Analysis of 92 deceased patients with COVID‐19

Yang, Fan; Shu, Shi; Zhu, Jinjin; Shi, Jingxue; Dai, Kai; Chen, Xiaobei

doi:10.1002/jmv.25891

Cited by 166 publications

(195 citation statements)

References 32 publications

Supporting

Mentioning

175

Contrasting

Unclassified

Order By: Relevance

“…Ninety‐two articles (of which four included pregnant patients) reported adult patients infected with SARS‐CoV‐2. Eleven articles included paediatric population, and four articles reported both adults and children infected with SARS‐CoV‐2 2,7,14‐118 . (Tables S1, S2 and S3) A total of 20 874 patients were included, of which 38 were pregnant patients, 395 were paediatric patients and the rest were adult patients.…”

Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: liver manifestations and outcomes in COVID‐19

Kulkarni

Kumar

Tevethia

et al. 2020

Aliment Pharmacol Ther

208

287

View full text Add to dashboard Cite

Summary Background The incidence of elevated liver chemistries and the presence of pre‐existing chronic liver disease (CLD) have been variably reported in COVID‐19. Aims To assess the prevalence of CLD, the incidence of elevated liver chemistries and the outcomes of patients with and without underlying CLD/elevated liver chemistries in COVID‐19. Methods A comprehensive search of electronic databases from 1 December 2019 to 24 April 2020 was done. We included studies reporting underlying CLD or elevated liver chemistries and patient outcomes in COVID‐19. Results 107 articles (n = 20 874 patients) were included for the systematic review. The pooled prevalence of underlying CLD was 3.6% (95% CI, 2.5‐5.1) among the 15 407 COVID‐19 patients. The pooled incidence of elevated liver chemistries in COVID‐19 was 23.1% (19.3‐27.3) at initial presentation. Additionally, 24.4% (13.5‐40) developed elevated liver chemistries during the illness. The pooled incidence of drug‐induced liver injury was 25.4% (14.2‐41.4). The pooled prevalence of CLD among 1587 severely infected patients was 3.9% (3%‐5.2%). The odds of developing severe COVID‐19 in CLD patients was 0.81 (0.31‐2.09; P = 0.67) compared to non‐CLD patients. COVID‐19 patients with elevated liver chemistries had increased risk of mortality (OR‐3.46 [2.42‐4.95, P < 0.001]) and severe disease (OR‐2.87 [95% CI, 2.29‐3.6, P < 0.001]) compared to patients without elevated liver chemistries. Conclusions Elevated liver chemistries are common at presentation and during COVID‐19. The severity of elevated liver chemistries correlates with the outcome of COVID‐19. The presence of CLD does not alter the outcome of COVID‐19. Further studies are needed to analyse the outcomes of compensated and decompensated liver disease.

show abstract

Section: Resultsmentioning

confidence: 99%

Systematic review with meta‐analysis: liver manifestations and outcomes in COVID‐19

Kulkarni

Kumar

Tevethia

et al. 2020

Aliment Pharmacol Ther

208

287

View full text Add to dashboard Cite

show abstract

“…60 Hepatic enzyme alterations in SARS-CoV-2-positive patients are also common and have been associated with the severity of the infection. 48,[61][62][63][64] Although CRP and IL-6 levels have been associated with higher mortality rates and severity of disease, 65 reports in the literature are contradictory. Some studies have reported no difference in the elevation of proinflammatory biomarkers between patients with and without altered liver enzymes.…”

