Liver injury in hospitalized patients with COVID-19 : An International observational cohort study
Copyright: © 2023 Vijayaraghavan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited..
BACKGROUND: Using a large dataset, we evaluated prevalence and severity of alterations in liver enzymes in COVID-19 and association with patient-centred outcomes.
METHODS: We included hospitalized patients with confirmed or suspected SARS-CoV-2 infection from the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) database. Key exposure was baseline liver enzymes (AST, ALT, bilirubin). Patients were assigned Liver Injury Classification score based on 3 components of enzymes at admission: Normal; Stage I) Liver injury: any component between 1-3x upper limit of normal (ULN); Stage II) Severe liver injury: any component ≥3x ULN. Outcomes were hospital mortality, utilization of selected resources, complications, and durations of hospital and ICU stay. Analyses used logistic regression with associations expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI).
RESULTS: Of 17,531 included patients, 46.2% (8099) and 8.2% (1430) of patients had stage 1 and 2 liver injury respectively. Compared to normal, stages 1 and 2 were associated with higher odds of mortality (OR 1.53 [1.37-1.71]; OR 2.50 [2.10-2.96]), ICU admission (OR 1.63 [1.48-1.79]; OR 1.90 [1.62-2.23]), and invasive mechanical ventilation (OR 1.43 [1.27-1.70]; OR 1.95 (1.55-2.45). Stages 1 and 2 were also associated with higher odds of developing sepsis (OR 1.38 [1.27-1.50]; OR 1.46 [1.25-1.70]), acute kidney injury (OR 1.13 [1.00-1.27]; OR 1.59 [1.32-1.91]), and acute respiratory distress syndrome (OR 1.38 [1.22-1.55]; OR 1.80 [1.49-2.17]).
CONCLUSIONS: Liver enzyme abnormalities are common among COVID-19 patients and associated with worse outcomes.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:18 |
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| Enthalten in: |
PloS one - 18(2023), 9 vom: 01., Seite e0277859 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Tirupakuzhi Vijayaraghavan, Bharath Kumar [VerfasserIn] |
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| Links: |
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| Themen: |
Journal Article |
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| Anmerkungen: |
Date Completed 15.09.2023 Date Revised 20.03.2024 published: Electronic-eCollection Citation Status MEDLINE |
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| doi: |
10.1371/journal.pone.0277859 |
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NLM362005915 |
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| 100 | 1 | |a Tirupakuzhi Vijayaraghavan, Bharath Kumar |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Liver injury in hospitalized patients with COVID-19 |b An International observational cohort study |
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| 500 | |a Date Revised 20.03.2024 | ||
| 500 | |a published: Electronic-eCollection | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright: © 2023 Vijayaraghavan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | ||
| 520 | |a BACKGROUND: Using a large dataset, we evaluated prevalence and severity of alterations in liver enzymes in COVID-19 and association with patient-centred outcomes | ||
| 520 | |a METHODS: We included hospitalized patients with confirmed or suspected SARS-CoV-2 infection from the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) database. Key exposure was baseline liver enzymes (AST, ALT, bilirubin). Patients were assigned Liver Injury Classification score based on 3 components of enzymes at admission: Normal; Stage I) Liver injury: any component between 1-3x upper limit of normal (ULN); Stage II) Severe liver injury: any component ≥3x ULN. Outcomes were hospital mortality, utilization of selected resources, complications, and durations of hospital and ICU stay. Analyses used logistic regression with associations expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI) | ||
| 520 | |a RESULTS: Of 17,531 included patients, 46.2% (8099) and 8.2% (1430) of patients had stage 1 and 2 liver injury respectively. Compared to normal, stages 1 and 2 were associated with higher odds of mortality (OR 1.53 [1.37-1.71]; OR 2.50 [2.10-2.96]), ICU admission (OR 1.63 [1.48-1.79]; OR 1.90 [1.62-2.23]), and invasive mechanical ventilation (OR 1.43 [1.27-1.70]; OR 1.95 (1.55-2.45). Stages 1 and 2 were also associated with higher odds of developing sepsis (OR 1.38 [1.27-1.50]; OR 1.46 [1.25-1.70]), acute kidney injury (OR 1.13 [1.00-1.27]; OR 1.59 [1.32-1.91]), and acute respiratory distress syndrome (OR 1.38 [1.22-1.55]; OR 1.80 [1.49-2.17]) | ||
| 520 | |a CONCLUSIONS: Liver enzyme abnormalities are common among COVID-19 patients and associated with worse outcomes | ||
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Research Support, Non-U.S. Gov't | |
| 700 | 1 | |a Bishnu, Saptarshi |e verfasserin |4 aut | |
| 700 | 1 | |a Baruch, Joaquin |e verfasserin |4 aut | |
| 700 | 1 | |a Citarella, Barbara Wanjiru |e verfasserin |4 aut | |
| 700 | 1 | |a Kartsonaki, Christiana |e verfasserin |4 aut | |
| 700 | 1 | |a Meeyai, Aronrag |e verfasserin |4 aut | |
| 700 | 1 | |a Mohamed, Zubair |e verfasserin |4 aut | |
| 700 | 1 | |a Ohshimo, Shinichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Lefèvre, Benjamin |e verfasserin |4 aut | |
| 700 | 1 | |a Al-Fares, Abdulrahman |e verfasserin |4 aut | |
| 700 | 1 | |a Calvache, Jose A |e verfasserin |4 aut | |
| 700 | 1 | |a Taccone, Fabio Silvio |e verfasserin |4 aut | |
| 700 | 1 | |a Olliaro, Piero |e verfasserin |4 aut | |
| 700 | 1 | |a Merson, Laura |e verfasserin |4 aut | |
| 700 | 1 | |a Adhikari, Neill K J |e verfasserin |4 aut | |
| 700 | 0 | |a ISARIC Clinical Characterisation Group |e verfasserin |4 aut | |
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