tetano
Editor, Senior Moderator
Hepatology
. 2020 Jul 21.
doi: 10.1002/hep.31472. Online ahead of print.
Elevated Liver Biochemistries in Hospitalized Chinese Patients with Severe COVID-19: Systematic Review and Meta-analysis
Alexander J Kovalic[SUP] 1 [/SUP], Glen Huang[SUP] 2 [/SUP], Paul J Thuluvath[SUP] 3 4 [/SUP], Sanjaya K Satapathy[SUP] 5 6 [/SUP]
Affiliations
Abstract
Background & aims: Several recent studies have reported an abnormal liver chemistry profile among patients with coronavirus disease 2019 (COVID-19), although its clinical significance remains unknown.
Approach & results: This novel systematic review and meta-analysis identified six studies of 586 patients delineating liver chemistries among patients with severe/critical illness versus mild cases of COVID-19 infection. Patients with severe/critical illness with COVID-19 infection have increased prevalence of coronary artery disease (CAD), cerebrovascular disease, and chronic obstructive pulmonary disease (COPD) as compared to mild cases. A significant association between severe/critical COVID-19 infections with elevations in aspartate aminotransferase (AST) (pooled mean difference [MD], 11.70 U/L; 95% confidence interval [CI], 2.97, 20.43; P = 0.009), elevated total bilirubin (pooled MD, 0.14 mg/dL; 95% CI, 0.06, 0.22; P = 0.0005), and decreased albumin (pooled MD, -0.68 g/L; 95% CI, -0.81, -0.55; P < 0.00001) was noted. There was also a trend toward elevated alanine aminotransferase (ALT) levels among these severe cases (pooled MD, 8.84 U/L; 95% CI, -2.28, 19.97; P = 0.12); however, this did not reach statistical significance. More severe/critically ill cases were associated with leukocytosis, neutrophilia, lymphopenia, elevated creatinine kinase, elevated lactate dehydrogenase (LDH), and elevated prothrombin time (PT).
Conclusions: Comorbidities, including CAD, cerebrovascular disease, and COPD, are more prevalent in hospitalized Chinese patients with severe/critical illness from COVID-19, and these patients are more likely to manifest with abnormal liver chemistries. Further prospective studies are crucial to understand the pathophysiologic mechanisms underlying the hepatic manifestations of the novel COVID-19 infection and its clinical significance.
This article is protected by copyright. All rights reserved.
. 2020 Jul 21.
doi: 10.1002/hep.31472. Online ahead of print.
Elevated Liver Biochemistries in Hospitalized Chinese Patients with Severe COVID-19: Systematic Review and Meta-analysis
Alexander J Kovalic[SUP] 1 [/SUP], Glen Huang[SUP] 2 [/SUP], Paul J Thuluvath[SUP] 3 4 [/SUP], Sanjaya K Satapathy[SUP] 5 6 [/SUP]
Affiliations
- PMID: 32692464
- DOI: 10.1002/hep.31472
Abstract
Background & aims: Several recent studies have reported an abnormal liver chemistry profile among patients with coronavirus disease 2019 (COVID-19), although its clinical significance remains unknown.
Approach & results: This novel systematic review and meta-analysis identified six studies of 586 patients delineating liver chemistries among patients with severe/critical illness versus mild cases of COVID-19 infection. Patients with severe/critical illness with COVID-19 infection have increased prevalence of coronary artery disease (CAD), cerebrovascular disease, and chronic obstructive pulmonary disease (COPD) as compared to mild cases. A significant association between severe/critical COVID-19 infections with elevations in aspartate aminotransferase (AST) (pooled mean difference [MD], 11.70 U/L; 95% confidence interval [CI], 2.97, 20.43; P = 0.009), elevated total bilirubin (pooled MD, 0.14 mg/dL; 95% CI, 0.06, 0.22; P = 0.0005), and decreased albumin (pooled MD, -0.68 g/L; 95% CI, -0.81, -0.55; P < 0.00001) was noted. There was also a trend toward elevated alanine aminotransferase (ALT) levels among these severe cases (pooled MD, 8.84 U/L; 95% CI, -2.28, 19.97; P = 0.12); however, this did not reach statistical significance. More severe/critically ill cases were associated with leukocytosis, neutrophilia, lymphopenia, elevated creatinine kinase, elevated lactate dehydrogenase (LDH), and elevated prothrombin time (PT).
Conclusions: Comorbidities, including CAD, cerebrovascular disease, and COPD, are more prevalent in hospitalized Chinese patients with severe/critical illness from COVID-19, and these patients are more likely to manifest with abnormal liver chemistries. Further prospective studies are crucial to understand the pathophysiologic mechanisms underlying the hepatic manifestations of the novel COVID-19 infection and its clinical significance.
This article is protected by copyright. All rights reserved.