Impact of the Severity of Liver Injury in COVID-19 Patients Admitted to an Intensive Care Unit During the SARS-CoV2 Pandemic Outbreak
, , , and | Aug 05, 2021
About this article
Article Category: Research Article
Published Online: Aug 05, 2021
Page range: 211 - 216
Received: Nov 30, 2020
Accepted: Jun 27, 2021
DOI: https://doi.org/10.2478/jccm-2021-0021
Keywords
© 2021 Adina Roman, Septimiu Moldovan, Ario Santini, Mircea Stoian, Daniela Dobru, published by Sciendo
This work is licensed under the Creative Commons Attribution 4.0 International License.
Demographics and para clinical characteristics of 156 enrolled COVID-19 patients.
| Group 1 . (n=98) | Group 2. (n=58) | p-value | |
|---|---|---|---|
| Haemoglobin (g/dL) mean (SD) | 13.74 (1.5) | 13.32 (2.65) | Student t test p= 0.377 |
| Platelet count (103/uL) mean (SD) | 212.71 (80.32) | 265.77(13.05) | indicates a significant difference |
| Leukocyte count (/uL) mean (SD) | 6310.69 (2603.41) | 8867.69(5205.24) | indicates a significant difference |
| Urea (mg/dL) mean (SD) | 36.49 (15.36) | 57.66 (23.59) | indicates a significant difference |
| Creatinine (mg/dL) mean (SD) | 0.85 (0.21) | 0.89 (0.24) | Student t test p= 0.592 |
| Sodium(mmol/L) mean (SD) | 138.73 (3.43) | 137.15 (4.88) | Student t test p= 0.135 |
| Potassium(mmol/L) mean (SD) | 4.33 (0.5) | 4.41 (0.74) | Student t test p= 0.603 |
| Glycaemia (mg/dL) mean (SD) | 118.59 (51.92) | 166.23 (87.71) | indicates a significant difference |
| Albumin (g/L) mean (SD) | 3.11 (0.36) | 3.22 (0.73) | Student t test p= 0.574 |
| Cholesterol (mg/dL) mean (SD) | 182.16(49.27) | 200.43 (46.17) | Student t test p= 0.364 |
| Triglycerides (mg/dL) mean (SD) | 139(70.79) | 247.29 (171.41) | Student t test p= 0.005 |
| CRP (mg/dL) mean (SD) | 4.7 (5.47) | 7.81 (7.93) | Student t test p= 0.065 |
| Ferritin (ng/mL) mean (SD) | 929.17 (982.6) | 2597.677 (2233.74) | indicates a significant difference |
| Length of stay in ICU. mean (SD) | 13.85(9.52) | 8.05(5.43) | indicates a significant difference |
| Death (Y/N) | 26/72 | 35/23 | Mann Whitney U test p= 0.57 |
Forms of SARS-COV2 associated liver disease
| A mild form of the disease: Mild symptoms without clinical or para clinical signs of pneumonia, or with a Chest X-Ray or CT scan showing < 25% parenchymal damage. |
| A moderate form of the disease: Mild to moderate symptoms with para clinical signs of pneumonia, or a Chest X-Ray or CT scan showing a 25-50% parenchymal damage. |
| A severe form of the disease: With a respiratory rate ≥ 30/min, pS02 ≤ 93%, PaO2/FiO2 ≤ 300 mm Hg, or a Chest X-Ray or CT scan showing more than 50% parenchymal damage, or signs of acute respiratory distress, confusion/coma, sepsis, shock. |
Classification of liver injury
| Mild: Liver function tests 3-5 upper limit of normal. |
| Moderate: Liver function tests 5-10 upper limit of normal. |
| Severe: Liver function tests ≥ 10 |
Classification of the pattern of liver injury.
| Hepatocellular pattern: Alanine transaminase levels ≥ 5 upper limit of normal; alanine transaminase levels/alkaline phosphatase levels ≥ 5. |
| Cholestatic pattern: Alanine transaminase levels ≥ 2 upper limit of normal; alanine transaminase levels /alkaline phosphatase ≤2. |
| Mixed pattern: Alanine transaminase levels/alkaline phosphatase 2-5. |