Increased Morbidity and Mortality in COVID-19 Patients with Liver Injury
Autor: | Mohammad Arsalan Siddiqui, Megan Karrick, Tobias Zuchelli, Suraj Suresh, Reena Salgia, Duyen Dang, Sarah Russell, Stephen Simmer, Mouhanna Abu-Ghanimeh, Mustafa Al-Shammari, Maher Musleh, Faisal Nimri, Jessica Jou, Vivek Mediratta |
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Jazyk: | angličtina |
Rok vydání: | 2021 |
Předmět: |
Adult
Male medicine.medical_specialty Physiology Bilirubin medicine.medical_treatment Liver injury Gastroenterology law.invention 03 medical and health sciences chemistry.chemical_compound 0302 clinical medicine law Internal medicine Clinical outcomes medicine Prevalence Intubation Humans Aspartate Aminotransferases Retrospective Studies business.industry SARS-CoV-2 Liver Diseases COVID-19 Alanine Transaminase Hepatology medicine.disease Intensive care unit Hospitalization chemistry Risk factors 030220 oncology & carcinogenesis Relative risk Cohort Alkaline phosphatase 030211 gastroenterology & hepatology Original Article Female business |
Zdroj: | Digestive Diseases and Sciences |
ISSN: | 1573-2568 0163-2116 |
Popis: | Background There is a high prevalence of liver injury (LI) in patients with coronavirus disease 2019 (COVID-19); however, few large-scale studies assessing risk factors and clinical outcomes in these patients have been done. Aims To evaluate the risk factors and clinical outcomes associated with LI in a large inpatient cohort of COVID-19 patients. Methods Adult patients with COVID-19 between March 1 and April 30, 2020, were included. LI was defined as peak levels of alanine aminotransferase/aspartate aminotransferase that were 3 times the ULN or peak levels in alkaline phosphatase/total bilirubin that were 2 times the ULN. Mild elevation in liver enzymes (MEL) was defined as abnormal peak liver enzyme levels lower than the threshold for LI. Patients with MEL and LI were compared to a control group comprising patients with normal liver enzymes throughout hospitalization. Results Of 1935 hospitalized COVID-19 patients, 1031 (53.2%) had MEL and 396 (20.5%) had LI. Compared to control patients, MEL and LI groups contained proportionately more men. Patients in the MEL cohort were older compared to control, and African-Americans were more highly represented in the LI group. Patients with LI had an increased risk of mortality (relative risk [RR] 4.26), intensive care unit admission (RR, 5.52), intubation (RR, 11.01), 30-day readmission (RR, 1.81), length of hospitalization, and intensive care unit stay (10.49 and 10.06 days, respectively) compared to control. Conclusion Our study showed that patients with COVID-19 who presented with LI had a significantly increased risk of mortality and poor clinical outcomes. |
Databáze: | OpenAIRE |
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