Object We aimed to evaluate the elevation of amylase and lipase enzymes in coronavirus disease 2019 (COVID‐19) patients and their relationship with the severity of COVID‐19. Method In this study, 1378 patients with COVID‐19 infection were included. Relation of elevated amylase and lipase levels and comorbidities with the severity of COVID‐19 was analysed. The effects of haemodynamic parameters and organ failure on pancreatic enzymes and their relations with prognosis were statistically analysed. Results The 1378 patients comprised of 700 (51.8%) men and 678 (%49.2) women. Of all patients, 687 (49.9%) had mild and 691 (50.1%) patients had severe COVID‐19 infection. Amylase elevation at different levels occurred in 316 (%23) out of 1378 patients. In these patients, the amylase levels increased one to three times in 261 and three times in 55 patients. Pancreatitis was detected in only six (%1.89) of these patients according to the Atlanta criteria. According to univariate and multivariate analyses, elevated amylase levels were significantly associated with the severity of COVID‐19 (odds ratio [OR]: 4.37; P < .001). Moreover, diabetes mellitus (DM; OR: 1.82; P = .001), kidney failure (OR: 5.18; P < .001), liver damage (OR: 6.63; P < .001), hypotension (OR: 6.86; P < .001) and sepsis (OR: 6.20; P = .008) were found to be associated with mortality from COVID‐19. Conclusion Elevated pancreatic enzyme levels in COVID‐19 infections are related to the severity of COVID‐19 infection and haemodynamic instability. In a similar way to other organs, the pancreas can be affected by severe COVID‐19 infection.
Objective: This study aims to investigate the mortality factors in hemodialysis patients and kidney transplant patients with COVID-19 patients. Method: The demographic, clinic, laboratory, and radiologic signs of the kidney transplant and hemodialysis patients diagnosed with COVID-19 between 11 March 2020-11 March 2021 were evaluated. Results: To this study, 72 hemodialysis (median age, 57.5 Q1-Q3:43-65; female:36/50%) and 58 kidney transplant (median age, 44.5 Q1-Q3:28.75-55.25; female:21/36.2%) were included. Fifteen HD patients (20.8%) died. To identify the independent predictors of in-hospital mortality, multivariable logistic regression analyses were performed using the variables in the univariate analyses including age, female gender, diabetes mellitus, ferritin, d-dimer, albumin, CRP, procalcitonin, dyspnea. Age (OR:1.12, 95% [CI]: 1.03-1.21, p=0.004), and dyspnea (OR: 9,7 95% CI 1.80-52.2, p=0.008) were found to be associated with in-hospital mortality. Nine (15.5%) of transplant patients died. The median time from the beginning of symptoms to the time of admission was 3 days (2-5). And this rate was 2 (2-3) and 5 (4-5.75) days, respectively, for patients followed up in our center and the external centers (p<0.001). Although an increase in CRP, ferritin, D-dimer levels, dyspnea, and bilateral involvement in CT images was statistically significant in the univariate analysis, no single factor was found to be related to mortality in multivariate analysis. Conclusion: Both HD and renal transplant patients should be followed closely. Early admission of HD and RT patients might be life-saving when suspected. Early inclusion of these patients into the vaccination program might reduce mortality. However, large-scale prospective randomized studies are needed.
Aim: The aim of this study; to investigate the clinical course and mortality of COVID-19 in chronic liver patients with and without cirrhosis and to determine decompensation rates during COVID'19 in cirrhotic patients. Materials and Methods: 96 patients with chronic liver disease (30 of them cirrhosis) and 153 patients without any comorbid disease were included in this study. It was examined whether there was a difference among these patient groups in terms of severity and mortality of COVID-19. Results: Severe COVID-19 developed in 46.6% (14/30) cirrhotic patients, in 15.1% (10/66) non-cirrhotic patients, and in 12.4% (19/153) patients with no chronic liver disease (p
Aim:The present study aimed to examine the prevalence of liver dysfunction in patients hospitalized due to coronavirus disease 2019 and to investigate the role of liver dysfunction in predicting intensive care unit admission and mortality. Material and Methods: A total of 2168 patients who had no previously known chronic liver disease and were found to be COVID-19 positive on polymerase chain reaction test were divided into mild and severe COVID-19 groups. The effect of the development of liver damage on the course and prognosis of COVID-19 was investigated. Results: Elevated liver enzymes developed in 26.3% (n=461) of the patients with mild COVID-19 and in 45.3% (n=189) of the patients with severe COVID-19. The highest ALT and AST elevation was detected in patients using more than one drug with antibiotics (p<0.001). Severe hepatitis developed in 1.4% (n=25) of the patients with mild COVID-19 and 6.5% (n=27) of the patients with severe COVID-19 (p<0.001). There was a weak negative correlation between ALT and albumin (p=0.017, r=-0.497), while a weak positive correlation with bilirubin (p=0.024, r=0.352), a moderate positive correlation with ferritin (p=0.016, r=0.504), and a weak positive correlation with INR (p=0.022, r=0.383) were found in patients with severe COVID-19. Conclusion:The results showed that 30% of COVID-19 patients had impaired liver function of varying severity and that liver damage was more common in patients with severe COVID-19. It was also determined that liver damage occurring during COVID-19 was an indicator of intensive care requirement and the mortality risk.
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