Section: Sars-cov-2 and Immune-mediated Collateral Damagementioning

confidence: 99%

Direct or Collateral Liver Damage in SARS-CoV-2–Infected Patients

et al. 2020

View full text Add to dashboard Cite

Liver injury can result from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection with more than one-third of COVID-19 patients exhibiting elevated liver enzymes. Microvesicular steatosis, inflammation, vascular congestion, and thrombosis in the liver have been described in autopsy samples from COVID-19 patients. Several factors, including direct cytopathic effect of the virus, immune-mediated collateral damage, or an exacerbation of preexisting liver disease may contribute to liver pathology in COVID-19. Due to its immunological functions, the liver is an organ likely to participate in the viral response against SARS-CoV-2 and this may predispose it to injury. A better understanding of the mechanism contributing to liver injury is needed to develop and implement early measures to prevent serious liver damage in patients suffering from COVID-19. This review summarizes current reports of SARS-CoV-2 with an emphasis on how direct infection and subsequent severe inflammatory response may contribute to liver injury in patients with and without preexisting liver disease.

show abstract

“…Increasing respiratory rate is an important clinical feature of acute respiratory distress syndrome (ARDS), which is a major cause of death in severe COVID-19 patients [9,18,30].A previous study has shown that respiratory rate≥24/min was a risk factor of death in the univariate analysis [19], whereas no signi cance was found after the multivariate regression analysis. Our multivariate regression analysis clari ed that respiratory rate≥30/min was a predictor of death.…”

Section: Discussionmentioning

confidence: 99%

Nomogram for Prediction of fatal outcome in Patients with Severe COVID-19: A Multicenter Study

Yang

Zhu

Huang

et al. 2020

Preprint

View full text Add to dashboard Cite

Background & Aims: To develop an effective model of predicting fatalOutcome in the severe coronavirus disease 2019 (COVID-19) patients.Methods: Between February 20, 2020 and April 4, 2020, consecutive COVID-19 patients from three designated hospitals were enrolled in this study. Independent high- risk factors associated with death were analyzed using Cox proportional hazard model. A prognostic nomogram was constructed to predict the survival of severe COVID-19 patients.Results: There were 124 severe patients in the training cohort, and there were 71 and 76 severe patients in the two independent validation cohorts, respectively. Multivariate Cox analysis indicated that age ≥ 70 years (HR 1.184, 95% CI 1.061-1.321), Panting(breathing rate ≥ 30/min) (HR 3.300, 95% CI 2.509-6.286), lymphocyte count < 1.0 × 109/L (HR 2.283, 95% CI 1.779-3.267), and IL-6 >10pg/mL (HR 3.029, 95% CI 1.567-7.116) were independent high-risk factors associated with fatal outcome. We developed the nomogram for identifying survival of severe COVID-19 patients in the training cohort (AUC 0.900, [95% CI 0.841-0.960], sensitivity 95.5%, specificity 77.5%); in validation cohort 1 (AUC 0.811, [95% CI 0.698-0.924], sensitivity 77.3%, specificity 73.5); in validation cohort 2 (AUC 0.862, [95% CI 0.763-0.961], sensitivity 92.9%, specificity 64.5%). The calibration curve for probability of death indicated a good consistence between prediction by the nomogram and the actual observation. The prognosis of severe COVID-19 patients with high levels of interleukin-6 (IL-6) receiving tocilizumab was better than that of those patients without tocilizumab both in the training and validation cohorts, but without difference (p = 0.105 for training cohort, p = 0.133 for validation cohort 1, and p = 0.210 for validation cohort 2).Conclusions: This nomogram could help clinicians to identify severe patients who have high risk of death, and to develop more appropriate treatment strategies to reduce the mortality of severe patients. Tocilizumab may improve the prognosis of severe COVID-19 patients with high levels of IL-6.

show abstract

Analysis of 92 deceased patients with COVID‐19

Cited by 166 publications

References 32 publications

Systematic review with meta‐analysis: liver manifestations and outcomes in COVID‐19

Systematic review with meta‐analysis: liver manifestations and outcomes in COVID‐19

Direct or Collateral Liver Damage in SARS-CoV-2–Infected Patients

Nomogram for Prediction of fatal outcome in Patients with Severe COVID-19: A Multicenter Study

Contact Info

Product

Resources

About