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Background & objectives: Coronavirus disease 2019 (COVID-19) affects respiratory, gastrointestinal, cardiovascular and other systems disease. Studies describing liver involvement and liver function test (LFT) abnormalities are sparse from our population. This study was undertaken to estimate the LFT abnormalities in patients with COVID-19 in a tertiary care set up in India. Methods: In this retrospective study conducted at a tertiary care centre in Mumbai, India, all consecutive patients with proven COVID-19 by reverse transcriptase–PCR from March 23 to October 31, 2020 were enrolled. Of the 3280 case records profiled, 1474 cases were included in the study. Clinical characteristics, biochemical parameters and outcomes were recorded. Results: Overall 681 (46%) patient had deranged LFTs. Hepatocellular type of injury was most common (93%). Patients with deranged LFTs had more probability of developing severe disease (P<0.001) and mortality (P<0.001). Advanced age (P<0.001), male gender (P<0.001), diabetes mellitus (P<0.001), lower oxygen saturation levels at admission (P<0.001), higher neutrophil–lymphocyte ratio (P<0.001), history of diabetes mellitus and cirrhosiss were associated with deranged LFTs. Acute liver injury was seen in 65 (4.3%) cases on admission and 57 (3.5%) cases during hospital stay. On multivariate analysis for predicting mortality, age >60 yr serum creatinine >2 mg%, PaO2/FiO2 ratio ?200 and raised AST >50 IU/l (OR: 2.34, CI: 1.59-3.48, P<0.001) were found to be significant. Interpretation & conclusions: In COVID-19, LFT abnormalities were common, and derangement increased as severity progressed. The presence of deranged LFT worsens the clinical outcome and predicts in-hospital mortality.
RESUMO
Background: Carotid Intima Media Thickness (CIMT) andCRP (C Reactive Protein) are have been used for measuringAtherosclerotic Risk in Diabetics. However there is paucity ofdata regarding their importance in Statin Naïve Diabetics.Aim: To study Correlation of CIMT with glycaemic control andhsCRP in Statin Naïve Diabetics.Materials and Methods: 80 Cases (Patient suffering from type2 Diabetes Mellitus) and 20 controls (non- diabetic healthpatients) presenting in outpatient department of a tertiaryHospital were included in this observational cross sectionalobservational study. Complete Blood Count, urine Routine andMicroscopy, urine for microalbuminuria, fasting plasma glucose(FPG), postprandial plasma glucose (PPPG), glycatedhaemoglobin (HbA1C), lipid profile, renal function test, hs-CRPand CIMT were evaluated in each individual. Independentsamples T-test was used to compare CIMT and hs-CRP bothcases and controls. Test of proportion and chi-square test wasused for association between categorical variables.Spearman’s method was used to assess correlation betweenhsCRP and CIMT.Results: 80 cases (Statin naïve and Non-smoker Diabeticpatients and 20 healthy controls were included in this study.Average CIMT in cases was significantly higher in Diabeticcases than Control (0.66 + 0.14 vs 0.56±0.05, difference= 0.10 mm, 95% C.I. (0.1 - 0.17), p < 0.0001). HsCRP wassignificantly correlated with average CIMT in Diabetic cases.(r=0.512, 95% C.I. 0.33-0.658, p<0.0001). Fasting Blood Sugarwas correlated with average CIMT in Diabetic cases. (r=0.234,95% C.I. 0.015-0.432, p=0.0366). Post Prandial Blood Sugarwas also correlated with average CIMT (r=0.300, 95% C.I.0.086-0.488, p=0.00677).Conclusion: Cardiovascular risk factors like glycaemic controland inflammatory markers like hsCRP are significantlyassociated with CIMT even in non-smoking and statin naïveDiabetics.