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Abnormal liver chemistries as a predictor of COVID-19 severity and clinical outcomes in hospitalized patients

World Journal of Gastroenterology 2022年第5期28卷 570-587页

作者： Arunkumar Krishnan laura prichett Xueting Tao Saleh A Alqahtani James P Hamilton Esteban Mezey Alexandra T Strauss Ahyoung Kim James J Potter Po-Hung Chen Tinsay A Woreta Division of Gastroenterology and Hepatology Johns Hopkins University School of MedicineBaltimoreMD 21287United States Department of Pediatrics Johns Hopkins University School of MedicineBaltimoreMD 21287United States Liver Transplant Center King Faisal Specialist Hospital&Research CenterRiyadh 12713Saudi Arabia

BACKGROUND Abnormal liver chemistries are common findings in patients with Coronavirus Disease 2019(COVID-19).However,the association of these abnormalities with the severity of COVID-19 and clinical outcomes is poorly understood AIM We aimed to assess the prevalence of elevated liver chemistries in hospitalized patients with COVID-19 and compare the serum liver chemistries to predict the severity and in-hospital *** This retrospective,observational study included 3380 patients with COVID-19 who were hospitalized in the Johns Hopkins Health System(Baltimore,MD,United States).Demographic data,clinical characteristics,laboratory findings,treatment measures,and outcome data were *** regression modeling was used to explore variables associated with abnormal liver chemistries on admission with disease severity and prognosis RESULTS A total of 2698(70.4%)had abnormal alanine aminotransferase(ALT)at the time of *** more prevalent abnormal liver chemistries were aspartate aminotransferase(AST)(44.4%),alkaline phosphatase(ALP)(16.1%),and total bilirubin(T-Bil)(5.9%).Factors associated with liver injury were older age,Asian ethnicity,other race,being overweight,and *** ALT,AST,T-Bil,and ALP levels were more commonly associated with disease *** adjusted Cox regression analysis revealed that abnormal AST and T-Bil were associated with the highest mortality risk than other liver injury indicators during *** AST,T-Bil,and ALP were associated with a need for vasopressor drugs,whereas higher levels of AST,T-Bil,and a decreased albumin levels were associated with mechanical ventilation CONCLUSION Abnormal liver chemistries are common at the time of hospital admission in COVID-19 patients and can be closely related to the patient’s severity and *** liver chemistries,specifically ALT,AST,ALP,and T-Bil levels,can be used to stratify risk and predict the need for advanced therapies in t

关键词： Severe acute respiratory syndrome coronavirus 2 Liver injury Liver tests Aspartate aminotransferase Alanine aminotransferase bilirubin

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