Little is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25–97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07–5.11, p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome.
Impact of COVID-19 on liver function: results from an internal medicine unit in Northern Italy
Lenti M. V.;Borrelli de Andreis F.;Pellegrino I.;Merli S.;Miceli E.;Aronico N.;Mengoli C.;Santacroce G.;Soriano S.;Melazzini F.;Delliponti M.;Baldanti F.;Corazza G. R.;Di Sabatino A.;Bertolino G.;Costanzo F.;Cresci R.;Derosa G.;Falaschi F.;Iadarola C.;Lovati E.;Mugellini A.;Noris P.;Pagani E.;Palumbo I.;Pecci A.;Perrone T.;Preti P. S.;Sgarlata C.;Staniscia A.;Achilli G.;Agostinelli A.;Antoci V.;Ballesio A.;Banfi F.;Barteselli C.;Benedetti I.;Brattoli M.;Calabretta F.;Canta R.;Conca F.;Coppola L.;Croce G.;Del Rio V.;Di Terlizzi F.;Ferrari S.;Fiengo A.;Forni T.;Freddi G.;Frigerio C.;Fumoso F.;Fusco A.;Gabba M.;Garolfi M.;Gentile A.;Gori G.;Grandi G.;Grimaldi P.;Lampugnani A.;Lapia F.;Lepore F.;Lettieri G.;Mambella J.;Mercanti C.;Nardone A.;Pace L.;Padovini L.;Parodi A.;Pitotti L.;Reduzzi M.;Rigano G.;Rotola G.;Sabatini U.;Salvi L.;Savioli J.;Spataro C.;Stefani D.
2020-01-01
Abstract
Little is known regarding coronavirus disease 2019 (COVID-19) clinical spectrum in non-Asian populations. We herein describe the impact of COVID-19 on liver function in 100 COVID-19 consecutive patients (median age 70 years, range 25–97; 79 males) who were admitted to our internal medicine unit in March 2020. We retrospectively assessed liver function tests, taking into account demographic characteristics and clinical outcome. A patient was considered as having liver injury when alanine aminotransferase (ALT) was > 50 mU/ml, gamma-glutamyl transpeptidase (GGT) > 50 mU/ml, or total bilirubin > 1.1 mg/dl. Spearman correlation coefficient for laboratory data and bivariable analysis for mortality and/or need for intensive care were assessed. A minority of patients (18.6%) were obese, and most patients were non- or moderate-drinkers (88.5%). Liver function tests were altered in 62.4% of patients, and improved during follow-up. None of the seven patients with known chronic liver disease had liver decompensation. Only one patient developed acute liver failure. In patients with altered liver function tests, PaO2/FiO2 < 200 was associated with greater mortality and need for intensive care (HR 2.34, 95% CI 1.07–5.11, p = 0.033). To conclude, a high prevalence of altered liver function tests was noticed in Italian patients with COVID-19, and this was associated with worse outcomes when developing severe acute respiratory distress syndrome.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
