Dynamic Changes in Liver Function Tests and Their Correlation with Illness Severity and Mortality in Patients with COVID-19: A Retrospective Cohort Study

Xu, Wei; Huang, Chenlu; Ling, Fei; Li, Qiang; Liang, Chen

doi:10.2147/cia.s303629

Cited by 33 publications

(33 citation statements)

References 26 publications

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“…There is also significant data published in the last year on liver injury caused by therapeutic drugs such as lopinavir, ritonavir, remdesivir, hydroxychloroquine and azithromycin. Drugs such as lopinavir are broken down by cytochrome P450 3A4 enzymes in hepatocytes, which may contribute to the elevated ALT and AST levels due to hepatocellular damage [ 172 ]. Antipyretic drugs containing acetaminophen at high doses used in treating COVID-19 patients can be hepatotoxic and may cause hepatocellular damage.…”

Section: Discussionmentioning

confidence: 99%

Abnormal Liver Biochemistry Tests and Acute Liver Injury in COVID-19 Patients: Current Evidence and Potential Pathogenesis

et al. 2021

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Globally, millions of persons have contracted the coronavirus disease 2019 (COVID-19) over the past several months, resulting in significant mortality. Health care systems are negatively impacted including the care of individuals with cancers and other chronic diseases such as chronic active hepatitis, cirrhosis and hepatocellular carcinoma. There are various probable pathogenic mechanisms that have been presented to account for liver injury in COVID-19 patients such as hepatotoxicity cause by therapeutic drugs, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of the bile duct cells and hepatocytes, hypoxia and systemic inflammatory response. Liver biochemistry tests such as aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transferase (GGT) and alkaline phosphatase (ALP) are deranged in COVID-19 patients with liver injury. Hepatocellular damage results in the elevation of serum AST and ALT levels in early onset disease while a cholestatic pattern that develops as the disease progress causes higher levels of ALP, GGT, direct and total bilirubin. These liver biochemistry tests are prognostic markers of disease severity and should be carefully monitored in COVID-19 patients. We conducted a systematic review of abnormal liver biochemistry tests in COVID-19 and the possible pathogenesis involved. Significant findings regarding the severity, hepatocellular pattern, incidence and related clinical outcomes in COVID-19 patients are highlighted.

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Section: Discussionmentioning

confidence: 99%

Abnormal Liver Biochemistry Tests and Acute Liver Injury in COVID-19 Patients: Current Evidence and Potential Pathogenesis

et al. 2021

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“…As for the laboratory markers, we observed that patients who fell had higher TSH and lower ALT levels compared to those that did not fall. Research has shown that COVID-19 disease patients with more severe illness have lower TSH and higher ALT levels than those with milder illness [ 38 – 40 ]. Thus, higher TSH and lower ALT in patients who fell may simply be attributable to the fact that they had a milder illness and fell because they were ambulatory.…”

Section: Discussionmentioning

confidence: 99%

Factors Associated with Falls During Hospitalization for Coronavirus Disease 2019 (COVID-19)

et al. 2022

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Background During the current Coronavirus Disease 2019 (COVID-19) pandemic, falls have been identified as a potential presenting symptom in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection; however, data on factors increasing fall risk in this patient population are limited. This study aimed to examine the factors that may predispose hospitalized COVID-19 disease patients to falls. Material/Methods In this retrospective observational study, hospitalized COVID-19 disease patients were examined for fall incidence, as well as demographics, comorbidities, and clinical and laboratory data. Patients were stratified according to their fall status and their characteristics were compared using Fisher’s exact test or Mann-Whitney U test. A total of 312 hospitalized COVID-19 disease patients were enrolled (median age, 75 years; males, 51.3%), of whom 11 (3.5%) fell. Results There was a greater prevalence of falls among patients who experienced arrhythmias than those that did not (28.6% vs 1.7%; P <0.001). Additionally, a significantly greater proportion of those that were discharged to the internal ward and to the intensive care unit fell (10.3% and 10.0%, respectively) compared to those that were discharged home (1.6%, P =0.008). Thyroid-stimulating hormone (TSH) was significantly elevated in patients who fell (5.3 vs 0.97 μIU/mL, P =0.013), while alanine aminotransferase (ALT) was significantly lower in those who fell (17.1 vs 33.5 IU/L, P =0.041). Conclusions Arrhythmias may be an important predisposing factor for falls in COVID-19 disease patients and fall prevention programs should prioritize interventions directed at this vulnerable patient population.

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“…We, therefore, assumed that the direct cytopathic effect of SARS-CoV-2 might not be the primary mechanism of COVID-19-associated liver damage. Liver dysfunction in COVID-19 can be associated with an uncontrolled immune reaction, sepsis, or druginduced liver injury, in addition to the direct cytopathic effect of the virus, but further monitoring is needed (Xu, et al, 2021).…”

Section: Association Of Clinical Characteristics With Post-treatment Conditions Of Covid-19 Patientsmentioning

confidence: 99%

Clinical Characteristics and Severity Profile of COVID-19 Patient with Hypertension in Palu, Central Sulawesi

et al. 2021

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Corona virus infection (COVID-19) is still an unsolved problem in Indonesia until this year. Apart from Java, other islands, including Sulawesi, were also badly affected. The very high mortality rate in Central Sulawesi (3.36%) poses a challenge for health workers; therefore, they should be well informed and with up-to-date information about correct therapeutic decisions. One of the most common comorbidities that often occurs with the severity and mortality of COVID-19 is hypertension. This study aims to determine the clinical characteristics and severity profile and their relationship with the mortality rate of COVID-19 patients with hypertension in Palu, Central Sulawesi. A total of 185 data on COVID-19 patients undergoing treatment at the Palu City Hospital during 2021 and meeting the criteria were recruited as research samples. Patients were divided into two categories, hypertensive (43%) and non-hypertensive (57%). The results showed that the age group, comorbid diabetes mellitus, cardiovascular, blood pressure, and blood glucose levels showed a significant relationship between the two groups (p < 0.05). The median length of stay was 12 days, with conditions leading to discharge (83%) and death (17%); patients who died were hospitalized in moderate and severe clinical conditions. Age group, liver function, and kidney function were positively correlated with severity and mortality. However, hypertension did not show a significant relationship with the severity and mortality of COVID-19 patients.

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Dynamic Changes in Liver Function Tests and Their Correlation with Illness Severity and Mortality in Patients with COVID-19: A Retrospective Cohort Study

Cited by 33 publications

References 26 publications

Abnormal Liver Biochemistry Tests and Acute Liver Injury in COVID-19 Patients: Current Evidence and Potential Pathogenesis

Abnormal Liver Biochemistry Tests and Acute Liver Injury in COVID-19 Patients: Current Evidence and Potential Pathogenesis

Factors Associated with Falls During Hospitalization for Coronavirus Disease 2019 (COVID-19)

Clinical Characteristics and Severity Profile of COVID-19 Patient with Hypertension in Palu, Central Sulawesi

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