Your browser doesn't support javascript.
Significant Liver Injury During Hospitalization for COVID-19 Is Not Associated With Liver Insufficiency or Death.
Chew, Michael; Tang, Zeyu; Radcliffe, Christopher; Caruana, Dennis; Doilicho, Natty; Ciarleglio, Maria M; Deng, Yanhong; Garcia-Tsao, Guadalupe.
  • Chew M; Digestive Diseases Section, Yale University School of Medicine, New Haven, Connecticut; VA-Connecticut Healthcare System, West Haven, Connecticut.
  • Tang Z; Yale University School of Medicine, New Haven, Connecticut.
  • Radcliffe C; Yale University School of Medicine, New Haven, Connecticut.
  • Caruana D; Yale University School of Medicine, New Haven, Connecticut.
  • Doilicho N; Yale University School of Medicine, New Haven, Connecticut.
  • Ciarleglio MM; Yale Center for Analytical Sciences, Yale University School of Public Health, New Haven, Connecticut.
  • Deng Y; Yale Center for Analytical Sciences, Yale University School of Public Health, New Haven, Connecticut.
  • Garcia-Tsao G; Digestive Diseases Section, Yale University School of Medicine, New Haven, Connecticut; VA-Connecticut Healthcare System, West Haven, Connecticut. Electronic address: guadalupe.garcia-tsao@yale.edu.
Clin Gastroenterol Hepatol ; 19(10): 2182-2191.e7, 2021 10.
Article in English | MEDLINE | ID: covidwho-1230397
ABSTRACT
BACKGROUND &

AIMS:

Coronavirus-19 disease (COVID-19) is associated with hepatocellular liver injury of uncertain significance. We aimed to determine whether development of significant liver injury during hospitalization is related to concomitant medications or processes common in COVID-19 (eg, ischemia, hyperinflammatory, or hypercoagulable states), and whether it can result in liver failure and death.

METHODS:

There were 834 consecutive patients hospitalized with COVID-19 who were included. Clinical, medication, and laboratory data were obtained at admission and throughout hospitalization using an identified database. Significant liver injury was defined as an aspartate aminotransferase (AST) level 5 or more times the upper limit of normal; ischemia was defined as vasopressor use for a minimum of 2 consecutive days; hyperinflammatory state was defined as high-sensitivity C-reactive protein value of 100 mg/L or more, and hypercoagulability was defined as D-dimer 5 mg/L or more at any time during hospitalization.

RESULTS:

A total of 105 (12.6%) patients developed significant liver injury. Compared with patients without significant liver injury, ischemia (odds ratio [OR], 4.3; range, 2.5-7.4; P < .0001) and tocilizumab use (OR, 3.6; range, 1.9-7.0; P = .0001) were independent predictors of significant liver injury. Although AST correlated closely with alanine aminotransferase (R = 0.89) throughout hospitalization, AST did not correlate with the international normalized ratio (R = 0.10) or with bilirubin level (R = 0.09). Death during hospitalization occurred in 136 (16.3%) patients. Multivariate logistic regression showed that significant liver injury was not associated with death (OR, 1.4; range, 0.8-2.6; P = .2), while ischemic (OR, 2.4; range, 1.4-4.0; P = .001), hypercoagulable (OR, 1.7; range, 1.1-2.6; P = .02), and hyperinflammatory (OR, 1.9; range, 1.2-3.1; P = .02) disease states were significant predictors of death.

CONCLUSIONS:

Liver test abnormalities known to be associated with COVID-19 are secondary to other insults, mostly ischemia or drug-induced liver injury, and do not lead to liver insufficiency or death.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Main subject: Hepatic Insufficiency / COVID-19 Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Clin Gastroenterol Hepatol Journal subject: Gastroenterology Year: 2021 Document Type: Article

Similar

MEDLINE

...
LILACS

LIS


Full text: Available Collection: International databases Database: MEDLINE Main subject: Hepatic Insufficiency / COVID-19 Type of study: Observational study / Prognostic study Limits: Humans Language: English Journal: Clin Gastroenterol Hepatol Journal subject: Gastroenterology Year: 2021 Document Type: Article