Early changes in laboratory tests predict liver function damage in patients with moderate coronavirus disease 2019: a retrospective multicenter study

Abstract

Background Most patients with coronavirus disease 2019 demonstrate liver function damage. In this study, the laboratory test data of patients with moderate coronavirus disease 2019 were used to establish and evaluate an early prediction model to assess the risk of liver function damage. Methods Clinical data and the first laboratory examination results of 101 patients with moderate coronavirus disease 2019 were collected from four hospitals’ electronic medical record systems in Jilin Province, China. Data were randomly divided into training and validation sets. A logistic regression analysis was used to determine the independent factors related to liver function damage in patients in the training set to establish a prediction model. Model discrimination, calibration, and clinical usefulness were evaluated in the training and validation sets. Results The logistic regression analysis showed that plateletcrit, retinol-binding protein, and carbon dioxide combining power could predict liver function damage (P < 0.05 for all). The receiver operating characteristic curve showed high model discrimination (training set area under the curve: 0.899, validation set area under the curve: 0.800; P < 0.05). The calibration curve showed a good fit (training set: P = 0.59, validation set: P = 0.19; P > 0.05). A decision curve analysis confirmed the clinical usefulness of this model. Conclusions In this study, the combined model assesses liver function damage in patients with moderate coronavirus disease 2019 performed well. Thus, it may be helpful as a reference for clinical differentiation of liver function damage. Trial registration retrospectively registered.

Serum biomarkers for nutritional status as predictors in COVID-19 patients before and after vaccination

“…Additionally, RBD is positively associated with cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), and obesity in humans ( Olsen and Blomhoff, 2020 ). In COVID-19 patients, lower serum levels reflect liver function damage (typically associated with prolonged hospitalization) and higher urine levels show up when acute tubular damage occurs associated with proteinuria ( Karras et al, 2021 , Wang et al, 2022 , Fierro, 2020 ). Interestingly, in this study, RBP levels increased with COVID-19 severity mostly in pre-vaccine cohorts, possibly indicating that, regardless nutritional status, patients analyzed presented comorbidities such as CVD, 2DM or obesity, diseases that are associated with worse prognosis and higher mortality in COVID-19 patients ( Cai et al, 2021 , Moghaddam Tabrizi et al, 2021 , Cordero et al, 2021 ).…”

Liver damage in the context of SARS-CoV-2. Covid-19 treatment and its effects on the liver

“…There have been contradictory opinions about liver enzymes involvement in mortality and morbidity prediction, as some have discarded the hypothesis that elevation in liver function tests may have any predictive value [ 69 , 73 ], and others proved that elevation over 5 times the upper limit is strongly correlated with high mortality risk [ 39 , 42 , 74 , 75 ]. It was suggested that patients with severe disease might respond more robustly to intensive treatments and prognostic indicators of higher liver enzyme levels [ 76 ].…”

Acute liver injury in COVID-19 patients hospitalized in the intensive care unit: Narrative review

“…Several prediction models have been proposed in order to estimate the risk of liver injury. For instance, it has been reported that a prediction model incorporating plateletcrit, retinol-binding protein and carbon dioxide combining power could sufficiently predict the occurrence of ALI in patients with moderate COVID-19 in a timely manner[ 165 ]. Another risk scoring system was proposed by Shao et al [ 163 ] with the intention to predict ALI risk, which included three variables upon admission, namely ALT, CRP and lactate dehydrogenase[ 163 ].…”