tetano
Editor, Senior Moderator
Clin Res Hepatol Gastroenterol
. 2022 Feb 25;101894.
doi: 10.1016/j.clinre.2022.101894. Online ahead of print.
Abnormal liver tests and non-alcoholic fatty liver disease predict disease progression and outcome of patients with Covid-19
Simona Tripon[SUP] 1 [/SUP], Pascal Bilbault[SUP] 2 [/SUP], Thibaut Fabacher[SUP] 3 [/SUP], Nicolas Lefebvre[SUP] 4 [/SUP], Sylvain Lescuyer[SUP] 5 [/SUP], Emmanuel Andres[SUP] 6 [/SUP], Elise Schmitt[SUP] 7 [/SUP], Sabrina Garnier-Kepka[SUP] 8 [/SUP], Pierrick Le Borgne[SUP] 9 [/SUP], Joris Muller[SUP] 3 [/SUP], Hamid Merdji[SUP] 10 [/SUP], Frédéric Chaffraix[SUP] 11 [/SUP], Didier Mutter[SUP] 12 [/SUP], Thomas F Baumert[SUP] 13 [/SUP], Ferhat Meziani[SUP] 14 [/SUP], Michel Doffoel[SUP] 15 [/SUP]
Affiliations
Abstract
Background and aims: Coronavirus disease 2019 (COVID-19) is a serious public health issue that became rapidly pandemic. Liver injury and comorbidities, including metabolic syndrome, are associated with severe forms of the disease. This study sought to investigate liver injury, clinical features, and risk factors in patients with mild, moderate, and severe COVID-19.
Methods: We retrospectively included all consecutive patients hospitalized with laboratory-confirmed COVID-19 between February, 22 and May 15, 2020 at the emergency rooms of a French tertiary hospital. Medical history, symptoms, biological and imaging data were collected.
Results: Among the 1,381 hospitalizations for COVID-19, 719 patients underwent liver tests on admission and 496 (68.9%) patients displayed abnormal liver tests. Aspartate aminotransferase was most commonly abnormal in 57% of cases, followed by gamma-glutamyl transferase, alanine aminotransferase, albumin, alkaline phosphatase, and total bilirubin in 56.5%, 35.9%, 18.4%, 11.4%, and 5.8%. The presence of hepatocellular type more than 2xULN was associated with a higher risk of hospitalization and a worse course of severe disease (odd ratio [OR] 5.599; 95%CI: 1.27-23.86; p=0.021; OR 3.404; 95% CI: 2.12-5.47; p <0.001 respectively). A higher NAFLD fibrosis score was associated with a higher risk of hospitalization (OR 1.754; 95%CI: 1.27-2.43, p<0.001). In multivariate analyses, patients with high fibrosis-4 index had a 3-fold greater risk of severe disease (p <0.001).
Conclusion: Abnormal liver tests are common in patients with COVID-19 and could predict the outcome. Patients with non-alcoholic fatty liver disease and liver fibrosis are at higher risk of progressing to severe COVID-19.
Keywords: Abbreviations; Alkaline phosphatase (ALP); COVID-19 disease; NAFLD fibrosis score (NFS); SARS-CoV-2 infection; alanine aminotransferase (ALT); aspartate aminotransferase (AST); body mass index (BMI); capillary oxygen saturation (SaO2); coronavirus disease (COVID-19); fibrosis-4 (FIB-4); gamma-glutamyl transferase (GGT); hepatic steatosis index (HSI); liver fibrosis; liver function tests (LFTs); liver steatosis; non-alcoholic fatty liver disease (NAFLD); obesity; prothrombin time (TP); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); total bilirubin (TBIL); upper limit of the normal (ULN).
. 2022 Feb 25;101894.
doi: 10.1016/j.clinre.2022.101894. Online ahead of print.
Abnormal liver tests and non-alcoholic fatty liver disease predict disease progression and outcome of patients with Covid-19
Simona Tripon[SUP] 1 [/SUP], Pascal Bilbault[SUP] 2 [/SUP], Thibaut Fabacher[SUP] 3 [/SUP], Nicolas Lefebvre[SUP] 4 [/SUP], Sylvain Lescuyer[SUP] 5 [/SUP], Emmanuel Andres[SUP] 6 [/SUP], Elise Schmitt[SUP] 7 [/SUP], Sabrina Garnier-Kepka[SUP] 8 [/SUP], Pierrick Le Borgne[SUP] 9 [/SUP], Joris Muller[SUP] 3 [/SUP], Hamid Merdji[SUP] 10 [/SUP], Frédéric Chaffraix[SUP] 11 [/SUP], Didier Mutter[SUP] 12 [/SUP], Thomas F Baumert[SUP] 13 [/SUP], Ferhat Meziani[SUP] 14 [/SUP], Michel Doffoel[SUP] 15 [/SUP]
Affiliations
- PMID: 35227956
- DOI: 10.1016/j.clinre.2022.101894
Abstract
Background and aims: Coronavirus disease 2019 (COVID-19) is a serious public health issue that became rapidly pandemic. Liver injury and comorbidities, including metabolic syndrome, are associated with severe forms of the disease. This study sought to investigate liver injury, clinical features, and risk factors in patients with mild, moderate, and severe COVID-19.
Methods: We retrospectively included all consecutive patients hospitalized with laboratory-confirmed COVID-19 between February, 22 and May 15, 2020 at the emergency rooms of a French tertiary hospital. Medical history, symptoms, biological and imaging data were collected.
Results: Among the 1,381 hospitalizations for COVID-19, 719 patients underwent liver tests on admission and 496 (68.9%) patients displayed abnormal liver tests. Aspartate aminotransferase was most commonly abnormal in 57% of cases, followed by gamma-glutamyl transferase, alanine aminotransferase, albumin, alkaline phosphatase, and total bilirubin in 56.5%, 35.9%, 18.4%, 11.4%, and 5.8%. The presence of hepatocellular type more than 2xULN was associated with a higher risk of hospitalization and a worse course of severe disease (odd ratio [OR] 5.599; 95%CI: 1.27-23.86; p=0.021; OR 3.404; 95% CI: 2.12-5.47; p <0.001 respectively). A higher NAFLD fibrosis score was associated with a higher risk of hospitalization (OR 1.754; 95%CI: 1.27-2.43, p<0.001). In multivariate analyses, patients with high fibrosis-4 index had a 3-fold greater risk of severe disease (p <0.001).
Conclusion: Abnormal liver tests are common in patients with COVID-19 and could predict the outcome. Patients with non-alcoholic fatty liver disease and liver fibrosis are at higher risk of progressing to severe COVID-19.
Keywords: Abbreviations; Alkaline phosphatase (ALP); COVID-19 disease; NAFLD fibrosis score (NFS); SARS-CoV-2 infection; alanine aminotransferase (ALT); aspartate aminotransferase (AST); body mass index (BMI); capillary oxygen saturation (SaO2); coronavirus disease (COVID-19); fibrosis-4 (FIB-4); gamma-glutamyl transferase (GGT); hepatic steatosis index (HSI); liver fibrosis; liver function tests (LFTs); liver steatosis; non-alcoholic fatty liver disease (NAFLD); obesity; prothrombin time (TP); severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); total bilirubin (TBIL); upper limit of the normal (ULN).