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Liver damage at admission is an independent prognostic factor for COVID-19.
Chen, Liu Ying; Chu, Hui Kuan; Bai, Tao; Tu, Sheng Jin; Wei, Yuan; Li, Zhong Lin; Hu, Li Lin; Zhu, Rui; Zhang, Lei; Han, Chao Qun; Xiao, Li; He, Qi; Song, Jun; Liu, Wei Hua; Zhu, Qing Jing; Chen, Hua; Yang, Ling; Hou, Xiao Hua.
  • Chen LY; Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
  • Chu HK; Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
  • Bai T; Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
  • Tu SJ; Department of Tuberculosis and Respiratory Disease, Wuhan Jinyintan Hospital, Wuhan, Hubei Province, China.
  • Wei Y; Department of Tuberculosis and Respiratory Disease, Wuhan Jinyintan Hospital, Wuhan, Hubei Province, China.
  • Li ZL; Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
  • Hu LL; Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
  • Zhu R; Department of Traditional Chinese Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
  • Zhang L; Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
  • Han CQ; Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
  • Xiao L; Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
  • He Q; Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
  • Song J; Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
  • Liu WH; Department of Tuberculosis and Respiratory Disease, Wuhan Jinyintan Hospital, Wuhan, Hubei Province, China.
  • Zhu QJ; Department of Liver and Infectious Diseases, Wuhan Jinyintan Hospital, Wuhan, Hubei Province, China.
  • Chen H; Department of Tuberculosis and Respiratory Disease, Wuhan Jinyintan Hospital, Wuhan, Hubei Province, China.
  • Yang L; Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
  • Hou XH; Division of Gastroenterology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China.
J Dig Dis ; 21(9): 512-518, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-670044
Semantic information from SemMedBD (by NLM)
1. Borg Category-Ratio 10 Perceived Exertion Score 5 PROCESS_OF Patients
Subject
Borg Category-Ratio 10 Perceived Exertion Score 5
Predicate
PROCESS_OF
Object
Patients
2. High probability PROCESS_OF Patients
Subject
High probability
Predicate
PROCESS_OF
Object
Patients
3. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
4. Laboratory Infection PROCESS_OF Patients
Subject
Laboratory Infection
Predicate
PROCESS_OF
Object
Patients
5. Liver Dysfunction PROCESS_OF Patients
Subject
Liver Dysfunction
Predicate
PROCESS_OF
Object
Patients
6. Normal liver function PROCESS_OF Patients
Subject
Normal liver function
Predicate
PROCESS_OF
Object
Patients
7. Borg Category-Ratio 10 Perceived Exertion Score 5 PROCESS_OF Patients
Subject
Borg Category-Ratio 10 Perceived Exertion Score 5
Predicate
PROCESS_OF
Object
Patients
8. High probability PROCESS_OF Patients
Subject
High probability
Predicate
PROCESS_OF
Object
Patients
9. COVID-19 PROCESS_OF Patients
Subject
COVID-19
Predicate
PROCESS_OF
Object
Patients
10. Laboratory Infection PROCESS_OF Patients
Subject
Laboratory Infection
Predicate
PROCESS_OF
Object
Patients
11. Liver Dysfunction PROCESS_OF Patients
Subject
Liver Dysfunction
Predicate
PROCESS_OF
Object
Patients
12. Normal liver function PROCESS_OF Patients
Subject
Normal liver function
Predicate
PROCESS_OF
Object
Patients
ABSTRACT

OBJECTIVE:

Abnormal liver function is a common form of extra-pulmonary organ damage in patients with coronavirus disease 2019 (COVID-19). Patients with severe COVID-19 have a higher probability and progression of liver injury than those without severe disease. We aimed to evaluate the prognosis of liver injury in patients with COVID-19.

METHODS:

We retrospectively included 502 patients with laboratory-confirmed SARS-CoV-2 infection. Clinical features and survival of patients with and without liver injury were compared. Cox proportional hazards models were used to determine the variables that might have an effect on survival.

RESULTS:

Among the 502 patients enrolled, 301 patients had abnormal liver function with increased neutrophil count, C-reactive protein, creatinine, troponin I (TnI), D-dimer, lactose dehydrogenase and creatine kinase. Patients with abnormal liver functions had a higher mortality rate (28.9% vs 9.0%, P < 0.001), a higher ratio of male sex (65.1% vs 40.8%, P < 0.001) and a higher chance of developing systemic inflammatory response syndrome (53.5% vs 41.3%, P = 0.007). Among patients with abnormal liver functions, patients with grade 2 liver damage (with both abnormal alanine aminotransferase or aspartate aminotransferase levels and abnormal alkaline phosphatase or gamma-glutamyl transpeptidase levels) had a higher ratio of male patients, elevated neutrophil count, procalcitonin, D-dimer levels and mortality rate. Multivariate Cox regression analyses suggested that the grade of liver damage (hazard ratio 1.377, 95% confidence interval 1.000-1.896, P = 0.049) was an independent predictor of death.

CONCLUSIONS:

Patients with COVID-19 and abnormal liver functions have a higher mortality than those with normal liver functions. Liver damage is an independent prognostic factor of COVID-19.
Subject(s)
Keywords

Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Pneumonia, Viral / Aspartate Aminotransferases / C-Reactive Protein / Fibrin Fibrinogen Degradation Products / Coronavirus Infections / Hepatic Insufficiency / Alanine Transaminase / Pandemics Subject: Pneumonia, Viral / Aspartate Aminotransferases / C-Reactive Protein / Fibrin Fibrinogen Degradation Products / Coronavirus Infections / Hepatic Insufficiency / Alanine Transaminase / Pandemics Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors Language: English Journal: J Dig Dis Clinical aspect: Diagnosis / Prediction / Prognosis Year: 2020

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Full text: Available Collection: International databases Database: MEDLINE Document Type: Article Main subject: Pneumonia, Viral / Aspartate Aminotransferases / C-Reactive Protein / Fibrin Fibrinogen Degradation Products / Coronavirus Infections / Hepatic Insufficiency / Alanine Transaminase / Pandemics Subject: Pneumonia, Viral / Aspartate Aminotransferases / C-Reactive Protein / Fibrin Fibrinogen Degradation Products / Coronavirus Infections / Hepatic Insufficiency / Alanine Transaminase / Pandemics Type of study: Diagnostic study / Etiology study / Observational study / Prognostic study / Risk factors Language: English Journal: J Dig Dis Clinical aspect: Diagnosis / Prediction / Prognosis Year: 2020
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