Impact of Coronavirus Diseases on Liver Enzymes.

Introduction Coronavirus disease 2019 (COVID-19) affects various organs including lungs, brain, and eyes. Very limited data is available related to the effect of COVID-19 on liver. This study is conducted to determine the impact of COVID-10 on liver by measuring the frequency of participants with deranged liver enzymes in patients diagnosed with COVID-19. Methods This cross-sectional study was conducted in a COVID-19 unit of a tertiary care hospital in Pakistan from February 2021 to June 2021. A total of 900 patients admitted with COVID-19 were enrolled in the study after seeking informed consent. After enrollment, taking history and vitals, 5 mL blood was drawn via phlebotomy and sent to the laboratory to test for C-reactive protein, lactate dehydrogenase, and liver enzymes. Results Overall 141 (28.2%) participants had a minimum of one deranged liver enzyme. The most commonly deranged liver enzyme found was alanine transaminase (ALT), both in males (19.9%) and females (21.3%), followed by aspartate transaminase (male: 18.3% and female: 20.3%). Serum total bilirubin was deranged in both males (8.4%) and females (8.3%). There was no significant difference in the gender-wise prevalence of deranged liver enzymes.  Conclusion Liver enzymes are frequently deranged in patients admitted with COVID-19. Liver enzymes should be regularly monitored during the course of management of COVID-19, as various medications used in the treatment of COVID-19 may further deteriorate liver enzymes and may cause long-term damage.

Dysnatremia is a Predictor for Morbidity and Mortality in Hospitalized Patients with COVID-19.

CONTEXT: Dysnatremia is an independent predictor of mortality in patients with bacterial pneumonia. There is paucity of data about the incidence and prognostic impact of abnormal sodium concentration in patients with coronavirus disease 2019 (COVID-19). OBJECTIVE: This work aimed to examine the association of serum sodium during hospitalization with key clinical outcomes, including mortality, need for advanced respiratory support and acute kidney injury (AKI), and to explore the role of serum sodium as a marker of inflammatory response in COVID-19. METHODS: This retrospective longitudinal cohort study, including all adult patients who presented with COVID-19 to 2 hospitals in London over an 8-week period, evaluated the association of dysnatremia (serum sodium < 135 or > 145 mmol/L, hyponatremia, and hypernatremia, respectively) at several time points with inpatient mortality, need for advanced ventilatory support, and AKI. RESULTS: The study included 488 patients (median age, 68 years). At presentation, 24.6% of patients were hyponatremic, mainly due to hypovolemia, and 5.3% hypernatremic. Hypernatremia 2 days after admission and exposure to hypernatremia at any time point during hospitalization were associated with a 2.34-fold (95% CI, 1.08-5.05; P = .0014) and 3.05-fold (95% CI, 1.69-5.49; P < .0001) increased risk of death, respectively, compared to normonatremia. Hyponatremia at admission was linked with a 2.18-fold increase in the likelihood of needing ventilatory support (95% CI, 1.34-3.45, P = .0011). Hyponatremia was not a risk factor for in-hospital mortality, except for the subgroup of patients with hypovolemic hyponatremia. Sodium values were not associated with the risk for AKI and length of hospital stay. CONCLUSION: Abnormal sodium levels during hospitalization are risk factors for poor prognosis, with hypernatremia and hyponatremia being associated with a greater risk of death and respiratory failure, respectively. Serum sodium values could be used for risk stratification in patients with COVID-19.