Baseline factors associated with death in a COVID-19 hospital cohort, Sao Paulo, 2020

Konstantyner, Thais Cláudia Roma de Oliveira; Martins, Camila Bertini; Luppi, Carla Gianna; Yashiro, Suely Miyuki; Sanches, Nívia Aparecida Pissaia; Cohrs, Frederico Molina; Ferreira, Paulo Roberto Abrão; Medeiros, Eduardo Alexandrino

doi:10.11606/s1518-8787.2021055003684

Cited by 1 publication

(2 citation statements)

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“…A multicenter retrospective study with 1765 patients in Hubei province, in China, reported an increased mortality risk in cases of elevated AST (above 34 U/L) (49) , although we did not find it, in line with some other studies (43,15) . In the present study, 23.6% of patients died, and patient aged above 60 years had a higher risk of death (40) These findings are consistent with several studies (14,50,51) including a Brazilian one (45) . This finding may be related to the physiological changes of aging.…”

Section: Discussionsupporting

confidence: 92%

“…However, we did not find any association here, the same reported in some studies (42,44) , including a meta-analysis of 8,800 patients (44) . On the other hand, a recent Brazilian study with 1,034 COVID-19 patients showed that CLD is linked to the mortality (45) . Moreover, patients with CLD could present higher expression of ACE2 receptor and could be more susceptible to the virus (10) , and Child-Pugh C cirrhotic have an increased risk of complications and mortality (46,47) .…”

Section: Discussionmentioning

confidence: 94%

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Minimal Liver Enzymes Abnormalities at Admission Are Related to Severe Covid-19 Clinical Course in a Large Brazilian Cohort

PICON,

JOVELEVITHS,

ALVARES-DA-SILVA

2023

Arq. Gastroenterol.

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Background: COVID-19 is a multisystemic disease, primarily affecting the respiratory system. Liver involvement is frequent, but the impact on the clinical course and outcomes are controversial. Objective: The aim was to assess liver function at the admission and evaluate its effects on severity and mortality in hospitalized patients with COVID-19. Methods: This is a retrospective study of hospitalized patients in a tertiary hospital in Brazil, with a PCR-confirmed SARS-CoV-2 infection between April and October 2020. 1080 out of 1229 patients had liver enzymes on admission and were divided in two cohorts, based on the presence or absence of abnormal liver enzymes (ALE). Demographic, clinical, laboratory, imaging, clinical severity, and mortality were evaluated. Patients were followed until discharge, death or transfer to another institution. Results: Median age was 60 years and 51.5% were male. The more frequent comorbidities were hypertension (51.2%), and diabetes (31.6%). Chronic liver disease and cirrhosis were present in 8.6% and 2.3%, respectively. ALE (aminotransferases higher than 40 IU/L) were present in 56.9% of patients [mild (1-2 times): 63.9%; moderate (2-5 times): 29.8%; severe (>5 times): 6.3%]. Male gender [RR 1.49, P=0.007], increased total bilirubin [RR 1.18, P<0.001] and chronic liver disease [RR 1.47, P=0.015] were predictors of abnormal aminotransferases on admission. Patients with ALE had a higher risk of disease severity [RR 1.19; P=0.004]. There was no association among ALE and mortality. Conclusion: ALE is common in COVID-19 hospitalized patients and were independently correlated with severe COVID-19. Even mild ALE at admission may be a severity prognostic marker.

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