. 2021 Feb 3;16(2):e0245772
pubmed: 33534813
Ann Hepatol. 2021 Mar-Apr;21:100298
pubmed: 33359234
Hepatology. 2020 Sep;72(3):807-817
pubmed: 32473607
J Hepatol. 2020 Sep;73(3):566-574
pubmed: 32298767
Lancet Gastroenterol Hepatol. 2020 Jul;5(7):667-678
pubmed: 32405603
Liver Int. 2020 Jun;40(6):1278-1281
pubmed: 32251539
Hepatol Int. 2021 Feb;15(1):202-212
pubmed: 33548030
Hepatology. 2020 Nov;72(5):1864-1872
pubmed: 32702162
J Med Virol. 2021 Jun;93(6):3305-3311
pubmed: 33174624
Clin Gastroenterol Hepatol. 2020 Jun;18(7):1561-1566
pubmed: 32283325
Iran J Microbiol. 2021 Feb;13(1):8-16
pubmed: 33889357
Dig Liver Dis. 2020 Sep;52(9):953-955
pubmed: 32487506
Expert Rev Mol Diagn. 2012 Jan;12(1):65-74
pubmed: 22133120
Liver Int. 2020 Oct;40(10):2394-2406
pubmed: 32526083