Abnormal liver function tests predict transfer to intensive care unit and death in COVID-19

Area of Science:

• Hepatology
• Infectious Diseases
• Critical Care Medicine

Background:

• Coronavirus disease 2019 (COVID-19) poses a global health threat.
• Abnormal liver function tests (LFTs) are frequently observed in COVID-19 patients, but their clinical significance remains debated.
• This study investigated the prevalence, characteristics, and clinical impact of abnormal LFTs in non-critical COVID-19 inpatients.

Purpose of the Study:

• To determine the prevalence and characteristics of abnormal LFTs in hospitalized COVID-19 patients.
• To assess the clinical impact of abnormal LFTs on patient outcomes, including transfer to intensive care unit (ICU) and mortality.
• To identify predictors of abnormal LFTs during hospitalization.

Main Methods:

• A multicentre, retrospective study involving 565 inpatients with COVID-19.
• LFTs were collected at admission and weekly during hospitalization.
• The primary outcome was a composite endpoint of death or transfer to ICU.

Main Results:

• 58% of patients presented with abnormal LFTs upon admission.
• Patients with abnormal LFTs exhibited more severe inflammation and organ dysfunction.
• Abnormal LFTs were associated with increased rates of ICU transfer, acute kidney injury, mechanical ventilation, and mortality.
• De novo LFT abnormalities during hospitalization were linked to specific medications but not clearly to the composite endpoint.

Conclusions:

• Abnormal LFTs are prevalent at COVID-19 admission and correlate with systemic inflammation and organ dysfunction.
• Abnormal LFTs serve as an independent predictor for ICU transfer or death in COVID-19 patients.
• Understanding LFT abnormalities aids in risk stratification and management of COVID-19 patients.