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Liver damage and hepatomegaly in COVID-19 patients
Pınar Yürük Atasoy1, Engin Beydoğan2
1Department of Infectious Diseases, Ankara City Hospital, Ankara, Turkey.
Insights
High liver function tests in COVID-19 patients without pre-existing liver disease did not impact outcomes. However, hepatomegaly and elevated LDH and CK levels were linked to severe disease and mortality in COVID-19 patients.
Area of Science:
- Hepatology
- Infectious Diseases
- Critical Care Medicine
Background:
- Elevated liver function tests (LFTs) are observed in some patients with coronavirus disease 2019 (COVID-19).
- The clinical significance of abnormal LFTs and liver size in COVID-19 patients without pre-existing liver conditions remains unclear.
Purpose of the Study:
- To evaluate the association between elevated liver function tests and clinical outcomes in hospitalized COVID-19 patients.
- To identify predictors of severe disease and mortality in COVID-19 patients.
Main Methods:
- Retrospective analysis of 367 hospitalized COVID-19 patients.
- Data collected included liver function tests, C-reactive protein, abdominal ultrasonography findings, and clinical outcomes.
- Statistical analysis was performed to identify factors associated with disease severity and mortality.
Main Results:
- Hepatomegaly was significantly more frequent in patients with severe COVID-19 and mortality (p < 0.001).
- Elevated lactate dehydrogenase (LDH) and creatine kinase (CK) levels were identified as risk factors for mortality (p < 0.001 and p = 0.032, respectively).
- Elevated LFTs in patients without acute/chronic liver disease did not correlate with clinical outcomes.
Conclusions:
- In hospitalized COVID-19 patients without pre-existing liver disease, elevated LFTs and increased liver size at presentation do not appear to influence clinical outcomes.
- Advanced age, comorbidities, hepatomegaly, and elevated LDH and CK levels are associated with poor clinical outcomes in COVID-19.
Introduction:
The aim of this study was to evaluate the patients with high liver function test results detected at admission to the hospital diagnosed with COVID-19.
Methodology:
Patients diagnosed with COVID-19 by a nasopharyngeal RT-PCR (+) test in the emergency department were included in the study. CRP, liver function tests, and abdominal ultrasonography (US) findings of the patients were recorded.
Results:
A total of 367 COVID-19 patients, 254 (69.2%) males and 113 (30.8%) females, with a mean age of 60.39 (16.81) years, were included in the study. It was seen that 236 (68.7%) patients were treated without complications, 131 (35.7%) patients needed intensive care, and 81 (22.1%) patients died. The frequency of hepatomegaly was significantly higher in patients with severe course and mortality (p < 0.001). When COVID-19 patients who developed mortality were compared with other patients with a diagnosis of COVID-19, no additional risk factors affecting mortality were detected, except LDH [OR: 1.009, (1.006-1.012); p < 0.001] and high CK [OR: 1.001 CI: 95%, (1.000-1.001); p = 0.032].
Conclusions:
Patients who need to be hospitalized with COVID-19 and who do not have acute and/or chronic liver disease, elevated liver function test results, and an increase in liver sizes at presentation, it was seen that these did not have an effect on the clinical outcome. However, in addition to the presence of advanced age and comorbidity, the presence of hepatomegaly measured by CT at admission, and high LDH and CK levels were associated with poor clinical outcomes.
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