Subject(s)
2019-nCoV Vaccine mRNA-1273 , BNT162 Vaccine , COVID-19 , Chemical and Drug Induced Liver Injury , Risk Adjustment/methods , 2019-nCoV Vaccine mRNA-1273/administration & dosage , 2019-nCoV Vaccine mRNA-1273/adverse effects , BNT162 Vaccine/administration & dosage , BNT162 Vaccine/adverse effects , Biopsy/methods , Biopsy/statistics & numerical data , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/administration & dosage , COVID-19 Vaccines/adverse effects , Chemical and Drug Induced Liver Injury/blood , Chemical and Drug Induced Liver Injury/diagnosis , Chemical and Drug Induced Liver Injury/epidemiology , Chemical and Drug Induced Liver Injury/prevention & control , Cholangiopancreatography, Endoscopic Retrograde/methods , Cholangiopancreatography, Endoscopic Retrograde/statistics & numerical data , Cohort Studies , Female , Humans , Liver Function Tests/methods , Male , Middle Aged , Pharmacovigilance , SARS-CoV-2 , Time FactorsSubject(s)
Alanine Transaminase/blood , Aspartate Aminotransferases/blood , Betacoronavirus , Chemical and Drug Induced Liver Injury , Chloroquine , Coronavirus Infections , Hepatitis, Viral, Human , Lopinavir , Pandemics , Pneumonia, Viral , Ritonavir , Antiviral Agents/administration & dosage , Antiviral Agents/adverse effects , Betacoronavirus/isolation & purification , Betacoronavirus/pathogenicity , COVID-19 , COVID-19 Testing , Chemical and Drug Induced Liver Injury/blood , Chemical and Drug Induced Liver Injury/diagnosis , Chemical and Drug Induced Liver Injury/etiology , Chloroquine/administration & dosage , Chloroquine/adverse effects , Clinical Laboratory Techniques/methods , Coronavirus Infections/complications , Coronavirus Infections/diagnosis , Coronavirus Infections/drug therapy , Coronavirus Infections/physiopathology , Diagnosis, Differential , Drug Combinations , Hepatitis, Viral, Human/blood , Hepatitis, Viral, Human/diagnosis , Hepatitis, Viral, Human/etiology , Humans , Liver/pathology , Liver Function Tests/methods , Lopinavir/administration & dosage , Lopinavir/adverse effects , Male , Middle Aged , Pneumonia, Viral/complications , Pneumonia, Viral/diagnosis , Pneumonia, Viral/physiopathology , Ritonavir/administration & dosage , Ritonavir/adverse effects , SARS-CoV-2 , COVID-19 Drug TreatmentABSTRACT
BACKGROUND: Reports of liver injury in patients with novel coronavirus disease 2019 (COVID-19) are emerging from China and the USA. A wide variety of liver function test abnormalities and few cases of severe liver failure have been reported. No data on the hepatic phenotype from Europe are available at current. METHODS: We report a case series of 44 consecutive patients hospitalized for COVID-19 in Germany. RESULTS: At the time of admission, aspartate aminotransferase greater than the upper limit of normal was present in 70%, while alanine aminotransferase was elevated in 15.8%. Markers of cholestatic liver injury were altered only in a minority of patients. During hospitalization, 31% and 22% experienced increasing aspartate aminotransferase and alanine aminotransferase, respectively, when transaminases were normal at admission. Severe liver injury defined by 3×> upper limit of normal was observed in 9.1% over a mean time of 10.5 days. Importantly, patients exhibited cytotoxicity including lactate dehydrogenase and creatinine kinase elevations, but no signs of relevant liver function impairment. CONCLUSION: In summary, in a case series of hospitalized patients in Germany, cytotoxicity in the absence of severe liver dysfunction at admission and only few cases suggestive of severe liver injury during hospital were observed.