A Retrospective Analysis of COVID-19-infected Patients with Acute Hepatitis who Develop Acute Liver Failure in a Safety Net Hospital
| Autor: | Swapna Munnangi, James R. Pellegrini, Nourma Sajid, Elisa Szydziak, Rezwan Munshi, Daniel Meshoyrer, Bhanu Siva Kumar R. Sabbula, Jose R. Russe-Russe, Jagadish Akella, Alex Gutierrez |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment RC799-869 Logistic regression liver Hepatitis Coronary artery disease Internal medicine Diabetes mellitus medicine Intubation Humans Hepatic encephalopathy Retrospective Studies Hepatology business.industry SARS-CoV-2 Mortality rate Confounding digestive oral and skin physiology Gastroenterology Acute kidney injury COVID-19 acute liver failure Diseases of the digestive system. Gastroenterology Liver Failure Acute medicine.disease Female business Safety-net Providers |
| Zdroj: | BMJ Open Gastroenterology BMJ Open Gastroenterology, Vol 8, Iss 1 (2021) |
| ISSN: | 2054-4774 |
| Popis: | ObjectiveIn early 2019, a new coronavirus called SARS-CoV-2 emerged and changed the course of civilization. Our study aims to analyze the association between acute liver failure (ALF) and mortality in patients infected with COVID-19. A retrospective analysis of 864 COVID-19-infected patients admitted to Nassau University Medical Center in New York was performed.DesignALF is identified by acute liver injury (elevations in liver enzymes), hepatic encephalopathy and an international normalised ratio greater than or equal to 1.5. These parameters were analysed via daily blood work and clinical assessment. Multivariate logistic regression model predicting mortality and controlling for confounders such as age, coronary artery disease, intubation, hypertension, diabetes mellitus and acute kidney injury were used to determine the association of ALF with mortality.ResultsA total of 624 patients, out of the initial 864, met the inclusion criteria—having acute hepatitis and COVID-19 infection. Of those 624, 43 (6.9%) patients developed ALF during the course of their hospitalisation and their mortality rate was 74.4%. The majority of patients with ALF were male (60.6%). The logistic model predicting death and controlling for confounders shows COVID-19 patients with ALF had a nearly four-fold higher odds of death in comparison to those without ALF (p=0.0063).ConclusionsFindings from this study suggest that there is a significant association between mortality and the presence of ALF in patients infected with COVID-19. Further investigation into patients with COVID-19 and ALF can lead to enhanced treatment regimens and risk stratification tools, which can ultimately improve mortality rates during these arduous times. |
| Databáze: | OpenAIRE |
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