Year 2021 / Volume 113 / Number 12
Original
Abnormal liver chemistry constitutes an independent prognostic factor of less favorable clinical course in patients with COVID-19

825-832

DOI: 10.17235/reed.2021.7842/2021

Carlos Alventosa Mateu, Juan José Urquijo Ponce, Francesc Puchades Gimeno, Salvador Benlloch Pérez, Francisco Sanz Herrero, Mercedes Latorre Sánchez, Miguel García Deltoro, Concepción Gimeno Cardona, María Dolores Ocete Mochón, Moisés Diago Madrid,

Abstract
Introduction: abnormal liver biochemistry (ALB) is correlated with increased clinical involvement or severity in COVID-19, but its prognostic implications have not been studied extensively. The aim of this study was to determine whether ALB is a risk factor for unfavorable clinical outcome and involvement. Materials and methods: a retrospective, single-center study in confirmed COVID-19 cases. Patients with pharmacological hepatotoxicity or liver diseases were excluded. ALB was defined as any elevation of total bilirubin, AST, ALT, alkaline phosphatase, and/or GGT above the upper limit of normal. First, an assessment was made of the correlation between ALB and need for hospitalization. This was followed by an assessment of the correlation of ALB in hospitalized patients with demographic variables, comorbidities, and treatment for COVID-19, and with clinical involvement and outcome. The statistical analysis was performed using an age-adjusted multiple logistic regression with a p-value < 0.05. Results: of 1,277 confirmed cases, 346 required hospitalization and 302 were included. The prevalence of ALB was higher in hospitalized patients compared to non-hospitalized patients (60.9 % vs. 10.3 %, p ˂ 0.001). Among hospitalized patients, there was no correlation between ALB and demographic variables, comorbidities, or treatment for COVID-19, except for low molecular weight heparin. There was a significant correlation between ALB and moderate/severe COVID-19 involvement and between unfavorable clinical outcomes and elevated total bilirubin. The period of greatest clinical worsening and deterioration of liver biochemistry parameters occurred during the first seven days. There was a significant correlation of ALB with longer hospital stay and admission to the intensive care unit, but this did not imply increased mortality. Conclusions: ALB correlates with greater clinical involvement and worse clinical outcomes in hospitalized patients with COVID-19.
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25/02/2022 14:09:11
AGRADECIDOS A LA SOCIEDADESPAÑOLA DE ENFERMEDADES DIGESTIVAS POR TAN LOABLE LABOR DIDACTICA, ACADEMICA
Dr. Cristóbal Betancourt Natera
Puerto Ordaz, VENEZUELA


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Alventosa Mateu C, Urquijo Ponce J, Puchades Gimeno F, Benlloch Pérez S, Sanz Herrero F, Latorre Sánchez M, et all. Abnormal liver chemistry constitutes an independent prognostic factor of less favorable clinical course in patients with COVID-19. 7842/2021


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Publication history

Received: 30/01/2021

Accepted: 03/06/2021

Online First: 23/06/2021

Published: 09/12/2021

Article revision time: 121 days

Article Online First time: 144 days

Article editing time: 313 days


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