Liver Involvement during SARS-CoV-2 Infection Is Associated with a Worse Respiratory Outcome in COVID-19 Patients

Coronavirus disease of 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may be complicated by life-threatening interstitial pneumonia. SARS-CoV-2 infection may also damage several tissues and/or organs beyond the lungs, including the liver. However, controvers...

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Main Authors: Ciro Romano, Domenico Cozzolino, Riccardo Nevola, Marianna Abitabile, Caterina Carusone, Francesca Cinone, Giovanna Cuomo, Francesco Nappo, Ausilia Sellitto, Giuseppina Rosaria Umano, Luigi Elio Adinolfi, Aldo Marrone, Luca Rinaldi
Format: Article
Language:English
Published: MDPI AG 2023-09-01
Series:Viruses
Subjects:
Online Access:https://www.mdpi.com/1999-4915/15/9/1904
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author Ciro Romano
Domenico Cozzolino
Riccardo Nevola
Marianna Abitabile
Caterina Carusone
Francesca Cinone
Giovanna Cuomo
Francesco Nappo
Ausilia Sellitto
Giuseppina Rosaria Umano
Luigi Elio Adinolfi
Aldo Marrone
Luca Rinaldi
author_facet Ciro Romano
Domenico Cozzolino
Riccardo Nevola
Marianna Abitabile
Caterina Carusone
Francesca Cinone
Giovanna Cuomo
Francesco Nappo
Ausilia Sellitto
Giuseppina Rosaria Umano
Luigi Elio Adinolfi
Aldo Marrone
Luca Rinaldi
author_sort Ciro Romano
collection DOAJ
description Coronavirus disease of 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may be complicated by life-threatening interstitial pneumonia. SARS-CoV-2 infection may also damage several tissues and/or organs beyond the lungs, including the liver. However, controversy still exists as to whether SARS-CoV-2-induced liver alterations can have an impact on the outcome of COVID-19. The aim of this study was therefore to assess whether SARS-CoV-2-infected patients with liver abnormalities at the time of hospital referral had a worse outcome with respect to patients with no liver biochemistry alterations. To this end, the medical records of 123 patients admitted to our COVID center between the end of 2020 and spring 2021 were retrospectively reviewed. Patients were divided into two groups: those with normal liver biochemistries (group 1, 77 patients) and those with altered liver function tests (group 2, 46 patients). Serum levels of aminotransferases (AST and ALT) and bile duct cell injury markers (γ-GT and ALP) were used to dichotomize patients. A higher percentage of patients with liver enzyme alterations were found to develop COVID-19 pneumonia with respect to group 1 patients (74% vs. 65%); moreover, they needed more days of respiratory support and, more importantly, more intensive administration of supplemental oxygen. A statistically significant correlation was also found between aminotransferase levels and duration of respiratory support. The mortality rate was not superior in group 2 vs. group 1 patients. In conclusion, liver abnormalities on admission predisposed COVID-19 patients to development of more severe interstitial pneumonia, because of a longer requirement for supplemental oxygen and a more intensive respiratory support, indicative of a worse disease evolution in these patients.
