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Mild versus Severe Liver Injury in SARS-CoV-2 Infection.
Anastasiou, Olympia E; Korth, Johannes; Herbstreit, Frank; Witzke, Oliver; Lange, Christian M.
  • Anastasiou OE; Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany, olympia.anastasiou@uni-due.de.
  • Korth J; Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
  • Herbstreit F; Department of Anesthesiology and Intensive Care, Essen University Hospital, Essen, Germany.
  • Witzke O; Department of Infectious Diseases, West German Centre of Infectious Diseases, Universitätsmedizin Essen, University Duisburg-Essen, Essen, Germany.
  • Lange CM; Department of Gastroenterology and Hepatology, University Hospital Essen, Essen, Germany.
Dig Dis ; 39(1): 52-57, 2021.
Article in English | MEDLINE | ID: covidwho-1039935
ABSTRACT

BACKGROUND:

Abnormal liver function has been reported in patients with COVID-19 infection. The aim of our study was to report on the prevalence of liver injury in our cohort, to evaluate the association of mild versus severe liver injury with mortality in COVID-19 patients and to scrutinize the temporal pattern of viral detection and liver injury.

METHODS:

We present data from a German cohort of 147 SARS-CoV-2 infected patients. The patients were divided into 3 groups according to their liver status during treatment. The first group included patients without elevated alanine aminotransferase or bilirubin, the third group patients meeting the biochemical criteria of acute liver failure (ALF), and the second group all other patients.

RESULTS:

Liver injury was detected in 75 (50.7%) and 93 (63%) patients by admission and during treatment, respectively. ALF was associated with the male sex, younger age, and higher BMI. Mortality was associated with the presence of ALF (OR = 9.423, 95% CI 2.410-36.858) in contrast to milder liver injury (OR 1.101, 95% CI 0.435-2.791). In 30% of patients with mild liver injury and in 50% of ALF patients, peak liver injury was observed at a time point when the virus was no longer detectable in the respiratory tract.

CONCLUSION:

Mild liver injury was not associated with worse outcome in our cohort, and the pattern of liver injury did not fit well to the theory of SARS-CoV-2 directly causing liver impairment. Instead, severe liver injury in our cohort was associated multiple-organ failure and acute vascular events.
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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Bilirubin / Liver Failure, Acute / Alanine Transaminase / SARS-CoV-2 / COVID-19 / Liver Function Tests Subject: Bilirubin / Liver Failure, Acute / Alanine Transaminase / SARS-CoV-2 / COVID-19 / Liver Function Tests Type of study: Risk factors Language: English Journal: Dig Dis Clinical aspect: Etiology Year: 2021

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Bilirubin / Liver Failure, Acute / Alanine Transaminase / SARS-CoV-2 / COVID-19 / Liver Function Tests Subject: Bilirubin / Liver Failure, Acute / Alanine Transaminase / SARS-CoV-2 / COVID-19 / Liver Function Tests Type of study: Risk factors Language: English Journal: Dig Dis Clinical aspect: Etiology Year: 2021
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