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J Clin Transl Hepatol . Elevated Liver Enzymes along with Comorbidity Is a High Risk Factor for COVID-19 Mortality: A South Indian Study on 1,512 P

tetano

Editor, Senior Moderator
J Clin Transl Hepatol


. 2022 Feb 28;10(1):120-127.
doi: 10.14218/JCTH.2020.00100. Epub 2021 Jun 16.
Elevated Liver Enzymes along with Comorbidity Is a High Risk Factor for COVID-19 Mortality: A South Indian Study on 1,512 Patients


Narayanasamy Krishnasamy[SUP] 1 [/SUP], Karthick Rajendran[SUP] 2 [/SUP], Parimita Barua[SUP] 1 [/SUP], Arunkumar Ramachandran[SUP] 2 [/SUP], Priyadarshini Panneerselvam[SUP] 2 [/SUP], Muthukumaran Rajaram[SUP] 2 [/SUP]



Affiliations

Abstract

Background and aims: Liver enzyme abnormalities in coronavirus 2019 (COVID-19) are being addressed in the literature. The predictive risk of elevated liver enzymes has not been established for COVID-19 mortality. In this study, we hypothesized that elevated liver enzymes at admission can predict the outcome of COVID-19 disease with other known indicators, such as comorbidities.
Methods: This retrospective study included all the consecutive hospitalized patients with confirmed COVID-19 disease from March 4[SUP]th[/SUP] to May 31[SUP]st[/SUP], 2020. The study was conducted in Rajiv Gandhi Government General Hospital, Chennai, Tamil Nadu, India. We assessed demography, clinical variables, COVID-19 severity, laboratory parameters, and outcome.
Results: We included 1,512 patients, and median age was 47 years (interquartile range: 34-60) with 36.9% being female. Liver enzyme level (aspartate aminotransferase and/or alanine aminotransferase) was elevated in 450/1,512 (29.76%) patients. Comorbidity was present in 713/1,512 (47.16%) patients. Patients with liver enzymes' elevation and presence of comorbidity were older, more frequently hospitalized in ICU and had more severe symptoms of COVID-19 at the time of admission. Presence of liver enzymes' elevation with comorbidity was a high risk factor for death (OR: 5.314, 95% CI: 2.278-12.393), as compared to patients with presence of comorbidity (OR: 4.096, 95% CI: 1.833-9.157).
Conclusions: Comorbidity combined with liver enzymes' elevation at presentation independently increased the risk of death in COVID-19 by at least 5-fold.

Keywords: Alanine aminotransferase; Aspartate aminotransferase; COVID-19; Comorbidity; Liver enzyme; SARS-CoV-2.
 
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