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...
Main Authors: | , , , , , , , , , , , , |
---|---|
Format: | Article |
Language: | English |
Published: |
MDPI AG
2023-09-01
|
Series: | Viruses |
Subjects: | |
Online Access: | https://www.mdpi.com/1999-4915/15/9/1904 |
_version_ | 1797576375598579712 |
---|---|
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. |
first_indexed | 2024-03-10T21:51:17Z |
format | Article |
id | doaj.art-2ed94b973d72459bb8500da9b32da633 |
institution | Directory Open Access Journal |
issn | 1999-4915 |
language | English |
last_indexed | 2024-03-10T21:51:17Z |
publishDate | 2023-09-01 |
publisher | MDPI AG |
record_format | Article |
series | Viruses |
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 |
work_keys_str_mv | AT ciroromano liverinvolvementduringsarscov2infectionisassociatedwithaworserespiratoryoutcomeincovid19patients AT domenicocozzolino liverinvolvementduringsarscov2infectionisassociatedwithaworserespiratoryoutcomeincovid19patients AT riccardonevola liverinvolvementduringsarscov2infectionisassociatedwithaworserespiratoryoutcomeincovid19patients AT mariannaabitabile liverinvolvementduringsarscov2infectionisassociatedwithaworserespiratoryoutcomeincovid19patients AT caterinacarusone liverinvolvementduringsarscov2infectionisassociatedwithaworserespiratoryoutcomeincovid19patients AT francescacinone liverinvolvementduringsarscov2infectionisassociatedwithaworserespiratoryoutcomeincovid19patients AT giovannacuomo liverinvolvementduringsarscov2infectionisassociatedwithaworserespiratoryoutcomeincovid19patients AT francesconappo liverinvolvementduringsarscov2infectionisassociatedwithaworserespiratoryoutcomeincovid19patients AT ausiliasellitto liverinvolvementduringsarscov2infectionisassociatedwithaworserespiratoryoutcomeincovid19patients AT giuseppinarosariaumano liverinvolvementduringsarscov2infectionisassociatedwithaworserespiratoryoutcomeincovid19patients AT luigielioadinolfi liverinvolvementduringsarscov2infectionisassociatedwithaworserespiratoryoutcomeincovid19patients AT aldomarrone liverinvolvementduringsarscov2infectionisassociatedwithaworserespiratoryoutcomeincovid19patients AT lucarinaldi liverinvolvementduringsarscov2infectionisassociatedwithaworserespiratoryoutcomeincovid19patients |