Correlation of Plasma Albumin Status with Markers of Hepato-biliary Dysfunction and Systemic Inflammation Among COVID-19 Patients

Amadi, Collins; Lawson, Stephenson; Amadi, Bright; Agbo, Ezra

doi:10.11648/j.bs.20220801.17

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…Data also indicate that the hepatocellular-specific pattern of liver pathologies occurs early during SARS-CoV-2 infection which transitions to the cholestatic-specific pattern with worsening severity of the infection [25]. As previously documented, worsening COVID-19 severity is associated with marked hyper-inflammatory responses [12]- [15]. This may also explain the correlation documented between inflammatory markers and those of cholestatic-specific markers in the current study.…”

Section: Pathomechanismssupporting

confidence: 85%

“…The mechanism underlying the COVID-19-induced hepatobiliary pathologies is conflicting in the literature, though several investigators have suggested the involvement of the hyper-inflammatory response [6]- [11]. Hyperinflammatory response is a cardinal feature of disease [12]- [15]. However, a large number of the previous studies on this subject have been documented among western populations while including patients with various pre-existing comorbid conditions and those on various medications/toxicants known to have negative influence on normal hepatobiliary functions [6]- [10].…”

Section: Introductionmentioning

confidence: 99%

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Patterns of Hepatobiliary Pathologies and Their Relationship with Markers of Inflammation in COVID-19 Patients

Amadi

Lawson²,

Nyeche³

et al. 2023

CLINICMED

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Background: Altered hepatobiliary status has been reported in association with COVID-19 which has been linked, with limited evidence, to the exaggerated COVID-19-induced hyper-inflammatory response. Hence, the current study evaluated hepatocellular status and its association with indicators of inflammation among COVID-19 patients. Methods: This study was conducted among the RT-PCR-confirmed and treatment-naïve COVID-19 patients in Port Harcourt, South-south Nigeria. Pre-medical/surgical data were retrieved retrospectively from archived patients’ case notes, medical review charts, nurses’ vital signs/medication sheets, and laboratory records at the center using validated data acquisition templates. All retrieved data were analyzed using standard protocols. Results: Among the 396 studied, 16.7% (n=66) had hepatobiliary pathologies. The majority of those with hepatobiliary pathologies had severe COVID-19 (93.3%). Patients with severe COVID-19 and concurrent hepatobiliary pathologies were mostly males and of older age. Cholestatic-specific pathology was the most common pattern observed among the general cases with hepatobiliary pathologies and among those having specific mild, moderate, and severe COVID-19. Among those with severe COVID-19, significant positive relationships were observed between markers of inflammation (Proclacitonin/C-reactive protein/D-dimer) and cholestatic-specific hepatobiliary markers (ALP/G-GT/TBil/CBil) (p<0.05), but not with the hepatocellular-specific markers (ALT/AST) (p>0.05). In contrast, no significant relationship existed between the relevant markers of inflammation and all the cholestatic/hepatocellular markers among those with mild and moderate COVID-19 (p>0.05). Conclusion: Hepatobiliary pathologies, mostly of cholestatic patterns, are frequent among the studied COVID-19 patients which were associated with inflammatory markers among those with severe disease. Therefore, hepatobiliary evaluation should be prioritized, especially among those with severe COVID-19.

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Section: Pathomechanismssupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Patterns of Hepatobiliary Pathologies and Their Relationship with Markers of Inflammation in COVID-19 Patients

Amadi

Lawson²,

Nyeche³

et al. 2023

CLINICMED

View full text Add to dashboard Cite

show abstract

“…Additionally, various studies have been documented on the hyper-inflammatory responses to COVID-19 [20]- [23]. Consequently, COVID-19-induced dyslipidemia has been implicated in the tendency to develop hyper-inflammatory responses among patients with the disease.…”

