tetano
Editor, Senior Moderator
Front Med (Lausanne)
. 2020 Nov 13;7:572115.
doi: 10.3389/fmed.2020.572115. eCollection 2020.
Pre-existing Liver Diseases and On-Admission Liver-Related Laboratory Tests in COVID-19: A Prognostic Accuracy Meta-Analysis With Systematic Review
Szil?rd V?ncsa[SUP] 1 2 [/SUP], P?ter Jeno Hegyi[SUP] 1 [/SUP], No?mi Z?dori[SUP] 1 2 [/SUP], Lajos Szak?[SUP] 1 2 [/SUP], N?ra V?rhendi[SUP] 1 2 [/SUP], Klementina Ocskay[SUP] 1 2 [/SUP], M?ria F?ldi[SUP] 1 2 3 [/SUP], Fanni Dembrovszky[SUP] 1 2 [/SUP], Zsuzsa R?ka D?m?t?r[SUP] 4 [/SUP], Krist?f J?nosi[SUP] 5 [/SUP], Zolt?n Rakonczay Jr[SUP] 6 [/SUP], Petra Hartmann[SUP] 7 [/SUP], Tamara Horv?th[SUP] 7 [/SUP], B?lint Erőss[SUP] 1 [/SUP], Szabolcs Kiss[SUP] 1 2 3 [/SUP], Zsolt Szak?cs[SUP] 1 2 [/SUP], D?vid N?meth[SUP] 1 [/SUP], P?ter Hegyi[SUP] 1 2 [/SUP], Gabriella P?r[SUP] 8 [/SUP]
Affiliations
Abstract
Background: We aimed to perform a systematic search and meta-analysis to evaluate the prognostic value of on-admission liver function tests and pre-existing liver diseases on the clinical course of coronavirus disease 2019 (COVID-19). Methods: The study was registered on PROSPERO (CRD42020182902). We searched five databases between 01/01/2020 and 04/23/2020. Studies that reported on liver-related comorbidities and/or laboratory parameters in patients with COVID-19 were included. The main outcomes were COVID-19 severity, intensive care unit (ICU) admission, and in-hospital mortality. Analysis of predictive models hierarchical summary receiver-operating characteristic (HSROC) was conducted with a 95% confidence interval (CI). Results: Fifty studies were included in the meta-analysis. High specificity was reached by acute liver failure associated by COVID-19 (0.94, 95% CI: 0.71-0.99) and platelet count (0.94, 95% CI: 0.71-0.99) in the case of mortality; chronic liver disease (CLD) (0.98, 95% CI: 0.96-0.99) and platelet count (0.82, 95% CI: 0.72-0.89) in the case of ICU requirement; and CLD (0.97, 95% CI: 0.95-0.98), chronic hepatitis B infection (0.97, 95% CI: 0.95-0.98), platelet count (0.86, 95% CI: 0.77-0.91), and alanine aminotransferase (ALT) (0.80, 95% CI: 0.66-0.89) and aspartate aminotransferase (AST) (0.84, 95% CI: 0.77-0.88) activities considering severe COVID-19. High sensitivity was found in the case of C-reactive protein (CRP) for ICU requirement (0.92, 95% CI: 0.80-0.97) and severe COVID-19 (0.91, 95% CI: 0.82-0.96). Conclusion: On-admission platelet count, ALT and AST activities, CRP concentration, and the presence of acute and CLDs predicted the severe course of COVID-19. To highlight, pre-existing liver diseases or acute liver injury associated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection plays an important role in the prediction of mortality.
Keywords: COVID-19; SARS—CoV-2; hepatology; pandemic (COVID-19); prognosis.
. 2020 Nov 13;7:572115.
doi: 10.3389/fmed.2020.572115. eCollection 2020.
Pre-existing Liver Diseases and On-Admission Liver-Related Laboratory Tests in COVID-19: A Prognostic Accuracy Meta-Analysis With Systematic Review
Szil?rd V?ncsa[SUP] 1 2 [/SUP], P?ter Jeno Hegyi[SUP] 1 [/SUP], No?mi Z?dori[SUP] 1 2 [/SUP], Lajos Szak?[SUP] 1 2 [/SUP], N?ra V?rhendi[SUP] 1 2 [/SUP], Klementina Ocskay[SUP] 1 2 [/SUP], M?ria F?ldi[SUP] 1 2 3 [/SUP], Fanni Dembrovszky[SUP] 1 2 [/SUP], Zsuzsa R?ka D?m?t?r[SUP] 4 [/SUP], Krist?f J?nosi[SUP] 5 [/SUP], Zolt?n Rakonczay Jr[SUP] 6 [/SUP], Petra Hartmann[SUP] 7 [/SUP], Tamara Horv?th[SUP] 7 [/SUP], B?lint Erőss[SUP] 1 [/SUP], Szabolcs Kiss[SUP] 1 2 3 [/SUP], Zsolt Szak?cs[SUP] 1 2 [/SUP], D?vid N?meth[SUP] 1 [/SUP], P?ter Hegyi[SUP] 1 2 [/SUP], Gabriella P?r[SUP] 8 [/SUP]
Affiliations
- PMID: 33282888
- PMCID: PMC7691431
- DOI: 10.3389/fmed.2020.572115
Abstract
Background: We aimed to perform a systematic search and meta-analysis to evaluate the prognostic value of on-admission liver function tests and pre-existing liver diseases on the clinical course of coronavirus disease 2019 (COVID-19). Methods: The study was registered on PROSPERO (CRD42020182902). We searched five databases between 01/01/2020 and 04/23/2020. Studies that reported on liver-related comorbidities and/or laboratory parameters in patients with COVID-19 were included. The main outcomes were COVID-19 severity, intensive care unit (ICU) admission, and in-hospital mortality. Analysis of predictive models hierarchical summary receiver-operating characteristic (HSROC) was conducted with a 95% confidence interval (CI). Results: Fifty studies were included in the meta-analysis. High specificity was reached by acute liver failure associated by COVID-19 (0.94, 95% CI: 0.71-0.99) and platelet count (0.94, 95% CI: 0.71-0.99) in the case of mortality; chronic liver disease (CLD) (0.98, 95% CI: 0.96-0.99) and platelet count (0.82, 95% CI: 0.72-0.89) in the case of ICU requirement; and CLD (0.97, 95% CI: 0.95-0.98), chronic hepatitis B infection (0.97, 95% CI: 0.95-0.98), platelet count (0.86, 95% CI: 0.77-0.91), and alanine aminotransferase (ALT) (0.80, 95% CI: 0.66-0.89) and aspartate aminotransferase (AST) (0.84, 95% CI: 0.77-0.88) activities considering severe COVID-19. High sensitivity was found in the case of C-reactive protein (CRP) for ICU requirement (0.92, 95% CI: 0.80-0.97) and severe COVID-19 (0.91, 95% CI: 0.82-0.96). Conclusion: On-admission platelet count, ALT and AST activities, CRP concentration, and the presence of acute and CLDs predicted the severe course of COVID-19. To highlight, pre-existing liver diseases or acute liver injury associated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection plays an important role in the prediction of mortality.
Keywords: COVID-19; SARS—CoV-2; hepatology; pandemic (COVID-19); prognosis.