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Transaminitis is an indicator of mortality in patients with COVID-19: A retrospective cohort study
Vishnu Charan Suresh Kumar1, Prateek Suresh Harne2, Samiran Mukherjee2
1Department of Internal Medicine, SUNY Upstate Medical University, Syracuse, NY 13202, United States. drvishnucharan@gmail.com.
Insights
Transaminitis, or elevated liver enzymes, in COVID-19 patients is linked to worse outcomes. This finding highlights the importance of monitoring liver function during coronavirus disease 19 infection.
Area of Science:
- Hepatology
- Infectious Diseases
- Critical Care Medicine
Background:
- The novel coronavirus (COVID-19) pandemic has raised interest in its effects on the liver.
- Hepatic manifestations of COVID-19 require further investigation.
Purpose of the Study:
- To characterize COVID-19 patients.
- To assess the relationship between transaminitis and mortality in COVID-19 patients.
Main Methods:
- Retrospective cohort study of 130 COVID-19 positive patients.
- Statistical analysis included Wilcoxon-rank sum test, paired t-test, and multivariable logistic regression.
- Transaminitis and mortality association was studied using SAS 9.4.
Main Results:
- 56% of patients had transaminitis.
- Patients with transaminitis had higher BMI (30.2 vs 27.3 kg/m²).
- Transaminitis was associated with 3.4 times higher odds of mortality, adjusting for confounders.
Conclusions:
- Transaminitis on admission correlates with severe COVID-19 outcomes.
- Outcomes include ICU admission, mechanical ventilation, and increased mortality.
- Monitoring liver enzymes is crucial for COVID-19 patient management.
Background:
Since its discovery in Wuhan, China in December of 2019, the novel coronavirus has progressed to become one of the worst pandemics seen in the last 100 years. Recently, there has been an increased interest in the hepatic manifestations of coronavirus disease 19 (COVID-19).
Aim:
To describe the demographic and clinical characteristics of COVID-19 positive patients and study the association between transaminitis and all-cause mortality.
Methods:
This is a descriptive retrospective cohort study of 130 consecutive patients with a positive COVID PCR test admitted between March 16, 2020 to May 14, 2020 at a tertiary care University-based medical center. The Wilcoxon-rank sum test and paired t-test were used for comparing non-parametric and parametric continuous variables respectively and a multivariable logistic regression models to study the association between transaminitis and mortality using SAS version 9.4 (SAS Institute, Cary, NC, United States).
Results:
Out of the 130 patients, 73 (56%) patients were found to have transaminitis and 57 (44%) did not. When compared to patients without transaminitis, the transaminitis group was found to have a higher median body mass index (30.2 kg/m2 vs 27.3 kg/m2, P = 0.04). In the multivariate analysis those with transaminitis were found to have 3.4 times higher odds of dying as compared to those without transaminitis adjusting for gender, the Age-adjusted Charlson Comorbidity Index and admission to the intensive care unit (P = 0.03).
Conclusion:
Our study showed that transaminitis on admission was associated with severe clinical outcomes such as admission to the intensive care unit, need for mechanical ventilation, and mortality.
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