Section: B Relationship With Existing Literaturementioning

confidence: 99%

COVID-19-induced Dyslipidemia and Disease Severity: Perspectives from Southern Nigeria

et al. 2023

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Background: The relationship between dyslipidemia and the severity of coronavirus disease 2019 (COVID-19) has extensively been characterized in the Western population with a dearth of data among Nigerians. Hence, the current study evaluated the lipid/lipoprotein disorders inherent in COVID-19 and its relationship with disease severity among Nigerians. Methods: This was a retrospective study conducted among 600 patients with RT-PCR-confirmed COVID-19 at the Eleme COVID-19 treatment facility in Port Harcourt, Southern Nigeria. Data were obtained from medical records using validated acquisition templates and analyzed based on lipid/lipoprotein abnormalities and disease severity status. Results: Among those studied, 54.7% had dyslipidemia while others were normolipidemic. HDL-C dyslipidemia was the most common with a preponderance of hypoalphalipoproteinemia (84.4%). Dyslipidemia afflicted mostly middle-aged, males, urban dwellers, the overweight, and those with classic COVID-19-induced respiratory symptoms. Dyslipidemic cohorts had higher pro-calcitonin, C-reactive protein, D-dimer, total white cell count, and neutrophils, but lower albumin, lymphocyte, and platelet counts compared to the normolipidemic cohorts. Dyslipidemic cohorts with concurrent severe COVID-19 had lower levels of TChol, Tg, HDL-C, and LDL-C levels compared to patients with the less-severe disease. HDL-C was the only lipid/lipoprotein parameter that was associated with severe COVID-19 on crude (OR:8.65; CI:5.96-11.44; p<0.001) and adjusted (OR:8.11; CI:5.65-10.87; p<0.001) regression models compared to other lipid/lipoprotein indices. At 96.77% sensitivity and 89.20% specificity, HDL-C had robust predictive potentials (AUC:0.97; CI:0.84-1.00; p<0.001) over COVID-19 severity. Conclusion: Dyslipidemia is frequent among those presenting with COVID-19 in association with disease severity, especially among the HDL-C dyslipidemic cohorts. Hence, these findings should be factored in during COVID-19 treatment among Nigerians with the disease.

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Sodium Status and Its Correlation with Indices of Pulmonary Dysfunction in COVID-19 Patients

Otukunefor

Amadi

Lawson

et al. 2023

EJMED

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Background: COVID-19-induced hyponatremia is reportedly associated with pulmonary dysfunction, but mostly among Caucasians. Hence, the current study evaluated sodium status and its correlation with indices of pulmonary dysfunctions among Nigerians of Negroid race. Methods: This was a retrospectively-designed observational study. Data, all obtained at presentation, were acquired from medical records of 480 RT-PCR-confirmed COVID-19 patients managed at a COVID-19-designated treatment facility in Port Harcourt, Southern Nigeria. Analysis of acquired data was done by COVID-19 clinical grades and sodium status using descriptive and inferential statistics. Results: At presentation, hyponatremia and hypernatremia were observed in 47.7% and 1.0% of the entire studied cohorts (n=480), respectively. Both disorders (hyponatremia/hypernatremia) were mostly observed among the moderate, severe, and critical cases. Most hyponatremic cases (n=154;67.2%) and the entire hypernatremic cases (n=5;100%) were of mild grades. Hyponatremics had higher proportions of fever, breathlessness, confusion, and a higher burden of inflammatory markers which increased with worsening hyponatremic grade. Etiologically, hyponatremia was mostly associated with the syndrome of inappropriate anti-diuretic hormone secretion (SIADH) (n=132;56.7%). Among the hyponatremics, an inverse correlation existed between sodium and respiratory rate (RR), while a correlation existed between sodium and oxygen saturation (SpO2). Compared to mild hyponatremics, the moderate/severe hyponatremics had a greater risk of having RR>30 and SpO2 <95%. Conclusion: Hyponatremia, mostly of mild grade, was common among the studied COVID-19 patients and was associated with indices of pulmonary dysfunctions, including disease severity, inflammatory markers, and SIADH. Hence, hyponatremia should be utilized to triage COVID-19 patients at presentation. However, further studies are recommended to verify these findings.

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Correlation of Plasma Albumin Status with Markers of Hepato-biliary Dysfunction and Systemic Inflammation Among COVID-19 Patients

Cited by 3 publications

References 14 publications

Patterns of Hepatobiliary Pathologies and Their Relationship with Markers of Inflammation in COVID-19 Patients

Patterns of Hepatobiliary Pathologies and Their Relationship with Markers of Inflammation in COVID-19 Patients

COVID-19-induced Dyslipidemia and Disease Severity: Perspectives from Southern Nigeria

Sodium Status and Its Correlation with Indices of Pulmonary Dysfunction in COVID-19 Patients

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