Prevalence and Prognostic Impact of Deranged Liver Blood Tests in COVID-19: Experience from the Regional COVID-19 Center over the Cohort of 3812 Hospitalized Patients.

BACKGROUND: Derangement of liver blood tests (LBT) is frequent in patients with Coronavirus disease 2019 (COVID-19). We aimed to evaluate (a) the prevalence of deranged LBT as well as their association with (b) clinical severity at admission and (c) 30-day outcomes among the hospitalized patients with COVID-19. METHODS: Consecutive patients with COVID-19 hospitalized in the regional referral center over the 12-month period were included. Clinical severity of COVID-19 at hospital admission and 30-day outcomes (need for intensive care, mechanical ventilation, or death) were analyzed. RESULTS: Derangement of LBT occurred in 2854/3812 (74.9%) of patients, most frequently due to elevation of AST (61.6%), GGT (46.1%) and ALT (33.4%). Elevated AST, ALT, GGT and low albumin were associated with more severe disease at admission. However, in multivariate Cox regression analysis, when adjusted for age, sex, obesity and presence of chronic liver disease, only AST remained associated with the risk of dying (HR 1.5081 and 2.1315, for elevations 1-3 × ULN and >3 × ULN, respectively) independently of comorbidity burden and COVID-19 severity at admission. Patients with more severe liver injury more frequently experienced defined adverse outcomes. CONCLUSIONS: Deranged LBTs are common among patients hospitalized with COVID-19 and might be used as predictors of adverse clinical outcomes.

The dynamic changes in the pattern of liver function tests in pregnant obese women.

Obesity is an important problem in healthcare regarding gestating women. The objective of the present study was to highlight the impact that obesity has on the hepatic function in pregnant women by comparing the functional tests used in current practice. In addition, the aim was to identify possible predictors of liver damage by analyzing specific anthropometric data. The present study was descriptive, observational, retrospective, and based on the observation sheets found in the database of the Institute for the Health of the Mother and Child, the Obstetrics Gynecology Department of Polizu Hospital. Patients who presented for consultation in each trimester of pregnancy were included in the study. Demographic data taken into account included age, body mass index (BMI), provenance environment, anthropometric data: Abdominal circumference and the complete set of paraclinical data from which we extracted these specific liver tests: Aspartate aminotransferase (AST), alanine transferase (ALT), direct bilirubin (BD), serum albumin and gamma-glutamyl transferase (GGT). The present study included 157 patients divided into two groups, distributed as follows: Group A: 66 obese pregnant women (BMI >25 kg/m2) and group B: 91 patients with normal weight (BMI <25 kg/m2). Measurement of serum ALT and AST were the most useful tests for routine diagnosis of liver disease. The effects of pregnancy on serum levels of ALT and AST are controversial. In some studies, there was a slight increase in ALT and AST during the second and third trimesters, a fact confirmed by our study, albeit the result was not statistically significant Most published studies claim that serum ALT and AST levels do not change during pregnancy. In conclusion, obesity during pregnancy does not drastically influence liver function. However, patients with greater abdominal circumference are prone to developing minor hepatic cytolysis syndrome during the gestation period. The liver functional tests described in the aforementioned groups agree with the results provided by the specialized studies.

Coinfección por el virus de la hepatitis C y el virus de la inmunodeficiencia humana en una población de riesgo / Co-infection due to the hepatitis C virus and the human immunodeficiency virus in a population at risk

Se realizó un estudio descriptivo, prospectivo y transversal de 25 pacientes con coinfección por el virus de la hepatitis C y el de la inmunodeficiencia humana, quienes habían sido remitidos al Hospital General Docente "Dr. Juan Bruno Zayas Alfonso" en Santiago de Cuba, en el período de enero del 2012 a igual mes del 2014, a fin de determinar las características epidemiológicas, clínicas y humorales en ellos. En la serie se obtuvo que la infección por ambos virus fuera más frecuente en el grupo etario de 3039 años (36,0 %), en el sexo masculino (96,0 %) y en los integrantes del grupo de múltiples riesgos (64,0 %). La mayoría de los pacientes habían sido diagnosticados con la coinfección en un período inferior a los 3 años, referían más de una manifestación clínica y presentaron resultados elevados en las pruebas funcionales hepáticas.

A descriptive, prospective and cross-sectional study of 25 patients with diagnosis of co-infection due to hepatitis C virus and that of the human immunodeficiency who had been referred to "Dr. Juan Bruno Zayas Alfonso" Teaching General Hospital in Santiago de Cuba, was carried out from January, 2012 to the same month in 2014, in order to determine the epidemiological, clinical and humoral characteristics in them. In the series it was obtained that the infection due to both viruses was more frequent in the 30-39 age group (36.0%), in male sex (96.0%) and in the members of the multiple risks group (64.0%). Most of the patients had been diagnosed with the co-infection in less than the 3 years, they stated more than one clinical feature and presented high results in the liver functional tests.

The role of liver function test in diagnosing concomitant asymptomatic common bile duct stone in patients with cholecystolithiasis / 中华肝胆外科杂志

Objective To determine the role of liver function test in the preoperative diagnosis of concomitant asymptomatic common bile duct (CBD)stone in patients with cholecystolithiasis.Methods A retrospective study was conducted from January 2012 to October 2013 at the Department of Hepatobiliary Surgery,the Affiliated Hospital of Zunyi Medical College on 426 patients who were operated for cholecystolithiasis.According to whether they had abnormal liver function,these patients were divided into the CBD stone group (n =44) and the cholecystolithiasis group (n =382).The values of the different components of liver functions test such as ALT,AST,AKP,GGT,TBIL and DBIL in diagnosing CBD stone were statistically analyzed.Results This study involved 426 patients,159 men and 231 women,with a mean age of (50.96 ± 12.93) years.44 patients with both CBD stone and cholecystolithiasis.The rates of abnormal liver function were 77.27％ (34/44) vs 4.45％ (17/382) in CBD stone group vs cholecystolithiasis group.The difference was significant (x2 =198.54 ; P =0.000).In logistic regression analysis,only elevated serum level of GGT (OR =10.067 ; P =0.007) remained as an independent predictor of CBD stone.On ROC (receiver operating characteristic) curves analysis,the area under the curve was 0.881.With a cut-off point for GGT at 84.5 U/L,there was a sensitivity of 72.2 per cent,specificity of 96.1 per cent,and positive and negative predictive values of 76.3 per cent and 96.2 per cent respectively.Conclusion Our study showed that liver function,especially GGT,was a predictor of CBD stone.