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Clinical Features of Patients Infected With Coronavirus Disease 2019 With Elevated Liver Biochemistries: A
1Department of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Insights
Elevated liver biochemistries are common in COVID-19 patients, particularly those with hypoxia or severe inflammation. Abnormal liver function, especially elevated AST or TBIL, indicates a higher risk of complications and mortality.
Area of Science:
- Hepatology
- Infectious Diseases
- Internal Medicine
Background:
- The COVID-19 pandemic, caused by SARS-CoV-2, has led to a global health crisis.
- While liver enzyme abnormalities have been noted in some COVID-19 patients, comprehensive data on their clinical significance and prognostic implications are limited.
Purpose of the Study:
- To investigate the prevalence, clinical features, and prognostic value of abnormal liver biochemistries in hospitalized COVID-19 patients.
- To identify factors associated with elevated liver enzymes in COVID-19.
Main Methods:
- A multicenter, retrospective study involving 482 laboratory-confirmed COVID-19 patients in Wuhan, China.
- Data collected included demographics, comorbidities, symptoms, laboratory results, complications, treatment, and outcomes.
- Analysis focused on patients with abnormal liver biochemistries (elevated ALT, AST, or TBIL) on admission.
Main Results:
- Nearly 30% of COVID-19 patients exhibited abnormal liver biochemistries upon admission.
- Patients with elevated liver enzymes were more likely to have severe disease, comorbidities, and symptoms like dyspnea and chest pain.
- Abnormal AST or total bilirubin levels were associated with increased rates of complications and mortality.
Conclusions:
- Abnormal liver biochemistries are a frequent finding in COVID-19 patients.
- Hypoxia and severe inflammation are linked to increased liver enzyme levels.
- Elevated AST or TBIL on admission serves as a predictor of severe complications and poorer outcomes in COVID-19.
Background And Aims:
In December 2019, an outbreak of coronavirus disease 2019 (COVID-19) emerged in Wuhan, China. Although it has been reported that some patients with COVID-19 showed elevated liver biochemistries, there are few studies regarding the clinical features and prognosis of these patients.
Approach And Results:
In this multicenter, retrospective study, we collected data on laboratory-confirmed patients with COVID-19 from three hospitals in Wuhan, China, who died or were discharged between February 1, 2020, and February 20, 2020. Data on demographics, comorbidities, clinical symptoms, laboratory examinations on admission, complications, treatment, and outcome were collected. A total of 482 patients were enrolled in this study. Of those, 142 (29.5%) patients showed abnormal liver biochemistries on admission, and patients with elevated alanine aminotransferase, aspartate aminotransferase (AST), and total bilirubin (TBIL) accounted for 67.6%, 69.0%, and 16.2%, respectively. Those with abnormal liver biochemistries showed higher percentages of severe cases and comorbidities and were more likely to have dyspnea, chest distress or pain, and increased hemoglobin (Hb) on admission. Higher rates of complications and mortality and worse recovery when discharged were observed in patients with abnormal AST or TBIL. Multivariable regression analysis showed that chest distress or pain (odds ratio [OR], 1.765; P = 0.018), dyspnea (OR, 2.495; P = 0.001), elevated C-reactive protein level (OR, 1.007; P = 0.008), elevated white blood count (OR, 1.139; P = 0.013), and elevated Hb concentration (OR, 1.024; P = 0.001) were independent factors associated with elevated liver biochemistries in patients with COVID-19.
Conclusions:
Elevated liver biochemistries were common in patients with COVID-19. Patients with hypoxia or severe inflammation are more likely to experience increased liver biochemistries on admission. Those with abnormal AST or TBIL on admission are more likely to suffer from severe complications and death.
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