ABSTRACT
Introduction SARS-CoV-2 can cause respiratory and extrapulmonary complications, including liver injury. Therefore, understanding the virus's impact on the liver and the coronavirus disease 2019 (COVID-19) vaccine's protective effect is crucial, given the correlation between hepatic involvement and disease severity. Our study aims to evaluate this relationship and the impact of vaccination on liver injury in COVID-19-infected patients. Methods A retrospective cohort study analyzed liver function outcomes in COVID-19-infected patients who received two doses of the Pfizer-BioNTech or Moderna mRNA vaccine from October 2019 to October 2021. The study population was matched based on baseline characteristics, and Fisher's T-test was used for analysis. Secondary outcomes included COVID-19-related death, hospital stay, and SARS-CoV-2 infection after the second dose. SPSS (IBM Corp., Armonk, NY) and RStudio (RStudio, PBC, Boston, USA) software were utilized to ensure robust statistical analysis. Results A group of 78 patients with a propensity score were matched and analyzed, resulting in two groups of 39 patients each: vaccinated and unvaccinated. The vaccinated group had a lower incidence of liver injury, reduced length of stay, and mortality. The study suggests that COVID-19 vaccination can positively impact infected patients. These findings should be considered when making decisions about vaccine distribution and usage, and more research is needed to fully understand the vaccine's impact on ending the pandemic. Conclusion This study emphasizes the COVID-19 vaccine's significance in reducing liver injury and related outcomes, such as length of stay and mortality in infected patients. The results provide further evidence of vaccination benefits, with implications for healthcare professionals and policymakers. Further research is needed to deepen our understanding of COVID-19's complex effects on the liver and the vaccine's impact. Investing in research can inform clinical management, improve patient outcomes, and ultimately help end the pandemic.
ABSTRACT
Background: The Acute Physiologic and Chronic Health Evaluation II (APACHE-II), Sequential Organ Failure Assessment (SOFA), and Model for End-Stage Liver Disease modified for Sodium concentration (MELD-Na) scores are validated to predict disease mortality. We studied the prognostic utility of these scoring systems in critically ill coronavirus disease 2019 (COVID-19) patients with liver injury. Methods: This was a retrospective study of 291 confirmed COVID-19 and liver injury patients requiring intensive care unit level of care. These patients required supplemental oxygen requirement with fraction of inspired oxygen >55% and/or the use of vasopressor. MELD-Na, SOFA, and APACHE-II scores were adjusted. Outcomes were mortality and length of stay (LOS). Results: SOFA (odds ratio: 0.78, 95% confidence interval: 0.63-0.98, P < 0.05) was associated with decreased odds for mortality. APACHE-II and MELD-Na were not associated with mortality or LOS. Conclusions: We suggest that the novel nature of COVID-19 necessitates new scoring systems to predict outcomes in critically ill COVID-19 patients with liver injury.