Liver Dysfunction and Its Association with the Risk of Death in COVID-19 Patients: A Prospective Cohort Study

Fu, Lin; Fei, Jun; Xu, Shuchang; Xiang, Hui-Xian; Xiang, Ying; Hu, Biao; Li, Meng-Die; Liu, Fangfang; Liu, Ying; Li, Xiuyong; Zhao, Hui; Xu, De-Xiang

doi:10.14218/jcth.2020.00043

Cited by 33 publications

(30 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…COVID-19 infection causes systemic responses in the body, including the liver ( 22 , 23 ), kidney ( 22 , 24 , 25 ), heart ( 24 , 26 ), and even the brain ( 27 , 28 ). Consistent with previous reports ( 29 , 30 ), we found that patients with severe COVID-19 infection have significantly increased ALT, AST, ALP, TBIL, and DBIL levels, especially AST levels, which are much higher than the normal range. The level of BUN is also significantly increased in patients with severe COVID-19 infection.…”

Section: Discussionsupporting

confidence: 93%

Abnormal Coagulation Function of Patients With COVID-19 Is Significantly Related to Hypocalcemia and Severe Inflammation

Kong

Ding

et al. 2021

Front. Med.

View full text Add to dashboard Cite

This study aimed to detect, analyze, and correlate the clinical characteristics, blood coagulation functions, blood calcium levels, and inflammatory factors in patients with mild and severe COVID-19 infections. The enrolled COVID-19 infected patients were from Wuhan Jin Yin-tan Hospital (17 cases, Wuhan, China), Suzhou Infectious Disease Hospital (87 cases, Suzhou, China), and Xuzhou Infectious Disease Hospital (14 cases, Xuzhou, China). After admission, basic information was collected; X-ray and chest CT images were obtained; and data from routine blood tests, liver and kidney function, myocardial enzymes, electrolytes, blood coagulation function, (erythrocyte sedimentation rate) ESR, C-reactive protein (CRP), IL-6, procalcitonin (PCT), calcitonin, and other laboratory tests were obtained. The patients were grouped according to the clinical classification method based on the pneumonia diagnosis and treatment plan for new coronavirus infection (trial version 7) in China. The measurements from mild (56 cases) and severe cases (51 cases) were compared and analyzed. Most COVID-19 patients presented with fever. Chest X-ray and CT images showed multiple patchy and ground glass opacities in the lungs of COVID 19 infected patients, especially in patients with severe cases. Compared with patients with mild infection, patients with severe infection were older (p = 0.023) and had a significant increase in AST and BUN. The levels of CK, LDH, CK-MB, proBNP, and Myo in patients with severe COVID-19 infection were also increased significantly compared to those in patients with mild cases. Patients with severe COVID-19 infections presented coagulation dysfunction and increased D-dimer and fibrin degradation product (FDP) levels. Severe COVID-19 patients had low serum calcium ion (Ca2+) concentrations and high calcitonin and PCT levels and exhibited serious systemic inflammation. Ca2+ in COVID-19 patients was significantly negatively correlated with PCT, calcitonin, D-dimer, PFDP, ESR, CRP and IL-6. D-dimer in COVID-19 patients was a significantly positively correlated with CRP and IL-6. In conclusion, patients with severe COVID-19 infection presented significant metabolic dysfunction and abnormal blood coagulation, a sharp increase in inflammatory factors and calcitonin and procalcitonin levels, and a significant decrease in Ca2+. Decreased Ca2+ and coagulation dysfunction in COVID-19 patients were significantly correlated with each other and with inflammatory factors.

show abstract

Section: Discussionsupporting

confidence: 93%

Abnormal Coagulation Function of Patients With COVID-19 Is Significantly Related to Hypocalcemia and Severe Inflammation

Kong

Ding

et al. 2021

Front. Med.

View full text Add to dashboard Cite

show abstract

“…In addition, SARS-CoV-2-evoked renal dysfunction was not fully recovered in 2 weeks after discharge. Mounting evidences have confirmed that SARS-CoV-2 injection evoked multiple organ injuries, primarily containing liver dysfunction, myocardial injury, lymphocyte reduction and even respiratory failure [8][9][10][11]. In this research, the levels of serum uric acid, urea nitrogen, creatinine, cystatin C and eGFR were detected and renal dysfunction was evaluated among COVID-19 patients between on admission and discharge.…”

Section: Discussionmentioning

confidence: 72%

“…Previous studies have demonstrated that COVID-19 patients mainly accompanied with fever, diarrhea, dry cough, lymphocyte reduction and radiographic evidence of pneumonia [7]. Now, more and more studies have confirmed that SARS-CoV-2 not only evoked severe acute respiratory syndrome, but also induced multiple organ injuries, such as myocardial injury, lymphocyte reduction and even liver dysfunction [8][9][10][11]. Nevertheless, the clinical characteristics of renal dysfunction caused by SARS-CoV-2 are rarely described.…”

