Prevalence and Prognostic Impact of Deranged Liver Blood Tests in COVID-19: Experience from the Regional COVID-19 Center over the Cohort of 3812 Hospitalized Patients
Background: Derangement of liver blood tests (LBT) is frequent in patients with Coronavirus disease 2019 (COVID-19). We aimed to evaluate (a) the prevalence of deranged LBT as well as their association with (b) clinical severity at admission and (c) 30-day outcomes among the hospitalized patients wi...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2021-09-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/10/18/4222 |
| _version_ | 1797518776952946688 |
|---|---|
| author | Frane Paštrovic Marko Lucijanic Armin Atic Josip Stojic Mislav Barisic Jaman Ida Tjesic Drinkovic Marko Zelenika Marko Milosevic Barbara Medic Jelena Loncar Maja Mijic Tajana Filipec Kanizaj Dominik Kralj Ivan Lerotic Lucija Virovic Jukic Neven Ljubicic Kresimir Luetic Dora Grgic Matea Majerovic Rajko Ostojic Zeljko Krznaric Ivica Luksic Nevenka Piskac Zivkovic Tatjana Keres Vlatko Grabovac Jasminka Persec Bruno Barsic Ivica Grgurevic |
| author_facet | Frane Paštrovic Marko Lucijanic Armin Atic Josip Stojic Mislav Barisic Jaman Ida Tjesic Drinkovic Marko Zelenika Marko Milosevic Barbara Medic Jelena Loncar Maja Mijic Tajana Filipec Kanizaj Dominik Kralj Ivan Lerotic Lucija Virovic Jukic Neven Ljubicic Kresimir Luetic Dora Grgic Matea Majerovic Rajko Ostojic Zeljko Krznaric Ivica Luksic Nevenka Piskac Zivkovic Tatjana Keres Vlatko Grabovac Jasminka Persec Bruno Barsic Ivica Grgurevic |
| author_sort | Frane Paštrovic |
| collection | DOAJ |
| description | Background: Derangement of liver blood tests (LBT) is frequent in patients with Coronavirus disease 2019 (COVID-19). We aimed to evaluate (a) the prevalence of deranged LBT as well as their association with (b) clinical severity at admission and (c) 30-day outcomes among the hospitalized patients with COVID-19. Methods: Consecutive patients with COVID-19 hospitalized in the regional referral center over the 12-month period were included. Clinical severity of COVID-19 at hospital admission and 30-day outcomes (need for intensive care, mechanical ventilation, or death) were analyzed. Results: Derangement of LBT occurred in 2854/3812 (74.9%) of patients, most frequently due to elevation of AST (61.6%), GGT (46.1%) and ALT (33.4%). Elevated AST, ALT, GGT and low albumin were associated with more severe disease at admission. However, in multivariate Cox regression analysis, when adjusted for age, sex, obesity and presence of chronic liver disease, only AST remained associated with the risk of dying (HR 1.5081 and 2.1315, for elevations 1–3 × ULN and >3 × ULN, respectively) independently of comorbidity burden and COVID-19 severity at admission. Patients with more severe liver injury more frequently experienced defined adverse outcomes. Conclusions: Deranged LBTs are common among patients hospitalized with COVID-19 and might be used as predictors of adverse clinical outcomes. |
| first_indexed | 2024-03-10T07:33:24Z |
| format | Article |
| id | doaj.art-f3c7fc9271044eab9a820fcdcbf6eda5 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T07:33:24Z |
| publishDate | 2021-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-f3c7fc9271044eab9a820fcdcbf6eda52023-11-22T13:41:30ZengMDPI AGJournal of Clinical Medicine2077-03832021-09-011018422210.3390/jcm10184222Prevalence and Prognostic Impact of Deranged Liver Blood Tests in COVID-19: Experience from the Regional COVID-19 Center over the Cohort of 3812 Hospitalized PatientsFrane Paštrovic0Marko Lucijanic1Armin Atic2Josip Stojic3Mislav Barisic Jaman4Ida Tjesic Drinkovic5Marko Zelenika6Marko Milosevic7Barbara Medic8Jelena Loncar9Maja Mijic10Tajana Filipec Kanizaj11Dominik Kralj12Ivan Lerotic13Lucija Virovic Jukic14Neven Ljubicic15Kresimir Luetic16Dora Grgic17Matea Majerovic18Rajko Ostojic19Zeljko Krznaric20Ivica Luksic21Nevenka Piskac Zivkovic22Tatjana Keres23Vlatko Grabovac24Jasminka Persec25Bruno Barsic26Ivica Grgurevic27Department of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, CroatiaDepartment