Año 2021 / Volumen 113 / Número 11
Original
Mild AST elevation as an early sign of COVID-19 severity in a multicenter Madrid cohort

780-786

DOI: 10.17235/reed.2021.8007/2021

Carlos Fernández Carrillo, Christie Perelló, Elba Llop, Javier García-Samaniego, Miriam Romero, José María Mostaza, Luis Ibáñez, Rafael Bañares Cañizares, Federico Bighelli, Clara Usón Perón, Inmaculada Fernández Vázquez, Olga Hernández Castro, Antonio Lalueza, Agustín Albillos, Rosa Malo de Molina, Elena Múñez, Elena Jiménez Tejero, José Luis Calleja,

Resumen
Introduction: liver enzyme elevation has been reported in SARS-CoV-2 disease (COVID-19) in heterogeneous cohorts, mainly from China. Comprehensive reports from other countries are needed. In this study, we dissect the pattern, evolution, and predictive value of such abnormalities in a cohort from Madrid, Spain. Methods: a retrospective study with a prospective 14-day follow-up of 373 patients with confirmed COVID-19 in five Madrid hospitals, including 50 outpatients. A COVID-19 severe course was defined as the need for mechanical ventilation. Results: a total of 33.1 % of hospitalized patients showed baseline AST elevation and 28.5 % showed ALT elevation, compared with 12 % and 8 % of outpatients (p ≤ 0.001). Baseline AST, ALT and GGT levels correlated with LDH and C-reactive protein (CRP) levels (r ≤ 0.598, p < 0.005). AST elevation was associated with other severity markers such as male sex, lymphopenia, and pneumonia on X-Ray (p < 0.05 for all). ALP and bilirubin levels were rarely increased. Patients with elevated baseline AST showed a progressive normalization of this enzyme and an increase in ALT and GGT levels. Patients with normal baseline AST showed a flattened evolution pattern with levels within the range. Patients with a severe course of COVID-19 more frequently showed elevated baseline AST than those with a milder evolution (54.2 % vs. 25.4 %, p < 0.001). Age, AST and CRP were independent risk factors for a severe course of COVID-19. Conclusion: mild liver enzyme elevation is associated with COVID-19 severity. Baseline AST is an independent predictor of severe COVID-19 course, and tends to normalize over time. ALT and GGT show a late elevation.
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14/12/2022 16:58:25
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Instrucciones para citar
Fernández Carrillo C, Perelló C, Llop E, García-Samaniego J, Romero M, Mostaza J, et all. Mild AST elevation as an early sign of COVID-19 severity in a multicenter Madrid cohort. 8007/2021


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Recibido: 27/03/2021

Aceptado: 03/05/2021

Prepublicado: 05/05/2021

Publicado: 05/11/2021

Tiempo de revisión del artículo: 33 días

Tiempo de prepublicación: 39 días

Tiempo de edición del artículo: 223 días


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