Transaminitis is an indicator of mortality in patients with COVID-19: A retrospective cohort study

Abstract

BACKGROUND Since its discovery in Wuhan, China in December of 2019, the novel coronavirus has progressed to become one of the worst pandemics seen in the last 100 years. Recently, there has been an increased interest in the hepatic manifestations of coronavirus disease 19 (COVID-19). AIM To describe the demographic and clinical characteristics of COVID-19 positive patients and study the association between transaminitis and all-cause mortality. METHODS This is a descriptive retrospective cohort study of 130 consecutive patients with a positive COVID PCR test admitted between March 16, 2020 to May 14, 2020 at a tertiary care University-based medical center. The Wilcoxon-rank sum test and paired t -test were used for comparing non-parametric and parametric continuous variables respectively and a multivariable logistic regression models to study the association between transaminitis and mortality using SAS version 9.4 (SAS Institute, Cary, NC, United States). RESULTS Out of the 130 patients, 73 (56%) patients were found to have transaminitis and 57 (44%) did not. When compared to patients without transaminitis, the transaminitis group was found to have a higher median body mass index (30.2 kg/m 2 vs 27.3 kg/m 2 , P = 0.04). In the multivariate analysis those with transaminitis were found to have 3.4 times higher odds of dying as compared to those without transaminitis adjusting for gender, the Age-adjusted Charlson Comorbidity Index and admission to the intensive care unit ( P = 0.03). CONCLUSION Our study showed that transaminitis on admission was associated with severe clinical outcomes such as admission to the intensive care unit, need for mechanical ventilation, and mortality.

Outcome of COVID-19 Patients Presented with Gastrointestinal and Hepatic Manifestations

“…In addition to digestive symptoms, patients with COVID-19 are also at risk of developing liver injury and abnormal LFT, especially in severe cases, but the results have been inconsistent, and the exact magnitude remains uncertain. In the present study, out of a total of 241 patients admitted to the hospital, 52.7% presented with abnormal liver transaminases on admission, which is in line with 56% in the study of Kumer et al [24] and 58.5% in the study of Saini et al [25] showing that significant portion of the study population may be affected. Unlike the present study, Bender & Worman [26] stated that the pattern of laboratory abnormalities was most often cholestatic (58.2%) and then (35.2%) in mixed, and (6.6%) in hepatocellular pattern.…”

The Impact of Nonalcoholic Fatty Liver Disease on the Outcomes of Coronavirus Disease 2019 Infection

“…Its expression has been shown to further increase in conditions of steatosis using experimental models of diet‐induced NAFLD and chronic liver injury 14 . Thus, through the upregulated ACE2 receptors in patients with NAFLD, SARS‐CoV‐2 is thought to enter cells in cholangiocytes and cause direct viral damage with resulting hepatic function test abnormalities, including derangements in albumin, gamma‐glutamyl transferase, and transaminases, as has been noted in a significant proportion (56%) of hospitalized patients 15 …”

Hepatic and gastrointestinal disturbances in Egyptian patients infected with coronavirus disease 2019: A multicentre cohort study

“…Diarrhoea is the most frequently recorded GI symptom reported with COVID-19, ranging from 3% to 30%, followed by anorexia, nausea, vomiting, and abdominal pain[ 7 ]. SARS-CoV-2 RNA has been detected in stool specimens from patients with polymerase chain reaction-confirmed COVID-19 in respiratory samples.…”