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Increased Morbidity and Mortality in COVID-19 Patients with Liver Injury

Mohammad Arsalan Siddiqui1, Suraj Suresh2, Stephen Simmer2

  • 1Department of Gastroenterology and Hepatology, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, MI, 48202, USA. msiddiq1@hfhs.org.

Digestive Diseases and Sciences
|May 4, 2021
PubMed

Insights

Patients with COVID-19 and liver injury (LI) face significantly higher risks of mortality and poor outcomes. This large study highlights the severe consequences of liver injury in coronavirus disease 2019 patients.

Area of Science:

  • Hepatology
  • Infectious Diseases
  • Critical Care Medicine

Background:

  • Liver injury (LI) is common in COVID-19 patients.
  • Large-scale studies on risk factors and outcomes of LI in COVID-19 are limited.

Purpose of the Study:

  • To evaluate risk factors and clinical outcomes of LI in a large inpatient COVID-19 cohort.
  • To compare outcomes of patients with mild liver enzyme elevation (MEL) and LI against a control group.

Main Methods:

  • Included adult COVID-19 patients hospitalized between March and April 2020.
  • Defined LI and MEL based on peak liver enzyme levels (ALT/AST, ALP/bilirubin).
  • Compared patients with MEL and LI to a control group with normal liver enzymes.

Main Results:

  • 53.2% had MEL, 20.5% had LI among 1935 patients.
  • LI group had higher proportion of men, older patients, and African-Americans.
  • LI significantly increased risk of mortality (RR 4.26), ICU admission (RR 5.52), intubation (RR 11.01), and 30-day readmission (RR 1.81).

Conclusions:

  • COVID-19 patients with liver injury face significantly increased mortality risk.
  • Liver injury is associated with poorer clinical outcomes in coronavirus disease 2019.
  • Findings underscore the importance of monitoring liver function in COVID-19 patients.
Abstract

Keywords:
COVID-19Clinical outcomesLiver injuryRisk factorsSARS-CoV-2

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