Prospective Latin American cohort evaluating outcomes of patients with COVID-19 and abnormal liver tests on admission

Mendizábal, Manuel; Piñero, Federico; Ridruejo, Ezequiel; Anders, Margarita; Silveyra, María Dolores; Torre, Aldo; Montes, Pedro; Urzúa, Álvaro; Pages, Josefina; Toro, Luis; Díaz, José Alfredo Jáuregui; Ballerga, Esteban González; Miranda-Zazueta, Godolfino; Peralta, Mirta; Gutiérrez, Isabel; Michelato, Douglas; Venturelli, María Grazia; Varón, Adriana; Vera-Pozo, Emilia; Tagle, Martín; García, Matías; Tassara, Alfredo; Brutti, Julia; García, Sandro Ruiz; Bustios, Carla; Escajadillo, Nataly; Macias, Yuridia; Tijera, Fátima Higuera-de la; Gómez, Andrés; Dominguez, Alejandra; Castillo-Barradas, M.; Contreras, F.; Scarpin, Aldana; Schinoni, María Isabel; Toledo, Claudio; Girala, Marcos; Mainardi, Victoria; Sanchez, Abel; Bessone, Fernando; Rubinstein, Fernando; Silva, Marcelo O.

doi:10.1016/j.aohep.2020.100298

Cited by 29 publications

(36 citation statements)

References 24 publications

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“…Another meta-analysis revealed that, among 15407 patients with SARS-CoV-2 infection, the incidence of elevated liver chemistries was 23.1% at early presentation and 24.4% throughout the course of illness[ 21 ]. A prospective cohort study in 1611 hospitalized patients from 11 Latin American countries found abnormal liver tests on admission in 45.2% and that such was independently associated with death [odds ratio (OR): 1.5, 95% confidence interval (CI): 1.1-2.0] and severe COVID-19 (OR: 2.6, 95%CI: 2.0-3.3)[ 22 ]. A systematic review of 24 studies (5961 subjects) found that, among COVID-19 patients who were critically ill, the OR of hypoalbuminemia was 7.1, of AST elevation was 3.4, of ALT elevation was 2.5, and of hyperbilirubinemia was 1.7[ 23 ].…”

Section: Sars-cov-2 Infection and Liver Dysfunction In Patients With No Previous Liver Diseasementioning

confidence: 99%

“…In patients with SARS-CoV-2 infection, the degree of transaminitis is generally mild[ 22 , 23 ], defined as less than 5 times the upper reference limit, and severe liver failure occurs infrequently[ 28 ]. In a cohort of 5700 patients from New York, United States, AST and ALT were both commonly increased (58.4% and 39.0% of subjects, respectively).…”

Section: Sars-cov-2 Infection and Liver Dysfunction In Patients With No Previous Liver Diseasementioning

confidence: 99%

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Liver dysfunction and SARS-CoV-2 infection

Gracia‐Ramos¹,

Jáquez-Quintana²,

Contreras-Omaña³

et al. 2021

WJG

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Severe acute respiratory syndrome coronavirus 2 infection is the cause of coronavirus disease 2019 (COVID-19), which predominantly affects the respiratory system; it also causes systemic and multi-organic disease. Liver damage is among the main extrapulmonary manifestations. COVID-19-associated liver injury is defined as any liver damage occurring during the disease course and treatment of COVID-19 in patients with or without pre-existing liver disease, and occurs in approximately one in five patients. Abnormal liver test results have been associated with a more severe course of COVID-19 and other complications, including death. Mechanisms linking COVID-19 to liver injury are diverse. Particular consideration should be made for patients with pre-existing liver disease, such as metabolic dysfunction-associated fatty liver disease, chronic liver disease due to viral or autoimmune disease, liver transplant carriers, or cirrhosis, given the risk for more severe outcomes. This manuscript summarizes the current lines of evidence on COVID-19-associated liver injury regarding pathophysiology, clinical significance, and management in both patients with or without pre-existing liver disease, to facilitate clinicians’ access to updated information and patient care. Finally, we mention the ideas and recommendations to be considered for future research.

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Section: Sars-cov-2 Infection and Liver Dysfunction In Patients With No Previous Liver Diseasementioning

confidence: 99%

Section: Sars-cov-2 Infection and Liver Dysfunction In Patients With No Previous Liver Diseasementioning

confidence: 99%

Liver dysfunction and SARS-CoV-2 infection

Gracia‐Ramos¹,

Jáquez-Quintana²,

Contreras-Omaña³

et al. 2021

WJG

View full text Add to dashboard Cite

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“…Given the health crisis presented, and the collapse of health services, there had been no opportunity to collect data and submit them to statistical analysis. Comparing a recent Latin American cohort [2], we can observe several similarities. For example, the mean age in deceased patients is 59.20 years old and 48.20 years old for alive, and in the aforementioned cohort it is 52.3 years, with a predominance of males, as in our study.…”

Section: Discussionmentioning

confidence: 78%

“…Hypoalbuminemia has also been implicated as an independent predictor of mortality [4]. In a recent study in a Latin American population, including Guatemala, alterations in liver function tests had an OR of 1.5 (CI 1.1-2, p 0.01) of mortality and of 2.6 (CI 2.0 -3.3 p <0.0001) of presenting severe COVID-19 [2]. Among the non-specific markers of cellular damage, we have LDH, whose increase is severely correlated, it has been suggested that it is an indirect marker of respiratory function [4].…”

Section: Introductionmentioning

confidence: 99%

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

Sandoval¹,

Sanchez²,

Samayoa³

et al. 2021

JJGH

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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.

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