Abnormal liver chemistry constitutes an independent prognostic factor of less favorable clinical course in patients with COVID-19
Por:
Mateu, C, Ponce, J, Gimeno, F, Perez, S, Herrero, F, Supsup, M, Deltoro, M, Cardona, C, Mochon, M and Madrid, M
Publicada:
1 ene 2021
Resumen:
Introduction: abnormal liver biochemistry (ALB) is correlated with increased clinical involvement or severity in COVID-19, but its prognostic implications have not been studied extensively. The aim of this study was to determine whether ALB is a risk factor for unfavorable clinical outcome and involvement.
Materials and methods: a retrospective, single-center study in confirmed COVID-19 cases. Patients with pharmacological hepatotoxicity or liver diseases were excluded. ALB was defined as any elevation of total bilirubin, AST, ALT, alkaline phosphatase, and/or GGT above the upper limit of normal. First, an assessment was made of the correlation between ALB and need for hospitalization. This was followed by an assessment of the correlation of ALB in hospitalized patients with demographic variables, comorbidities, and treatment for COVID-19, and with clinical involvement and outcome. The statistical analysis was performed using an age-adjusted multiple logistic regression with a p-value < 0.05.
Results: of 1,277 confirmed cases, 346 required hospitalization and 302 were included. The prevalence of ALB was higher in hospitalized patients compared to non-hospitalized patients (60.9 % vs. 10.3 %, p. 0.001). Among hospitalized patients, there was no correlation between ALB and demographic variables, comorbidities, or treatment for COVID-19, except for low molecular weight heparin. There was a significant correlation between ALB and moderate/severe COVID-19 involvement and between unfavorable clinical outcomes and elevated total bilirubin. The period of greatest clinical worsening and deterioration of liver biochemistry parameters occurred during the first seven days. There was a significant correlation of ALB with longer hospital stay and admission to the intensive care unit, but this did not imply increased mortality.
Conclusions: ALB correlates with greater clinical involvement and worse clinical outcomes in hospitalized patients with COVID-19.
Filiaciones:
Mateu, C:
Consorcio Hosp Gen Univ Valencia, Dept Gastroenterol, Valencia, Spain
Ponce, J:
Consorcio Hosp Gen Univ Valencia, Dept Gastroenterol, Valencia, Spain
Gimeno, F:
Consorcio Hosp Gen Univ Valencia, Dept Internal Med, Valencia, Spain
:
Hosp Arnau Vilanova, CiberEHD, Dept Gastroenterol, Valencia, Spain
Herrero, F:
Consorcio Hosp Gen Univ Valencia, Dept Pneumol, Valencia, Spain
Supsup, M:
Consorcio Hosp Gen Univ Valencia, Dept Gastroenterol, Valencia, Spain
Deltoro, M:
Consorcio Hosp Gen Univ Valencia, Dept Infect Dis, Valencia, Spain
Cardona, C:
Consorcio Hosp Gen Univ Valencia, Dept Microbiol, Valencia, Spain
Mochon, M:
Consorcio Hosp Gen Univ Valencia, Dept Microbiol, Valencia, Spain
Madrid, M:
Consorcio Hosp Gen Univ Valencia, Dept Gastroenterol, Valencia, Spain
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