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Clinical Course and Risk Factors for Liver Injury of Severe and Critical Patients With COVID-19
Ang Li
Capital Medical University Affiliated Beijing Ditan Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1478-3072
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Information regarding the clinical course of COVID-19 patients with liver injury is very limited, especially in severe and critical patients. The objective of this study was to describe the characteristics and clinical course of liver function in patients admitted with severe and/or critical SARS-CoV-2 infection, as well as explore the risk factors that affect liver function in the enrolled COVID-19 patients.
Methods: Information on clinical characteristics of 63 severe and critical patients with confirmed COVID-19 were collected and analyzed.
Results: The incidence of abnormal aspartate aminotransferase, alanine aminotransferase, and total bilirubin in the critical group was significantly higher than in the severe group (respectively 81.48%, 81.49%, 62.67%, and 45.71%, 63.88%, 22.86%, p＜0.05). The time for liver function parameters to reach their extremes was approximately 2-3 weeks after admission. The independent factors associated with liver injury were patients with invasive ventilators, decreased percentages of neutrophils, lymphocytes and monocytes, and sequential organ failure assessment (SOFA) score ≥ 2 (p＜0.05).
Conclusions: Abnormal liver tests are commonly observed in severe and critical patients with COVID-19. The patients with severe illness should be closely observed to monitor liver function parameters, particularly when they present with independent risk factors of liver injury.
Keywords
Abnormal liver tests, Coronavirus disease 2019 (COVID-19), Liver injury, Pneumonia, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
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Figure 3
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- supplementalfigure1.pdf
Supplemental Fig. 1 Caption: Dynamic profile of liver function indicators among different groups. Fig. a: Description text: Dynamic changes of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) among the normal group, the abnormal group, and the liver injury group. Fig. b: Description text: Dynamic changes of total bilirubin (TBIL) and albumin among the normal group, the abnormal group, and the liver injury group. Fig. c: Description text: Dynamic changes of INR and albumin/globulin (A/G) ratio among the normal group, the abnormal group, and the liver injury group.
- supplementalfigure2.pdf
Supplemental Fig. 2 Caption: the cycle threshold (Ct) values in different groups. Fig. a: Description text: the peak Ct values between the severe group and the critical group. Fig. b: Description text: the peak Ct values among the normal group, the abnormal group, and the liver injury group.
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Research
Clinical Course and Risk Factors for Liver Injury of Severe and Critical Patients With COVID-19
Ang Li
Capital Medical University Affiliated Beijing Ditan Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0002-1478-3072
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
History
CURRENT STATUS: Posted
Version 1
Posted 13 Jan, 2021
No community comments so far
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Internal Medicine
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Information regarding the clinical course of COVID-19 patients with liver injury is very limited, especially in severe and critical patients. The objective of this study was to describe the characteristics and clinical course of liver function in patients admitted with severe and/or critical SARS-CoV-2 infection, as well as explore the risk factors that affect liver function in the enrolled COVID-19 patients.
Methods: Information on clinical characteristics of 63 severe and critical patients with confirmed COVID-19 were collected and analyzed.
Results: The incidence of abnormal aspartate aminotransferase, alanine aminotransferase, and total bilirubin in the critical group was significantly higher than in the severe group (respectively 81.48%, 81.49%, 62.67%, and 45.71%, 63.88%, 22.86%, p＜0.05). The time for liver function parameters to reach their extremes was approximately 2-3 weeks after admission. The independent factors associated with liver injury were patients with invasive ventilators, decreased percentages of neutrophils, lymphocytes and monocytes, and sequential organ failure assessment (SOFA) score ≥ 2 (p＜0.05).
Conclusions: Abnormal liver tests are commonly observed in severe and critical patients with COVID-19. The patients with severe illness should be closely observed to monitor liver function parameters, particularly when they present with independent risk factors of liver injury.
Figure 1
Figure 2
Figure 3