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Impact of liver enzymes on SARS-CoV-2 infection and the severity of clinical course of COVID-19

Liver Research 2021年第1期5卷 21-27页

作者： Fátima Higuera-de la Tijera Alfredo Servín-Caamaño Daniel Reyes-Herrera Argelia Flores-López enrique j.a.robiou-vivero Felipe Martínez-Rivera Victor Galindo-Hernández Oscar Chapa-Azuela Alfonso Chávez-Morales Victor H.Rosales-Salyano Multidisciplinary Team for the Attention and Care of Patients with COVID-19 Hospital General de México Dr.Eduardo LiceagaMexico CityMexico Gastroenterology and Hepatology Department Hospital General de México Dr.Eduardo LiceagaMexico CityMexico Internal Medicine Department Hospital General de México Dr.Eduardo LiceagaMexico CityMexico Hepatobiliary and Pancreatology Clinic Surgery DepartmentHospital General de México Dr.Eduardo LiceagaMexico CityMexico Intensive Care Unit Hospital General de México Dr.Eduardo LiceagaMexico CityMexico

Background and aim Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),the virus responsible for the current pandemic,can have multi-organ impact.Recent studies show that liver injury could be a manifestation of the disease,and that liver disease could also be related to a worse prognosis.Our aim was to compare the characteristics of patients with severe coronavirus disease 2019(COVID-19)due to SARS-CoV-2 who required intubation versus stable hospitalized patients to identify the early biochemical predictive factors of a severe course of COVID-19 and subsequent requirement for intubation,specifically in Mexican.Methods This was an observational case-control study nested in a cohort study.Complete medical records of patients admitted for confirmed COVID-19 at a tertiary level center in Mexico City were reviewed.Clinical and biochemical data were collected,and the characteristics of patients who required invasive mechanical ventilation(IMV)(cases)were compared with stable hospitalized patients without ventilation(controls).Results We evaluated 166 patients with COVID-19 due to SARS-CoV-2 infection;114(68.7%)were men,the mean age was 50.6±13.3 years,and 27(16.3%)required IMV.The comparative analysis between cases and controls showed(respectively)significantly lower blood oxygen saturation(SpO_(2))(73.5±12.0%vs.83.0±6.8%,P<0.0001)and elevated alanine aminotransferase(ALT)(128(14–1123)IU/L vs.33(8–453)IU/L,P=0.003),aspartate aminotransferase(AST)(214(17–1247)vs.44(12–498)IU/L,P=0.001),lactic dehydrogenase(LDH)(764.6±401.9 IU/L vs.461.0±185.6 IU/L,P=0.001),and D-dimer(3463(524–34,227)ng/mL vs.829(152–41,923)ng/mL,P=0.003)concentrations.Patients in the cases group were older(58.6±12.7 years vs.49.1±12.8 years,P=0.001).Multivariate analysis showed that important factors at admission predicting the requirement for IMV during hospitalization for COVID-19 were AST≥250 IU/L(odds ratio(OR)=64.8,95%confidence interval(CI)7.5–560.3,P<0.0001)and D-dimer≥3500 ng/mL(OR=4.1,95%CI 1.2–13.7,P=0.02).Conclusions Our study confi

关键词： Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) Coronavirus disease 2019(COVID-19) Liver enzymes D-dimer Disease severity Invasive mechanical ventilation(IMV) Multi-organ failure

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