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Progressive liver injury and increased mortality risk in COVID-19 patients: A retrospective cohort study in China.
Zhang, Shui-Sheng; Dong, Li; Wang, Gao-Ming; Tian, Yuan; Ye, Xiao-Fang; Zhao, Yue; Liu, Zheng-Yin; Zhai, Jia-Yu; Zhao, Zhi-Ling; Wang, Jun-Hong; Zhang, Hui-Min; Li, Xiao-Long; Wu, Chang-Xin; Yang, Cai-Ting; Yang, Li-Juan; Du, Hai-Xia; Wang, Hui; Ge, Qing-Gang; Xiu, Dian-Rong; Shen, Ning.
  • Zhang SS; Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.
  • Dong L; Institutes of Biomedical Sciences, Shanxi University, Taiyuan 030006, Shanxi Province, China.
  • Wang GM; Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.
  • Tian Y; Department of Radiotherapy Oncology, Shandong Provincial Qianfoshan Hospital, The First Hospital Affiliated with Shandong First Medical University, Jinan 250014, Shandong Province, China.
  • Ye XF; Department of Respiratory and Critical Medicine, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
  • Zhao Y; Department of General Surgery, Peking University Third Hospital, Beijing 100191, China.
  • Liu ZY; Department of Infectious Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100005, China.
  • Zhai JY; Department of Rheumatology, Peking University Third Hospital, Beijing 100191, China.
  • Zhao ZL; Department of Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China.
  • Wang JH; Department of Emergency Medicine, Peking University Third Hospital, Beijing 100191, China.
  • Zhang HM; Department of Cardiac Surgery, Peking University Third Hospital, Beijing 100191, China.
  • Li XL; Department of Urology, Peking University Third Hospital, Beijing 100191, China.
  • Wu CX; Institutes of Biomedical Sciences, Shanxi University, Taiyuan 030006, Shanxi Province, China.
  • Yang CT; Institutes of Biomedical Sciences, Shanxi University, Taiyuan 030006, Shanxi Province, China.
  • Yang LJ; Department of Gynecology, Peking University Third Hospital, Beijing 100191, China.
  • Du HX; Department of Rehabilitation, Peking University Third Hospital, Beijing 100191, China.
  • Wang H; Department of Gastroenterology, Peking University Third Hospital, Beijing 100191, China.
  • Ge QG; Department of Critical Care Medicine, Peking University Third Hospital, Beijing 100191, China.
  • Xiu DR; Department of General Surgery, Peking University Third Hospital, Beijing 100191, China. xiudianrong@yeah.net.
  • Shen N; Department of Respiratory and Critical Medicine, Peking University Third Hospital, Beijing 100191, China.
World J Gastroenterol ; 27(9): 835-853, 2021 Mar 07.
Article in English | MEDLINE | ID: covidwho-1138767
ABSTRACT

BACKGROUND:

Liver injury is common and also can be fatal, particularly in severe or critical patients with coronavirus disease 2019 (COVID-19).

AIM:

To conduct an in-depth investigation into the risk factors for liver injury and into the effective measures to prevent subsequent mortality risk.

METHODS:

A retrospective cohort study was performed on 440 consecutive patients with relatively severe COVID-19 between January 28 and March 9, 2020 at Tongji Hospital, Wuhan, China. Data on clinical features, laboratory parameters, medications, and prognosis were collected.

RESULTS:

COVID-19-associated liver injury more frequently occurred in patients aged ≥ 65 years, female patients, or those with other comorbidities, decreased lymphocyte count, or elevated D-dimer or serum ferritin (P < 0.05). The disease severity of COVID-19 was an independent risk factor for liver injury (severe patients Odds ratio [OR] = 2.86, 95% confidence interval [CI] 1.78-4.59; critical patients OR = 13.44, 95%CI 7.21-25.97). The elevated levels of on-admission aspartate aminotransferase and total bilirubin indicated an increased mortality risk (P < 0.001). Using intravenous nutrition or antibiotics increased the risk of COVID-19-associated liver injury. Hepatoprotective drugs tended to be of assistance to treat the liver injury and improve the prognosis of patients with COVID-19-associated liver injury.

CONCLUSION:

More intensive monitoring of aspartate aminotransferase or total bilirubin is recommended for COVID-19 patients, especially patients aged ≥ 65 years, female patients, or those with other comorbidities. Drug hepatotoxicity of antibiotics and intravenous nutrition should be alert for COVID-19 patients.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Liver Diseases Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: World J Gastroenterol Journal subject: Gastroenterology Year: 2021 Document Type: Article Affiliation country: Wjg.v27.i9.835

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Full text: Available Collection: International databases Database: MEDLINE Main subject: COVID-19 / Liver Diseases Type of study: Cohort study / Diagnostic study / Observational study / Prognostic study Topics: Long Covid Limits: Adult / Aged / Female / Humans / Male / Middle aged Country/Region as subject: Asia Language: English Journal: World J Gastroenterol Journal subject: Gastroenterology Year: 2021 Document Type: Article Affiliation country: Wjg.v27.i9.835