| Autor: |
Żmudka K; Department of Infectious Diseases and Hepatology, Medical University of Silesia, 40-635 Katowice, Poland., Jaroszewicz J; Department of Infectious Diseases and Hepatology, Medical University of Silesia, 40-635 Katowice, Poland., Zarębska-Michaluk D; Department of Infectious Diseases and Allergology, Jan Kochanowski University, 25-317 Kielce, Poland., Rogalska M; Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland., Czupryna P; Department of Infectious Diseases and Neuroinfections, Medical University of Bialystok, 15-540 Bialystok, Poland., Rorat M; Department of Social Sciences and Infectious Diseases, Medical Faculty, Wroclaw University of Science and Technology, 50-470 Wroclaw, Poland., Kozielewicz D; Department of Infectious Diseases and Hepatology, Faculty of Medicine, Collegium Medicum in Bydgoszcz, Nicolaus Copernicus University, 85-030 Bydgoszcz, Poland., Maciukajć J; Department of Infectious Diseases, District Healthcare Center, 27-200 Starachowice, Poland., Kiciak S; Independent Voivodeship Hospital 'Jana Bożego' in Lublin, 20-400 Lublin, Poland., Krępa M; Szpital Powiatowy w Mielcu, 39-300 Mielec, Poland., Dutkiewicz E; Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-252 Szczecin, Poland., Stojko M; Department of Infectious Diseases and Hepatology, Medical University of Silesia, 40-635 Katowice, Poland., Spychał A; Department of Infectious Diseases and Hepatology, Medical University of Silesia, 40-635 Katowice, Poland., Ciechanowski P; Department of Pediatrics and Infectious Diseases, Regional Hospital in Szczecin, 71-252 Szczecin, Poland., Bolewska B; Department of Infectious Diseases, Poznań University of Medical Sciences, 61-285 Poznan, Poland., Podlasin R; IV-th Department, Hospital for Infectious Diseases, 01-201 Warsaw, Poland.; Department of Infectious Diseases, Collegium Medicum, Cardinal Stefan Wyszynski University in Warsaw, 01-815 Warsaw, Poland., Flisiak R; Department of Infectious Diseases and Hepatology, Medical University of Bialystok, 15-540 Bialystok, Poland. |
| Abstrakt: |
(1) Background: Liver damage is an important component of acute COVID-19, and the advancement of preexisting liver disease is associated with a worse prognosis; (2) Methods: A nationwide retrospective study including 7444 patients aimed to evaluate levels of selected markers of liver damage and disease advancement and their association with mortality and mechanical ventilation (MV); (3) Results: Elevation of the following markers in multivariate models were associated with increased odds of mortality: Alanine transaminase (ALT), aspartate transaminase (AST), gamma-glutamyltransferase (GGT), lactate dehydrogenase (LDH), fibrosis-4 score (FIB-4), AST-to-platelet ratio index (APRI), and decreased levels of platelet count (PLT). Elevated levels of AST, LDH, APRI, FIB-4, and the AST/ALT ratio and decreased levels of PLT were associated with increased odds of MV in multivariate models. The best predictive accuracy against mortality was achieved with FIB-4 with AUC = 0.733 (95% CI, 0.718-0.749) at the optimal cut-off point of 2.764, while against MV was achieved with LDH with AUC = 0.753 (95% CI, 0.727-0.778) at the optimal cut-off point of 449.5 IU/L. (4) Conclusions: Our study confirms that the advancement of liver damage contributes to a worse prognosis in COVID-19 patients. Markers for liver damage and the advancement of liver disease can provide predictive value in clinical practice among COVID-19 patients. |