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spelling doaj.art-2ed94b973d72459bb8500da9b32da6332023-11-19T13:23:21ZengMDPI AGViruses1999-49152023-09-01159190410.3390/v15091904Liver Involvement during SARS-CoV-2 Infection Is Associated with a Worse Respiratory Outcome in COVID-19 PatientsCiro Romano0Domenico Cozzolino1Riccardo Nevola2Marianna Abitabile3Caterina Carusone4Francesca Cinone5Giovanna Cuomo6Francesco Nappo7Ausilia Sellitto8Giuseppina Rosaria Umano9Luigi Elio Adinolfi10Aldo Marrone11Luca Rinaldi12COVID Center, Division of Internal Medicine, Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, ItalyDepartment of Precision Medicine, “Luigi Vanvitelli” University of Campania, 80131 Naples, ItalyCOVID Center, Division of Internal Medicine, Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, ItalyCOVID Center, Division of Internal Medicine, Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, ItalyCOVID Center, Division of Internal Medicine, Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, ItalyCOVID Center, Division of Internal Medicine, Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, ItalyDepartment of Precision Medicine, “Luigi Vanvitelli” University of Campania, 80131 Naples, ItalyCOVID Center, Division of Internal Medicine, Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, ItalyCOVID Center, Division of Internal Medicine, Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, ItalyDepartment of Woman & Child Health and General and Specialist Surgery, “Luigi Vanvitelli” University of Campania, 80131 Naples, ItalyCOVID Center, Division of Internal Medicine, Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, ItalyCOVID Center, Division of Internal Medicine, Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, ItalyCOVID Center, Division of Internal Medicine, Department of Advanced Medical and Surgical Sciences, “Luigi Vanvitelli” University of Campania, 80131 Naples, ItalyCoronavirus disease of 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), may be complicated by life-threatening interstitial pneumonia. SARS-CoV-2 infection may also damage several tissues and/or organs beyond the lungs, including the liver. However, controversy still exists as to whether SARS-CoV-2-induced liver alterations can have an impact on the outcome of COVID-19. The aim of this study was therefore to assess whether SARS-CoV-2-infected patients with liver abnormalities at the time of hospital referral had a worse outcome with respect to patients with no liver biochemistry alterations. To this end, the medical records of 123 patients admitted to our COVID center between the end of 2020 and spring 2021 were retrospectively reviewed. Patients were divided into two groups: those with normal liver biochemistries (group 1, 77 patients) and those with altered liver function tests (group 2, 46 patients). Serum levels of aminotransferases (AST and ALT) and bile duct cell injury markers (γ-GT and ALP) were used to dichotomize patients. A higher percentage of patients with liver enzyme alterations were found to develop COVID-19 pneumonia with respect to group 1 patients (74% vs. 65%); moreover, they needed more days of respiratory support and, more importantly, more intensive administration of supplemental oxygen. A statistically significant correlation was also found between aminotransferase levels and duration of respiratory support. The mortality rate was not superior in group 2 vs. group 1 patients. In conclusion, liver abnormalities on admission predisposed COVID-19 patients to development of more severe interstitial pneumonia, because of a longer requirement for supplemental oxygen and a more intensive respiratory support, indicative of a worse disease evolution in these patients.https://www.mdpi.com/1999-4915/15/9/1904COVID-19SARS-CoV-2liver enzymesinterstitial pneumonia
spellingShingle Ciro Romano
Domenico Cozzolino
Riccardo Nevola
Marianna Abitabile
Caterina Carusone
Francesca Cinone
Giovanna Cuomo
Francesco Nappo
Ausilia Sellitto
Giuseppina Rosaria Umano
Luigi Elio Adinolfi
Aldo Marrone
Luca Rinaldi
Liver Involvement during SARS-CoV-2 Infection Is Associated with a Worse Respiratory Outcome in COVID-19 Patients
Viruses
COVID-19
SARS-CoV-2
liver enzymes
interstitial pneumonia
title Liver Involvement during SARS-CoV-2 Infection Is Associated with a Worse Respiratory Outcome in COVID-19 Patients
title_full Liver Involvement during SARS-CoV-2 Infection Is Associated with a Worse Respiratory Outcome in COVID-19 Patients
title_fullStr Liver Involvement during SARS-CoV-2 Infection Is Associated with a Worse Respiratory Outcome in COVID-19 Patients
title_full_unstemmed Liver Involvement during SARS-CoV-2 Infection Is Associated with a Worse Respiratory Outcome in COVID-19 Patients
title_short Liver Involvement during SARS-CoV-2 Infection Is Associated with a Worse Respiratory Outcome in COVID-19 Patients
title_sort liver involvement during sars cov 2 infection is associated with a worse respiratory outcome in covid 19 patients
topic COVID-19
SARS-CoV-2
liver enzymes
interstitial pneumonia
url https://www.mdpi.com/1999-4915/15/9/1904
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