The Impact of Liver Chemistries on Respiratory Failure among Hemodialysis Patients with COVID-19 during the Omicron Wave.

Autor: Hori M; Department of Nephrology, Masuko Memorial Hospital, Japan., Yasuda K; Department of Nephrology, Masuko Memorial Hospital, Japan., Takahashi H; Department of Nephrology, Fujita Health University School of Medicine, Japan., Aoi T; Department of Nephrology, Masuko Memorial Hospital, Japan., Mori Y; Department of Nephrology, Masuko Memorial Hospital, Japan., Tsujita M; Department of Nephrology, Masuko Memorial Hospital, Japan., Shirasawa Y; Department of Nephrology, Masuko Memorial Hospital, Japan., Kondo C; Department of Nephrology, Masuko Memorial Hospital, Japan., Hashimoto T; Department of General Internal Medicine, Masuko Memorial Hospital, Japan., Koyama H; Department of General Internal Medicine, Masuko Memorial Hospital, Japan., Morozumi K; Department of Nephrology, Masuko Memorial Hospital, Japan., Maruyama S; Department of Nephrology, Nagoya University Graduate School of Medicine, Japan.
Jazyk: angličtina
Zdroj: Internal medicine (Tokyo, Japan) [Intern Med] 2023 Sep 15; Vol. 62 (18), pp. 2617-2625. Date of Electronic Publication: 2023 Jul 05.
DOI: 10.2169/internalmedicine.2115-23
Abstrakt: Objective Although the coronavirus disease 2019 (COVID-19) Omicron variant causes less severe symptoms than previous variants, early indicators for respiratory failure are needed in hemodialysis patients, who have a higher mortality rate than the general population. Liver chemistries are known to reflect the severity of COVID-19 in the general population. This study explored the early indicators for worsened respiratory failure based on patient characteristics, including liver chemistries. Methods This retrospective study included 117 patients admitted for COVID-19 during the Omicron wave. Respiratory failure was defined as oxygen requirement during treatment. Information on the symptoms and clinical characteristics, including liver chemistries [aspartate aminotransferase (AST) and alanine aminotransferase (ALT)], at admission was collected. Results Thirty-five patients (29.9%) required oxygen supply during treatment. In the multivariate logistic regression analyses, AST [odds ratio (OR) 1.06, 95% confidence interval (CI) 1.00-1.13, p=0.029], ALT (OR 1.09, 95% CI 1.02-1.18, p=0.009), and moderate COVID-19 illness (Model including AST, OR 6.95, 95% CI 2.23-23.17, p<0.001; Model including ALT, OR 7.19, 95% CI 2.21-25.22, p=0.001) were independent predictors for respiratory failure. Based on the cutoff values determined by the receiver operating characteristic curve, higher AST (≥23 IU/L) and ALT levels (≥14 IU/L) were also independently associated with respiratory failure (higher AST: 64.3% vs. 18.8%, OR 3.44, 95% CI 1.08-11.10, p=0.035; higher ALT: 48.8% vs. 19.7%, OR 4.23, 95% CI 1.34-14.52, p=0.013, respectively). Conclusion The measurement of AST and ALT levels at baseline may help predict oxygen requirement in hemodialysis patients with COVID-19.
Databáze: MEDLINE