Subject(s)
Acute Kidney Injury/virology , Adalimumab/adverse effects , Anti-Inflammatory Agents/adverse effects , COVID-19/virology , Crohn Disease/drug therapy , Kidney/virology , SARS-CoV-2/pathogenicity , Virion/pathogenicity , Acute Kidney Injury/diagnosis , Acute Kidney Injury/immunology , Adult , COVID-19/diagnosis , COVID-19/immunology , Crohn Disease/diagnosis , Crohn Disease/immunology , Humans , Immunocompromised Host , Kidney/immunology , Kidney/pathology , Male , Risk FactorsABSTRACT
Little is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25-97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07-5.11, p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome.