Liver injury in hospitalized patients with COVID-19: An International observational cohort study.
<h4>Background</h4>Using a large dataset, we evaluated prevalence and severity of alterations in liver enzymes in COVID-19 and association with patient-centred outcomes.<h4>Methods</h4>We included hospitalized patients with confirmed or suspected SARS-CoV-2 infection from the...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Public Library of Science (PLoS)
2023-01-01
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| Series: | PLoS ONE |
| Online Access: | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0277859&type=printable |
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| author | Bharath Kumar Tirupakuzhi Vijayaraghavan Saptarshi Bishnu Joaquin Baruch Barbara Wanjiru Citarella Christiana Kartsonaki Aronrag Meeyai Zubair Mohamed Shinichiro Ohshimo Benjamin Lefèvre Abdulrahman Al-Fares Jose A Calvache Fabio Silvio Taccone Piero Olliaro Laura Merson Neill K J Adhikari ISARIC Clinical Characterisation Group |
| author_facet | Bharath Kumar Tirupakuzhi Vijayaraghavan Saptarshi Bishnu Joaquin Baruch Barbara Wanjiru Citarella Christiana Kartsonaki Aronrag Meeyai Zubair Mohamed Shinichiro Ohshimo Benjamin Lefèvre Abdulrahman Al-Fares Jose A Calvache Fabio Silvio Taccone Piero Olliaro Laura Merson Neill K J Adhikari ISARIC Clinical Characterisation Group |
| author_sort | Bharath Kumar Tirupakuzhi Vijayaraghavan |
| collection | DOAJ |
| description | <h4>Background</h4>Using a large dataset, we evaluated prevalence and severity of alterations in liver enzymes in COVID-19 and association with patient-centred outcomes.<h4>Methods</h4>We included hospitalized patients with confirmed or suspected SARS-CoV-2 infection from the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) database. Key exposure was baseline liver enzymes (AST, ALT, bilirubin). Patients were assigned Liver Injury Classification score based on 3 components of enzymes at admission: Normal; Stage I) Liver injury: any component between 1-3x upper limit of normal (ULN); Stage II) Severe liver injury: any component ≥3x ULN. Outcomes were hospital mortality, utilization of selected resources, complications, and durations of hospital and ICU stay. Analyses used logistic regression with associations expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI).<h4>Results</h4>Of 17,531 included patients, 46.2% (8099) and 8.2% (1430) of patients had stage 1 and 2 liver injury respectively. Compared to normal, stages 1 and 2 were associated with higher odds of mortality (OR 1.53 [1.37-1.71]; OR 2.50 [2.10-2.96]), ICU admission (OR 1.63 [1.48-1.79]; OR 1.90 [1.62-2.23]), and invasive mechanical ventilation (OR 1.43 [1.27-1.70]; OR 1.95 (1.55-2.45). Stages 1 and 2 were also associated with higher odds of developing sepsis (OR 1.38 [1.27-1.50]; OR 1.46 [1.25-1.70]), acute kidney injury (OR 1.13 [1.00-1.27]; OR 1.59 [1.32-1.91]), and acute respiratory distress syndrome (OR 1.38 [1.22-1.55]; OR 1.80 [1.49-2.17]).<h4>Conclusions</h4>Liver enzyme abnormalities are common among COVID-19 patients and associated with worse outcomes. |
| first_indexed | 2024-03-08T12:29:17Z |
| format | Article |
| id | doaj.art-74fb1b0178314631a23a311ded77b693 |
| institution | Directory Open Access Journal |
| issn | 1932-6203 |
| language | English |
| last_indexed | 2024-04-24T20:26:57Z |
| publishDate | 2023-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS ONE |
| spelling | doaj.art-74fb1b0178314631a23a311ded77b6932024-03-22T05:35:20ZengPublic Library of Science (PLoS)PLoS ONE1932-62032023-01-01189e027785910.1371/journal.pone.0277859Liver injury in hospitalized patients with COVID-19: An International observational cohort study.Bharath Kumar Tirupakuzhi VijayaraghavanSaptarshi BishnuJoaquin BaruchBarbara Wanjiru CitarellaChristiana KartsonakiAronrag MeeyaiZubair MohamedShinichiro OhshimoBenjamin LefèvreAbdulrahman Al-FaresJose A CalvacheFabio Silvio TacconePiero OlliaroLaura MersonNeill K J AdhikariISARIC Clinical Characterisation Group<h4>Background</h4>Using a large dataset, we evaluated prevalence and severity of alterations in liver enzymes in COVID-19 and association with patient-centred outcomes.<h4>Methods</h4>We included hospitalized patients with confirmed or suspected SARS-CoV-2 infection from the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) database. Key exposure was baseline liver enzymes (AST, ALT, bilirubin). Patients were assigned Liver Injury Classification score based on 3 components of enzymes at admission: Normal; Stage I) Liver injury: any component between 1-3x upper limit of normal (ULN); Stage II) Severe liver injury: any component ≥3x ULN. Outcomes were hospital mortality, utilization of selected resources, complications, and durations of hospital and ICU stay. Analyses used logistic regression with associations expressed as adjusted odds ratios (OR) with 95% confidence intervals (CI).<h4>Results</h4>Of 17,531 included patients, 46.2% (8099) and 8.2% (1430) of patients had stage 1 and 2 liver injury respectively. Compared to normal, stages 1 and 2 were associated with higher odds of mortality (OR 1.53 [1.37-1.71]; OR 2.50 [2.10-2.96]), ICU admission (OR 1.63 [1.48-1.79]; OR 1.90 [1.62-2.23]), and invasive mechanical ventilation (OR 1.43 [1.27-1.70]; OR 1.95 (1.55-2.45). Stages 1 and 2 were also associated with higher odds of developing sepsis (OR 1.38 [1.27-1.50]; OR 1.46 [1.25-1.70]), acute kidney injury (OR 1.13 [1.00-1.27]; OR 1.59 [1.32-1.91]), and acute respiratory distress syndrome (OR 1.38 [1.22-1.55]; OR 1.80 [1.49-2.17]).<h4>Conclusions</h4>Liver enzyme abnormalities are common among COVID-19 patients and associated with worse outcomes.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0277859&type=printable |
| spellingShingle | Bharath Kumar Tirupakuzhi Vijayaraghavan Saptarshi Bishnu Joaquin Baruch Barbara Wanjiru Citarella Christiana Kartsonaki Aronrag Meeyai Zubair Mohamed Shinichiro Ohshimo Benjamin Lefèvre Abdulrahman Al-Fares Jose A Calvache Fabio Silvio Taccone Piero Olliaro Laura Merson Neill K J Adhikari ISARIC Clinical Characterisation Group Liver injury in hospitalized patients with COVID-19: An International observational cohort study. PLoS ONE |
| title | Liver injury in hospitalized patients with COVID-19: An International observational cohort study. |
| title_full | Liver injury in hospitalized patients with COVID-19: An International observational cohort study. |
| title_fullStr | Liver injury in hospitalized patients with COVID-19: An International observational cohort study. |
| title_full_unstemmed | Liver injury in hospitalized patients with COVID-19: An International observational cohort study. |
| title_short | Liver injury in hospitalized patients with COVID-19: An International observational cohort study. |
| title_sort | liver injury in hospitalized patients with covid 19 an international observational cohort study |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0277859&type=printable |
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