Severity of liver test abnormalities in coronavirus disease 2019 depends on comorbidities and predicts early in-hospital mortality

Kuntzen, Christian; Qiu, He; Jiang, Yu; Bodenheimer, Henry C.; Roth, Nitzan; Lee, Tai-Ping; Hirsch, Jamie S.; Trindade, Arvind J.; Bernstein, David

doi:10.1097/meg.0000000000002055

Cited by 7 publications

(9 citation statements)

References 18 publications

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“…Patients infected with COVID-19 commonly experience LFT abnormalities [ 30 ]. Huang et al showed that patients with an AST level over three times the ULN (>3x ULN) had the greatest risk of mortality and artificial ventilation.…”

Section: Reviewmentioning

confidence: 99%

A Systematic Review of SARS-CoV-2-Associated Hepatic Dysfunction and the Impact on the Clinical Outcome of COVID-19

Radivojevic¹,

Jad²,

Ravanavena³

et al. 2022

Cureus

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Coronavirus disease 2019 (COVID-19) has rapidly spread across the globe since December 2019. The spectrum of clinical manifestations of COVID-19 ranges from mild to life-threatening forms. Alteration of hepatic function in COVID-19 is multifactorial. The objective of this systematic review is to assess the relationship between severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-induced hepatic dysfunction and the clinical outcome in patients infected with COVID-19. We methodically explored several electronic databases (PubMed, PubMed Central, MEDLINE, and Google Scholar) in April 2022 using focused words and terms of medical subject headings for appropriate studies. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for conducting our systematic review. Hepatic dysfunction was identified as elevation of liver function tests (LFTs) above the upper limit of normal. The clinical outcome was described as a combination of mortality, intensive care unit (ICU) transfer, and the need for mechanical ventilation (MV). The initial search yielded a total of 7187 studies. After elimination of duplicates, exclusion of studies based on irrelevant titles and abstracts, comprehensive analysis of full-text formats, and evaluation of quality, a total of 16 studies were eligible to be included in our systematic review. In the 16 selected studies, there were 23,962 patients. The SARS-CoV-2 virus can negatively affect several organ systems by interacting with specific receptors widely expressed in the human body. A multifactorial etiology of hepatic dysfunction is observed in COVID-19. SARS-CoV-2 infection is associated with abnormal LFTs. Significantly higher mortality, ICU admissions, and requirement for MV are associated with LFT alterations. For this reason, patients infected with COVID-19 must have their hepatic function closely monitored.

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Section: Reviewmentioning

confidence: 99%

A Systematic Review of SARS-CoV-2-Associated Hepatic Dysfunction and the Impact on the Clinical Outcome of COVID-19

Radivojevic¹,

Jad²,

Ravanavena³

et al. 2022

Cureus

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“…The worldwide figures of coronavirus disease 2019 (COVID-19) presently stand at 154640649 confirmed cases with 3232285 deaths[ 1 ]. Although primarily a respiratory syndrome, COVID-19 has been reported to cause liver injury in multiple studies, including metanalyses[ 2 - 4 ]. The incidence of liver injury as assessed by several indicators like transaminases, bilirubin and albumin has been found to be higher in patients with severe COVID-19 infection[ 3 , 5 ].…”

Section: Introductionmentioning

confidence: 99%

“…The incidence of liver injury as assessed by several indicators like transaminases, bilirubin and albumin has been found to be higher in patients with severe COVID-19 infection[ 3 , 5 ]. Increasing severity of liver chemistry abnormalities on hospital admission predicts early in-hospital mortality in COVID-19 patients[ 4 ].…”

Section: Introductionmentioning

confidence: 99%

“…In such a background of widespread prevalence of chronic liver disease especially NAFLD, the incidence of liver injury in COVID-19 and its impact on disease progression assumes greater significance. In a recent study, we found that mortality associated with the known risk factors of COVID19 (hypertension, diabetes, male sex, and old age) was accentuated in the presence of liver chemistry abnormalities in those diagnosed with COVID-19[ 4 ].…”

Section: Introductionmentioning

confidence: 99%

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Association of non-alcoholic fatty liver disease and COVID-19: A literature review of current evidence

Anirvan

Singh

Giammarino

2021

WJH

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The coronavirus disease 2019 (COVID-19) pandemic has swept through nations, crippled economies and caused millions of deaths worldwide. Many people diagnosed with COVID-19 infections are often found to develop liver injury, which, in a small portion of patients, progresses to severe liver disease. Liver injury in the form of elevated transaminases, hyperbilirubinemia and alterations in serum albumin has been observed to be higher in patients with severe forms of the disease. Those who already have insult to the liver from chronic disease, such as nonalcoholic fatty liver disease (NAFLD) may be at the greatest disadvantage. The severity of COVID-19 also seems to be driven by the presence of NAFLD and other co-morbidities. About 25% of the global population has NAFLD. With such a widespread prevalence of NAFLD, understanding the disease progression of COVID-19 and the occurrence of liver injury in this vulnerable population assumes great significance. In this review, we present an overview of COVID-19 infection in patients with NAFLD.

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“…Satapathy et al . demonstrated that liver chemistry abnormalities (LCA) including aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and bilirubin were associated with the severity of COVID-19 [ 2 ]. Furthermore, LCA were linked to chronic liver disease but not with other risk factors of severe COVID-19, indicating chronic liver disease is an independent indicator of severe COVID-19.…”

mentioning

confidence: 99%

The gut–liver axis in chronic liver disease associated with severe COVID-19

Chen

Vitetta

2021

European Journal of Gastroenterology &Amp; Hepatology

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Severity of liver test abnormalities in coronavirus disease 2019 depends on comorbidities and predicts early in-hospital mortality

Abstract: Supplemental Digital Content is available in the text.

Cited by 7 publications

References 18 publications

A Systematic Review of SARS-CoV-2-Associated Hepatic Dysfunction and the Impact on the Clinical Outcome of COVID-19

A Systematic Review of SARS-CoV-2-Associated Hepatic Dysfunction and the Impact on the Clinical Outcome of COVID-19

Association of non-alcoholic fatty liver disease and COVID-19: A literature review of current evidence

The gut–liver axis in chronic liver disease associated with severe COVID-19

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