Infectious Disease
The severity of COVID-19 is related to an abnormality in liver function tests
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Canillas L, et al. Summary OS-1921. Presented at: the International Liver Congress; 23-26 June (virtual meeting).
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Patients admitted to hospital with COVID-19 developed liver dysfunction within the first few days of admission; Virus severity also correlated with liver function test abnormalities.
“In terms of liver involvement [in COVID-19], Liver function test (LFT) abnormalities are common, and the most common is an increase in aspartate aminotransferase. In addition, most LFT anomalies are minor and less than 20% exceeded the upper limit of the anomaly. ” Lidia Canillas, This was announced by the Hospital del Mar in Barcelona (Spain). “Serious LFT abnormalities have been linked to more severe infections; To the best of our knowledge, no data have been reported on the development of elective LFTs and liver damage as an acute infection resolves. “
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In a retrospective observational study, researchers analyzed 595 patients hospitalized with COVID-19 (mean age 62 years; 60.7% men) to assess factors related to the LFT abnormality amid COVID-19. They determined the degree of abnormality (1-4) using AST, alanine aminotransferase, and total bilirubin levels; additional recorded ratings included socio-demographics, comorbidities, COVID-19 infection severity, laboratory tests, treatments, and mortality. Researchers found severe COVID-19 in 42% of patients.
Study results showed an LFT abnormality in 61.5% of Grade 1 patients, 38.8% of Grade 2 patients, 11.8% of Grade 3 patients, and 10.3% of Grade 4 patients In patients with severe LFT, the abnormality varied between mild (64.5%) and severe (35.5%) at hospital admission, with the median onset of maximum LFT impairment 12 days after hospital admission. Another multivariate analysis showed an LFT abnormality that correlated with higher levels of interleukin-6 (1.63; 1.01-2.62) and ferritin (2.68; 1.64-4.37); worsened LFTs during hospital admission correlated with ICU admission (5.34; 3.08–9.28) and use of immunomodulatory drugs (2.57; 1.5–4.39). The mortality within this cohort was 10.7%.
“The presence of abnormal LFTs at follow-up was not related to abnormal LFTs during COVID-19 hospital admission,” Canillas concluded. “Patients with altered LFTs at follow-up have an underlying cause, most of them fatty liver.”
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