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Clinical Significance of Liver Function Abnormality in Patients with COVID-19: A Single-center Experience from
Chetan R Kalal1, Harshad Joshi1, Vivek Kumar2
1Department of Gastroenterology, Hepatology and Liver Transplant, Sir HN Reliance Foundation Hospital and Research Centre, Mumbai, Maharashtra, India.
Insights
Abnormal liver function tests (LFTs) were common in severe COVID-19 cases and linked to longer hospital stays and increased mortality risk. Vigilant monitoring of liver function is crucial for hospitalized COVID-19 patients.
Area of Science:
- Hepatology
- Infectious Diseases
- Critical Care Medicine
Background:
- The impact of coronavirus disease-2019 (COVID-19) on liver function requires further clarification.
- Understanding liver function's role in COVID-19 prognosis is essential.
Purpose of the Study:
- To investigate the impact of COVID-19 on liver function.
- To determine the clinical significance of liver function tests (LFTs) in predicting COVID-19 mortality risk.
Main Methods:
- A retrospective study of 184 COVID-19 patients (March-July 2020).
- Analysis of clinical characteristics, medical history, laboratory tests, and outcomes from electronic medical records.
Main Results:
- Over half (51.6%) of patients exhibited abnormal LFTs upon admission.
- Abnormal LFTs and severe COVID-19 were associated with longer hospital stays and higher mortality.
- Elevated liver enzymes and hypoalbuminemia were more prevalent in severe COVID-19 cases.
Conclusions:
- Abnormal liver function is more frequent in severe COVID-19 and correlates with prolonged hospitalization.
- COVID-19 severity is directly associated with mortality risk.
- Continuous monitoring of LFTs is vital for assessing liver injury risk in hospitalized COVID-19 patients.
Background And Aims:
The impact of coronavirus disease-2019 (COVID-19) on liver function remains to be fully elucidated. This study was designed to investigate such and determine the clinical significance in determining mortality risk.
Methods:
A retrospective study was conducted in patients with COVID-19 from March 2020 to July 2020. Clinical details were retrieved from electronic medical records to obtain clinical characteristics, medical history, laboratory tests, therapeutic intervention, and outcome data.
Results:
A total of 184 patients with COVID-19 were included (median age: 45.5 years), comprised of 62.5% men. In total, 22 (12.0%) patients had severe infection and 162 (88.0%) had mild to moderate infection. Overall, 95 (51.6%) showed abnormal liver function test (LFT) and 17 (9.2%) showed normal LFT at admission. The median age, hospital stay, and LFT were significantly higher in severe vs. non-severe infection (p<0.001). Out of 12 deaths, the majority were due to severe infection (n=11). Deaths were also due to acute respiratory distress syndrome (n=5), cardiac reasons (n=3), and sepsis with multiorgan failure (n=3). The median age, hospital stay and number of intensive care unit admissions were higher in patients having abnormal LFT compared to normal LFT. Incidence of elevated aspartate aminotransferase (42.8% and 40.4%), alanine transaminase (43.7% and 41.6%), and hypoalbuminemia (71.4% and72.7%) at admission and discharge were more common in severe infection. The mean survival was significantly lower in severe infection compared to those with non-severe disease (17.2 vs. 52.3 days; p<0.001).
Conclusions:
Incidence of abnormal liver function was higher in patients with severe COVID-19 and was associated with prolonged hospital stay; mortality was associated with severity of COVID-19. For ruling out the risk of liver injury, it is crucial to vigilantly monitor the liver function parameters in patients with COVID-19 admitted to hospital.
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