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Lipase elevation on admission predicts worse clinical outcomes in patients with COVID-19
1Department of Gastroenterology, Health Science University, Istanbul, Turkey.
Insights
High lipase activity in COVID-19 patients upon admission indicates a higher risk of severe outcomes. This elevated lipase, even without pancreatitis, is an independent predictor of poor prognosis and increased mortality in coronavirus disease 2019 patients.
Area of Science:
- Clinical Medicine
- Infectious Diseases
- Biochemistry
Background:
- Hyperlipasemia is a common finding in patients with coronavirus disease 2019 (COVID-19).
- The prognostic significance of lipase activity at admission requires further investigation.
Purpose of the Study:
- To evaluate the impact of admission lipase activity on the clinical course and mortality of COVID-19 patients.
- To determine if elevated lipase activity predicts adverse outcomes in COVID-19.
Main Methods:
- A cohort of 3244 hospitalized COVID-19 patients was analyzed.
- Patients were categorized into high and normal lipase activity groups based on admission levels.
- Outcomes including ICU admission, mechanical ventilation, and mortality were compared.
Main Results:
- Nearly 30% of patients exhibited high lipase activity at admission.
- High lipase activity was significantly associated with increased rates of ICU admission (36.1% vs 9.9%), mechanical ventilation (33.7% vs 8.3%), and mortality (24.6% vs 6.4%).
- Multivariate analysis confirmed high lipase activity as an independent predictor of mortality (OR: 3.191).
Conclusions:
- Elevated lipase activity upon admission is a significant independent predictor of poor prognosis in COVID-19 patients.
- This association holds true even in the absence of acute pancreatitis.
- Lipase levels at admission can aid in risk stratification for hospitalized COVID-19 patients.
Background And Objectives:
Hyperlipasemia is highly prevalent among coronavirus disease 2019 (COVID-19) patients. The aim of this study was to assess the effect of lipase activity, measured at the time of admission, on the clinical course and mortality in COVID-19 patients.
Methods:
The population of this study comprised 12,139 patients who were hospitalized due to COVID-19 between June 2020 and June 2021 in a pandemic hospital. Of these, 8819 patients were excluded from the study due to missing data, four patients were excluded due to a diagnosis of acute pancreatitis (according to the revised Atlanta criteria), and 72 patients were excluded due to alcohol use or having a history of chronic pancreatitis. The final study sample consisted of the remaining 3244 COVID-19 patients. Laboratory results, intensive care unit (ICU) follow-up periods, the need for mechanical ventilation, and mortality rates were compared between the normal lipase activity and high lipase activity groups.
Results:
There were 968 (29.8%) patients with high lipase activity at the time of admission. The rate of ICU admission was 36.1% vs. 9.9% (p < 0.001), mechanical ventilation requirement rates were 33.7% vs. 8.3% (p < 0.001), and mortality rates were as 24.6% vs. 6.4% (p < 0.001) in the high lipase activity group compared to the normal lipase activity group. Multivariate regression analysis revealed that high lipase activity was an independent factor in predicting mortality in hospitalized COVID-19 patients (odds ratio [OR]: 3.191, p < 0.001).
Conclusion:
Elevated lipase activity without acute pancreatitis at the time of admission in COVID-19 patients was determined as an independent predictor of poor prognosis.
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