Abnormal liver function tests predict transfer to intensive care unit and death in COVID-19.

Autor: Piano S; Department of Medicine - DIMED, University and Hospital of Padova, Padova, Italy., Dalbeni A; Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy., Vettore E; Internal Medicine Unit, Ospedale Dell'Angelo, Mestre, Italy., Benfaremo D; Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy., Mattioli M; UOC Pronto Soccorso e Medicina d'Urgenza, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Pesaro, Italy., Gambino CG; Department of Medicine - DIMED, University and Hospital of Padova, Padova, Italy., Framba V; Department of Medicine - DIMED, University and Hospital of Padova, Padova, Italy., Cerruti L; Department of Medicine - DIMED, University and Hospital of Padova, Padova, Italy., Mantovani A; Department of Medicine, University and Azienda Ospedaliera Universitaria Integrata of Verona, Verona, Italy., Martini A; Department of Medicine - DIMED, University and Hospital of Padova, Padova, Italy.; Internal Medicine Unit, Ospedale Dell'Angelo, Mestre, Italy., Luchetti MM; Dipartimento di Scienze Cliniche e Molecolari, Università Politecnica delle Marche, Ancona, Italy., Serra R; Department of Medicine - DIMED, University and Hospital of Padova, Padova, Italy., Cattelan A; Infectious Disease Unit, University and Hospital of Padova, Padova, Italy., Vettor R; Department of Medicine - DIMED, University and Hospital of Padova, Padova, Italy., Angeli P; Department of Medicine - DIMED, University and Hospital of Padova, Padova, Italy.
Jazyk: angličtina
Zdroj: Liver international : official journal of the International Association for the Study of the Liver [Liver Int] 2020 Oct; Vol. 40 (10), pp. 2394-2406. Date of Electronic Publication: 2020 Jul 05.
DOI: 10.1111/liv.14565
Abstrakt: Background: The pandemic of coronavirus disease 2019 (COVID-19) has emerged as a relevant threat for humans worldwide. Abnormality in liver function tests (LFTs) has been commonly observed in patients with COVID-19, but there is controversy on its clinical significance. The aim of this study was to assess the prevalence, the characteristics and the clinical impact of abnormal LFTs in hospitalized, non-critically ill patients with COVID-19.
Methods: In this multicentre, retrospective study, we collected data about 565 inpatients with COVID-19. Data on LFTs were collected at admission and every 7 ± 2 days during the hospitalization. The primary outcome was a composite endpoint of death or transfer to intensive care unit (ICU).
Results: Upon admission 329 patients (58%) had LFTs abnormality. Patients with abnormal LFTs had more severe inflammation and higher degree of organ dysfunction than those without. During hospitalization, patients with abnormal LFTs had a higher rate of transfer to ICU (20% vs 8%; P < .001), acute kidney injury (22% vs 13%, P = .009), need for mechanical ventilation (14% vs 6%; P = .005) and mortality (21% vs 11%; P = .004) than those without. In multivariate analysis, patients with abnormal LFTs had a higher risk of the composite endpoint of death or transfer to ICU (OR = 3.53; P < .001). During the hospitalization, 86 patients developed de novo LFTs abnormality, which was associated with the use of tocilizumab, lopinavir/ritonavir and acetaminophen and not clearly associated with the composite endpoint.
Conclusions: LFTs abnormality is common at admission in patients with COVID-19, is associated with systemic inflammation, organ dysfunction and is an independent predictor of transfer to ICU or death.
(© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
Databáze: MEDLINE
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