Liver Injury as Mortality Risk Factor in Sars-Cov-2

Abstract

Background:The current COVID-19 pandemic has put all health units in crisis. The easy transmissibility facilitated the fast spread to all countries, and Guatemala was not the exception. By May 2020 almost 229 thousand cases were reported, with 3.2% of case fatality. Among the principal mortality risks factors there are: advance age, diabetes mellitus, cardiovascular disease, etc. Due to the systemic injury associated with moderate to severe SARS-CoV2, the clinic presentation is not limited to fever and lung lesion, but neurological, renal, and liver damage have been reported. Some studies have linked liver injury and mortality, so we decided to recollect data with our patients seeking for this association. Material and Methods: Data were recollected from over 18-year-old patients admitted to the COVID-19 service at Roosevelt Hospital, looking for epidemiological and laboratory data, making correlation with mortality during April -September 2020. Then logistic regression was made looking for the best variables to predict mortality. Results: The main results were mean age 48.26 and 59.2 years old for alive and deceased cases respectively, no differences in transaminases, albumin, INR nor alkaline phosphatase. The best sensibility and specificity predicting mortality were obtained with lactate dehydrogenase > 400 and bilirubin > 0.58. Conclusions: According with our data the best predictors for COVID-19 mortality were lactate dehydrogenase > 400 and Bilirubin > 0.58.