of Hematology, University Hospital Dubrava, 10000 Zagreb, CroatiaDepartment of Emergency Medicine, University Hospital Dubrava, 10000 Zagreb, CroatiaDepartment of Emergency Medicine, University Hospital Dubrava, 10000 Zagreb, CroatiaDepartment of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, CroatiaDepartment of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, CroatiaDepartment of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, CroatiaDepartment of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, CroatiaDepartment of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, CroatiaDepartment of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, CroatiaDepartment of Gastroenterology and Hepatology, University Hospital Merkur, 10000 Zagreb, CroatiaDepartment of Gastroenterology, Hepatology and Clinical Nutrition, School of Medicine, University of Zagreb, 10000 Zagreb, CroatiaDepartment of Gastroenterology and Hepatology, University Hospital Sestre Milosrdnice, 10000 Zagreb, CroatiaDepartment of Gastroenterology and Hepatology, University Hospital Sestre Milosrdnice, 10000 Zagreb, CroatiaDepartment of Gastroenterology, Hepatology and Clinical Nutrition, School of Medicine, University of Zagreb, 10000 Zagreb, CroatiaDepartment of Gastroenterology, Hepatology and Clinical Nutrition, School of Medicine, University of Zagreb, 10000 Zagreb, CroatiaDepartment of Gastroenterology and Hepatology, University Hospital Sveti Duh, 10000 Zagreb, CroatiaDepartment of Gastroenterology and Hepatology, University Hospital Center Zagreb, 10000 Zagreb, CroatiaDepartment of Gastroenterology and Hepatology, University Hospital Center Zagreb, 10000 Zagreb, CroatiaDepartment of Gastroenterology, Hepatology and Clinical Nutrition, School of Medicine, University of Zagreb, 10000 Zagreb, CroatiaDepartment of Gastroenterology, Hepatology and Clinical Nutrition, School of Medicine, University of Zagreb, 10000 Zagreb, CroatiaDepartment of Gastroenterology, Hepatology and Clinical Nutrition, School of Medicine, University of Zagreb, 10000 Zagreb, CroatiaDepartment of Pulmology, University Hospital Dubrava, 10000 Zagreb, CroatiaIntensive Care Unit, Department of Internal Medicine, University Hospital Dubrava, 10000 Zagreb, CroatiaDepartment of Emergency Medicine, University Hospital Dubrava, 10000 Zagreb, CroatiaIntensive Care Unit, Department of Anestesiology, Renimatology and Intensive Care, University Hospital Dubrava, 10000 Zagreb, CroatiaDepartment of Gastroenterology, Hepatology and Clinical Nutrition, School of Medicine, University of Zagreb, 10000 Zagreb, CroatiaDepartment of Gastroenterology, Hepatology and Clinical Nutrition, University Hospital Dubrava, 10000 Zagreb, CroatiaBackground: Derangement of liver blood tests (LBT) is frequent in patients with Coronavirus disease 2019 (COVID-19). We aimed to evaluate (a) the prevalence of deranged LBT as well as their association with (b) clinical severity at admission and (c) 30-day outcomes among the hospitalized patients with COVID-19. Methods: Consecutive patients with COVID-19 hospitalized in the regional referral center over the 12-month period were included. Clinical severity of COVID-19 at hospital admission and 30-day outcomes (need for intensive care, mechanical ventilation, or death) were analyzed. Results: Derangement of LBT occurred in 2854/3812 (74.9%) of patients, most frequently due to elevation of AST (61.6%), GGT (46.1%) and ALT (33.4%). Elevated AST, ALT, GGT and low albumin were associated with more severe disease at admission. However, in multivariate Cox regression analysis, when adjusted for age, sex, obesity and presence of chronic liver disease, only AST remained associated with the risk of dying (HR 1.5081 and 2.1315, for elevations 1–3 × ULN and >3 × ULN, respectively) independently of comorbidity burden and COVID-19 severity at admission. Patients with more severe liver injury more frequently experienced defined adverse outcomes. Conclusions: Deranged LBTs are common among patients hospitalized with COVID-19 and might be used as predictors of adverse clinical outcomes.https://www.mdpi.com/2077-0383/10/18/4222COVID-19liver functional testsmortality |