Section: Introductionmentioning

confidence: 99%

Renal dysfunction and prognosis of COVID-19 patients: a hospital-based retrospective cohort study

et al. 2021

Self Cite

View full text Add to dashboard Cite

Introduction Increasing evidence indicate that coronavirus disease 2019 (COVID-19) is companied by renal dysfunction. However, the association of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)-induced renal dysfunction with prognosis remains obscure. Materials and methods All 154 patients with COVID-19 were recruited from the Second People’s Hospital of Fuyang City in Anhui, China. Demographic characteristics and laboratory data were extracted. Renal dysfunction was evaluated and its prognosis was followed up based on a retrospective cohort study. Results There were 125 (81.2%) mild and 29 (18.8%) severe cases in 154 COVID-19 patients. On admission, 16 (10.4%) subjects were accompanied with renal dysfunction. Serum creatinine and cystatin C were increased and estimated glomerular filtration rate (eGFR) was decreased in severe patients compared with those in mild patients. Renal dysfunction was more prevalent in severe patients. Using multivariate logistic regression, we found that male gender, older age and hypertension were three importantly independent risk factors for renal dysfunction in COVID-19 patients. Follow-up study found that at least one renal function marker of 3.33% patients remained abnormal in 2 weeks after discharge. Conclusion Male elderly COVID-19 patients with hypertension elevates the risk of renal dysfunction. SARS-CoV-2-induced renal dysfunction are not fully recovered in 2 weeks after discharge.

show abstract

“…Acute kidney injury (AKI) has been observed in 3%–15% of COVID-19 patients ( 6 ) and ≤25% in critically-ill COVID-19 patients ( 7 ). Greater possibility can be presented for AKI among patients with severe acute respiratory distress syndrome (ARDS), which necessitates invasive mechanical ventilation, especially for older patients or those with comorbidities such as hypertension or type 2 diabetes mellitus (T2DM) ( 8 ). Recent studies have suggested that acute renal damage can occur in the early stages of COVID-19, which is associated with death ( 5 , 9 , 10 ).…”

Section: Introductionmentioning

confidence: 99%

Association Between the Concentration and Rangeability of Cystatin C and Mortality of COVID-19 Patients With or Without Type 2 Diabetes Mellitus: A Retrospective Analysis

Yang

Tan

et al. 2021

Front. Endocrinol.

View full text Add to dashboard Cite

BackgroundWe investigated if the concentration and “rangeability” of cystatin C (CysC) influenced the prognosis of coronavirus disease 2019 (COVID-19) in patients suffering from, or not suffering from, type 2 diabetes mellitus (T2DM).MethodsA total of 675 T2DM patients and 572 non-T2DM patients were divided into “low” and “high” CysC groups and low and high CysC-rangeability groups according to serum CysC level and range of change of CysC level, respectively. Demographic characteristics, clinical data, and laboratory results of the four groups were analyzed.ResultsCOVID-19 patients with a high level and rangeability of CysC had more organ damage and a higher risk of death compared with those with a low level or low rangeability of CysC. Patients with a higher level and rangeability of CysC had more blood lymphocytes and higher levels of C-reactive protein, alanine aminotransferase, and aspartate aminotransferase. After adjustment for possible confounders, multivariate analysis revealed that CysC >0.93 mg/dL was significantly associated with the risk of heart failure (OR = 2.231, 95% CI: 1.125–5.312) and all-cause death (2.694, 1.161–6.252). CysC rangeability >0 was significantly associated with all-cause death (OR = 4.217, 95% CI: 1.953–9.106). These associations were stronger in patients suffering from T2DM than in those not suffering from T2DM.ConclusionsThe level and rangeability of CysC may influence the prognosis of COVID-19. Special care and appropriate intervention should be undertaken in COVID-19 patients with an increased CysC level during hospitalization and follow-up, especially for those with T2DM.

show abstract

Liver Dysfunction and Its Association with the Risk of Death in COVID-19 Patients: A Prospective Cohort Study

Cited by 33 publications

References 33 publications

Abnormal Coagulation Function of Patients With COVID-19 Is Significantly Related to Hypocalcemia and Severe Inflammation

Abnormal Coagulation Function of Patients With COVID-19 Is Significantly Related to Hypocalcemia and Severe Inflammation

Renal dysfunction and prognosis of COVID-19 patients: a hospital-based retrospective cohort study

Association Between the Concentration and Rangeability of Cystatin C and Mortality of COVID-19 Patients With or Without Type 2 Diabetes Mellitus: A Retrospective Analysis

Contact Info

Product

Resources

About