| spellingShingle | Frane Paštrovic Marko Lucijanic Armin Atic Josip Stojic Mislav Barisic Jaman Ida Tjesic Drinkovic Marko Zelenika Marko Milosevic Barbara Medic Jelena Loncar Maja Mijic Tajana Filipec Kanizaj Dominik Kralj Ivan Lerotic Lucija Virovic Jukic Neven Ljubicic Kresimir Luetic Dora Grgic Matea Majerovic Rajko Ostojic Zeljko Krznaric Ivica Luksic Nevenka Piskac Zivkovic Tatjana Keres Vlatko Grabovac Jasminka Persec Bruno Barsic Ivica Grgurevic Prevalence and Prognostic Impact of Deranged Liver Blood Tests in COVID-19: Experience from the Regional COVID-19 Center over the Cohort of 3812 Hospitalized Patients Journal of Clinical Medicine COVID-19 liver functional tests mortality |
| title | Prevalence and Prognostic Impact of Deranged Liver Blood Tests in COVID-19: Experience from the Regional COVID-19 Center over the Cohort of 3812 Hospitalized Patients |
| title_full | Prevalence and Prognostic Impact of Deranged Liver Blood Tests in COVID-19: Experience from the Regional COVID-19 Center over the Cohort of 3812 Hospitalized Patients |
| title_fullStr | Prevalence and Prognostic Impact of Deranged Liver Blood Tests in COVID-19: Experience from the Regional COVID-19 Center over the Cohort of 3812 Hospitalized Patients |
| title_full_unstemmed | Prevalence and Prognostic Impact of Deranged Liver Blood Tests in COVID-19: Experience from the Regional COVID-19 Center over the Cohort of 3812 Hospitalized Patients |
| title_short | Prevalence and Prognostic Impact of Deranged Liver Blood Tests in COVID-19: Experience from the Regional COVID-19 Center over the Cohort of 3812 Hospitalized Patients |
| title_sort | prevalence and prognostic impact of deranged liver blood tests in covid 19 experience from the regional covid 19 center over the cohort of 3812 hospitalized patients |
| topic | COVID-19 liver functional tests mortality |
| url | https://www.mdpi.com/2077-0383/10/18/4222 |
| work_keys_str_mv | AT franepastrovic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT markolucijanic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT arminatic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT josipstojic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT mislavbarisicjaman prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT idatjesicdrinkovic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT markozelenika prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT markomilosevic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT barbaramedic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT jelenaloncar prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT majamijic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT tajanafilipeckanizaj prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT dominikkralj prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT ivanlerotic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT lucijavirovicjukic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT nevenljubicic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT kresimirluetic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT doragrgic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT mateamajerovic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT rajkoostojic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT zeljkokrznaric prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT ivicaluksic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT nevenkapiskaczivkovic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT tatjanakeres prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT vlatkograbovac prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT jasminkapersec prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT brunobarsic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients AT ivicagrgurevic prevalenceandprognosticimpactofderangedliverbloodtestsincovid19experiencefromtheregionalcovid19centeroverthecohortof3812hospitalizedpatients |